ELECTROMYOGRAPHY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1 Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Electromyography: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84407-0 1. Electromyography-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on electromyography. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ELECTROMYOGRAPHY .............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Electromyography ......................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 61 The National Library of Medicine: PubMed ................................................................................ 62 CHAPTER 2. NUTRITION AND ELECTROMYOGRAPHY .................................................................... 79 Overview...................................................................................................................................... 79 Finding Nutrition Studies on Electromyography........................................................................ 79 Federal Resources on Nutrition ................................................................................................... 80 Additional Web Resources ........................................................................................................... 81 CHAPTER 3. ALTERNATIVE MEDICINE AND ELECTROMYOGRAPHY .............................................. 83 Overview...................................................................................................................................... 83 National Center for Complementary and Alternative Medicine.................................................. 83 Additional Web Resources ........................................................................................................... 90 General References ....................................................................................................................... 91 CHAPTER 4. DISSERTATIONS ON ELECTROMYOGRAPHY ................................................................ 93 Overview...................................................................................................................................... 93 Dissertations on Electromyography............................................................................................. 93 Keeping Current .......................................................................................................................... 95 CHAPTER 5. CLINICAL TRIALS AND ELECTROMYOGRAPHY ........................................................... 97 Overview...................................................................................................................................... 97 Recent Trials on Electromyography............................................................................................. 97 Keeping Current on Clinical Trials ............................................................................................. 98 CHAPTER 6. PATENTS ON ELECTROMYOGRAPHY ......................................................................... 101 Overview.................................................................................................................................... 101 Patents on Electromyography .................................................................................................... 101 Patent Applications on Electromyography ................................................................................ 122 Keeping Current ........................................................................................................................ 131 CHAPTER 7. BOOKS ON ELECTROMYOGRAPHY ............................................................................ 133 Overview.................................................................................................................................... 133 Book Summaries: Federal Agencies............................................................................................ 133 Book Summaries: Online Booksellers......................................................................................... 134 Chapters on Electromyography.................................................................................................. 137 CHAPTER 8. MULTIMEDIA ON ELECTROMYOGRAPHY .................................................................. 139 Overview.................................................................................................................................... 139 Video Recordings ....................................................................................................................... 139 CHAPTER 9. PERIODICALS AND NEWS ON ELECTROMYOGRAPHY ............................................... 141 Overview.................................................................................................................................... 141 News Services and Press Releases.............................................................................................. 141 Newsletters on Electromyography ............................................................................................. 143 Newsletter Articles .................................................................................................................... 143 Academic Periodicals covering Electromyography .................................................................... 144 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 147 Overview.................................................................................................................................... 147 NIH Guidelines.......................................................................................................................... 147 NIH Databases........................................................................................................................... 149 Other Commercial Databases..................................................................................................... 151 APPENDIX B. PATIENT RESOURCES ............................................................................................... 153 Overview.................................................................................................................................... 153
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Patient Guideline Sources.......................................................................................................... 153 Finding Associations.................................................................................................................. 156 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 159 Overview.................................................................................................................................... 159 Preparation................................................................................................................................. 159 Finding a Local Medical Library................................................................................................ 159 Medical Libraries in the U.S. and Canada ................................................................................. 159 ONLINE GLOSSARIES................................................................................................................ 165 Online Dictionary Directories ................................................................................................... 166 ELECTROMYOGRAPHY DICTIONARY................................................................................. 167 INDEX .............................................................................................................................................. 229
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with electromyography is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about electromyography, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to electromyography, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on electromyography. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to electromyography, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on electromyography. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON ELECTROMYOGRAPHY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on electromyography.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and electromyography, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “electromyography” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Electromyography of the Female Urethral Sphincter Source: International Urogynecology Journal. (3)2: 152-155. September 1991. Summary: This review article explores the literature on electromyography (EMG) of the female urethral sphincter. EMG of the urethral striated sphincter gives information on the functioning of this muscle, which consists of two structures: the intraurethral and periurethral sphincter. The authors review the types of electrode used to perform EMG of this sphincter. The EMG findings are given for the peri-and intraurethral sphincters with empty bladder at rest, during maximal voluntary contraction, and during bladder filling. Assessment of the urethral sphincter is described in different pathological situations. The methods and results of evoked potentials and nerve conduction
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measurements also are described in normal and pathological conditions. 3 figures. 26 references. (AA-M).
Federally Funded Research on Electromyography The U.S. Government supports a variety of research studies relating to electromyography. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to electromyography. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore electromyography. The following is typical of the type of information found when searching the CRISP database for electromyography: •
Project Title: A RODENT MODEL FOR LOCOMOTOR TRAINING WITH FNS Principal Investigator & Institution: Jung, Ranu; Associate Professor; Ctr for Biomedical Engineering; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2002; Project Start 17-JAN-2002; Project End 31-OCT-2002 Summary: The long-term goal of this work is to develop strategies for using functional neuromuscular stimulation (FNS) of paralyzed muscles to enhance the recovery of individuals with incomplete spinal cord injury. The proposed work is motivated by three important developments. First, recent basic science and clinical studies have demonstrated that the degree of functional recovery of the injured spinal cord depends on the activity patterns of neural inputs to the spinal cord. Second, recent advances have produced adaptive controllers for FNS systems that provide a means of automatically adjusting stimulation parameters to reliably achieve specified rhythmic movements. Third, rodent models of spinal cord injury (complete and incomplete lesions) are extensively being used at the molecular, cellular, and systems level to investigate the effects of traumatic injury and to assess the results of therapeutic intervention. A combination therapy that utilizes locomotor training with FNS and pharmacological intervention is likely to be the most effective in enhancing the reorganization (plasticity) of the spinal circuitry that is spared after spinal trauma. A rodent model for FNSassisted locomotion would facilitate quantitative evaluation of therapeutic regimens that include FNS and would provide the ability to characterize effects of FNS-assisted locomotion on the neuroanatomy and neurophysiology of the injured spinal cord. This biomedical engineering research grant proposal will develop a rodent model of locomotor training that utilizes treadmill walking and functional neuromuscular stimulation (FNS) with fixed-pattern and adaptive controllers. Kinematic and electromyogram (EMG) patterns of intact animals will be examined and then used to
2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
Studies
5
develop stimulation patterns for FNS-assisted movement. A series of tasks will be performed using FNS stimulation of hindlimb muscles in spinalized rats. These tasks will progress in difficulty from controlling suspended hindlimb movements to controlling hindlimb movements during treadmill locomotion in spinalized rats with partial weight support. Two different FNS control strategies will be used for each movement: a fixed-pattern, or open-loop, stimulation pattern and an adaptive stimulation control system. The adaptive stimulation control system will build upon our previous work and is expected to provide movement patterns that are more accurate and more repeatable. Successful completion of the proposed project will result in a novel animal model for FNS-assisted locomotor training and provide quantitative methods for evaluating locomotor behavior. In future studies, we plan to use a rodent model of incomplete spinal cord injury with FNS-assisted locomotion to test the hypothesis that FNS-assisted locomotor training enhances motor recovery after incomplete spinal cord injury. We anticipate that the improved performance provided by the adaptive control system may enhance the therapeutic effects of the technique. This locomotor training could also be combined with pharmacological intervention, tissue transplant, and neural repair therapies to determine if locomotor training can enhance the effectiveness of these therapies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ACL DEFICIENT KNEE--MRI AND BIOMECHANICAL MODELING Principal Investigator & Institution: Buchanan, Thomas S.; Professor and Director; Mechanical Engineering; University of Delaware Newark, De 19716 Timing: Fiscal Year 2002; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: The overall goal of this work is to provide a detailed understanding of the effect of anterior cruciate ligament injury on knee movement in those who compensate well for the injury and those who do not. Some persons (copers) are able to fully compensate for the absence of the anterior cruciate ligament (ACL) while others (noncopers) are not. Non-copers demonstrate quadriceps femoris weakness, and use kinematic, kinetic, and muscle activity patterns that stiffen the knee joint for stability. They accomplish the joint stiffening via general cocontraction of the muscles around the knee and by reducing the force with which the foot hits the ground. Copers have no quadriceps weakness, normal ground reaction forces, and possess an ability to coordinate the activity of the lower extremity muscles to efficiently distribute control of the knee among the hip, knee and ankle while maintaining normal knee motion. Even using sophisticated motion analysis techniques, copers are indistinguishable from uninjured subjects. A new approach to in vivo analysis of musculoskeletal dynamics uses Cine-phase contrast (Cine-PC) magnetic resonance imaging (MRI) to image and track the moving knee. Cine-PC MRI, a non-invasive technique, is capable of measuring 3D muscle fiber and skeletal velocity, in vivo, during dynamic tasks. Through integration, 3D musculoskeletal movement can be tracked. A combination of the use of this new technology and conventional MRI, electromyography, and musculoskeletal modeling will provide a unique opportunity to elucidate the compensation strategies employed by the copers. There are two aims to this proposal. Aim I is to identify differences in knee kinematics, ligament lengths, tendon lengths, and muscle activation patterns of ACL deficient patients using Cine-phase contrast MRI and electromyographic analysis that characterize the mechanisms with which the copers, in altering their muscle activation pattern, alter their knee joint kinematics in order to stabilize their knees. Aim II is to identify differences in muscle activation patterns in ACL deficient copers and non-copers using electromyography and biomechanical
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modeling. Patient specific models of the ACL deficient knee using T1-weighted MRI will be developed and used as input to a biomechanical analysis. Previous work suggests that patients with ACL deficiencies balance knee joint loads between muscles and ligaments using a strategy that is different than that employed by unimpaired subjects. This will be examined for copers and non-copers in this study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AIRWAY GASTROESOPHAGOPHARYNGEAL REFLUX
PROTECTION
DURING
Principal Investigator & Institution: Shaker, Reza; Professor and Chief; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2003 Summary: The goal of this subproject is to investigate pharyngoesophageal and laryngeal function in health and in conditions which lead to gastroesophagealpharyngeal reflux and laryngeal aspiration. Two specific objectives are listed: 1) to determine the pathophysiological basis of laryngeal complications of reflux and 2) to investigate the afferent sensory pathways in animals and humans which influence the occurrence and frequency of gastroesophago-pharyngeal reflux. These objectives will be met by performing 15 studies. These can be grouped into human and animal studies, and further subdivided as follows: Human studies of gastroesophageal-pharyngeal reflux and its consequences. These include: Characterization and quantification of gastroesophago-pharyngeal reflux, mechanisms of gastroesophago-pharyngeal reflux, studies of esophago-glottal closure reflux, stimulation of esophago-glottal reflex in response to gastroesophageal reflux. These studies will be performed in four groups of subject/patients: controls (male and female), patients with esophageal reflux but no laryngeal symptoms, patients with acid damage to the larynx (acid laryngitis), and patients with laryngeal symptoms but no endoscopic evidence of acid laryngitis. The results from each group will be compared. The presence of acid will be detected by intraluminal pH probes, sphincter function by specialized Dent sleeves, common cavity events and peristalsis by intraluminal pressure detectors, and glottal closure by nasal videoendoscopy. Human studies of other esophageal and pharyngeal reflexes include: studies of secondary peristalsis, pharyngo-UES contractile reflex and reflexive pharyngeal swallow, pharyngoglottal adduction reflex, inhibitory effect of pharyngeal water stimulation on esophageal peristalsis and bolus transport, and inhibitory effect of pharyngeal stimulation on LES tone and gastroesophageal reflux. These studies will utilize the same techniques and study the same control/patient groups as in the studies outlined above. In addition, secondary peristalsis will be stimulated by a barostat connected to a long thin non-compliant balloon. Videofluorography will also be used to document bolus transport. The last set of human studies examines esophageal sensation. In the same four groups of controls/patients, cerebral activation of the cortex by esophageal stimulation will be studied by fMRI. After stimulation with intraesophageal balloons, hot and cold water and acid, changes in cerebral blood flow will be documented by fMRI. Animal studies of pharyngeal and esophageal reflexes include: studies of the pharyngoesophageal inhibitory reflexes, studies of the pharyngoglottal closure reflex, determination of stimuli for pharyngo-UES, pharyngo-glottal, contractile reflexes, esophago-glottal and esophageal-UES contractile. These studies will be done in decerebrate cats. Laryngeal muscle function will be measured by electromyography or by direct observation. Nerves will be stimulated or transected to study pathways and mucosal anesthetic or capsaicin will disable mucosal receptors. In some studies, anesthetized opossums will be used so that inhibition of nitric oxide can be done by
Studies
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intra-arterial infusions of nitric oxide inhibitors. Isolated vagal fiber single unit electrode recordings will be made. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANKLE STRENGTHENING TO IMPROVE GAIT AND FUNCTION IN CP Principal Investigator & Institution: Engsberg, Jack R.; Associate Professor; Neurological Surgery; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-MAY-2005 Summary: (provided by the applicant): Many treatments exist to improve the gait and function of persons with Cerebral Palsy (CP). Despite recognizing that muscle weakness is a major impairment in CP, none of the treatments have the direct aim of strengthening muscles. Our results from an NIH investigation (R01-NS035830) indicated high correlations between ankle strength and function, with greater strength correlated with higher function. The idea of strengthening muscles has been controversial for safety issues. The purposes of this pilot investigation are to: 1) establish sample sizes for a future randomized clinical trial determining if intensive ankle strength training programs can improve strength, gait, and function without increasing spasticity; and 2) investigate potential safety issues arising from the training programs. Aim 1: Establish sample sizes for a future randomized clinical trial determining if intensive ankle strength training programs can improve ankle strength, gait, and function without increasing spasticity. Twenty ambulatory subjects with spastic diplegia CP will be randomly assigned to one of 4 groups: 1) Dorsi-flexor strength training group; 2) Plantar-flexor strength training group; 3) Dorsi-plantarflexor strength training group; and 4) the group undergoing no intensive strength training program. Subjects in the strength training groups will participate in a 12-week progressive, resistance strengthtraining program. Prior to, and at the end of the training program, all subjects will be objectively assessed for ankle Plantar-flexor spasticity, ankle strength, gait, and GMFM. The data will be used in a repeated measures power analysis to establish sample sizes for the clinical trial. Aim 2: Investigate potential safety issues arising from the training programs. The aim has 2 components. The first is the weekly measurement of Plantarflexor spasticity and tightness. The data will permit continuous monitoring of spasticity and tightness, and alert investigators to potential problems during each subject's participation. In the second component, both the pre- and post-intervention measures, and the weekly monitoring of spasticity and tightness, will determine if potential changes could be a concern for the future clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: BREATHING
AUTOMATED
(AI)
ANALYSIS
OF
SLEEP
DISORDERED
Principal Investigator & Institution: Ayappa, Indu A.; Research Assistant Professor; Medicine; New York University School of Medicine 550 1St Ave New York, Ny 10016 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2005 Summary: (provided by applicant) This training grant is designed to advance the academic career of Dr. Indu Ayappa by building on the applicant?s strong biomedical engineering and computer background and providing comprehensive multidisciplinary training which will allow her to become an independent investigator. The applicant?s career goals are to enter full time academic research in sleep physiology. Training activities proposed will include academic course work designed to support the
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Electromyography
research program and expose her to aspects of clinical research in sleep, neural science and artificial intelligence techniques. She will be mentored by David Rapoport, M.D., Joyce Walsleben, Ph.D., and Maurice Ohayon, M.D., Ph.D., as well as faculty in computer science and neurophysiology. The aims of the planned research are to develop an artificial intelligence system for the identification and quantification of sleep disordered breathing (SDB) based solely on non-invasive cardiopulmonary signals collected during routine polysomnography. This will simplify, standardize and improve the diagnosis of SDB and facilitate research in this area. With the long term goal of physiologic characterization of the spectrum of SDB in order to clinically diagnose upper airway resistance syndrome (UARS), the aims of this project are to: 1. Extract features from the nasal cannula airflow signal to characterize the state of resistance/collapsibility of individual breaths. These include amplitude, inspiratory flow contour, Ti/Ttot and presence of vibration which will be used as inputs to a neural network that will be trained and evaluated against breaths that have been classified by reference measurement of upper airway resistance (pressure/flow). 2A. Incorporate information from this classification of individual breaths to detect and classify respiratory events based on the flow signal alone using a trained neural network. 2B. Evaluate the utility of including additional cardiopulmonary signals like oxygen saturation, heart rate, pulse transit time and rib/abdominal movements (amplitude and phase) in the detection and classification of these events. Successful completion of the training and research program will allow Dr. Ayappa to contribute independently to research in the field of sleep physiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOMECHANICS OF AVOIDING A FALL FOLLOWING A SLIP Principal Investigator & Institution: Grabiner, Mark D.; Director and Professor; School of Kinesiology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2003; Project Start 01-JUN-2001; Project End 31-MAY-2005 Summary: (verbatim from application) The long-term objective of the presently proposed project is to reduce the incidence of injuries to older adults that result from slip-related falls. We will induce controlled slips in young and older adults using a specially designed slipping platform. The purpose of the presently proposed project is to determine the biomechanical variables limit the ability of young and older adults to prevent a backward fall as a result of a forward-directed slip of the foot during locomotion. In particular, we will focus our attention on the non-slipping rear leg as a crucial component of recovering one's balance and avoiding a fall. We hypothesize that avoidance of a fall subsequent to a slip is dictated by the biomechanics of the nonslipping leg and that the higher rate of falling by older adults can be attributed to the biomechanics of the non-slipping rear leg. If the hypotheses are supported then the results will provide support for further investigating appropriate means by which older adults can be better protected from slip-related falls and injuries. We will test these hypotheses by addressing the following Specific Aims. Specific Aim 1: characterize the slip conditions that distinguish the ability of young and older adults to avoid a fall after slipping. Specific Aim 2: characterize the biomechanical differences that distinguish the ability of young and older adults to avoid a fall after slipping. Specific Aim 3: define the importance of the non-slipping, rear leg to avoiding a fall after slipping. The impact of the proposed work is that it will quantify biomechanical determinants of the outcome (recovery or fall) of a slipping event. The health-relatedness of the project is that it will contribute to further systematic design and testing of intervention methods that may
Studies
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effectively reduce the number of slip-related injuries and deaths, particularly in older adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BODY IMAGE DISTURBANCE: EMOTIONAL REACTIVITY Principal Investigator & Institution: Janelle, Christopher M.; To Be Determined; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2004 Summary: Body image disturbance is a precursor to eating disorders, which in turn afflict approximately 4% of the population of the United States. Though numerous attempts have been made to delineate the emotions experienced by individuals with body image disturbance, existing research is largely observational descriptive, and selfreported. Combining psychophysiological and self-report measures will permit a more direct and comprehensive account of the multidimensional nature of emotion among individuals with body image disturbance. In the context of the biphasic theory of emotion, the overall objection of the proposed research will be to assess and compare the emotional reactivity of males and females who are symptomatic (body image disturbed) and asymptomatic (not body image disturbed) for eating disorders. How attentional biases and emotional reactivity differ among these groups, while viewing pictures of themselves as well as individuals with societal ideal bodies, will be determined. Psychophysiological measures known to index emotional reactivity among clinical and subclinical will be collected using a startle prove in the context of a pictureviewing paradigm, and are expected to reliably differentiate symptomatic and asymptomatic individuals. As indexed by eye movements, symptomatic individuals are predicted to attend more to somatic regions of body dissatisfaction than will asymptomatic individuals when viewing themselves, but will avoid these areas when viewing others. They are also expected to exhibit greater potentiation of the reflexive eyeblink in response to the startle probe as compared to asymptomatic individuals when viewing physique pictures of themselves and others. Also, the P3 wave of the cortical event-related potential to the startle probe will be smaller in amplitude to physique pictures of themselves and others for the symptomatic as compared to the asymptomatic individuals. Finally, symptomatic participants will report more emotional and mood disturbance while viewing pictures of themselves and aesthetically ideal bodies compared to the asymptomatic participants. Findings obtained from this investigation will permit researchers and clinicians a greater understanding of how commonly encountered environmental stimuli are differentially attended to, processed, and responded to among individuals with body image disturbance; thus leading to the development and refinement of effective interventions to alleviate the negative emotional responses that preclude and perpetuate eating disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BONE GROWTH, PERIOSTEAL MIGRATION AND MUSCLE FUNCTION Principal Investigator & Institution: Herring, Susan W.; Professor & Acting Chair; Orthodontics; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2003; Project Start 01-MAY-1990; Project End 31-MAR-2008 Summary: (provided by applicant): Our overall goal is to clarify the influence of function on the growth and ultimate morphology of the head. The mechanical environment influences skull growth at every level from individual cells to gross
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structure. Although usually neglected, soft tissues such as muscles, ligaments and cartilages play a critical role in cranial mechanics and growth. This proposal focuses on two ways in which soft tissue mechanics may direct the growth of skull bones, using the pig as a model. First, the osteogenic activity of the periosteum is linked to its blood supply, which originates from muscles and ligaments. We hypothesize that the deformation of these soft tissues during function can modify periosteal perfusion. In Specific Aim 1, new methodology will be employed to map the three-dimensional deformation of muscles and ligaments during awake mastication and to test whether buccinator contraction places significant pressure on the alveolar periosteum. Specific Aim 2 addresses the periosteal vascular system directly with both immunocytochemical assays of cellular activity and in vivo measures of blood flow. These studies will provide evidence for or against a causal linkage between soft tissue behavior and periosteal perfusion. The second way in which soft tissues may direct skull growth involves the nasal septum. Despite being an unmineralized cartilage, the septum has been considered an important mechanical support of the face. Moreover, forces generated by septal growth are claimed to separate the sutures between facial bones, causing compensatory growth. These assertions have never been tested directly. In Specific Aim 3 a novel indwelling transducer will be used to reveal the mechanical loading pattern of the septum and to investigate the timing of its growth in relation to that of facial sutures. Specific Aim 4 will test the mechanical plausibility of the hypothesis that the septum controls facial growth by comparing the viscoelastic stiffness of the cartilaginous septum to the resistance of the facial sutures. Taken together, these studies will develop new techniques for monitoring soft tissue function, provide fundamental new information about the mechanical behavior of the head, and test hypotheses about how soft tissues influence skull growth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BOTULINUM TOXIN FOR SPASTICITY IN CEREBRAL PALSY Principal Investigator & Institution: Hays, Ross M.; Associate Professor; Children's Hospital and Reg Medical Ctr Box 5371, 4800 Sand Point Way Ne, Ms 6D-1 Seattle, Wa 98105 Timing: Fiscal Year 2001; Project Start 15-AUG-1997; Project End 31-JUL-2004 Summary: (Adapted from the applicant's description): The purpose of this study is to evaluate the effectiveness of botulinum toxin injection (BTX) in reducing spasticity and improving function and mobility in children with spastic diplegia, a common form of cerebral palsy (CP). This study proposes to evaluate the effects of the treatment across the five domains of science relative to disability: pathophysiology, impairment, functional limitation, disability, and societal limitation. The study design is a prospective, randomized, double-masked clinical trial with a 6 month evaluation period. Forty children, ages 4-12 years, will be recruited and randomized into two groups. Group A will receive BTX. Group B will receive a placebo injection. Outcomes will be assessed in a masked evaluation at baseline, 3 weeks, 8 weeks, 12 weeks, and 24 weeks. Group B subjects will have the opportunity for BTX treatment after 24 weeks. Outcome variables are proposed to provide information in the five different domains. Change in pathophysiology will be represented by quantitative electromyographic kinesiology measurements. Change in impairment will be represented by electromechanical measurement of joint torque across the ankle joint using the Spasticity Measurement System. Change in functional limitation will be represented by changes in gross motor function as measured by the Gross Motor Function Measure, physical exam parameters, energy expenditure using the Energy Cost Index, and kinematic gait analysis. Changes
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in disability will be represented by serial assessments of age appropriate task performance using the Canadian Occupational Performance Measure. Any change in societal limitation will be measured by the use of Goal Attainment Scaling in the areas of community and school activities. Sample size has been based on the power calculation necessary to demonstrate a change in the Gross Motor Function Measure and the Spasticity Measurement System. The large number of assessments required for each patient necessitate that subject enrollment be distributed over the first four and one half years of the study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAINSTEM INFORMATION
CONTROL
OF
SUBCORTICAL
VISUAL
Principal Investigator & Institution: Godwin, Dwayne W.; Anatomy and Neurobiology; Wake Forest University Health Sciences Winston-Salem, Nc 27157 Timing: Fiscal Year 2002; Project Start 01-DEC-1997; Project End 31-JAN-2006 Summary: (provided by applicant): The dorsal lateral geniculate nucleus (LGN) is a vital link in the chain of perception. Retinal ganglion cells encode the visual world and transmit it to the LGN. Most agree that gating of this information occurs at the retinogeniculate synapse, but a complete mechanism is elusive. Our recent findings demonstrate several new and exciting sources of dynamic control of visual information at the LGN. Two of these are known modulators of relay neurons: the cholinergic parabrachial brainstem (PBR) and the massive corticogeniculate (CG) feedback. The PBR releases nitric oxide (NO), and our data indicate an amazing difference in the way NO affects retinal and cortical inputs. NO has a powerful and selective inhibitory influence on retinogeniculate transmission in the LGN through interaction with the NMDA receptor; however, transmission through the CG pathway is enhanced by two separate mechanisms. The other great remaining mystery of thalamic function is the purpose of the cortical feedback to LGN from layer 6, which we now see as intimately linked with the PBR and NO. We propose a new series of experiments to reveal the contributions of the PBR, and cortical feedback influences, with a global hypothesis that vision requires cooperative activity patterns of both of these pathways. Aim 1: How does NO affect LGN relay cell membrane properties? NO suppresses NMDA receptor function in the retinogeniculate pathway. We hypothesize that NO also targets the low threshold Ca2+ current (I(T)) and a key K+ currents (I) (As)). We will probe I(T) and I(As) with intracellular patch recordings from slices of the LGN, while delivering NO donors and scavengers, and by stimulating intrinsic NO production through the enzyme bNOS. Aim 2: How does NO affect fast synaptic inputs to LGN relay cells? We will stimulate the retinal and CG pathways (to evoke GABAergic IPSP/JPSCs) and the CG pathway (to evoke glutamatergic EPSP/EPSCs) in slices while manipulating NO levels. We hypothesize a stark difference in how NO affects retinal and cortical EPSP/EPSCs; cortical EPSP/EPSCs are enhanced, indicating that the PBR, through NO, may shift the balance away from retinal feedforward processing and toward cortical feedback processing. Aim 3: How does the corticogeniculate projection control the thalamocortical dialog? Relay cells respond to retinal inputs in one of two modes, burst or tonic. We hypothesize that layer 6 promotes a visuotopic gradient of burst and tonic responses, and synchronous firing, in the LGN. We will record from thalamic ensembles during visual processing, while activating and inactivating layer 6 of visual cortex, and while activating brainstem pathways. The impact of retinal inputs to LGN is well known, but the field is struggling with the nature and scope of extraretinal synaptic influences. The answers to these questions will completely transform our view of
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thalamic function from that of a slave of the periphery to a partner with cortex in binding together the threads of visual perception. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAINSTEM MECHANISMS OF ALERTING Principal Investigator & Institution: Morrison, Adrian R.; Professor; Animal Biology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-AUG-1987; Project End 31-JUL-2004 Summary: (Adapted from applicant's abstract): This project seeks further understanding of the mechanisms underlying the generation and maintenance of one phase of sleep, REM sleep. REM normally follows the other stages of sleep, collectively known as nonREM (NREM). Its differentiating features are a total paralysis of skeletal muscles with superimposed phasic muscle twitches, electroencephalographic activity resembling wakefulness rather than NREM, and profound depression of the brain mechanisms regulating homeostasis, i.e., those controlling such vital features of life as temperature, cardiovascular activity and respiration. Further, as we demonstrated 20 years ago, the brain in REM functions much like the brain during orienting in wakefulness. The project's focus will be study of the activity of nerve cells in the amygdala of the forebrain of rats and their interactions with those in the pons of the hindbrain that have long been studied and heavily implicated in the control of REM. The investigator is stimulated by the facts that the amygdala and pons are tightly interconnected and that the amygdala is a key structure investing environmental stimuli with emotional significance. Thus, a change in sensitivity of structures like the amygdala to arousing stimuli must precede entrance into REM. Indeed, in narcoleptics the shift to REM is so poorly modulated that sufferers enter REM directly from wakefulness when confronted by such stimuli. The investigator shall record single-neuronal activity in three amygdalar nuclei, the central (CNA), basolateral (BLA) and lateral (LA), across sleep-wake states. The investigator shall determine how stimulation and suppression of key pontine neurons of different transmitter types, serotonergic, noradrenergic and cholinergic, affect spontaneously active amygdalar neurons and those responding to novel or significant auditory stimuli. These experiments address basic mechanisms likely to be altered in narcolepsy and PTSD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CA2+ SPARKS & URINARY BLADDER SMOOTH MUSCLE EXCITABILITY Principal Investigator & Institution: Nelson, Mark T.; Professor and Chair; Pharmacology; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2007 Summary: (provided by applicant): Detrusor instability is a major component of urinary bladder dysfunction, including outflow obstruction associated with benign prostate hyperplasia. The goal of this project is to understand the normal physiological regulation of urinary bladder smooth muscle (UBSM) excitability and to apply an experimental model of partial urinary outflow obstruction to address pathophysiological aspects of UBSM function. This proposal focuses on the communication among four key ion channels involved in regulating the excitationcontraction (E-C) coupling process in UBSM: 1) Voltage-dependent calcium channels (VDCC), which mediate the upstroke of the UBSM action potential. 2) Ryanodine-
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sensitive calcium release channels in the sarcoplasmic reticulum (RyRs), which release Ca2+ in the form of Ca2+ sparks. 3) Large-conductance, voltage/calcium-activated potassium (BK) channels, which mediate membrane repolarization of an action potential. 4) Small-conductance, calcium-activated (SK) channels, which are responsible for the after-hyperpolarization. This work builds on our discovery of Ca2+ sparks and their communication to BK channels in smooth muscle, and elucidation of key molecular components of this process. In an important advancement, we have found that the beta 1-subunit of the BK channel plays a major role by tuning the voltage/Ca2+ -sensitivity of this channel. We provide novel evidence that the BK channel beta 1-subunit and SK channels have profound effects on bladder function; data that point to potassium channel dysfunction as a significant contributor to detrusor instability following obstruction. An integrated approach, combining molecular and electrophysiological studies with functional measures of bladder contractility and cystometric parameters, will be applied using wild-type and genetically engineered mouse models. Our specific objectives are to elucidate the functional communication among VDCCs, RyRs and BK channels in normal and outflow obstructed bladders (Aim 1), to characterize the role of the beta 1-subunit in tuning the Ca2~ and voltage sensitivity of the BK channel (Aim 2), and to defme the roles of SK channels in the regulation of UBSM function (Aim 3). The long-term goal is to develop novel approaches for regulating urinary bladder function, with the main focus being on the therapy of detrusor instability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CAUSES OF SLEEP-INDUCED BREATHING INSTABILITIES Principal Investigator & Institution: Dempsey, Jerome A.; Professor; Population Health Sciences; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: During sleep and with the loss of the "wakefulness" drive to pump and upper airway respiratory muscles, the control of breathing becomes highly dependent upon and vulnerable to reflexive feedback inputs from chemoreceptors and mechanoreceptors. Accordingly, sleep-induced breathing instabilities are common and have a significant prevalence even in the general population. Sleep unmasks a highly sensitive hypocapnic-induced apneic threshold, but we do not know what role this mechanism plays in various types of sleep-disordered breathing, because we do not know its sites of action, its changes in sensitivity in the presence of powerful background influences such as CNS hypoxia, chronic hypocapnia/hypercapnia, changing sleep states, or changing stimuli to breathe which might be specific to sleep. We will use sleeping humans and dogs, the latter with extra corporeal perfusion of isolated carotid chemoreceptors-to quantify the effect of these influences on both the apneic threshold and on the important stabilizing mechanism of short term potentiation of ventilatory output. This dog model with isolation of carotid chemoreceptors will also be used to address the question of central versus peripheral hypoxic effects on periodic breathing in sleep. A second dog model as well as human patients with chronic heart failure will be studied to address the mechanisms of Cheyne-Stokes respiration, with specific emphasis on the effects of the added stimulus to hyperventilation originating from the lungs of the patient in congestive heart failure. Finally, we will use dogs and humans-with and without innervated lungs-to address the role of non-chemical, mechanoreceptor inhibitory feedback effects during sleep on upper airway and pump muscles; a) influences from high frequency low amplitude pressure oscillations in the upper airway; b) the effects of amplitude, timing and duration of normocapnic mechanical ventilation on the resetting of inherent respiratory rhythm and on the "short-
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term inhibition" of respiratory motor output following cessation of phasic inhibitory sensory input. These latter studies conduced in sleep are important to testing the sensitivity of respiratory control mechanisms to mechanical feedback-a problem which remains relatively unexplored, especially in the human. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CENTRAL AUDITORY PATHWAY OF THE MIDDLE EAR REFLEX Principal Investigator & Institution: Lee, Daniel; Otolaryngology; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, Ma 01655 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 31-MAY-2008 Summary: (provided by applicant): The goal of this project is to understand the anatomic and physiologic features of interneurons of the mammalian middle ear muscle (MEM) reflex pathway. The neurons of this reflex coordinate the activity of the MEMs to protect the inner ear from intense acoustic stimuli as well as reduce masking. This reflex arc is composed of primary auditory afferents originating in the cochlea, a single or series of interneurons originating in the cochlear nucleus and ultimately synapsing on MEM motoneurons, and efferent fibers of the facial and trigeminal nerves that terminate on the stapedius and tensor tympani muscles, respectively. Although features of primary auditory afferents and the motoneuron efferents have been well characterized, little is known about the reflex interneurons. Which subdivision of the cochlear nucleus contains the reflex interneurons? Is there a single or a series of interneurons from the cochlear nucleus to the facial and trigeminal nuclei? For Aim 1, we will perform focal lesioning studies of the cochlear nucleus using kainic acid, an excitatory neurotoxin. We will correlate focal lesioning of the cochlear nucleus with loss of the MEM electromyography (EMG) response, to determine which division of the cochlear nucleus is involved in the MEM reflex pathway. Since the anatomical cell types of the cochlear nucleus subdivisions are well known, these studies will narrow down the identity of the cochlear nucleus interneurons. For Aim 2, we will examine the cochlear nucleus interneurons by double-injection experiments. We will inject retrograde tracer into either the stapedius or tensor tympani muscles to label their respective motoneurons, and, at the same time, inject an anterograde tracer into the cochlear nucleus to label the interneurons of the MEM reflex. Injections of the cochlear nucleus will be guided by our lesion studies described in Aim 1. Labeled projections from the cochlear nucleus will be identified as interneurons of the MEM reflex if they terminate on labeled MEM motoneurons. Such terminations would reveal a direct connection between the cochlear nucleus and the MEM motoneurons. Overall, the proposed project will improve our understanding of the brainstem connections that comprise the MEM reflex pathway. These findings may provide a basis for refining and extending our interpretation of clinical tests of MEM reflex integrity and brainstem auditory processing in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CI-2 MODULATION OF SPINAL PROCESSES: SUPRASPINAL EFFECTS Principal Investigator & Institution: Foreman, Robert D.; Professor & Chair; Physiology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2002; Project Start 01-SEP-1996; Project End 31-MAY-2007 Summary: (provided by applicant): The purpose of this study is to examine how neurons of propriospinal pathway(s) originating in the C1-C2 region process
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information from amygdala, subcoeruleus/parabrachial (SC/PB) nuclei, and vagal afferent fibers to modulate sensory-motor integration in the spinal cord. We previously demonstrated that chemical stimulation of C1-C2 neurons modulated spontaneous and visceral-evoked activity in lumbosacral spinal neurons and EMG activity of thoracic paraspinal muscles. Our preliminary data further demonstrate that chemical stimulation of C1 C2 neurons can strongly influence the activity of T3-T4 respiratory-related interneurons. Especially critical to this application are our preliminary results indicating that excitotoxic blockade of C1-C2 neurons with ibotenic acid, attenuated amygdalar and SC/PB modulation of lumbosacral spinal cells. The same lesion reduced vagal effects on lumbosacral neurons and paraspinal muscles. Our results challenge the assumption that descending pathways from supraspinal regions modulate activity of thoracic and lumbosacral neurons through direct projections only. The present application addresses the hypothesis that C1-C2 neurons process information from amygdala, SC/PB and vagal afferents. In turn, C1-C2 neurons strongly influence activity of spinal sensory neurons, thoracic respiration-related interneurons, and somatomotor reflexes. We also hypothesize that amygdala and vagal afferents transmit information to C1-C2 neurons via SC/PB nuclei. Specific aims are designed to answer the following questions: 1) Are discharge patterns and activities of C1-C2 neurons affected by stimulating specific supraspinal nuclei? 2) Do neurons in C1-C2 segments process information from specific supraspinal nuclei to change sensory and integrative/motor activity in the spinal cord? 3) Do neurons in C1-C2 segments process information from vagal afferents to change integrative/motor and sensory activity in the spinal cord? 4) Do SC/PB nuclei relay information from amygdala and vagal afferent fibers to the C1C2 segments to change sensory and integrative/motor activity in the spinal cord? Neurophysiological studies to examine extracellular discharge patterns and studies using c-fos as a marker of neuronal activation will be conducted in anesthetized rats. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMPARING THREE ELECTRODE PLACEMENTS TO OPTIMIZE ECT Principal Investigator & Institution: Kellner, Charles H.; Professor and Chairman; Psychiatry; Univ of Med/Dent Nj Newark Newark, Nj 07103 Timing: Fiscal Year 2002; Project Start 16-SEP-2002; Project End 31-MAY-2006 Summary: (provided by applicant): Electroconvulsive therapy remains an important treatment for severely depressed patients who do not respond adequately to, or are intolerant of, antidepressant medication. As the prevalence of major depression increases, particularly in the geriatric population, the need for effective treatments is an urgent public health concern. Despite refinements in technique, the cognitive impairment associated with ECT remains a serious concern for many patients. Traditionally, ECT has been administered with one of two standard techniques: 1) bilateral (bitemporal) electrode placement or 2) right unilateral electrode placement. Bilateral electrode placement has greater efficacy but causes more cognitive impairment, while right unilateral electrode placement is less effective for some patients but causes less cognitive impairment. Recently, two innovative techniques have shown promise in preliminary studies: 1) right unilateral ECT administered at much higher electrical dose, which may achieve efficacy equivalent to bilateral ECT and 2) a novel electrode placement (bifrontal) which may combine the beneficial properties of both bilateral and unilateral ECT. We propose a double blind, randomized, controlled clinical trial comparing the standard technique of bilateral ECT with two novel techniques - highdose unilateral ECT and bifrontal ECT. The primary aims of the study are to compare
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the three treatments in terms of 1) antidepressant efficacy and 2) cognitive effects during and at the end of the treatment course, and over a two-month naturalistic follow-up period. An additional aim is to compare the treatments in terms of quality of life over two months. In this study, 360 patients with major depression are randomized over 4 years at 4 sites. Assessments are the Hamilton Rating Scale for Depression (HRSD), a comprehensive neuropsychological test battery, and quality of life outcome measures. Provisions are made for assuring the ongoing quality of treatments and assessments. The investigators are experienced ECT providers and researchers who are now successfully collaborating on an ongoing NIMH-funded trial of continuation ECT vs. pharmacotherapy (MH55489, MH55486, MH55484). The proposed study will be the first direct comparison of the three types of ECT and will inform psychiatrists about the optimal technique of ECT. The results of this study will promote more effective and safer treatment of the most severely ill depressed patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TECHNIQUES
COMPARISON
OF
POST-SCI
LOCOMOTOR
TRAINING
Principal Investigator & Institution: Field-Fote, Edelle C.; Assistant Professor; Orthopedics and Rehabilitation; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: In recent years there has been an increased understanding of the role of activity-dependent plasticity in promoting functional recovery following neurologic injury. There is also an emerging appreciation for the role of spinal mechanisms in control of behaviors such as walking. Research indicates that activity-dependent adaptive changes in spinal cord circuitry may play an important part in the recovery of walking function in individuals with spinal cord injury (SCI), perhaps long after the stage of spontaneous recovery. Two technologies that appear effective in promoting functional recovery are body weight support (BWS) and functional electrical stimulation (FES). In preliminary studies, improved overground walking speed, leg strength and endurance was observed in subjects with SCI who trained using an approach combining these interventions. This proposal will assess, in individuals with chronic incomplete SCI, responses to a BWS-assisted treadmill training regimen under one of three training conditions: 1) passive (manual)-assisted stepping, 2) active (FES)-assisted stepping, or 3) non-assisted (voluntary) stepping. Each condition has distinct advantages. Manuallyassisted stepping allows assistance to be graded to individual needs; FES-assisted stepping takes advantage of spinal reflex circuitry and may contribute to beneficial changes in spinal cord neurophysiology; and voluntary stepping may encourage the greatest voluntary effort. These investigations will determine which condition best promotes efficient overground walking, and will examine changes in spinal cord neurophysiology, strength and cardiorespiratory capacity associated with the three forms of training. Performance-based measures will include: computerized kinematic analysis to assess lower limb coordination and key parameters of gait (speed, stride length and step rhythm), electromyographic assessment of muscle recruitment and work capacity evaluation to assess changes in strength and gait efficiency. Neurophysiologic techniques (e.g., reflex testing and transcranial magnetic stimulation) will be used to assess supraspinal, spinal and peripheral control of mechanisms that contribute to walking, to voluntary movement and to reflex activation. The proposed experiments will test the hypotheses that: 1) walking performance in subjects with SCI improve to a greater extent when active, as opposed to passive or no assistance is given
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to advance the limb, 2) post-training spinal cord reflex activity will be more similar to normal values in those subjects who participate in the FES-assisted group, and 3) electromyographic (EMG) activity observed during walking will be more robust than EMG observed during voluntary movement. These studies will allow us to compare the efficacy of rehabilitation strategies aimed at improving functional mobility in individuals with SCI. In addition, they will provide information about neural and cardiorespiratory bases of these functional changes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONTROL OF BREATHING DURING PHYSIOLOGIC CONDITIONS Principal Investigator & Institution: Forster, Hubert V.; Professor; Physiology; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2002; Project Start 01-JUN-1986; Project End 31-MAY-2005 Summary: Several theories on the neural control of breathing that were based on data from reduced preparations were not supported by our recent findings in awake and asleep goats on the effects of rostral medullary neuronal dysfunction and/or carotid body denervation (CBD). Some findings mimicked the altered breathing found in obstructive sleep apnea (OSA) and congenital central hypoventilation syndrome (CCHS). The mechanisms that mediated these effects are not established, but one likely mechanism is through intracranial chemoreceptors for years thought to exist only near the ventral medullary surface (including the retrotrapezoid nucleus RTN)). However, findings in reduced preparations of chemoreceptors at widespread brain sites have raised questions related to the location and role of chemoreceptors that affect breathing in awake and asleep states and whether brain chemoreceptor sensitivity is altered by CBD. One recently identified site of chemoreception is the medullary raphe nuclei (MRN) whose role in the control of breathing during awake and asleep states remains speculative. Accordingly, to study chemosensitivity and the role of the RTN and MRN in the control of breathing, we will implant microtubules into these nuclei of goats to: a) create a focal acidosis by dialysis of mock cerebrospinal fluid with different PCO2's, or b) induce neuronal dysfunction through injection of glutamate or serotonin receptor antagonists or agonists, or a neurotoxin. Major hypotheses are: 1) focal acidosis (equivalent to that breathing 7 percent inspired CO2, delta brain pH approximately -.05) in the RTN will increase breathing in awake, but not asleep states, while acidosis in the MRN will increase breathing in asleep, but not awake states, 2) at RTN sites where focal acidosis increases breathing, neuronal dysfunction will attenuate whole body CO2 sensitivity, but not alter rest and exercise breathing, 3) neuronal dysfunction in the MRN will attenuate CO2 sensitivity and rest and exercise breathing, 4) during the first 10 days after CBD, the effect of RTN and MRN focal acidosis will be attenuated but 15 plus days after CBD, the effect of focal acidosis will be accentuated. and 5) at most RTN and MRN sites, the acute effects of neurotoxic lesions will be hypoventilation (rest and exercise) and attenuated CO2 sensitivity; the acute effects of these lesions will be greater in CBD than in intact goats, but recovery after lesioning will be greater in intact than in CBD goats. Our unique studies are important because hypotheses generated largely from reduced preparations will be tested in awake and asleep states to enhance the understanding of medullary chemoreceptor contribution to the control of breathing and how abnormalities in this contribution may underlie diseases such as OSA, CCHS, and the Sudden Infant Death Syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORE--TECHNICAL SUPPORT Principal Investigator & Institution: Demer, Joseph L.; Professor; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Core B provides on-site technical expertise to install, maintain, and repair harware for: 1) traditional clinical testing of vestibular function by electronystagmography, bithermal caloric irrigations and posturgraphy; 2) novel tests of vestibular function by related balance function using powerful rotational and linear stimulators, eye movement recording by the magnetic coil technique, electromyography, and evoked potentials; and 3) digitally assisted, quantitative microscopy and micrography. Core B also provides support necessary to permit efficient use by researchers in all projects of: 1) locally developed software for eye and head analysis (MacEyeball); 2) database management and systematic backups of patient demographic, clinical and genetic data, digitally sampled eye and head movement data, and digital images; 3) general computer hardware and software networking, installation, and maintenance; and 4) digital processing of text and figures for publication. Core B provides all projects with immediate and reliable access to these essential services. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORTICAL CONTROL OF MOVEMENT Principal Investigator & Institution: Keller, Asaf; Professor; Anatomy and Neurobiology; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2002; Project Start 22-APR-1996; Project End 31-MAR-2004 Summary: (Adapted from the Investigator's Abstract): The goal of this research is to understand the role of the motor cortex in controlling movement. Despite intense efforts over the last two centuries, there is still little consensus about the mechanisms by which the motor cortex controls voluntary movements. Recently, exploratory movements of the mystacial vibrissae ("whisking") have emerged as a promising, simpler model system for addressing this issue. However, progress has been limited by the lack of data on the pathways and mechanisms responsible for the motor act. Based on our findings, we hypothesize that pre-motoneurons in the parvocellular reticular formation are a key part of a network that controls exploratory whisking, and that the motor cortex modulates whisking by its action on these pre-motoneurons. Several hypotheses will be tested using electrophysilolgical and neuroanatomical approaches in vivo and in vitro. The proposed studies will provide data pertinent to understand the normal functions of the mortor cortex, and the processes underlying congenital or acquired neurological diseases resulting in sensory-motor deficits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORTICAL CONTROL OF SEQUENTIAL MOTOR BEHAVIOR Principal Investigator & Institution: Ashe, James; Associate Professor; Neuroscience; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 24-AUG-2001; Project End 31-JUL-2006 Summary: Many of our skilled behaviors involve not single actions but sequences of movements. Lesion and imaging studies in humans, in addition to neural recording in sub human primates have demonstrated that the medial motor areas in the frontal cortex are particularly important for the generation of motor sequences. What is less
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clear is the exact relation between neural activity in the different areas and the spatial and temporal features of sequence performance. Our general thesis is that the more rostral motor areas code for global aspects of sequence production such as serial order or complete sequence specification. Whereas neurons in areas with direct access to motor output such as the SMA, caudal cingulate, and motor cortex reflect sequences by changes in their directional properties. (1) To determine the extent to which the directional properties of cells in the motor cortex reflect aspects of the performance of over-learned motor sequences. The hypothesis is that cells in the motor cortex show a dynamic re-organization of directional properties during sequence production. (2) To determine the relation between neural activity in the SMA and pre-SMA and the spatial and temporal aspects of over-learned sequences. The hypothesis is that global aspects of sequence production will be more commonly coded in pre-SMA, while neural activity in SMA will reflect an interaction between the directional properties of the neurons and sequence parameters. (3) To record the neural activity in the cingulate motor areas during the performance of over-learned sequences. The hypothesis is that cingulate motor areas are an integral component of the cortical system for sequence control. The methods used will be those of standard multi-electrode recording in the target cortical areas of highly trained rhesus monkeys with appropriate instrumentation for behavioral control and monitoring. Our experimental approach differs from other attempts to examine the neural correlates of sequences in several important respects: we will use behavioral tasks which exploit the spatial dimension inherent in sequence performance and we place particular emphasis on changes in the spatial properties of the recorded neurons. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORTICAL MECHANISMS OF MOTOR PROCESSING Principal Investigator & Institution: Crutcher, Michael D.; Professor and Chair; Neurology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2001; Project Start 01-JUL-1992; Project End 31-MAY-2004 Summary: (Adapted from Applicant's Abstract): The broad, long-term objectives of our research are to: 1) determine how the central nervous system (CNS) controls visuallyguided limb movements by identifying neural activity related to the behavioral processes and variables that underlie such movements, and 2) characterize the specialized functional roles of different cortical motor areas in the control of movement. The current proposal is based upon the results of single cell recording studies which found evidence that several different types of neural activity related to the early stages of vasomotor processing are located in the cortical motor areas of monkeys performing visually-guided tracking tasks. These include activity related independently to: 1) which visual target is captured, 2) the direction of Specific Aim 1: To test the hypothesis that there is a differential distribution of target-independent activity in the four premotor areas. The results of this study will provide new information about the extent to which these four premotor areas participate in early stages of vasomotor transformations. Specific Aim 2: To test the hypothesis that target-dependent activity is a neural correlate of visually guided-limb movements. An oculomotor delayed response task will be used to verify that target-dependent activity is contingent upon the execution of limb and/or cursor movements. This task will provide convincing evidence that the previously observed target-dependent activity is indeed related to high-level aspects of vasomotor transformations. Specific Aim 3: To test the hypothesis that there are neurons in these four premotor areas whose activity is related independently to 1) the target captured by the cursor, 2) the director of cursor movement, or 3) the endpoint of hand/joystick
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Electromyography
movement. Since the equilibrium point hypothesis and analytical models of motor processing would make different predictions regarding the occurrence of these different patterns of activity, the results of these studies will provide evidence regarding the plausibility of these two models of vasomotor processing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEVELOPMENT OF EARLY OROFACIAL MOTILITY AND CONTROL Principal Investigator & Institution: Green, Jordan R.; Waisman Ctr/Mr & Human Devlmt; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: (adapted from applicant's abstract): The goal of this project is to identify the characteristics of the immature oromotor control system that shape early speech production. Fundamental similarities in vocal development within and across cultures suggest that young children have a propensity for certain articulatory movements and configurations (Kent, 1992; Locke, 1983; Oller, Eilers, Urbano, and Cobo-Lewis, 1997). These universal tendencies probably reflect the properties of the immature oromotor control system that, in part, delimit early phonetic abilities. The few existing studies of early articulatory control have revealed the coordinative organization for speech to emerge much earlier than previously suggested (Moore and Ruark, 1996; Ruark and Moore, 1997). Accordingly, an improved understanding of speech development requires more direct information about the organization of spontaneous and task-related orofacial movements produced in early infancy. Early lip and jaw movements and associated muscle activity will be studied in five different groups at differing stages of early development (age range: birth to 12 months) using a 3D computerized movement capture system. Movement data will be collected from the upper lip, lower lip, and jaw using three reflective markers placed midline on the vermilion border of the upper and lower lip, and just superior to the mental protuberance of the mandible. Muscle activity will be recorded using miniature surface electrodes from five targeted muscles sites: right temporalis, right masseter, anterior belly of digastric, right quadrant of the orbicularis oris superior, and right quadrant of the orbicularis oris inferior. Lip and jaw data will be subjected to analyses that will characterize early oromotor coordination and control at multiple levels (e.g., spatio-temporal stability, inter- articulator coupling, and frequency of movement). These analyses will also include the novel use of 3D movement space mapping to describe the diversity and richness of early lip and jaw movements exhibited at each age across and within distinct oromotor behaviors (e.g., spontaneous vs. chewing vs. sucking vs. vocalization). It is hypothesized that even newborn subjects will exhibit some stereotypic lip and jaw movement patterns for certain tasks and that changes in spontaneous movements will parallel changes in taskrelated movement patterns. The developmental sequence observed in this study will provide empirically based guidelines for advancing underlying movement competencies in children with speech motor delays and will lead to a descriptive framework in which speech motor delays can be detected at an earlier stage of development. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DIAGNOSTIC AND NATURAL HISTORY MARKERS IN ALS Principal Investigator & Institution: Mitsumoto, Hiroshi; Professor; Neurology; Columbia University Health Sciences New York, Ny 10032
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Timing: Fiscal Year 2002; Project Start 15-JUN-2001; Project End 31-MAY-2004 Summary: Amyotrophic lateral sclerosis (ALS) is one of the most devastating neurological diseases. It affects upper and lower motor neurons (UMN and LMN). The cause is largely unknown, so no effective treatments are available. To date, "no objective and quantitative UMN or LMN markers" are available---one of most serious deficiencies in ALS. Thus, "understanding of the pathogenesis of UMN and LMN involvement" is limited, and no reliable early diagnosis and effective surrogate markers are available. Therefore, we propose (1) to investigate several novel technologies to establish accurate UMN and LMN markers, (2) to investigate whether these markers provide early diagnosis and clinically meaningful natural history data that indicate changes over time with high sensitivity, (3) to identify whether these markers prognosticate ALS disability and survival, and (4) to validate histologically the changes observed with technologyidentified markers. First, test-retest validity and normal data will be established in healthy controls using emerging neuroimaging technologies at two hospital campuses. In patients with suspected/possible ALS or probable/definite ALS, we will investigate quantitative evidence for (1) UMN involvement at the motor cortex area by single-voxel magnetic resonance spectroscopy (MRS) and more accurately at the primary motor cortex by multiple-voxel MRS; (2) fiber tract integrity of descending UMN fiber tracts by MR diffusion tensor imaging; and (3) physiological integrity of the corticospinal tracts using transcranial magnetic stimulation technology. An LMN marker will be studied by motor unit number estimation using multiple point stimulation technology. ALS status will be measured by well- validated quantitative clinical assessments. The patients will be followed every 3 months for 15 months. The potential value of the technologyidentified markers for use as surrogate markers as endpoints in clinical trials will be analyzed by statistical modeling. Functional disability and survival also will be correlated with these markers. When autopsy is permitted, technology-identified markers will be validated histologically. To our knowledge, this project will be the first comprehensive approach to investigate ways to develop a reliable and early diagnosis of ALS, to develop surrogate markers in clinical trials, and to improve prognostication in ALS. The knowledge gained from this project not only will expand understanding of the pathogenesis of UMN and LMN involvement in ALS, but also will permit more effective clinical trials of new drugs in the near future and improve diagnosis and treatment for patients with this disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIFFERENCES IN SWALLOW MECHANICS IN INFANTS Principal Investigator & Institution: German, Rebecca Z.; Professor; Biological Sciences; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2002; Project Start 01-JUL-1998; Project End 31-JUL-2006 Summary: (provided by applicant): Swallowing requires the coordination of a large number of muscles; this complexity arises partly from the need for airway protection. In the previous funding period, we added to the understanding of muscle activity and oropharyngeal kinematics in infant deglutition. However, the role of the majority of muscles during emptying of the valleculae and in the transport of the bolus past the laryngeal opening or the natural stimuli that initiate the emptying of the valleculae over maturation is not well understood. Our preliminary data suggest that two distinct pathways of bolus movement exist, either around the epiglottis/laryngeal opening (in the newborn) or over it (by the age of weaning). However the timing of the transition, from one path to the other and the associated changes in the kinematics or motor patterns, are unknown. The decerebrate pig is an excellent model for studying vallecular
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Electromyography
emptying because this phase of the swallow can be isolated experimentally. We propose to apply our existing techniques both to this model and to intact animals, in order to answer the following questions. What natural stimuli initiate vallecular emptying, and do they change during maturation? What is the pattern of muscle activity during vallecular emptying in terms of the order and amplitude of muscle activation? Does change in the consistency of the bolus alter the motor pattern during vallecular emptying, and does this change over developmental time? Does epiglottal movement result from: (i) direct muscle contraction; (ii) indirect movement of the rest of the larynx, (iii) the mechanical action of food on the epiglottis, or a combination of all three? Current studies of human dysphagia and rehabilitation rely heavily on several older studies of oral function in adult man and animal; these studies did not have the means to examine the ontogeny of vallecular function in detail. The proposed study of the maturation of motor patterns will provide an important baseline for treatment strategies aimed at human infant dysphagia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ASYMMETRIES
DIGITIZING
THE
FACE:PRIMING,TMS&HEMISPHERIC
Principal Investigator & Institution: Bowers, Dawn; Associate Professor; Clinical & Health Psychology; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2002; Project Start 07-JUN-2002; Project End 31-MAY-2005 Summary: (provided by applicant) Facial expressions are complex signals caused by rapid changes in facial muscular activity that are brief and last only a few seconds. Humans typically decode these signals during dynamic interactions in which the face moves. The present proposal aims to fulfill a gap in the literature regarding a well documented, but poorly explained phenomenon. Over the years, numerous studies have shown that the left side of the face is more emotionally expressive than the right. This asymmetry is more predominant for right- than left-handers and seems to occur for both negative and positive expressions. Even nonhuman primates such as the rhesus monkey have been reported to display more intense expressions over the left side of the face. The basis for these asymmetries is unclear. The most popular neuropsychological interpretation has been that this left hemi-face asymmetry is a consequence of a right hemisphere advantage in processing emotional material. Unfortunately, little progress has been made since the late 1970?s to more clearly articulate this position or to evaluate alternative explanations for observations that the left hemi-face is more intensely expressive than the right. The overall purpose of the proposed research is to examine three hypotheses that might contribute to our understanding of hemi-facial movement asymmetries and assess their viability using contemporary state-of-the-art methodologies. The specific aims of this project are: (a) to use trans-cranial magnetic stimulation (TMS) to learn whether the left lower hemi-face receives more cortical influence (either contra-lateral or ipsilateral) and determine whether this relates to behavioral asymmetries in dynamic facial expression; (b) to test the hypothesis of material specific (linguistic, emotion) hemispheric priming of contra-lateral motor systems; and (c) to test the hypothesis of lateralized inhibition of contra-lateral motor systems. A series of 6 studies are planned using cognitive priming, trans-cranial magnetic stimulation, and computer-based systems for digitizing dynamic facial signals. Either singly, or in combination, an increased understanding of these hypothesized mechanisms will likely contribute to our knowledge of expressive asymmetries and provide information that will ultimately be useful for examining emotional
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communication disturbances associated with psychiatric and neurologic disease in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DYNAMIC KNEE STABILITY AFTER ACL RECONSTRUCTION Principal Investigator & Institution: Tashman, Scott L.; Head, Motion Analysis Section; Bone and Joint Center; Case Western Reserve Univ-Henry Ford Hsc Research Administraion Cfp-046 Detroit, Mi 48202 Timing: Fiscal Year 2002; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: Surgical reconstruction of the anterior cruciate ligament (ACL) has become the treatment of choice for many ACL-deficient individuals wishing to maintain an active lifestyle. This procedure, though beneficial to many, is plagued by inconsistent outcome and can fail to protect against long-term joint degeneration. The key to successful treatment of ACL injury is restoration of dynamic knee stability; i.e. stability during functional movement. Implantation of a replacement graft does not guarantee success. The mechanical properties of ACL grafts deteriorate after implantation due to biological remodeling. Neuromuscular control of the ACL-reconstructed knee is impaired due to loss of sensory input from the intact ACL. The effects of these factors on graft and knee function are unknown. In fact, little is known about the dynamic behavior of the ACL-reconstructed knee, since traditional motion analysis techniques are incapable of reliably measuring knee stability during functional activities. This has hampered efforts to design optimal rehabilitation strategies, identify mechanisms leading to graft failure and improve outcome. This study will employ novel technology to study function of the ACL-injured and contralateral (uninjured)knees of subjects after ACL reconstruction surgery. A high frame-rate (250 frame/s), accurate (plus or minus 0.1 mm) biplane digital radiography system will be used along with dynamic electromyography to assess three-dimensional knee motion and neuromuscular function during movements known to stress the ACL (single-leg hopping, downhill running) at 4, 8 and 24 months after reconstruction surgery. Standard measures of clinical function (IKDC, VAS and Cincinnati Knee Ligament Rating System) will also be acquired. Accelerated and conservative rehabilitation strategies will be compared. This will enable evaluation of the effectiveness of ACL reconstruction surgery for restoring dynamic stability, the time course of changes in dynamic knee stability and control following ACL reconstruction, the nature and importance of compensatory neuromuscular strategies, and the effects (if any) of accelerated rehabilitation on dynamic knee stability. Findings from this study will facilitate the design of optimal postoperative rehabilitation strategies and the development of approaches to improve outcome following surgical ACL repair. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECTS OF HYDROTHERAPY ON ANXIETY AND PAIN IN LABOR Principal Investigator & Institution: Benfield, Rebecca D.; Parent-Child Nursing; East Carolina University 1000 E 5Th St Greenville, Nc 27858 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): The candidate's long-term goals include: 1) testing and refining two theoretical models to explain the psychophysiological effects of anxiety and pain in labor and the effectiveness of hydrotherapy, and 2) gaining consultation and collaboration with other researchers and students using physiological measurement techniques in the laboratory and clinical settings. Immediate goals are to increase
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Electromyography
knowledge and skill in: (1) physiology, including general, neural/hormonal, and immersion; (2) physiological instrumentation, including radioimmunoassay (RIA), immunoenzymatic assay (EIA), high performance liquid chromatography (HPLC) and electromyography (EMG); (3) statistics, both general and repeated measures; and (4) professional growth, including preparation of manuscripts and grants, with the goal of becoming an independent scientist. The effects of intervention with hydrotherapy in labor are poorly understood though use has escalated. The proposed study will focus on the psychophysiological effects of hydrotherapy during labor and the physiological indicators of sympathetic nervous system and adrenocortical inhibition associated with immersion and the relaxation response. Using a repeated measures correlational design, data will be gathered from 15 healthy patients, immersed to the xiphoid in 37 degrees C water for 1 hour. Data will be collected prior to and at 15 and 45 minutes of hydrotherapy. Visual analogue scales (VAS) will measure anxiety and pain; physiological measures will include plasma catecholamines, cortisol, beta endorphin, oxytocin, plasma volume shift, and uterine contractility, and will be analyzed using HPLC, EIA, RIA, hemoglobin (HGB) and hematocrit (HCT), and abdominal EMG respectively. Statistical analyses will include a one-way within-subjects analysis of variance and Pearson r technique. While these physiological measures, excluding plasma volume shift, have not been previously used to study hydrotherapy in labor, it is anticipated that post intervention measures will reflect a decrease in parturient anxiety and pain, as will subjective measures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ELASTIC/PLASTIC HUMAN JOINT COMPLIANCE Principal Investigator & Institution: Gottlieb, Gerald L.; Professor; None; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 01-DEC-1983; Project End 31-MAY-2005 Summary: (Adapted from the Investigator's Abstract): Our long-term aim is to achieve a deeper understanding of how the brain interacts with the environment to produce coordinated voluntary movement through the control of the peripheral, neuromuscular apparatus. This study continues our theoretical development of the rule-based model that we have proposed for control of voluntary limb movements. Our experiments proceed from the premise that the ultimate goal of any motor theory is to predict the behavior of measurable variables, not merely in terms of each other but in terms of the externally given definition of the movement task. The unifying theme of all the proposed experiments is to expand and validate the model as a basis for understanding how the central nervous system performs simple movements and continually adapts to ever changing tasks and environments. To this end, we propose experiments to study single-joint, flexion-extension movement at the elbow. We will examine kinematic, kinetic and myoelectrical changes brought on by different manipulations of the movement task. Two tasks examine dynamic changes in the patterns, brought on by behaviorally realistic task demands or fatigue. A third task examines the distinction between forward and backward internal models for dealing with external perturbations. The fourth task examines the postural aspects of the central commands and the relatively little studied aspects of how the CNS controls the transition from movement to posture. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EMG-BASED METHODS FOR TESTING NON-KEYBOARD IMPUT DEVICES Principal Investigator & Institution: Bonato, Paolo; None; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: My doctoral and postdoctoral training has focused on advanced signal processing techniques for the analysis of surface electromyographic (EMG) signals recorded during dynamic contractions. My work as Research Assistant Professor at the NeuroMuscular Research Center of Boston University has been oriented toward the development and application of EMG analysis techniques to real life situations (e.g., lifting and load carrying) of interest in ergonomics. The use of surface EMG in ergonomics has been limited in the past by the inability of traditional analysis techniques to extract spectral information from surface EMG signals that are recorded during dynamic contractions. Recent developments in EMG analysis have made techniques available that appear to overcome such limitations. My long-term goal is to establish a research career in electromyography by applying advanced EMG analysis techniques to ergonomics. The NeuroMuscular Research Center at Boston University provides an ideal place to pursue my career goals. The mentorship of Prof. Carlo J. De Luca and Prof. Serge H. Roy, the availability of laboratory space and equipment, and the opportunity for discussions with colleagues (e.g., Prof. Gerald Gottlieb, Prof. Lars Oddsson, who are well-know and respected scientists in areas related to the research herein proposed) are unique opportunities to motivate the success of the project. In addition, the mentorship of Dr. Lawrence Hettinger, director of human factors and ergonomics at Arthur D Little, constitutes a great help to ensure that this research project, and my future career goals, will give me the opportunity of addressing problems of paramount importance in ergonomics. The proposed research is to establish preliminary work toward the definition of standards for the assessment of nonkeyboard input devices (computer mouse) using EMG-based methodologies. The work is based on establishing a relationship between time and frequency parameters of the EMG signal and the different designs of computer mice. The identification of different patterns of muscle use and localized fatigue for different input devices will lead to future studies to develop a user-friendly assessment procedure for application in the field of ergonomics. Future studies by the applicant will focus on utilizing the innovation to gain a better understanding of overuse injury mechanisms related to work tasks and the operation of devices in the workplace. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EMG-CONTROLLED REHABILITATION
STIMULATION
FOR
STROKE
Principal Investigator & Institution: Fang, Zi-Ping; Vice President for Research and Developm; Neurocontrol Corporation 8333 Rockside Rd, 1St Fl Valley View, Oh 44125 Timing: Fiscal Year 2001; Project Start 05-JUN-1998; Project End 31-MAY-2004 Summary: (Adapted from the applicant's abstract): EMG-controlled neuromuscular stimulation is a rehabilitation technique which allows volitional activation of paretic limbs in patients with stroke. This type of active training has been shown to be more effective than passive exercises. The devices used in these pilot studies, however, relied on surface electrodes for EMG recording and muscle stimulation, resulting in low sensitivity to the EMG activity, limited selectivity of muscles for activation, and pain with stimulation. These factors have hindered the clinical adoption of this as a
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Electromyography
therapeutic intervention. The purpose of this project is to develop a percutaneous intramuscular sensing-stimulation system which overcomes the deficiencies of the surface electrode system. During the completed Phase I study, a prototype device was developed to extract weak EMG signals from stimulation artifacts, and to activate specific muscles without inducing pain. The preliminary clinical study in patients with chronic hemiplegia has demonstrated the technical feasibility of this intervention. During the proposed Phase II study, a pre-production device will be designed, fabricated, and tested. A randomized controlled pilot clinical study will be conducted in patients with recent hemiplegia due to stroke to demonstrate the effectiveness of EMGcontrolled stimulation in improving motor impairments in this patient population. PROPOSED COMMERCIAL APPLICATION: The device developed by this project can be used in the rehabilitation process of many hemiplegic stroke survivors. The training promoted with this device is expected to accelerate recovery, shorten hospitalization period, reduce attendant needs, and thus improve patients' quality of life and lower medical care cost. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EMOTION REGULATION AND ITS CONSEQUENCES Principal Investigator & Institution: Gross, James J.; Associate Professor; Psychology; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003; Project Start 13-JUN-2003; Project End 31-MAY-2008 Summary: (provided by investigator): The overall goal of this application is to understand two fundamental strategies for regulating emotion. Cognitive reappraisal involves changing how one thinks about an emotion-eliciting situation in order to decrease emotion. Expressive suppression involves changing how one behaves in an emotion-eliciting situation in order to decrease emotion. Our framework is a model of emotion regulation that distinguishes among regulation strategies based on when during the emotion-generative process the strategy has its primary impact. In this model, reappraisal acts early, and efficiently shuts down the entire emotion before emotion response tendencies have been fully activated. Suppression acts later on, and inefficiently shuts down just behavior. This model suggests that reappraisal should generally have more favorable affective and social consequences than suppression. We propose to test these predictions using two complementary research approaches (experimental, correlational) and assessing multiple response domains (experiential, behavioral, autonomic, neural). Study 1 addresses how reappraisal and suppression alter affective response magnitude. Study 2 tests predictions regarding affective response coherence, and examines how dissociations between experience and behavior influence autonomic responding. To provide converging evidence for our model, Studies 3A and 3B use fMRI to examine the neural bases of the affective processes tested in Studies 1 and 2. Study 4 addresses short term social consequences of reappraisal and suppression, and tests several mediators. Study 5 takes a longer-term perspective, and examines the cumulative affective and social consequences of individual differences in the use of reappraisal and suppression with a 5-year longitudinal study of young adults undergoing two major life transitions. These programmatic and theoretically motivated studies coordinate experimental and individual-difference approaches to test the role reappraisal and suppression play inaffective and social functioning, and to elucidate the mechanisms that underlie these effects. The broad, on regulation processes, laying the foundation for advances in theory long-term objective of this research is to further our understanding of basic emotion and emotion-regulation processes, laying the
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foundation for advances in theory and clinical interventions that will improve psychological and physical health. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EXPIRATORY MUSCLE ACTIVATION TO PRODUCE COUGH Principal Investigator & Institution: Dimarco, Anthony F.; Physiology and Biophysics; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2002; Project Start 01-FEB-1986; Project End 31-JUL-2004 Summary: (Applicant's abstract):Patients with spinal cord injury frequently suffer from respiratory complications due to their inability to cough and clear secretions. In recent animal studies, we have demonstrated that lower thoracic spinal cord stimulation (SCS) and magnetic stimulation (MS) results in the generation of large increases in airway pressure and high peak flow rates. These techniques, therefore, have the potential to produce an effective cough mechanism in spinal cord injured patients. The purpose of these studies is to resolve important basic science issues concerning these techniques in animal studies. In OBJECTIVE I, the efficacy of cough by these techniques will be assessed by radiolabeled clearance studies. In OBJECTIVE II, the pathway(s) by which the motor nerves innervating the expiratory muscles are activated during SCS and MS will be determined. The importance of motor root activation via stimulation of spinal cord pathways will be assessed by monitoring pressure generation before and after sequential section of the ventral roots. The specific pathways responsible for pressure generation will be localized anatomically by evaluating the effects of spinal cord section. Nerve compound action potentials will also be recorded from the motor roots during stimulation. In OBJECTIVE III, the electric field generated around and within the spinal cord during SCS and MS will be measured and used in conjunction with finite element analysis modeling techniques to determine optimum electrode and coil design. In OBJECTIVE IV, we will characterize the changes in expiratory muscle structure and function following upper motoneuron denervation. An effective cough is dependent upon optimal function of the expiratory muscles which are most likely atrophied in patients with spinal cord injury. Therefore, we will also assess the capacity or SCS and MS to maintain expiratory muscle function in a chronic animal model of spinal cord injury. In OBJECTIVE V, the safety profile of SCS will be assessed in chronic animals. The results of these studies should provide important information relevant to the potential use of these techniques in human clinical trials. Restoration of affective cough mechanism may allow patients with spinal cord injury to clear secretions more easily, reduce the incidence of respiratory complication and, ultimately, improve their life quality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EYE RELATIONSHIPS
MOVEMENTS:
FORCE,
MOTION,
AND
ANATOMY
Principal Investigator & Institution: Goldberg, Stephen J.; Professor; Anatomy and Neurobiology; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2002; Project Start 06-DEC-1995; Project End 31-JUL-2004 Summary: The exquisite precision with which the eyes acquire, pursue and fixate visual targets appears to stand in contrast to the more gross methods used to correct abnormalities in the system. Extraocular muscles (EOMs) may be surgically shortened or repositioned to compensate for inappropriate motor activity. Botulinum toxin type A can be injected in order to weaken a particular muscle so that it may perform better in
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Electromyography
relation to other muscles, although force changes after such injections have not been systematically studied. The predicted outcome of these measures can be unreliable and the interventions may need to be repeated in the same patient because it's often difficult to obtain the proper alignment of the eyes with a single procedure. While the clinical effectiveness of these strategies is unquestioned, there is obvious need to improve their precision and predictability. This proposal, using cats and monkeys, will primarily focus on two related aspects of eye movement control exposed by perturbing the normal system. I) How does EOM contractile force change from O-2 months post botulinum toxin injection and do those changes directly relate to eye displacement changes? 2) How precise are motoneuron MN firing patterns during repeated identical movements and how might that precision be altered after botulinum toxin injection? Additionally, is there a relationship between VIth nerve branching and orbital and global layer of the lateral rectus muscle? Studies of EOM electromyography (EMG), muscle immunohistochemistry and myosin expression will be carried out concurrently with the examination of these questions. The correlative evaluation of MN firing, whole muscle plus motor unit force, muscle cytology and EMG measures with eye displacement is unique and unavailable in either normal or botulinum toxin treated motor systems. It is hoped that these studies will provide information critical to clinicians seeking to improve patient outcomes as well as basic researchers who want to understand the complex dynamics of eye movements. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENERATION OF RESPIRATORY RHYTHM Principal Investigator & Institution: Feldman, Jack L.; Chairman; Neurobiology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): The mammalian brain is vigilant in the control of breathing, regulating blood O2 and CO2 over an order of magnitude range in metabolism, wide ranges of posture and body movements, and compromises in muscle or cardiopulmonary function from birth till death without lapses beyond a few minutes. The long-term objectives of this grant are to understand the mechanisms by which the central nervous system generates respiratory rhythm and modulates respiratory pattern to appropriately regulate blood gases and pH. In this grant, we propose to test, in behaving awake/sleeping adult rats hypotheses related to the sites and mechanisms for generation of breathing rhythm. In particular, we will test the hypothesis that the preBotzinger Complex, a compact brainstem nucleus, contains the critical circuits generating the normal rhythm of breathing. The experiments will determine the effects of destroying targeted populations of preBotzinger Complex neurons in adult rats and measuring the changes in breathing pattern and related physiological variables that result. Our published results indicate that destroying a small population of less than 1000 neurokinin-1 receptor expressing preBotzinger Complex neurons will result in pathological breathing in awake rats, as well as severely perturb their ability to respond to hypoxia; preliminary data indicate marked disturbances following destruction of opioid receptor expressing neurons. Understanding the neural mechanisms producing respiratory rhythm and underlying its modulation appropriate for eupnea, i.e., the breathing pattern necessary to keep the arterial partial pressure of O2 and CO2 and pH at physiological levels when at rest, is important in understanding human disease. Failure of the brain to maintain eupnea in humans suffering from a variety of disorders, including sleep apnea, apnea of prematurity, congenital central hypoventilation, central
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alveolar hypoventilation, and perhaps sudden infant death syndrome, leads to serious adverse health consequences, even death. If these pathologies are to be understood, the site(s) and mechanism(s) of respiratory rhythmogenesis must be revealed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETIC AND ANATOMIC BASIS OF THE FIBROSIS SYNDROMES Principal Investigator & Institution: Engle, Elizabeth C.; Associate Professor of Neurology; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2002; Project Start 20-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): The congenital fibrosis syndromes are oculomotility disorders characterized by restrictive ophthalmoplegia with or without ptosis, and each disorder varies in the fixed position of the globes and in the specifically affected cranial nerve(s) and extraocular muscles (EOMs). The neuropathologic bases of two fibrosis syndromes have been described; Duane syndrome results from absence of the abducens nerve and nucleus, while CFEOM1 results from an absence of the superior division of the oculomotor nerve and corresponding oculomotor subnuclei. The laboratory's longterm goals are to uncover the molecular basis of the fibrosis syndromes and to study the development of the oculomotor lower motor neuron system. Toward these goals, we have genetically defined four congenital fibrosis loci and one congenital ptosis locus, and are in the process of positionally cloning these genes. In this grant, we seek funding to address the following specific aims: (1) Identify families with the congenital fibrosis syndromes for our clinical and genetic studies and analyze their DNA for linkage to the known CFEOM loci. (2) Define the anatomic and functional basis of CFEOM by highresolution orbital MRI studies in affected members of genetically defined families. (3) Clone the CFEOM1 disease gene (which is mutated in the most common inherited form of the congenital fibrosis syndromes) and analyze CFEOM1 families for disease-causing mutations. (4) Initiate structural and functional characterization of the CFEOM1 RNA and protein product. Significance: The molecular bases of strabismic disorders remain poorly understood. Though rare, several of the fibrosis syndromes are inherited, and thus provide a unique opportunity to investigate the etiology of this subset of strabismic disorders. Our large collection of CFEOM1 families, coupled with a detailed physical map and access to genomic sequence within the CFEOM1 critical region, places us in a unique position to identify this disease gene. In addition, the correlation of this genetic data with the proposed clinical, anatomic, and functional characterization of genetically defined patients provides a unique and strong foundation for phenotype-genotype correlations and functional studies. By defining the genetic and anatomic bases of CFEOM1, we will develop a tool with which to study its molecular basis and to search for related fibrosis genes, and with which we should gain important new insights into brainstem cranial nerve development. These data will be invaluable to our understanding of the developmental roles of these genes, and should also contribute to improved therapy of the fibrosis syndromes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HARNESSING MOTONEURON ACTIVITY: FROM LAB TO CLINIC Principal Investigator & Institution: Deluca, Carlo J.; Professor; None; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 10-JUN-2000; Project End 31-MAY-2005 Summary: (Adapted from the applicant's abstract): This study will develop an automatic system for decomposing the electromyographic signal into the constituent action
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potentials corresponding to the firing of individual motor units activated by motorneurons. The system will be an enhancement of a current system used over the past 20 years in many studies carried out by the Neuromuscular Research Lab at Boston University. Although the current system has been a valuable research tool, it has never been useful as a clinical tool due to limitations in processing time, accuracy and portability. Proposed enhancements will be introduced by redesigning the hardware and rewriting the decomposition software using a knowledge-based artificial intelligence language (IPUS), which has recently been developed by the team. As part of this application the enhanced system will be used in two laboratory studies and two clinical studies. The laboratory studies will investigate the modifications that occur in the firing of motor units as a function of ageing and will quantify the benefits that can be restored by exercise. The system will also be used to investigate the phenomena of motor unit substitution. The clinical studies will address the use of the device in quantifying the degree of denervation in paralyzed laryngeal muscles and in studying the effect of acute ataxia on the firing characteristics of the motorneurons in cerebellar stroke. As well as testing specific hypotheses, these studies will be used to test and improve the evolving design of the new decomposition system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INJECTABLE SENSORS FOR CONTROL OF FES Principal Investigator & Institution: Loeb, Gerald E.; Professor and Director; Biomedical Engineering; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2002; Project Start 10-JUN-2000; Project End 31-MAY-2004 Summary: (adapted from the Investigator's abstract): In order to reanimate a paralyzed limb to produce clinically useful movements, three functions must be provided: 1) Electrical stimulators to cause muscles to contract; 2) A controller to coordinate the stimulation; and 3) Sensors of command and feedback signals from the patient to the controller. The investigators have recently completed development and preclinical testing of a novel stimulation technology that permits large numbers of individual muscles to be precisely controlled by injectable, wireless microstimulators that receive power and data by RF transmission from an external controller. They propose to extend that technology by incorporating and testing various types of sensors in similar injectable modules. These will use a novel, compatible system for RF back-telemetry to send signals out of the limb for command and feedback purposes. Their immediate goal is a family of generic "BIONs" (bionic neurons)-that can be configured flexibly to serve a wide range of Functional Electrical Stimulation (FES) applications. The investigators have selected the following basic sensing modalities: 1) Low-level bioelectric signal recording such as electromyography, to monitor (the) level of electrical recruitment (Mwaves) and spontaneous activity from muscles with some remaining voluntary control (useful as myoelectric commands for prostheses);and 2) Triangulation of relative position between devices, to be used for determining limb posture Acceleration and inclination (vs. gravity), using microelectromachined silicon (MEMS) sensor technology. The research will proceed in overlapping stages, the first of which is already underway in pilot work: 1) Design, build and test the basic circuit functions for low-level, lowpower signal detection, digitization and telemetric transmission; 2) Design, build and test specialized MEMS sensors; 3) Build complete injectable BIONs with sensing and back-telemetry capabilities; 4) Perform preclinical tests of sensor BIONs for biocompatibility; 5) Test sensing and telemetry functions in vitro with artificiallygenerated inputs; and 6) Test sensing and telemetry functions in alert, behaving animals.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INSTABILITY AND MUSCULAR DEMAND DURING OBSTACLE CROSSING Principal Investigator & Institution: Chou, Li-Shan; Exercise & Movement Science; University of Oregon Eugene, or 97403 Timing: Fiscal Year 2003; Project Start 04-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): Falls are among the most serious problems facing the aging population and have become the largest single cause of accidental death. Moreover, the total direct cost of fall injuries in 1994 among people 65 and older was $20.2 billion. Most falls in the elderly stem from interactions between environmental hazards and increased individual susceptibility to hazards from accumulated effects of age and intrinsic factors. Research on biomechanics of selected physical tasks, that take both environmental and intrinsic factors into account, is needed to quantify impairment magnitudes, to determine what elements are critical to the impairment, and ultimately to design more effective interventions for preventing falls in the elderly. The long-term goals of this proposed project are to advance the understanding of the mechanisms underlying the increased incidence of falls in the elderly, to determine a more effective method of identifying aged persons at risk of falling, and eventually to design more effective exercise/strengthening programs for the prevention of falls in the elderly. Specific aims of this project are to (1) demonstrate that motion of the whole body center of mass (COM) during obstacle crossing could better distinguish fallers from non-fallers when compared to individual segmental motion, (2) examine the relationship between ability to accommodate to environmental hazards during locomotion and muscle weakness, and (3) to identify quantitative, biomechanical indices (muscular demand-tocapacity ratios) that can better indicate the level of mechanical challenge imposed on selected muscles. Motion analysis and muscle strength testing will be performed on 24 elderly non-fallers and 24 elderly fallers (65 years or older). Body segment motion, ground reaction forces, and electromyography will be collected during unobstructed walking and stepping over obstacles of heights corresponding to 2.5% and 10% of each subject's height. Isometric strength of selected lower extremity muscles will be measured bilaterally. A thirteen-link biomechanical model, with kinematic inputs of each body segment and ground reaction forces will be used to compute the three-dimensional motion of the whole body COM and three-dimensional joint moments (torques) of the lower limbs. Data analysis will be performed on both mechanical and neuromuscular levels, including the isometric muscle strength, electromyography, motion of the COM, and it's interaction with the center of pressure (COP) of the stance foot derived from ground reaction forces and moments. Finally, correlation between muscle strength and dynamic balance control (indicated by the motion of the whole body COM) will be examined. This proposed project is expected to identify/define more sensitive biomechanical measures (both intrinsic and extrinsic) for better quantification of agerelated mobility impairment and functional challenges imposed on our musculoskeletal system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INTERVENTIONS WHEELCHAIRS
FOR
SCI
SHOULDER
FUNCTION
IN
Principal Investigator & Institution: Mulroy, Sara J.; Director; Los Amigos Research/Education Institute Education Institute, Inc. Downey, Ca 90242 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2005
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Summary: (verbatim from the application) Today, the increased longevity and mobility of individuals with spinal cord injury (SCI) has led to disabling shoulder pain becoming a significant clinical problem which has been related to the demands of wheelchair propulsion (WCP). The goal of this project will be to develop guidelines for the reduction of the demands on the shoulder during WCP for persons with SCI. Specifically, the aims are to determine the effects of changes in the horizontal wheelchair seat position and a muscle strengthening exercise intervention on the shoulder joint forces and muscle activity during WCP in persons with paraplegia and tetraplegia from complete SCI. Subjects with SCI who are asymptomatic for shoulder joint pain and those who report shoulder pain during WCP will be tested. Participants will be grouped according to SCI level of injury (paraplegia, C7 tetraplegia and C6 tetraplegia). Subjects will wheel their chairs, on a wheelchair ergometer in three horizontal seat positions at free and fast velocities and on a simulated 8 percent incline. Subjects will maintain fixed velocities in the three seat positions for each propulsion condition. Function of the supraspinatus, infraspinatus, sbscapularis, anterior and middle deltoid, serratus anterior, sternal pectoralis major, middle and lower rapezius and rhomboid major will be recorded with dynamic EMG using intramuscular fine wire electrodes. Motion of the shoulder, elbow and wrist joints will be measured with the Vicon Motion Analysis System. WCP forces will be recorded with a strain gauge instrumented wheel. Maximal isometric shoulder elevation in the sagittal and scapular planes (scaption), shoulder adduction and internal and external rotation torques will be measured with a LIDO dynamometer. A sub‑group of the subjects will participate in a 12 week shoulder muscle strengthening and flexibility exercise program. Those subjects who do not participate in the exercise program will serve as a control group. Both exercise and control subjects will return every three weeks for strength assessment. The strength and propulsion tests will be repeated for all subjects at the end of the 12 week period. The data will be analyzed to compare the shoulder joint forces, moments, patterns of muscle activity and reports of shoulder pain during WCP in the three seat positions and before and after the exercise program. Statistical significance of the findings will be determined by repeated measures MANOVA analyses with grouping factors for SCI level and exercise/control groups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTRASPINAL MICROSTIMULATION FOR RESTORING LIMB MOVEMENT Principal Investigator & Institution: Mushahwar, Vivian K.; Postdoctorate Fellow; University of Alberta Edmonton T6g 2E1, Canada Edmonton, Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): The goal of this project is to evaluate the long-term efficacy of intraspinal microstimulation (ISMS) in restoring leg function after spinal cord injury (SCI). and to investigate certain aspects of neuronal and muscular plasticity induced by ISMS. The principal activity supported by this grant will be to provide spinal cord locations and stimulation parameters for long-term restoration of stable, weight-bearing standing and stepping after SCI. ISMS is expected to eliminate several of the difficulties associated with conventional peripheral nerve functional electrical stimulation (FES) systems used for augmenting limb movements in paralyzed individuals. The initial phase of the project entails mapping the lumbosacral region of the spinal cord during acute experiments in adult cats with complete spinal transections (T11) performed a week earlier. Once target locations within the spinal cord that yield reliable extensor and flexor limb movements after SCI are determined, 12 to 15
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microwires will be chronically implanted in each side of the cord in intact cats. ISMS stimulus thresholds and elicited limb responses will be documented and the cats will be subsequently spinalized at T11. Patterned and tonic ISMS will be applied to generate weight-bearing standing and stepping of the hindlimbs. Stimulation sessions will take place 5 times per week (up to 6 months post-spinalization) and the quality of standing and stepping induced by ISMS will be assessed over time. Changes in the efficacy of reflex transmission will also be assessed throughout the experiments and will be used to estimate the level of ISMS-induce reorganization in spinal circuitry below the level of the lesion. The animals will then be euthanized and their spinal cords will be examined to determine the location of electrode tips and evaluate the effect of microwire implantation and long-term ISMS on neural damage. Immunohistochemical analysis of hindlimb muscles will be performed to determine the effect of ISMS on fiber type transformation. Finally, the efficacy of ISMS in generating functional limb movements under conditions of spastic hypertonus will be determined in adult rats with complete sacral cord transections rendering the tail paralyzed and spastic. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LOCOMOTOR DYNAMICS OF MUSCLE FUNCTION Principal Investigator & Institution: Biewener, Andrew A.; Professor & Chair; Organismic & Evolutionary Biol; Harvard University Holyoke Center 727 Cambridge, Ma 02138 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): The proposed research addresses the central question of how muscles function under dynamic conditions of locomotor activity. It does so in the context of how muscle function is modulated in relation to muscle architecture and fiber composition to accommodate changes in locomotor requirement. These questions will be addressed by making in vivo recordings of force (tendon buckle transducers), length change (sonomicrometry) and neural activation (electromyography) of key limb muscles in two animal models: quadrupedal goats and bipedal guinea fowl. Measurements will be obtained from animals trained to move over a range of speeds on a treadmill at different gaits and grades (level vs incline vs decline) to address the following hypotheses: (i) regional activation and fractional length change within muscles that have focal skeletal attachments is uniform both along a fascicle axis and between differing fascicle regions, but may vary in muscles with broader attachments and more complex architectures; as a result, (ii) the timing and strain of activated fascicles are homogeneous within a muscle performing a given motor task; and (iii) proximal muscles with long fibers account for the majority of mechanical work modulation; whereas distal short-fibered muscles with long tendons contract isometrically for more economical force production and tendon elastic savings. Differences in mechanical work rate with locomotor grade will be related to observed changes in the in vivo force-length behavior of key limb muscles. Recordings made while animals accelerate from rest will provide a second context to evaluate work modulation in relation to muscle architecture. Ground reaction force-platform and highspeed video recordings will also be carried out to integrate the in vivo force, length and EMG measurements of individual muscles into whole-limb mechanics. These studies have important consequences for understanding patterns of motor recruitment in relation to locomotor strategy and how regional differences in motor unit organization (and fiber type) may influence the neural control of movement. Prior work in this area has been limited by studies of motor function under more quasi-steady ranges of movement and/or indirect assessment of muscle length change and force development.
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Although an overarching goal is to understand factors that influence normal and agerelated changes in human motor function, animal studies allow direct experimental approaches for assessing the dynamics of motor function that are likely to apply to humans. Consequently, the proposed studies will have value for developing more effective physical, occupational and rehabilitative therapies, as well as for sports and exercise training, and prosthetics design. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LOW BACK PAIN: A MOTOR CONTROL IMPAIRMENT? Principal Investigator & Institution: Henry, Sharon M.; Physical Therapy; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2002; Project Start 01-JUN-1998; Project End 31-MAY-2003 Summary: The candidate for this Mentored Research Scientist Development Award, Sharon M. Henry, Ph.D. PT, is a physical therapist. Her clinical work covers the rehabilitation of persons with neurological and musculoskeletal impairments particularly low back pain (LBP). She has assisted with several clinical studies of LBP patients conducted through the Rehabilitation Engineering Center (REC) for LBP at the University of Vermont (UVM). Being interested in the role of somatosensory information in motor control, Dr. Henry proceeded to earn her Ph.D. in the Anatomy and Neurobiology Department at UVM, and completed her post- doctoral fellowship with Dr. Fay Horak in Portland OR. During this time, Dr. Henry received three postdoctoral awards and completed studies examining postural responses in healthy and spinal cord injured subjects. Her long term goals include examining motor control issues in patients with musculoskeletal impairments, specifically LBP. As a researcher and clinician, Dr. Henry wishes to contribute to the field of medical to the field of medical rehabilitation and conduct research that will impact on the way physical therapists and other rehabilitation specialists treat patients. Dr. Henry has a position as assistant professor in the Physical Therapy Department at UVM. The Department has committed to starting a new 2100 square foot state-of-the-art Motion Analysis Laboratory and has committed to fostering Dr. Henry's career as an independent investigator. Within the Department, there are several other faculty members who are involved in motor control and LBP research. In addition, there is an active scientific community on campus through the REC that has been conducting LBP research since 1982. The studies proposed in this application reflect a merging of Dr. Henry's background and interests. It has long been thought that poor neuromuscular control of trunk muscles may lead to injury by causing local mechanical damage to spinal structures, and thus, LBP. However, little is known about the function of specific trunk muscles in normal subjects during various activities of daily living (Specific aim 1), and the precise muscle dysfunction associated with LBP has not been satisfactorily characterized (Specific aim 2). Therefore, a better understanding is needed of when trunk muscles in active spinal and postural stabilization in healthy and in selected groups of persons with LBP. This goal will be achieved by characterizing muscle, kinematic, and force strategies used to control truck/spine in postural responses to multi-directional, multi-velocity surface translations. By having a better understanding of trunk motor coordination, evaluation and treatment strategies can be more specific and more effective in the rehabilitation of persons with LBP. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANICAL FUNCTION OF MUSCLE DURING MOVEMENT Principal Investigator & Institution: Marsh, Richard L.; Professor; Biology; Northeastern University 360 Huntington Ave Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-FEB-2001; Project End 31-JAN-2006 Summary: The performance of a skeletal muscle during movement is determined by the interaction of its intrinsic properties with the mechanical properties of the system to which it is linked. These interactions are complex and predictive equations are limited in some respects by the lack of empirical data on the performance of muscle under loading conditions that replicate those found during movement. Muscles serve three major mechanical functions during movement: producing force, producing work, and providing stability. These different functions are linked to differences in the length trajectory (sequence of length change) in relation to the motor activity of the muscles. Although we know that all three of these functions are performed by humans in walking and running, we know little of the conditions under which individual muscles operate while performing each function. Further we have no empirical data on the quantitative importance of each function to the cost of locomotion. The specific aims of this project are to: 1) Examine the in vivo contractile parameters (operational lengths, length trajectories, and amounts of series elasticity) for muscles that are active only while performing positive work in running and jumping; 2) Examine the prediction that during running and jumping actively lengthening muscles function to help stabilize the movement; 3) Quantify the relative energetic importance of the different mechanical functions served by muscles during running; 4) Measure the efficiency of fast and slow muscles under conditions of varying power output; 5) Quantify the influence of velocity dependent activation and deactivation on mechanical function of fast and slow muscles. The mechanical function of muscles used in running and jumping will be assessed in vivo using sonomicrometry and electromyography. Blood flow measurements using fluorescently labeled microspheres will be used in conjunction with other measures to estimate the relative contribution of the different limb muscles to the energy cost of running. In vitro work with the muscles used in jumping and running and computer modeling will examine the optimum conditions for accelerating inertial loads. Mouse muscles will be used to examine the influence of length trajectory and cycle frequency on mechanical performance and efficiency. This project is predicated on the assumption that examining how muscles are used in animals during movement allows us to better predict the design parameters important in human movement and will improve our understanding of both normal and dysfunctional human movement. Such studies will eventually assist in designing rehabilitative strategies that require an understanding of the diverse roles of muscles during movement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISMS AND REHABILITATION OF CEREBELLAR ATAXIA Principal Investigator & Institution: Bastian, Amy J.; Assistant Professor; Kennedy Krieger Research Institute, Inc. Baltimore, Md 21205 Timing: Fiscal Year 2002; Project Start 18-FEB-2002; Project End 31-JAN-2006 Summary: Cerebellar damage can be caused by tumor, stroke, hemorrhage, or degenerative disease. Ataxia resulting from cerebellar damage is extremely difficult to treat; most interventions include physical therapy. Our long range goal is to help elucidate the mechanisms by which cerebellar damage alters the production of normal movement and provide information that will enhance rehabilitation treatments for ataxia. The proposed studies will test the general hypothesis that the cerebellum adjusts
36
Electromyography
the relative movements between joints and limbs through trial-and-error practice, making movements automatic and efficient. We believe that deficits in automaticity and efficiency combine to make movements far more mentally and physically taxing, leading to a decline in general activity level and function. Experiments will address: (1) whether people with cerebellar damage show degradation of movement automaticity, (2) whether people with gait ataxia show relative scaling deficits of joints within a leg because of an inability to adjust for interaction torques, and (3) whether cerebellar damage interferes with learning to adjust the scaling between legs during walking. To address these aims, kinematic, kinetic, and electromyographic data will be collected from people with cerebellar damage and control subjects as they perform a variety of movements used in everyday function (e.g. walking, stepping over obstacles and reaching while standing). The proposed experiments are designed to more clearly define the nature of impairments caused by cerebellar damage and provide a basis for interventions that can improve the functional limitations of people with cerebellar damage. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MEDIALIZATION VS. REINNERVATION FOR VOCAL CORD PARALYSIS Principal Investigator & Institution: Paniello, Randal C.; Otolaryngology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Unilateral vocal fold paralysis (UVFP) is caused by injury to the recurrent laryngeal nerve. Patients with UVFP may have significant impairment of vocal cord function, including a breathy paralytic dysphonia. There are several available approaches for the treatment of this condition. Vocal fold medialization is currently used by most otolaryngologists and is probably the standard of care for treating this condition. An alternative approach is laryngeal reinnervation, which has a number of potential advantages over medialization but which requires several months before a final result is achieved. The primary goal of this study is to determine which approach produces a better outcome, i.e. to determine whether the theoretical advantages of reinnervation are actually achieved, and whether they outweigh the disadvantage of having to wait for them. Previous studies comparing these approaches have been small and limited by significant non-randomized patient selection bias. The study design is a multicenter, prospective, randomized clinical trial. Patients with UVFP meeting all inclusion criteria and released from therapy by a speech-language pathologist will be invited to participate. Participants will be stratified by site of lesion, electromyographic findings and pretreatment voice severity, then randomized into either a medialization arm or a reinnervation arm. Patients will be recruited from 12 academic medical centers with participating surgeons; 149 patients are planned for each study arm. An intense data collection protocol including voice recordings, aerodynamic measurements, electroglottography, videolaryngostroboscopy, and a validated clinical outcomes instrument will be collected pre-treatment and at 6 and 12 months post-treatment. Subjective perceptual scores will be obtained by presenting pre- and postoperative voice samples to both naive and experienced listeners using a custom computerized algorithm. The objective measurements will undergo multivariate analysis with stepwise multiple regression. These data will be used to test the hypothesis that reinnervation gives better results than medialization in patients with UVFP. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MEDICATION DEVELOPMENT FOR PROTRACTED ABSTINENCE IN ALCO Principal Investigator & Institution: Mason, Barbara J.; Associate Professor; Psychiatry and Behavioral Scis; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2002; Project Start 25-SEP-1999; Project End 31-MAY-2003 Summary: Protracted abstinence can be defined as a state of heightened reactivity to aversive and appetitive stimuli long after acute withdrawal that conveys a vulnerability to relapse in individuals with a history of dependence. The purpose of this proposal is to establish animal and human models of protracted abstinence that can predict efficacy of medications to treat the protracted abstinence stage of the alcoholic syndrome and protect against relapse. Animal models exist for all stages of the addiction cycle and have been useful in elucidating the neurobiological basis for vulnerability to alcoholism. Preliminary studies have shown that rats can be trained to self-administer alcohol and, when made dependent, increase their consumption during acute withdrawal and long after acute withdrawal. Studies are proposed to further characterize and develop this animal model of protracted abstinence and to attempt to manipulate alcohol intake with appetitive and aversive stimuli (Specific Aim 1). Neuropharmacological agents known to alter reward dysregulation will be tested on these models (Specific Aim 1). Optimal parameters from this model will be used to identify novel potential treatments for human laboratory testing (Specific Aim 2). In parallel, a human experimental model of protracted abstinence will be developed using cue reactivity and mood induction techniques (Specific Aim 3). Primary outcome measures are affective state and urge to drink with confirmatory physiological measures. The optimal parameters of the human laboratory model will be used to evaluate potential treatments for the protracted abstinence syndrome (Specific Aim 4), drawing on the pharmacological agents identified in the animal models of Specific Aim 2. The state of protracted abstinence in alcoholism is critical to vulnerability to relapse, and the results of the present proposed studies will provide novel treatments for protracted abstinence and thus unique approaches to alcoholism treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MEDULLARY SEROTONERGIC SYSTEM AND RESPIRATORY CONTROL IN THE UNANESTHETIZED PIG Principal Investigator & Institution: Nattie, Eugene E.; Professor of Physiology; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2003; Project Start 07-JUL-2003; Project End 31-MAR-2008 Summary: Based on observations made in brainstem tissue of SIDS cases we hypothesize that the pathogenesis of SIDS involves abnormalities in what we now call the 'medullary serotonergic system'. In this project we define in newborn piglets the neuroehemical and receptor anatomy of the neurons in the medullary serotonergic system, we specifically disrupt them focally or widely, and we observe the resultant effects on an army of homeostatic processes. These include the ventilatory responses to increased CO2 and decreased O2, upper airway reflexes, and blood pressure effects on breathing. We use an unanesthetized newborn piglet model in which we can easily test this array of homeostatic processes in both wakefulness and sleep. Initially we inhibit serotoncrgic neurons by microdialysis of an agonist for the 5-HT(1A) autorceeptor or kill them by injection of 5, 7 DHT or a conjugate of anantibody for the serotonin transport protein (SERT) and the cell toxin saporin (SAP). We will also inhibit and kill neurons within the medullary serotonergic system that express the NK1 or muscarinic M1
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subtype receptors. For neurons with NK1 receptors we use an NK1 antagonist or substance P-SAP. For neurons with M1 receptors we use telenzepine or the m1-toxin1 (a highly specific long acting M1 receptor antagonist). These experiments will involve focal application at various sites within three rostral-to-caudal colulumns that define the medullary serotonergic system or widely at 'all' sites simultaneously. With focal application we ask if each homeostatic process can be localized to a specific site within the medullary serotonergic system. With wide application we ask if these homeostatic processes utilize neurons distributed at many locations. Serotonergic neurons within the meduliary serotonergic system can be further classified by peptides that are co-localized within them. Thyrotropin releasing hormone (TRH) and substance P (SP) are two such that are of particular interest in that they have known strong effects on breathing and blood pressure. We will microdialyze T3 in the medullary raphe, which will bind to nuclear beta2 thyroid receptors and inhibit TRH production and release allowing us to examine the role of endogenous TRH in the function of our array of homeostatic processes. Overall, the goal of this project is to see if a induced focal or widely distributed abnormality in the medullary semtonergic system couid affect function in our array of homeostatic processes such as to contribute to sudden death. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MEMBRANE ELECTROPORATION
SEALING:BIOPOLYMERS
FOR
TISSUE
Principal Investigator & Institution: Lee, Raphael C.; Professor of Surgery, Medicine and Anato; Surgery; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2006 Summary: Disruption of the cell membrane lipid bilayer structure is a common cause of tissue necrosis in many illnesses, including high-energy trauma. Loss of membrane ionic barrier function is followed by rapid metabolic energy exhaustion and then acute cellular necrosis. Electrical shock induced tissue injury is superb model for this type of cell injury because membrane damage occurs by electroporation, exposure to high temperatures and possibly high-power acoustic stresses (Appendices I and II). Because of the relatively large size of the cells, skeletal muscle and nerve are especially vulnerable to the direct electrical mechanisms of cellular membrane damage (electroporation and electroconformational protein denaturation). Theoretical, experimental and clinical data all indicate that membrane damage by electroporation is a significant cause of much of the skeletal muscle and nerve injury that results (Appendix II). Our lab and others have shown that poloxamer surfactants (Poloxamer 188 and Poloxamine 1107) reduce acute necrosis mediated by membrane disruption (Appendix III, Sharma et al. 1996, Merchant et al. 1998, Hannig et al. 2000). Thus, we postulate that these surfactants can be used to substantially reduce tissue necrosis following electroporation to result in significantly improved tissue survival and function. We propose to determine how effective intravenous Poloxamer 188 with and without cofactors are in sealing electroporated skeletal muscle cell membranes in vivo and in improving functional recovery. We propose to assess outcomes using quantitative real- time functional assay measurement techniques (surface electromyography and radiopharmaceutical imaging) as well as by standard histological and biochemical markers reflective of membrane integrity and tissue necrosis. Furthermore, on the basis of completed experiments, we postulate that antioxidants (i.e. ascorbate) may protect poloxamers from oxidative degradation to enhance its efficacy, and propose that MgATP will enhance responsiveness to membrane sealing. A basic need also addressed in this proposal is the refinement and
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calibration of real-time surface electromyography and radiopharmaceutical imaging as tools for quantifying therapeutic responses to membrane sealing therapy and for realtime assessment in clinical studies. Such diagnostic tools would be of tremendous clinical value because rapid detection, discrimination, and localization of tissue injury would accelerate and guide clinical therapy. Although we choose electroporation as the experimental model to test in vivo membrane sealing, these results and experimental methods will be directly relevant to other diseases characterized by membrane permeabilization, e.g. ischemia-reperfusion, freeze-thaw and mechanical trauma. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOTOR ADAPTATION DURING HUMAN LOCOMOTION Principal Investigator & Institution: Ferris, Daniel P.; Assistant Professor; Kinesiology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-JUL-2006 Summary: (provided by applicant): Recent research suggests that locomotor training can improve human walking ability after neurological injury. When stroke and spinal cord injury patients practice stepping with manual assistance, they recover mobility more quickly due to task-specific motor learning. Although multiple studies support the efficacy of this rehabilitation method, there is considerable debate about the extent of motor adaptation possible in the human locomotor pattern. Some animal and clinical studies indicate that muscle activation patterns during locomotion are hardwired into the nervous system and incapable of substantial modification. This would suggest that there are limits to locomotor training as a therapeutic tool. The proposed research project will use powered ankle-foot orthoses to study human locomotor adaptation. The powered orthoses will exert a torque about the ankle joint, altering normal lower limb kinematics if muscle activity patterns are not modified. As a result, these studies will test the relative invariance of muscle activity patterns and lower limb kinematics during human locomotion. This will not only provide the opportunity to study human locomotor adaptation under controlled experimental conditions, it will also provide a means to test the hypothesis that the nervous system controls lower limb movements during locomotion based on kinematics. The overall objectives of the proposed research are 1) to determine the extent of motor adaptation possible in the human locomotor pattern and 2) to test and hypothesized neural control strategy for human walking. Healthy human subjects will walk while wearing carbon fiber ankle-foot orthoses that are powered by artificial pneumatic muscles and controlled via proportional myoelectrical control. The studies will test the hypothesis that subjects will modify their muscle activity patterns when walking with powered orthoses to maintain joint kinematics similar to normal walking. In addition to providing important insight into the neural control of human locomotion, the project will advance robotic technologies for assisting gait rehabilitation and controlling powered lower limb prostheses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MOTOR CONTROL AND MUSCLE ACTIVITY IN ELDERLY SUBJECTS Principal Investigator & Institution: Collins, James J.; University Professor; Hebrew Rehabilitation Center for Aged 1200 Centre St, Roslindale Boston, Ma 02131 Timing: Fiscal Year 2002; Project Start 15-APR-2002; Project End 31-MAR-2003
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Summary: The long-term goal of this project are: (1) to gain an increased understanding of the correlations between biomechanical and functional measures of motor control changes in a population of ambulatory elderly, and (2) to establish the scientific foundation fir abn intervention program that could be used to improve motor control in older adults and thereby serve to reduce the incidence of falls in the elderly. Our previous studies suggest that there are significant abnormalities in postural sway and gait initiation in elderly people, that may predispose these individuals to fall. In fact, in one pilot study, we found that elders at risk of falling had exaggerated impairments in postural sway. We also have preliminary evidence indicating that the abnormalities in postural sway and gait initiation are both associated with increased lower-limb muscle activity. It is now known, however, whether these abnormalities have functional consequences such as balance impairment and falls. In addition, it is not known whether reducing lower-limb muscle activity via EMG biofeedback improves or worsens balance function and gait initiation in elderly people. Therefore, the specific aims of this study are: (1) to determine the relationships between lower-limb muscle activity and (a) postural sway dynamics and balance function, and (b) gait-initiation dynamics and mobility function, in ambulatory elderly people; (2) to determine cross-sectionally whether variations in postural sway dynamics and gait initiation in elderly people are associated with falls; and (3) to determine whether reducing lower-limb muscle activity via EMG biofeedback improves or worsens balance function and gait initiation in elderly people. We plan to study two samples of healthy ambulatory elders: one sample of 100 fallers with unexplained falls and one sample of 100 non-fallers. Quiet-standing and gait- initiation tests (with and without EMG biofeedback) will be conducted on each subject. This work could serve to reduce significantly the frequency, morbidity and cost of falling and assist aged individuals in achieving maximal independence in activities of daily living and mobility. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOTOR CORTEX AND THALAMOCORTICAL NETWORK IN LOCOMOTION Principal Investigator & Institution: Beloozerova, Irina N.; St. Joseph's Hospital and Medical Center 350 W Thomas Rd Phoenix, Az 850134409 Timing: Fiscal Year 2002; Project Start 05-JUL-1999; Project End 31-JUL-2004 Summary: (adapted from applicant's abstract) This proposal is aimed at 1) understanding the relationship between identified elements within the motor cortical network and locomotion behavior, and 2) understanding the mechanisms governing thalamo-cortical relations in the intact, functioning motor system. All data will be obtained from cats trained to walk inside an experimental chamber on a flat surface at different speeds, uphill and downhill, with weights attached to forelimbs, overcoming obstacles and walking on flat cross-pieces of a horizontal ladder. The relationship of identified cortico-cortical neurons, corticofugal efferent neurons and putative interneurons will be recorded during different locomotion behaviors. In addition, the activity of these identified neurons will be recorded simultaneously with the activity of thalamo-cortical projection neurons, and interactions among them will be analyzed using cross correlation methods at " rest" and during locomotion. Special emphasis will be placed on elucidating rules governing the strength and specificity of functional connections among the population of thalamo-cortical and cortical neurons under study. Two major issues will be addressed: 1) To what extent does the activity of different classes of identified motor cortex efferent neurons (e.g., S1, SII, collosal, corticothalamic, corticospinal, etc) and putative inhibitory interneurons differ in relation to locomotion
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under different conditions? Are properties better associated with cortical layer, morphological cell type or the destination of the axon? 2) What are the activity patterns of VL thalamo-cortical projection neurons during locomotion under different conditions and how do these patterns compare with those of cortical neurons? What are the characteristics of the synaptic linkages between VL projection neurons and cortical recipient neurons and how do these linkages change under different conditions of locomotion? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MUSCLE RE-ASSEMBLY IN MI DURING SKILL ACQUISITION Principal Investigator & Institution: Humphrey, Donald R.; Professor; Physiology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: from applicant's abstract) It is now clear that motor cortical maps may undergo dynamic changes as new motor skills are acquired. Many studies have shown that the motor map of a body part may expand and become more excitable when that part is used in a new motor skill. Conversely, nearby, task-unrelated motor/muscle maps may shrink. The involvement of both excitatory and inhibitory processes has been shown, and the cellular mechanisms underlying these changes, including synaptic plasticity in intracortical horizontal connections, have been proposed. Significantly, however, we have as yet no clear understanding of how such changes in map size or configuration may contribute to the programming of new muscle synergies as a new skill is acquired. This application addresses this important problem. Using chronically implanted intracortical and EMG electrode arrays, we have tracked changes in the maps for task-related, single muscles, in the precentral (MI) motor cortex of an alert monkey, as it learned successive variants of a visuomotor, forelimb tracking task. Unexpectedly, we found that skill acquisition was marked by a fractionation of cortical muscle maps rather than an expansion. In addition, fractionated components of different muscle maps were observed to "move" into or out of spatial correlation with one another, as new tasks were acquired. We propose that such fractionation and re-assembly of MI muscle maps may contribute to and/or reflect the development of new muscle synergies during skill acquisition. Experiments are proposed here that will allow us to obtain new evidence for or against this hypothesis. In addition, we will examine: (a) the extent to which these learning induced changes in cortical muscle maps reflect intracortical as opposed to spinal sites of plasticity; (b) the extent to which changing cortical maps and related muscle synergies are reversible; and (c) the potentially confounding effects of repeated microstimulation in measuring cortical motor maps. Together, these experiments will provide important new evidence about the relationship between cortical map plasticity and the reprogramming of intramuscular coordination as new skills are acquired. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MYOFILAMENT PROTEIN ISOFORMS IN NEUROMUSCULAR REFLEX Principal Investigator & Institution: Jin, J-P P.; Physiology and Biophysics; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2003; Project Start 20-JUN-2003; Project End 31-MAY-2006 Summary: (provided by applicant): Neuromuscular reflex plays a central role in the maintenance of muscle tone and hypertonia forms a basis of muscle contracture. As a sensory organ for muscle length in the peripheral neuromuscular reflex loop, muscle
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spindle produces positive feedback (la and II afferent) to simulate alpha-motor neuron activity. The sensitivity of a spindle is filtered by the tension of intrafusal muscle fibers under gamma-efferent regulation. Much attention has been paid to the spindle function in muscle function and spasticity and the contractility of intrafusal fibers is an essential link in the reflex loop. The intrafusal fibers contain unique myosin isoforms as compared with the extrafusal fibers, but little is known for their Ca 2+ regulation and contractile features. The regulation of intrafusal myofilament protein isoform expression during muscle development, adaptation and diseases is largely unknown. Based on our previous studies, we plan to investigate the role of myofilament protein isoforms in neuromuscular reflex. Our research plan is focused on testing a hypothesis in which the changes in fiber type-specific myofilament protein isoforms, especially the actin filament-associated regulatory protein troponin T (TnT), in intrafusal fibers may play a role in the pathophysiology of muscle contracture. It has been found that spastic muscles have increased type I (slow) fibers. Cerebral palsy, joint immobilization and tenotomy, three very different original conditions which cause muscle contracture, have a common consequence that is a fixed shortening of the resting muscle length. We have found an increased expression of slow myosin in a tenotomy model and the expression of myosin and thin filament regulatory protein isoforms is coordinated in the muscle. As an acidic TnT isoform, an up-regulation of slow TnT would increase the sensitivity of myofilaments to Ca2+ activation. The increase in intrafusal fiber Ca2+ responsiveness will increase spindle tension and sensitivity, which in turn increases the positive feedback to stimulate alpha-motor neuron to activate the extrafusal fibers and result in hypertonia. To test this hypothesis will help to understand the pathophysiology of muscle contracture. Three specific aims will be pursued in this pilot study: I. To examine the thin filament regulatory protein isoforms expressed in intrafusal fibers in adult and developing muscles. II. To investigate whether fixed shortening of muscle length originated from different conditions induces similar changes in the expression of intrafusal myofilament protein isoforms. III. To test whether elevated slow TnT expression in transgenic mouse muscles will produce increased Ca2+ sensitivity of intrafusal fibers and increased alpha-motor neuron activity. To explore this largely unknown area of neuromuscular reflex, this research initiative will lay groundwork for understanding the molecular mechanism of muscle contracture and improving treatment of this disabling condition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NATURAL HISTORY OF MUSCULAR & REFLEX CHANGES IN STROKE Principal Investigator & Institution: Mirbagheri, Mehdi M.; Rehabilitation Institute Research Corp Research Corporation Chicago, Il 60611 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-MAY-2005 Summary: (provided by applicant): One of the main clinical problems associated with stroke recovery is spastic muscle "hypertonia," defined as an abnormal increase in muscle tone. However, despite intensive investigation, the nature, origin and natural history of the mechanical changes in muscle and related soft tissues associated with hypertonia are unknown, due largely to a lack of accurate and sensitive tools for separating the various mechanical contributions to net torque at the spastic joint. Accordingly, as the broad objective of this study, we have developed a novel system identification technique, called parallel cascade identification to address these deficits. This study is designed to demonstrate the feasibility of this technique in quantifying the contributions of intrinsic, passive and reflex mechanical properties to spastic hypertonia
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and in establishing the natural history of these contributions. Our study will also generate data to assess the feasibility of our novel technique for diagnostic and therapeutic applications. The specific aims are: (1) to characterize the relative contributions of intrinsic, passive and reflex mechanical properties to spastic hypertonia in the stroke elbow, (2) to examine operating point dependencies of these mechanical abnormalities: i.e. variation with joint position, voluntary contraction, and perturbation velocity at each time measured, (3) to explore the time course of mechanical abnormalities in spastic joints following stroke, and (4) to determine the correlation of mechanical abnormalities of spastic limbs with clinical assessment of spasticity and recovery of function. To address the specific aims, a series of perturbation sequences with small amplitudes will be applied to the elbow, and the resulting torque and position signals will be used by a parallel cascade system identification technique to characterize the various contributions to overall joint stiffness. The experiment will be carried out at 1, 3, 6 and 12 months after stroke. The contralateral side will be tested as control. The correlation between the results obtained by this technique with other clinical measures of the severity of spasticity and recovery of function will also be measured. We expect that the reflex contributions to mechanical abnormalities associated with spastic hypertonia increase within weeks of stroke and remain high. This hyperexcitability may lead progressively to shortening of fiber length in spastic muscle and to changes in the neutral position of the spastic joint. Persistent positional deformity and the accumulation of connective tissues in atrophic muscles secondary to the lesions may increase the passive contribution to joint torque continuously with time, but decrease intrinsic muscle contributions. The changes in passive and intrinsic stiffness are likely to be highly correlated with severity of spasticity and inversely correlated with recovery of function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEURAL CONTROL OF MUSCLE ACTIVITY Principal Investigator & Institution: Fetz, Eberhard E.; Professor; Physiology and Biophysics; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 30-SEP-1978; Project End 31-JUL-2006 Summary: We plan to investigate the neural mechanisms controlling voluntary hand and arm movement in primates. The functional roles of premotor (PreM) cells in motor cortex and spinal cord will be directly compared. PreM cells with a correlational linkage to forelimb motoneurons will be identified by post-spike effects in spike-triggered averages of EMG activity. The activity of PreM cells and multiple muscles will be documented during multidirectional wrist movements. Monkeys will operate a multijointed manipulandum that will allow wrist movements in three directions: flexionextension, radial-ulnar deviation and pronation-supination. In addition a grip handle will transduce force during a power grip. This repertoire of movements will activate muscles in different synergistic combinations and resolve whether PreM cells and nonPreM cells are organized primarily in terms of muscles or movement parameters. The directional tuning of forearm muscles will be compared with the tuning curves of PreM cells and non-PreM cells. We anticipate finding functionally significant differences between motor cortex cells and spinal interneurons with regard to their relation to muscles and movements. Spinal cord interneurons have been studied largely in immobilized animals; our study will provide new information about the involvement of interneurons in preparation and execution of voluntary movements. These interneurons will be identified by their synaptic inputs from different forelimb muscles and from functionally identified cortical sites. We will also systematically map the movements of
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arm and hand evoked by electrical stimulation of spinal cord sites; the modulations of these responses during an instructed delay task will reveal the interaction of intraspinally evoked responses with preparation and execution of voluntary movements. Activity of dorsal root afferent fibers also will be recorded during an instructed delay task to document the afferent input to the central nervous system during movement. The axonal excitability of afferent fibers will be tested to investigate task-related modulation of presynaptic inhibition. These studies of the primate motor system will provide unique information essential to understanding and effectively treating clinical motor disorders, like cerebral palsy, stroke and spinal cord injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROBIOLOGY OF DYSTONIA Principal Investigator & Institution: Jinnah, Hyder A.; Neurology and Neurosurgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 31-MAY-2004 Summary: (adapted from applicant's abstract): Dystonia is a neurological disorder characterized by involuntary twisting movements or abnormal postures that are caused by excessive activation of specific muscles or co-activation of agonist and antagonist muscle groups. Though there are many different types and causes for human dystonia, in most cases the pathogenesis is poorly understood and treatment strategies are limited. Recently, two lines of evidence have suggested that dystonia may be associated with abnormal calcium metabolism in the brain. First, + Bay K 8644 and FPL 64176, two structurally distinct and specific L-type calcium channel agonists can provoke dystonia in normal C57L/6J mice. Second, dystonia is a prominent feature of several strains of mice carrying mutations in genes encoding calcium channel proteins or related regulatory proteins. The overall goal of this proposal is to assess the pathogenesis of dystonia in mouse models of dystonia associated with abnormal calcium channel function. Our hypothesis is that aberrant calcium function in regions involved in motor control are responsible for dystonia. Specific aim 1 addresses the neuroanatomic and neuropharmacologic basis of dystonia in a mouse model induced by administration of L-type calcium channel agonists. We will use functional mapping techniques, 2deoxyglucose autoradiography and immediate early gene induction, to define regions of abnormal brain activity followed by regional microinjection studies to determine which of these regions is most responsible for dystonia in this model. To define the neuropharmacologic basis of dystonia in this model, we will examine the ability of several drugs selective towards specific neurotransmitter systems to modify dystonia caused by the L-type calcium channel agonists. Aim 2 involved the use of functional mapping in strains of mice with mutations in genes encoding calcium channel proteins to define regions of abnormal brain activity that appear normal in standard histopathologic studies. We will focus on three mutants, tottering, lethargic, and leaner, that have either generalized or inducible dystonia. In aim 3, we will develop electromyographic criteria to characterize dystonia in the pharmacologic and genetic models, and determine if they can be applied to other mouse mutants with abnormal motor behavior that is otherwise difficult to classify. Since preliminary animal work suggests that L-type calcium channel antagonists might be useful in the treatment of human dystonia, we will conduct a pilot double-blinded crossover trial of nifedipine in patients with three easily-defined subtypes of dystonia. These studies have direct relevance for advancing our understanding of the pathogenesis and treatment of dystonia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROCHEMICAL SUBSTRATES OF SLEEP HOMEOSTASIS Principal Investigator & Institution: Dorsey, Cynthia M.; Mc Lean Hospital (Belmont, Ma) Belmont, Ma 02478 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Difficulty initiating/maintaining sleep afflicts up to 30% of the population, yet the neurochemical processes associated with sleep and sleep disturbances have not been clearly identified. A better understanding of EEG slow-wave activity and its role in recovery from sleep loss could be invaluable in elucidating the homeostatic sleep mechanism and shedding light on how to treat disturbed sleep. Further, sleep disturbances contribute to relapse to drug use and such efforts might help address this serious public health problem. The purpose of the study is to identify neurochemical markers of sleep mechanism in an intact and an impaired system, by evaluating changes in brain chemistry produced by disrupted sleep. In response to RFAHL-01-009, "Interrelationship between sleep and heart, lung, and blood diseases" we propose two experiments. In the first, polysomnography (PSG) and phosphorous magnetic resonance spectroscopic imaging (31P MRSI) will be collected at baseline, after sleep deprivation, and after recovery sleep in controls and in methadone-maintained subjects. Measures will be repeated at 1 and 3 months to determine if the effects persist. In the second experiment, PSG and 31P MRSI data will be collected from unmedicated cocaine-dependent and opiate-dependent subjects during acute withdrawal and at 1 and 3 months post withdrawal. As the abstinence profile for sleep disturbance differs in these groups (hypersomnia vs insomnia, respectively) this experiment will help delineate the conditions under which altered brain bioenergenics exist. 31P MRSI can be used to measure global and focal changes in high energy phosphate alpha-,gamma,beta-NTP (ATP). Our pilot data showed significant increases in beta-NTP and decreases in phospholipid catabolite production after recovery following sleep deprivation in control subjects. 31P MRS changes have been observed in chronic opiate-dependent individuals at baseline, but have not been evaluated during sleep. Chronic sleep disturbances have been reported in opiate abusers and methadone-maintained patients and the homeostatic sleep mechanisms may be impaired in chronic opiate abuse. We hypothesize that methadone-maintained subjects will have decreased beta-NTP and will exhibit smaller slow wave sleep rebound and a more modest or no increase in beta-NTP after recovery. Further, the neurochemical response to sleep deprivation in these subjects will approach that of controls over time b-NTP will increase during cocaine withdrawal and decrease during opiate withdrawal, reflecting their differential effects on sleep during this time. Collectively, these studies may identify neurochemical markers for the recovery function of sleep, thus enhancing our understanding pf basic sleep mechanisms and potentially leading to new and improved treatments for sleep disturbances in both the substance-abusing and general population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROCHEMISTRY OF AMPHETAMINE INDUCED AROUSAL Principal Investigator & Institution: Berridge, Craig W.; Professor; Psychology; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 10-MAY-1999; Project End 31-MAR-2004 Summary: Stimulant drug abuse is a highly prevalent problem that constitutes a major public health concern. To gain better insight into mechanisms contributing to stimulant drug abuse, the neurochemical mechanisms subserving the behavioral effects of these drugs have been intensively examined. Neurochemically, these drugs increase synaptic
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concentrations of dopamine (DA) and norepinephrine (NE). Evidence indicates that actions of DA within the striatum and nucleus accumbens are critical components of the rewarding and locomotor activating effects of stimulants. In contrast, NE appears to serve a minimal contributory role in these behavioral actions of stimulants. The potent rewarding effects of these drugs are superimposed upon an alert behavioral state (e.g. prolonged periods of waking/enhanced alertness). The ability of stimulants to maintain waking and enhance alertness has long been exploited and is a contributing factor to the widespread use/abuse of these drugs. However, the degree to which NE or DA participates in the "arousal"-enhancing actions of stimulants and which anatomical site(s) subserve which actions remains enigmatic. A variety of observations suggests that the locus-coeruleus (LC)-noradrenergic system participates in the modulation of behavioral state. Previous studies by the PI demonstrated potent actions of LC on EEG and behavioral indices of waking via actions on beta- receptors located within a region of the basal forebrain encompassing the medial septum and the posterior shell of the nucleus accumbens (MS). Preliminary studies indicate that potent arousal-enhancing effects are observed following amphetamine infusions into this region (e.g. induction and maintenance of waking). These observations suggest that, at least some of, the arousal-enhancing actions of stimulants may be due to enhanced release of NE within MS. The propose multi-disciplinary studies assess the degree to which amphetamine acts within this region of the basal forebrain to enhance EEG, EMG, and behavioral indices of arousal and to assess the degree to which NE participates in these actions. As such, these studies will provide novel information concerning the degree to which NE participates in the behavioral effects of stimulants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEURONAL PATHWAYS UNDERLYING IN VITRO MOTOR LEARNING Principal Investigator & Institution: Keifer, Joyce N.; Associate Professor; Anatomy; University of South Dakota 414 E Clark St Vermillion, Sd 57069 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: Insights into the processes of learning and memory have fundamental implications for understanding memory disorders such as occur during amnesia and Alzheimer's disease. Conditioned response learning is a simple form of associative learning. A promising model to study the neural mechanisms underlying associative learning is the classically conditioned eye-blink reflex. The classically conditioned eyeblink reflex has been widely adopted for physiologic studies of the mechanisms of associative learning. Simple in vitro model systems of associative learning have been established in several species of marine mollusks. These preparations have greatly facilitated our understanding of the neural mechanisms of learning and memory. Similar model systems of learning in vertebrates have previously been hampered by the technical limitations of maintaining the viability of large portions of intact neural tissue in isolation. This problem was recently overcome by the development of an in vitro brainstem-cerebellum preparation from the turtle which takes advantage of this species' extraordinary resistance to anoxia. Using this preparation, conditioning of reflex pathways was undertaken simply by using electrical stimulation of sensory nerves rather than more natural stimuli such as a tone or airpuff. Preliminary data show that a neural correlate of the conditioned eye-blink reflex, the abducens nerve response, can be generated entirely in vitro. Using this model, studies of the neural mechanisms underlying this form of motor learning will complement those studies using whole animal preparations. The goals of the present project are to elucidate the synaptic
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organization of the abducens eye-blink reflex circuitry and the mechanisms that may underlie associative learning in this in vitro preparation. The Specific Aims are: to evaluate whether NMDA receptors are required for classical conditioning by training the preparation in the presence or absence of the NMDA receptor antagonist APV, to examine the morphological distribution of synaptic inputs from nerves V (US) and pVIII (CS) onto abducens motoneurons using anterograde transport of Fluoro-Ruby and intracellular Lucifer yellow fills in fixed slices, to examine the morphological distribution of NMDA and non-NMDA glutamate receptors on LY-filled abducens motoneurons using immunocytochemistry, to identify the premotor pathways afferent to the abducens motoneurons using retrograde and anterograde tract tracing methods, and to determine the behavioral correlate of the abducens nerve CR by recording EMGs in a reduced preparation and by classical conditioning of the eye-blink reflex in alert turtles. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OSTEOBLAST AND ADIPOCYTE DIFFERENTIATION BY FOSB Principal Investigator & Institution: Baron, Roland E.; Orthopedics and Rehabilitation; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: Anterior cruciate ligament (ACL) injury is prevalent and often leads to instability, quadriceps muscle weakness and osteoarthritis. (OA) Many of those with chronic ACL deficiency have evidence of knee OA years after ACL rupture. Weakness and instability experienced by those who do not compensate well for ACL deficiency (non-copers) independently lead to compensation strategies that could precipitate or worsen knee OA. These poor compensation strategies do not uniformly resolve after surgical reconstruction and those who undergo reconstruction also have an increased risk of developing knee OA. The overall goal of this work is to determine whether effective rehabilitation programs to dynamically stabilize the knee reduce the adaptations that lead to osteoarthritis in a population at great risk for the development of knee OA. Eighty individuals with ACL rupture who are scheduled for surgery will be randomly assigned to a group that includes a form of neuromuscular training called perturbation training, or a standard group. They will be evaluated before and after surgery using motion analysis and radiography. In vivo measures of kinematics, kinetics, tibial translation and EMG based models of joint compression will be used for comparison. This randomized trial is designed to demonstrate that, after preoperative rehabilitation that includes perturbation training, movement patterns adopted by noncopers: 1) demonstrate improve joint stability and reduced muscle cocontraction, 2) persist after reconstruction and 3) result in better functional outcomes after reconstruction and 4) lead to the development of less knee pain and OA over time than standard preoperative treatment strategies. The information derived from this project will provide valuable insight into the management of the approximately 100,000 Americans who rupture their ACLs each year and undergo reconstructive surgery. More importantly, if the perturbation training program's ability to induce dynamic knee stability actually results in joint protection, its application to others at risk for the development knee OA may help reduce the incidence of this disabling clinical condition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OTOLITHIC TRAJECTORIES
CONTROL
OF
HUMAN
POSTURAL
SWAY
Principal Investigator & Institution: Black, Franklin O.; Director; Emanuel Hospital and Health Center Portland, or 97208 Timing: Fiscal Year 2002; Project Start 01-JUL-1982; Project End 31-MAR-2004 Summary: This project will continue studies on the contributions of vestibular otolith and semicircular canal inputs to normal and abnormal human balance control, but will be expanded to study visual contributions to postural control sensory interactions. The specific aims are to: 1) determine sources of variability of otolith-vestibulo-ocular reflexes and vestibular evoked myogenic potentials in patients with vestibular deficiencies and in an existing normal population cross-sectioned by age decade and gender, 2) determine otolith and canal contributions to postural control in normals and patients with vestibular deficits, 3) determine the role of altered otolith inputs to adaptive postural control in normal and vestibular deficient subjects, 4) determine the role of macular and peripheral retinal contributions to the sensory interaction controlling posture, and 5) study gait initiation in normals, and patients with vestibular or visual disorders under controlled head and gaze position. Studies will be performed on computer controlled rotation devices and dynamic platform systems. Vestibuloocular responses to angular, linear or combined angular and linear accelerations will be used as independent estimates of vestibular function. Eye movement responses will be recorded by conventional electro-oculography and three-dimensional infrared video techniques and analyzed for horizontal, vertical and torsional eye movements, depending on the experiments. Balance, posture and gait responses will be recorded using a forceplate and an active marker motion analysis system and analyzed for torque and force measurements of the feet and for multi-dimensional body movements (head, trunk, legs) using special purpose computer methods. Outcomes of these experiments have resulted and will likely continue to result in a better understanding of normal and abnormal vestibulo-ocular and vestibulo-spinal control mechanisms, and will contribute to the development of new methods of diagnosis, prevention, treatment and rehabilitation of human balance disorders, including falls in the elderly. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PAIN MODULATION AND VISCERAL STIMULATION Principal Investigator & Institution: Mason, Peggy; Associate Professor; Neurobiology/Pharmacology/Phys; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Visceral nociception, like cutaneous nociception, is subject to descending modulatory influences from the medullary raphe magnus (RM). However, little is known about if and how RM cells contribute to: 1) visceral stimulus evoked nocifensive reactions; and 2) visceral stimulus evoked suppression of cutaneous nociception. The proposed experiments use colorectal distension (CRD) as a model visceral stimulus to explore these issues. There are 6 aims:. Aim 1A: Identify the spinal trajectory of afferents that carry ascending CRD information to RM cells. Aim 1B: Identify the contributions of descending modulatory input, arising from RM and elsewhere, to CRD-evoked cardiovascular and visceromotor reactions. Aim 2: Determine the effect of RM cellular inactivation on behavioral reactions to CRD. Aim 3: Identify the physiological characteristics of neurons that discharge in a pro-nociceptive manner, with increasing excitatory responses to increasing intensities of CRD
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stimulation. Aim 4: Determine the spinal pathway taken by descending modulatory input, from RM and elsewhere, to the lumbosacral spinal cord. Aim 5: Establish the role of RM cellular activation in heterotopic suppression of cutaneous nociception by a noxious visceral stimulus. Aim 6: Aim 3: Identify the physiological characteristics of neurons that may subserve the antinociceptive effects of CRD stimulation. The proposed experiments will test the novel hypothesis that RM's effects on spinal nociception consists of a "pro-nociceptive" component that is necessary for the normal behavioral reaction to a noxious visceral stimulus in addition to the better-studied "inhibitory modulation" component. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PARASPINAL MUSCLE DENERVATION AND SYMPTOMS IN LUMBAR SS Principal Investigator & Institution: Haig, Andrew J.; Phys Med and Rehabilitation; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-JUN-2001; Project End 31-MAY-2004 Summary: Objectives: The clinical syndrome of spinal stenosis is a significant problem for older Americans. Although stenosis causes neurogenic claudication, spinal canal size does not accurately predict the severity of symptoms. A pilot study shows that paraspinal muscle denervation relates to spinal canal size in symptomatic persons. It is possible that paraspinal denervation is a more accurate marker for the clinical syndrome than anatomical imaging. Other research shows that paraspinal denervation in a particular distribution also occurs in younger asymptomatic persons, and denervation increases with age. It is possible that paraspinal denervation causes subtle hypermobility and contributes to Kirkaldy-Willis's degenerative cascade of facet hypertrophy and canal stenosis. Specific Aims: 1. To assess whether paraspinal EMG scores or MRI measurements of stenosis relate best with the clinical syndrome in older persons. 2. To assess whether paraspinal EMG scores predict future symptoms of stenosis and future symptom severity in older persons with and without spinal stenosis. 3. To assess whether change in clinical status relates better to change in paraspinal EMG scores or change in MRI measurement of stenosis. 4. To assess the rate of denervation of the paraspinal muscles in older persons with and without back symptoms. Research Design: Blinded longitudinal study. Methods: Five groups of 30 subjects older than 55 years old, including: asymptomatic persons (healthy persons without low back pain) from the community, persons with lock back pain (LBP) but no stenosis on MRI, persons with stenosis symptoms with mild, moderate, and severe radiographic findings. An experienced neuroradiologist will measure spinal canal size and assign subjects to appropriate categories. A patient questionnaire, physical examination, a walking tolerance test with long latency nerve conduction studies (F- and H- waves) before and after walking, a 7-day pedometer test, and a measure of the flexion-relaxation phenomenon will be administered to the subjects. An unblinded examiner will perform one aspect of the MiniPM paraspinal EMG technique to acclimatize the patient, then a blinded examiner will perform the entire MiniPM, one extremity EMG, sensory and motor nerve conduction studies. Subjects will repeat the test battery (MRI, EMG, and clinical evaluation) approximately 18 months later. Appropriate statistics will test each of the four hypotheses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PERSONALITY AND SOCIAL CONTEXT IN REPRESSION OF EMOTION Principal Investigator & Institution: Mendolia, Marilyn; Associate Professor; Psychology; University of Mississippi P.O. Box 907 University, Ms 386770907 Timing: Fiscal Year 2002; Project Start 30-SEP-1998; Project End 31-MAY-2004 Summary: (Applicant's abstract): Repression involves distancing oneself from psychologically threatening ideas, emotions, memories, or experiences (Breuer & Freud, 1925/1955). Negative emotional events have provided the principal means by which to define repressive coping style and investigate repressive social behavior. The major objective of this research project is to test, using a nonclinical sample, a model of repression (Mendolia, Moore, & Tesser, 1996) which posits that features of the person (individual differences in responsiveness to negative and positive emotional events) and the situation (social threats to self-evaluation) combine to produce repressive behavior. According to the model, repressors are hypersensitive to both negative and positive emotional events, but they distance themselves from these events only under specific conditions-namely, when the situation threatens their self-evaluation. Thus, it is possible to identify the motivation for repressive response and to explain why repressors psychologically distance themselves from threatening emotional events more often than do nonrepressors. Furthermore, the proposed model addresses recent evidence (Asendorpf & Scherer, 1983; Davis, 1987; Davis & Schwartz, 1987; C.H. Hansen, Hansen, & Shantz, 1992) suggesting that repressors react more strongly to, fail to recall, and discretely appraise positive emotional events. The specific aims of this project are to demonstrate that (1) a motivational mechanism (individual differences in responsiveness, as indexed by autonomic activity, facial expressiveness, encoding, and recognition memory) and a situational mechanism (social situational threats to selfevaluation) underlay repressive behavior (Experiments 1 and 2) and that (2) a causal relationship exists between these two mechanisms and repressive behavior. The causal relationship will be demonstrated by manipulating individual differences in autonomic responsiveness (Experiments 3) and attention (Experiment 5) and repressors' cognitive appraisal of the situation (Experiment 4). This proposed 2-factor model extends the current conceptualization of repression in that it addresses why and when repressors employ a perceptual defense in response to negative and positive emotional events. This exploration of repressive behavior and the potential for modifying repressive response has significant health implications in that repressors' failure to recognize their somatic distress has been found to be associated with a wide range of illnesses (e.g., asthma, cardiovascular disease, cancer). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PHARMACOLOGY OF ANESTHETICS IN HEMORRHAGIC SHOCK Principal Investigator & Institution: Johnson, Ken B.; Anesthesiology; University of Utah Salt Lake City, Ut 84102 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: Anesthesiologists have long recognized the need to reduce the dose of intravenous anesthetic for patients who suffer significant blood loss before or during surgery. The scientific foundation upon which to base rational dosing regimens, however, does not exist. In the setting of hemorrhagic shock, intravenous agents can produce adverse hemodynamic consequences and prolonged duration of anesthetic effect. The absence of a scientific foundation to guide the rational selection and administration of intravenous anesthetics during shock represents a huge gap in the
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anesthesia clinical pharmacology literature. The goal of this grant is to investigate the influence of hemorrhagic shock and fluid resuscitation on the pharmacokinetic and pharmacodynamic properties of a short and long acting opioid, neuromuscular blocker, and sedative-hypnotic. The specific aims of this proposal are to characterize the influence of hemorrhagic shock and crystalloid resuscitation after hemorrhagic shock on the pharmacokinetic and pharmacodynamic profile of intravenously administered opioids, muscle relaxants, and sedative hypnotics. With this data, combined pharmacokinetic/pharmacodynamic models for each agent studied under normotensive, shocked, and resuscitated conditions will serve as a tool to explore how dosing can be adjusted to optimize the desired effect while minimizing the adverse consequences of over or under dosing. The principal investigator has had preliminary research experience in the areas of pharmacokinetic and pharmacodynamic analysis and the pathophysiology of hemorrhagic shock. The principal investigator has selected a mentor with (i) extensive research training in clinical pharmacology and (ii) a willingness to dedicate time and resources to ensure appropriate clinical research training. This grant will enable the principal investigator to expand his expertise in high resolution pharmacokinetic/ pharmacodynamic analysis and apply it to the study of how hemorrhagic shock influences the clinical pharmacology of intravenous anesthetics. Career development associated with this grant will include presenting results at national meetings, submission of results to peer reviewed journals for publication, and participation in courses and workshops related to the proposed study. The proposed studies will be carried out in the Department of Anesthesiology at the University of Utah which include an AAALAC accredited animal laboratory and animal housing facility. The principal investigator's long term career goals include: (i) develop collaborations with other investigators outside the University of Utah to enhance the work performed under this grant and future work and (ii) develop expertise and experimental methods needed to establish a laboratory capable of attracting future funding in areas pertinent to anesthesia and trauma care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PSYCHOPHYSIOLOGY OF EMOTION IN ALZHEIMER'S DISEASE Principal Investigator & Institution: Kaszniak, Alfred W.; Professor; Psychology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 08-MAY-2002; Project End 31-MAR-2004 Summary: The long-term goal of this research is to assess emotion processing abilities of individuals with Dementia of the Alzheimer Type (DAT). While much is now known about the cognitive deficits associated with DAT, relatively little is known about how the disease process might affect emotion-related experiences and behaviors. Many have observed that persons with DAT display changes in emotionality, including suspiciousness, agitation, and irritability, and these changes contribute in part to significant caregiver distress. However, several clinicians have made recommendations regarding how best to communicate with persons with DAT after language abilities with deteriorated, and these recommendations have including enlisting the use of emotion expression, which is assumed to remain relatively intact. There exists insufficient evidence to support the notion that emotion cue processing is preserved in DAT. What work has been done in this has resulted in conflicting conclusions regarding the abilities of individuals with DAT to process emotional information. The objective of the proposed research is to evaluate the emotion processing abilities of persons with DAT by utilizing psychophysiological and self-report measures of emotion while viewing and hearing emotion eliciting stimuli. The psychophysiological measures will
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include electromyogram recordings of corrugator supercillii, zygomaticus major, and orbicularis oculi muscle groups as well as skin conductance responses. Orbicularis oculi activity will be recorded to evaluate emotion-related startle reflex modulation. Selfreport of emotional experience will be obtained with the Self- Assessment Manikin (SAM). Our hypotheses are that individuals with DAT will: 1) exhibit alterations in the processing of emotional information, evidenced by an attenuation of the emotion modulation of the eye-blink startle reflex response; 2) display alterations in the facial expression of emotions, with a reduction in positive emotional expressions and an increase in negative emotional expressions; 3) exhibit reduced emotion-related SCR; and 4) rate their subjective experiences of emotion similarly to the control group. The findings will provide for a better overall understanding of the experience of individuals with DAT, inform the literature on emotion-based communication with persons with DAT, and further elucidate potentials areas of concern for caregivers. This study will establish whether this technique is a valid means for measuring emotion in DAT, and will pave the way for future investigations of neural correlates of emotional processes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: QUANTITATIVE STUDY OF URINARY BLADDER SENSORY PROCESSING Principal Investigator & Institution: Ness, Timothy J.; Professor; Anesthesiology; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 25-JUL-1997; Project End 31-MAY-2006 Summary: (provided by applicant): Acute and chronic pains originating from the urinary bladder are common clinical entities affecting more than 50% of females at some time in their lives. Some conditions are easy to treat, but others, such as interstitial cystitis, are conditions of visceral hypersensitivity that have proven resistant to diagnosis and treatment. There are multiple proposed etiologies for visceral hypersensitivity conditions including mast cell functional abnormalities, immunologic abnormalities, urothelial abnormalities and primary neuropathic mechanisms but the common theme among them is an eventual sensitization/activation of sensory elements. Abnormalities in the periphery leads to central neurophysiological changes that become expressed as enhanced sensory (pain-urgency) and reflex responses (i.e. reduced bladder capacity) which may outlast "triggering" events within the bladder. This proposal defines the consequences of altered primary afferent function by examining the spinal sites of sensory processing which magnify and prolong the effects of peripheral processes. The hypothesis central to these studies is the following: Pathological urinary bladder pain occurs secondary to a spinal sensitization process produced by repeated or continuous primary afferent activation which leads to a hypersensitivity state in which previously innocuous stimuli produce pain. To delineate mechanisms of this sensitization process, testable hypotheses are proposed: first, that sensitization occurs secondary to the selective activation of one of two spinal dorsal horn neuronal populations; second, that a driving force of this sensitization process is the activation of peripheral K-opioid receptor expressing primary afferents; and finally, it is proposed that spinal neurons which are selectively activated by visceral pain-producing manipulations have axonal projections located in the mid-dorsal spinal cord. To test the critical aspects of these hypotheses, neuronal and physiological responses to urinary bladder distension will be studied. Information gathered as part of these studies will allow for an improved definition of urinary bladder-related spinal nociceptive processing mechanisms and will suggest novel therapeutic interventions for urinary bladder pain which include the use of peripherally acting analgesics and
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modulation/interruption of selective pain pathways. To allow for methodological expansion, characterization of responses to urinary bladder distension in mice will also be examined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REPRESSIVE STYLE, SUPPRESSION AND CHRONIC PAIN Principal Investigator & Institution: Burns, John; Psychology; Finch Univ of Hlth Sci/Chicago Med Sch North Chicago, Il 60064 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2005 Summary: (provided by applicant): Although repressive style has been implicated in the maintenance and exacerbation of chronic pain, its true effects and how these are exerted remain obscure and largely anecdotal. This project will test a potential mechanism with a substantial empirical basis. Because repressors show high tolerance during acute pain, but report high levels of chronic pain and respond poorly to multidisciplinary pain treatment, it was hypothesized that repressor pain patients routinely suppress painrelated thoughts and emotions and thus suffer the ironic effects of such suppression (e.g., rebound). Two pain-induction studies with patients are proposed to test whether ironic effects of thought suppression represent a mechanism by which repressive style affects chronic pain. The first study examines whether repressors spontaneously show short-term pain tolerance but long-term pain sensitivity similar to that shown by high anxious patients instructed to suppress pain (i.e., analog repressors). Chronic pain patients will undergo a cold pressor, and then be followed through recovery, and another physical stimulus (massage device); half of patients will be instructed to suppress pain during cold pressor. The second study examines whether repressors reveal a bias toward pain-related information and sensitivity to acute pain when their efforts at thought suppression are undermined by competing cognitive demands. Chronic pain patients will identify pain-related and positive words imbedded in a letter grid, and undergo a cold pressor, recovery, and the massage device; half of patients will perform these tasks with a cognitive load. Repressors' tendency to suppress the distress of pain may confer beneficial immediate effects, but habitual suppression may hide an underlying paradoxical preoccupation with pain that incurs substantial long-term physiological and psychological costs. Support for the proposed model will provide empirical justification and an impetus for confronting repressive style among pain patients. Moreover, findings should provide theoretical principles on which to found new intervention strategies (e.g., "regulating" suppression by engaging in cognitive exercises). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RESPIRATORY ACTIVITIES OF INTRINSIC TONGUE MUSCLES Principal Investigator & Institution: Bailey, Elizabeth F.; Physiology; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): Tongue movement depends on the actions of both intrinsic (origin and insertion in the tongue) and extrinsic (attached to bone and inserted into the tongue) muscles. These muscles play a key role in swallowing, breathing, chewing, and speaking. Contraction of the extrinsic muscles is generally considered to change tongue position (protrusion or retrusion), whereas contraction of the intrinsic tongue muscles changes tongue shape. To date, research that examines the respiratoryrelated effects of tongue function in mammals has focused exclusively on the respiratory
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control and function of the extrinsic tongue muscles. The respiratory-related control and function of the intrinsic tongue muscles and their bearing on extrinsic tongue muscle activity are still unknown. Recent findings indicate that the intrinsic tongue muscles may contribute to tongue protrusion and retraction, and facilitate the actions of the extrinsic tongue muscles in swallowing. In light of these findings, our objective is to characterize the respiratory-related activities of the intrinsic tongue muscles in vivo. The specific goals of the present application are to test the following hypotheses: (1) intrinsic tongue muscles are co-activated with extrinsic tongue muscles during resting tidal breathing; (2) intrinsic and extrinsic tongue muscle activities are modulated in parallel by central and peripheral chemoreceptors and airway mechanoreceptors; and (3) the EMG of intrinsic and extrinsic tongue muscles exhibit similar onset times and burst characteristics during perturbations of chemoreceptor and mechanoreceptor feedback. Experiments will be conducted on urethane anesthetized, spontaneously breathing male Sprague-Dawley rats. Simultaneous EMG recordings of the hyoglossus, internal intercostal muscles and superior longitudinal muscles will be obtained under each of the following conditions: (1) hypoxia, hypercapnia, and asphyxia, to assess the effects of central and peripheral chemoreceptor stimulation of intrinsic tongue muscle activities; (2) before and after superior laryngeal nerve section, and before and after lingual nerve section, to quantify the influence of upper airway mechanosensory modulation of intrinsic tongue muscle activities; (3) with and without single-breath airway occlusion, to quantify the influence of phasic lung volume changes on drive to intrinsic tongue musculature. The results of this work will enhance our understanding of the functions of the tongue musculature and provide broad insights into the modulation of tongue muscle activities in breathing and other behaviors such as chewing and swallowing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SENSORY-MOTOR INTEGRATION IN THE PRIMATE CORTEX Principal Investigator & Institution: Graziano, Michael S.; Psychology; Princeton University 4 New South Building Princeton, Nj 085440036 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2009 Summary: (provided by applicant): The long term goal of this research is to contribute to the understanding of the sensory control of movement through studies of the cerebral cortex of macaques using physiological and behavioral methods. Emphasis will be placed on the role of primary motor, premotor, and parietal cortex in the control of limb, hand, and head movements. One major aim is to continue current research on the hypothesis that these areas represent movement by means of a stored set of behaviorally useful postures. A second aim is to study how these brain areas adapt as a function of practice with previously atypical movements. A third goal is to continue research on the hypothesis that restricted regions in motor and parietal cortex coordinate movements that defend the body from nearby threatening objects. These experiments will involve electrical stimulation of cortex using low currents (microamps); recording the activity of single neurons in cortex during movement; injection of muscimol, a chemical that temporarily deactivates a small region of cortex; and measuring behavior and muscle activity. This research should contribute to the diagnosis and treatment of disorders of sensory-motor function caused by developmental abnormalities, disease, trauma, aging, and unusual environments such as submersion in water or in outer space. The proposed research may also contribute to the development of limb prosthetics and artificial devices for object manipulation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SLEEP RETARDATION
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Principal Investigator & Institution: Kennedy, Craig H.; Special Education; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): Sleep dysfunction produces a range of negative health and psychological effects. The incidence of sleep problems for individuals with mental retardation (MR) has been reported to be three-fold greater than people without MR. However, previous research estimating the prevalence of sleep problems for people with MR have relied primarily on behavioral observation data. Such analyses can only identify gross behavioral changes in sleep states and are unable to identify subtler alterations in brain activity and sleep architecture that, nonetheless, have serious effects on a person's health and life quality. Hence, current estimates of sleep problems in this population may be underestimated. A more precise analysis of sleep and individual sleep stages is needed. The investigators propose to use polysomnography (i.e., EEG, EOG, and EMG) to investigate the sleep architecture of people with MR. Three groups of adults with MR (mild, moderate, and severe/profound) will be studied to assess the presence of altered sleep architectures as a function of level of MR. These groups will be compared to a contrast group of typical adults. In addition, the investigators propose to assess whether the presence of a co-morbid syndrome (i.e., autism) interacts with level of MR in determining the structure of a person's sleep architecture (i.e., autism plus mild MR, autism plus moderate MR, and autism plus severe MR). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SLEEP, AGING, AND THE HYPOCRETIN/OREXIN SYSTEM Principal Investigator & Institution: Kilduff, Thomas S.; Senior Director; Sri International 333 Ravenswood Ave Menlo Park, Ca 94025 Timing: Fiscal Year 2003; Project Start 15-FEB-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Sleep in the elderly is generally recognized as being of poorer quality than in younger adults. Nocturnal sleep in seniors is characterized by frequent awakenings, decreases in the quantity of deep slow wave sleep (Stages 3 and 4), and a concomitant decrease in delta frequencies in the EEG. Daytime alertness is reduced and naps are common, indicating diminution of the diurnal rhythms of sleep and wakefulness. Many of these changes in sleep architecture also occur in aged laboratory rodents. Our long-term objective is to understand the neural basis of agerelated sleep dysfunction. The hypocretin/orexin (H/O) neurotransmitter system has recently been identified as being important in arousal state regulation, and degeneration of the H/O neurons has been found in human narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy. Therefore, this system is an attractive target to study with respect to sleep and aging. The overall hypotheses of this proposal are that (1) the H/0 system is important in the maintenance of wakefulness; (2) a dysfunction of the H/O system occurs in the aged; and (3) this dysfunction is related to the sleep/wake disturbances characteristic of the elderly. Based on the literature, we conclude that aged rodents, like elderly humans, are a heterogenous population and differ with respect to their rate of physiological aging. Therefore, we will identify a subpopulation of aged rats having disrupted body temperature rhythms and sleep architecture and use these animals to test the following specific hypotheses: (1) an agerelated decline occurs in the number of H/O cells in aged F344 rats that is correlated with disrupted sleep architecture; (2) an age-related decline occurs in the levels of H/O
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mRNA and/or peptides; (3) waking-related activation of H/O cells declines with age; (4) the release of H/O peptides decreases with age; (5) an age-related decline in the mRNA for the H/O receptor 1 and receptor 2 occurs in brain regions associated with wakefulness; and (6) an age-related decrease in binding to H/O receptor 1 and receptor 2 and/or G protein activation occurs in arousal-related brain regions. To address these questions, we will use a combination of in vivo physiological, neuroanatomical, molecular, and receptor pharmacological methods. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SPATIAL AND TEMPORAL CONTROL OF TARGETED LIMB MOVEMENTS Principal Investigator & Institution: Cordo, Paul J.; Senior Scientist; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-DEC-1983; Project End 31-MAY-2007 Summary: The long-range goal of this project is to determine how the human central nervous system (CNS) coordinates voluntary movement and ultimately to use this information to develop treatments for motor disorders, such as stroke. The goal of the research proposed in this application is to determine how proprioception at the receptor level-in this case, the muscle spindle-leads to perception. The central hypothesis to be investigated is that, in active movement, the primary source of proprioceptive input is muscle spindles in the lengthening, "antagonist" muscles, rather than muscle spindles in the contracting, "agonist" muscles. Three specific aims are addressed: Specific Aim 1 is to contrast the information signaled by agonist and antagonist muscle spindles to determine which of these populations provides the CNS with the most accurate information about limb position and movement. Unlike agonist muscle spindles, little is known about how antagonist muscle spindles respond to active joint rotation. We will characterize how agonist and antagonist muscle spindles signal joint position and movement to test the hypothesis that the CNS uses the input from both populations, but that the information provided by antagonist muscle spindles is the most accurate. Specific Aim 2 is to investigate how antagonist muscle spindles encode position and movement variables, to inform the CNS of the location and movement of the limbs in space. The proposed experiments are designed to test the hypothesis that, during a movement, antagonist muscle spindles signal the CNS information about the starting position, movement velocity, and limb position during movement by three distinctive features within the firing pattern. Specific Aim 3 is to characterize the influence of fusimotor input on antagonist muscle spindles. Past research on agonist muscle spindles has failed to explain why the CNS activates the fusimotor system during voluntary movement. The proposed experiments are designed to test the hypothesis that fusimotor input increases the precision with which antagonist muscle spindles signal limb position and movement during precise movements and during motor learning, but that fusimotor input does not decrease the precision of signaling from antagonist muscle spindles during loaded movements. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STARTLE REFLEX AMPLITUDE AND CORTISOL IN PTSD. Principal Investigator & Institution: Miller, Mark W.; Anatomy; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 11-APR-2003; Project End 31-MAR-2005
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Summary: (provided by applicant): Posttraumatic Stress Disorder (PTSD) is a debilitating psychiatric condition defined by re-experiencing, avoidance, numbing, and hyperarousal symptoms that develop in response to a psychologically traumatic event. Theorists have suggested that the hyperarousal symptoms, which include sleep difficulties, anger, concentration problems, hypervigilance, and exaggerated startle response, reflect alterations in functioning of the hypothalamic-pituitary-adrenal (HPA)axis. Understanding the mechanisms of these symptoms and their neurobiological underpinnings is essential to our understanding of the disorder and the advancement of assessment and treatment techniques for individuals with PTSD. The proposed research builds on a body of work suggesting a link between amplitude of the startle reflex and activity of the HPA-axis and is designed to examine the hypothesis that there is a relationship between the symptom of exaggerated startle and abnormalities in function of the HPA-axis in patients with PTSD. To do so, we propose to pharmacologically manipulate cortisol levels via administration of hydrocortisone in combat veterans with and without PTSD and examine resultant effects on amplitude of the startle reflex. The immediate objectives are, first, to replicate the finding that increasing systemic cortisol via hydrocortisone administration attenuates startle reflex amplitude in humans (Buchanan, Brechtel, Sollers, & Lovallo, 2001). Second, to extend this work to a sample of patients with PTSD where cortisol manipulations are expected to exert more pronounced effects on the startle reflex via enhanced negative feedback inhibition (Yehuda, 2001). Third, to examine the hypothesis that in individuals with PTSD, there will be an association between the amplitude of the startle reflex and the degree to which basal cortisol levels are suppressed relative to controls, (i.e., individuals with the lowest basal cortisol levels will exhibit the largest overall startle responses). Evidence in support of the these hypotheses would suggest a link between HPA-axis activity and startle amplitude, provide support for the hypothesis of enhanced negative feedback of cortisol in PTSD (Yehuda, 2001), and contribute to the development of startle reflex methodology as a behavioral tool for indexing inter- and intra- individual differences in HPA-axis function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STEADINESS IN OLDER ADULTS Principal Investigator & Institution: Enoka, Roger M.; Professor; Kinesiology & Appld Physiology; University of Colorado at Boulder Boulder, Co 80309 Timing: Fiscal Year 2002; Project Start 01-AUG-1990; Project End 31-MAR-2004 Summary: (adapted from Investigator's abstract) many older adults are less steady when performing submaximal contractions. This impairment is evident as greater force fluctuations during isometric contractions and enhanced acceleration fluctuations during slow, anisometric contractions. When expressed in the frequency domain, the force fluctuations are of significant amplitude. The Principal Investigator's studies suggest that the decrease in steadiness is not due to an increase in motor unit force or motor unit synchronization, but that it is mainly due to a decrease in the regularity of the discharge of motor unit action potentials. They hypothesize that the age-related decline in steadiness is due to an increase in the variability of the discharge rate of motor units. They now propose four aims to test this hypothesis. Steadiness will be quantified as the coefficient of variation of force during isometric contractions and as the standard deviation of acceleration during anisometric contractions. Discharge rate variability will be expressed as the coefficient of variation of motor unit discharge rate. Aim 1 evaluates directly the effect of discharge rate variability on steadiness during simulated isometric contractions. Aim 2 extends on previous work to examine the range of forces and loads
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over which there is an association between steadiness and discharge rate variability. Aim 3 proposes to determine if the improvements that occur in steadiness with strength training are accompanied by reductions in discharge rate variability. Aim 4 compares changes in steadiness and antagonist muscle coactivation, which is the only other variation in motor output that might influence steadiness. The experiments (Aims 2-4) will be performed on young and old adults as they perform isometric and anisometric contractions with the first dorsal interosseus muscle. The computer simulations (Aim 1) will be based on a model that they have been developing to examine the effects of motor unit synchronization on the EMG and force of steady-state contractions. They expect to find that discharge rate variability can cause decreases in steadiness (Aim 1), that the association between steadiness and discharge rate variability extends up to forces and loads less than 20% of maximum (Aim 2), and that training-induced improvement in steadiness is accompanied by a decline in discharge rate variability (Aim 3), and that coactivation of the antagonist muscle does not co-vary with steadiness (Aim 4). It is anticipated that these findings will suggest that differences in steadiness among individuals during submaximal contractions are due to differences in the variability of motor unit discharge rate. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE ELECTROPHYSIOLOGY OF MOTOR NEURON DISEASES Principal Investigator & Institution: Bromberg, Mark B.; Professor; Neurology; University of Utah Salt Lake City, Ut 84102 Timing: Fiscal Year 2002; Project Start 01-AUG-2001; Project End 31-JUL-2003 Summary: (provided by applicant): Spinal muscular atrophy (SMA) and amyotrophic lateral sclerosis (ALS) are neurodegenerative disorders of unknown etiology. They have in common death of lower motor neurons (LMN) causing muscle weakness, and both disorders are fatal. Mechanisms of LMN death differ for SMA and ALS. In SMA, LMN death may occur over a limited period of time. Unanswered is whether there is late or continued LMN loss. Recent genetic studies in SMA indicate a relationship between survival motor neuron gene (SMN2) copy number and SMA type. Unanswered is the relationship between copy number and LMN number. In ALS, no single mechanism of LMN death explains known features, and a cascade of events ultimately leading to LMN death is likely. Unanswered in ALS is the natural pattern of progression of LMN loss from muscle to muscle. Although muscle weakness is the clinical manifestation of LMN loss for both disorders, the rate of loss of strength does not accurately reflect the rate of loss of LMNs. The discrepancy is due to the compensatory effects of reinnervation of denervated fibers by collateral sprouting from surviving motor nerve terminals. Similarly, routine electrophysiologic tests do not accurately measure LMN loss. Unanswered for both disorders is the dynamics of the compensatory process that determines the clinical state and level of function. Motor unit number estimation (MUNE) is a special electrophysiologic test that can directly assess the number of LMNs innervating a muscle. There are no data on the natural course of LMN loss for SMA, and little data for ALS. We propose to develop and refine MUNE and other electrophysiologic techniques to study, and follow the course of LMN loss and associated compensatory changes. For SMA, we will adapt MUNE techniques to study infants and children. For older SMA and ALS, we will refine MUNE techniques to optimize data collection. For SMA, we will correlate LMN loss with clinical type and SMN2 copy number. We will begin, in the two years of the grant-performing serial studies, to assess whether there is continued LMN loss. For ALS, we will determine and compare the rate and pattern of LMN loss in distal and proximal muscles. In older SMA
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and ALS, we will assess relationships between LMN loss and measures of collateral reinnervation and strength. We anticipate that MUNE and other electrophysiologic techniques will have direct applicability to the design of clinical trials for SMA and ALS, because these techniques can be used as informative end-point measures. To facilitate the use of MUNE in clinical trials, we will develop and refine the techniques in a form that can be used in any clinical center participating in trials. Currently, most MUNE techniques rely on proprietary software. We will develop software for use on PC-based computer systems, making them available to all laboratories. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE INFLUENCE OF NICOTINE ON FRACTIONATED REACTION TIME Principal Investigator & Institution: Marzilli, Thomas S.; Health/Leisure & Exercise Sci; University of West Florida 11000 University Pky Pensacola, Fl 32514 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): This R03 grant, in response to NIDA's PAR-00-059 "Small Grant Program," will importantly support the implementation of exploratory research that incorporates a novel and extremely fine-grained approach to the study of nicotine and human performance. This innovative methodology uses electromyography to dissociate the central (cognitive) and peripheral (neuromuscular) processing related to the successful completion of a variety of reaction time tasks. To further discriminate at what level of the central processing stream nicotine is most likely to have an effect, a basic chronometric approach to studying information processing will be incorporated. This chronometric approach will allow for the independent examination of each of the three theoretically nonoverlapping information processing stages which include stimulus identification, response selection and response programming. This methodology provides the opportunity to investigate nicotine's effects on the time between the initiation of the stimulus and the initiation of the motor response (central processing) as well as the time delay between the initiation of the motor response and the actual movement or button release (neuromuscular processing) during a variety of reaction time tasks. This paradigm has been shown to be sensitive to a number of variables such as: intensity of stimulus, number of response alternatives, complexity of movement, age, physical activity and pathologies, but has yet to be used to investigate the affects of nicotine on movement preparation, initiation and execution. These methodologies are well grounded in the field of Motor Learning and Cognitive Psychology, and will be a definite addition to the literature in regards to nicotine effects on human performance. Moreover, the methodologies offered herein could have clinical payoffs in populations, such as Parkinson's disease, Huntington's disease and other pathologies where the planning of movement is thought to be intact, but the initiation of movement may be compromised. This laboratory-based project uses cigarette smokers to better understand how nicotine affects the individual components (pre-motor and motor time) of a variety of reaction time tasks. This disassociation of central and neuromuscular components within a reaction time paradigm offers a substantial positive deviation from previous research utilizing only simple or choice reaction time methodologies because it may be that individual task components are influenced differentially by nicotine, which would not be evident if only a single, summary measure of reaction time was used. This study will be accomplished by systematically varying experimenter supplied nicotinised and denicotinised cigarettes while administering a variety of subjective, physiological and performance measures under double blind, placebo controlled conditions.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE OSTEOARTHRITIC KNEE: A BIOMECHANICAL ANALYSIS Principal Investigator & Institution: Manal, Kurt; University of Delaware Newark, De 19716 Timing: Fiscal Year 2002; Project Start 23-FEB-2002; Project End 31-JAN-2007 Summary: SUBPROJECT ABSTRACT NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VACHT EXPRESSION ACROSS SLEEP-WAKEFULNESS Principal Investigator & Institution: Greco, Mary Ann K.; Project Leader; Sri International 333 Ravenswood Ave Menlo Park, Ca 94025 Timing: Fiscal Year 2003; Project Start 15-JUN-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Over 70 million people in the U.S. are estimated to suffer from alterations in sleep-wakefulness. Existing therapies are of limited utility in treating these disorders. The difficulties in devising more effective treatments stem, in large part, from the fact that there is no one sleep center in the brain. As a result, the biological function(s) of sleep have not been elucidated. The neuronal circuitry underlying sleep-wakefulness is beginning to be understood. The intracellular events associated with the activity of these neurons across sleep-wakefulness, however, are not well defined. Understanding cellular mechanisms that occur during sleep is key to the identification of biological function(s). Acetylcholine (ACh) is associated with sleepwakefulness. Preliminary results examining the ACh synthesis enzyme, choline acetyltransferase (ChAT) are consistent with the hypothesis that sleep may play a role in maintaining neurotransmitter levels that are depleted during waking via changes in mRNA during sleep. The vesicular acetylcholine transporter (VAChT) performs the essential function of packaging nascent acetylcholine into vesicles. The gene encoding yacht lies within the gene encoding chat in all species examined, an extremely rare mammalian genomic organization. Preliminary studies suggest that chat and vacht mRNA levels are differentially expressed during sleep. In these studies, we focus first on delineating VAChT expression. In the first specific aim, we test the hypothesis that vacht mRNA and protein vary across individual sleep-wake bouts (i.e., waking, SWS and REM sleep) occurring over a 24h period. Preliminary studies of vacht mRNA suggest that it is higher during waking than during sleep. The second specific aim tests the hypothesis that mRNA and protein are associated with wakefulness. Initial results show vacht mRNA did not vary following six hours of sleep deprivation compared to controls. Specific aims 3 and 4 focus on comparisons of vacht and chat mRNAs, given the genomic organization of the genes and preliminary results that show that vacht mRNA contrasts with chat mRNA expression. Specific aim 3 tests the hypothesis that chat and vacht mRNAs are differentially expressed during sleep, while specific aim 4 tests the hypothesis that vacht mRNA subtypes are differentially expressed in response to sleep-wakefulness. Identification of these patterns of expression are key to understanding cellular mechanisms underlying sleep and wakefulness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VESTIBULAR SOMATOSENSORY INTERACTIONS FOR HUMAN POSTURE Principal Investigator & Institution: Horak, Fay B.; Senior Scientist and Professor; Neurology; Oregon Health & Science University Portland, or 972393098
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Timing: Fiscal Year 2002; Project Start 01-DEC-1992; Project End 31-MAR-2004 Summary: (Adapted from the Applicant's Abstract): The long-term goal of the proposal is to elucidate how somatosensory and vestibular input interact to provide the sensory information which determines postural control. Using Mergner's model of this interaction as the hypothetical construct the proposed studies manipulate vestibular input with anodal, galvanic vestibular stimulation or use patients with vestibular lesions to vary this sensation. In the presence of altered surface somatosensory input the investigators propose that they will demonstrate postural control deficits in these subjects. These defects will be demonstrated by quantified muscle activation patterns (surface EMG), surface reactive forces under each foot (torque, CoP movement), and kinematics of body movement (e.g., CoM movement). For the first series of experiments, the investigators hypothesize that alterations in somatosensory input by surface movement and sway referencing of the surface will reveal vestibulospinal asymmetries and deficits in subjects with vestibular loss. In experiment 1, they will determine if patients with unilateral vestibular loss show postural asymmetries when standing on a slowly tilting or translating platform. In experiment 2, they seek to determine if binaural, anodal galvanic vestibular stimulation produces a temporary, acute loss of vestibular input required for postural control. In the second series of experiments the somatosensory input is limited by selecting subjects with sensory neuropathy to determine if patients compensate for somatosensory loss by altering vestibular sensitivity for posture. They hypothesize that loss of somatosensation will result in an increased sensitivity to vestibular disruption of postural control. In the 3rd experiment they will "total" body somatosensory loss in a patient with a severe loss of large sensory fibers affects responses to galvanic stimulation and surface perturbation. The 4th experiment will characterize how subjects with somatosensory loss in the lower legs caused by diabetic neuropathy respond to galvanic vestibular stimulation during surface perturbations and on a sway referenced surface. The third series of experiments determines the extent to which haptic sensory information can compensate for vestibular loss in supporting postural control. The investigators propose that very light contact of one index finger stabilizes posture by improving control of the trunk when subjects stand on unstable surfaces and that subjects with bilateral loss of vestibular function will show more improvement than normal subjects. Experiment 5 will determine how light touch improves postural stability in narrow stance, on an unstable surface and during surface perturbations. The investigators propose that the studies will lead to a better understanding of the interactive mechanisms underlying compensation for vestibular and somatosensory deficits and which will facilitate development of new approaches to postural rehabilitation in patients with sensory deficits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age.
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unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “electromyography” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for electromyography in the PubMed Central database: •
Exercise Sandals Increase Lower Extremity Electromyographic Activity During Functional Activities. by Troy Blackburn J, Hirth CJ, Guskiewicz KM.; 2003 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=233171
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Knee Extensor Electromyographic Activity-to-Work Ratio is Greater With Isotonic Than Isokinetic Contractions. by Schmitz RJ, Westwood KC.; 2001 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=155433
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with electromyography, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “electromyography” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for electromyography (hyperlinks lead to article summaries): •
A Bayesian change-point analysis of electromyographic data: detecting muscle activation patterns and associated applications. Author(s): Johnson TD, Elashoff RM, Harkema SJ. Source: Biostatistics (Oxford, England). 2003 January; 4(1): 143-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12925335&dopt=Abstract
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A dynamic recurrent neural network for multiple muscles electromyographic mapping to elevation angles of the lower limb in human locomotion. Author(s): Cheron G, Leurs F, Bengoetxea A, Draye JP, Destree M, Dan B. Source: Journal of Neuroscience Methods. 2003 October 30; 129(2): 95-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14511813&dopt=Abstract
5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A pilot study on the effect of oral contraceptives on electromyography and mechanomyography during isometric muscle actions. Author(s): Drake SM, Evetovich T, Eschbach C, Webster M. Source: Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology. 2003 June; 13(3): 297-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706609&dopt=Abstract
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A preliminary study of modification of gait in real-time using surface electromyography. Author(s): Bolek JE. Source: Applied Psychophysiology and Biofeedback. 2003 June; 28(2): 129-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12827991&dopt=Abstract
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A supination splint worn distal to the elbow: a radiographic, electromyographic, and retrospective report. Author(s): Lee MJ, LaStayo PC, vonKersburg AE. Source: J Hand Ther. 2003 July-September; 16(3): 190-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943121&dopt=Abstract
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Abnormal single-fiber electromyography in patients not having myasthenia: risk for diagnostic confusion? Author(s): Mercelis R. Source: Annals of the New York Academy of Sciences. 2003 September; 998: 509-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14592921&dopt=Abstract
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Acute compartment syndrome of the leg following diagnostic electromyography. Author(s): Farrell CM, Rubin DI, Haidukewych GJ. Source: Muscle & Nerve. 2003 March; 27(3): 374-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12635126&dopt=Abstract
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An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Author(s): Falla D, Jull G, Dall'Alba P, Rainoldi A, Merletti R. Source: Physical Therapy. 2003 October; 83(10): 899-906. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14519061&dopt=Abstract
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An electromyographic study of isokinetic axial rotation in young adults. Author(s): Kumar S, Narayan Y, Garand D. Source: The Spine Journal : Official Journal of the North American Spine Society. 2003 January-February; 3(1): 46-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14589245&dopt=Abstract
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An introduction to electromyography: an invited review. Author(s): Prahlow ND, Buschbacher RM. Source: Journal of Long-Term Effects of Medical Implants. 2003; 13(4): 289-307. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14649568&dopt=Abstract
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Anterior spinal artery syndrome: the diagnostic value of electromyography (EMG). Author(s): Kornhuber ME, Schluter A, Zierz S. Source: Journal of Neurology. 2002 December; 249(12): 1744-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12529804&dopt=Abstract
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Automatic identification of motor unit action potential trains from electromyographic signals using fuzzy techniques. Author(s): Chauvet E, Fokapu O, Hogrel JY, Gamet D, Duchene J. Source: Medical & Biological Engineering & Computing. 2003 November; 41(6): 646-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14686590&dopt=Abstract
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Bispectral index-derived facial electromyography-guided fentanyl titration in the opiate-exposed patient. Author(s): Mathews DM, Kumaran KR, Neuman GG. Source: Anesthesia and Analgesia. 2003 April; 96(4): 1062-4, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12651661&dopt=Abstract
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Can continuous physical training counteract aging effect on myoelectric fatigue? A surface electromyography study application. Author(s): Casale R, Rainoldi A, Nilsson J, Bellotti P. Source: Archives of Physical Medicine and Rehabilitation. 2003 April; 84(4): 513-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690589&dopt=Abstract
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Can triggered electromyograph thresholds predict safe thoracic pedicle screw placement. Author(s): Finkelstein JA. Source: Spine. 2003 May 1; 28(9): 960. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942016&dopt=Abstract
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Computer-assisted evoked electromyography with stimulating surgical instruments for recurrent/external laryngeal nerve identification and preservation in thyroid and parathyroid operation. Author(s): Dackiw AP, Rotstein LE, Clark OH. Source: Surgery. 2002 December; 132(6): 1100-6; Discussion 1107-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490861&dopt=Abstract
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Crosstalk in surface electromyography of the proximal forearm during gripping tasks. Author(s): Mogk JP, Keir PJ. Source: Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology. 2003 February; 13(1): 63-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488088&dopt=Abstract
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Decomposition-based quantitative electromyography: methods and initial normative data in five muscles. Author(s): Doherty TJ, Stashuk DW. Source: Muscle & Nerve. 2003 August; 28(2): 204-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12872325&dopt=Abstract
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Detecting neuromuscular problems with electromyography. Author(s): Lawrence BL, Tasota FJ. Source: Nursing. 2003 April; 33(4): 82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12722725&dopt=Abstract
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Diagnosing multiple system atrophy with greater accuracy: combined analysis of the clonidine-growth hormone test and external anal sphincter electromyography. Author(s): Lee EA, Kim BJ, Lee WY. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2002 November; 17(6): 1242-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12465063&dopt=Abstract
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Diagnostic value of electromyography and muscle biopsy in arthrogryposis multiplex congenita. Author(s): Kang PB, Lidov HG, David WS, Torres A, Anthony DC, Jones HR, Darras BT. Source: Annals of Neurology. 2003 December; 54(6): 790-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14681888&dopt=Abstract
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Disposable concentric needle electromyography electrodes artifact discharge mimicking positive sharp waves. Author(s): Anlar O, Baslo MB, Ertas M, Oge AE, Yazici J. Source: Electromyogr Clin Neurophysiol. 2003 January-February; 43(1): 37-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12613139&dopt=Abstract
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Effect of computer keyboard slope on wrist position and forearm electromyography of typists without musculoskeletal disorders. Author(s): Simoneau GG, Marklin RW, Berman JE. Source: Physical Therapy. 2003 September; 83(9): 816-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940768&dopt=Abstract
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Effect of static stretching of the biceps brachii on torque, electromyography, and mechanomyography during concentric isokinetic muscle actions. Author(s): Evetovich TK, Nauman NJ, Conley DS, Todd JB. Source: Journal of Strength and Conditioning Research / National Strength & Conditioning Association. 2003 August; 17(3): 484-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12930173&dopt=Abstract
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Effects of positive and negative affect on electromyographic activity over zygomaticus major and corrugator supercilii. Author(s): Larsen JT, Norris CJ, Cacioppo JT. Source: Psychophysiology. 2003 September; 40(5): 776-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14696731&dopt=Abstract
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Effects of supramaximal exercise on the electromyographic signal. Author(s): Hunter AM, St Clair Gibson A, Lambert MI, Nobbs L, Noakes TD. Source: British Journal of Sports Medicine. 2003 August; 37(4): 296-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893711&dopt=Abstract
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Effects of the antigravitary modification of the myotension of asset (MAGMA) therapy on myogenic cranio-cervical-mandibular dysfunction: a longitudinal surface electromyography analysis. Author(s): D'Attilio M, Di Meo S, Perinetti G, Filippi MR, Tecco S, D'Alconzo F, Festa F. Source: Cranio. 2003 January; 21(1): 24-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12555928&dopt=Abstract
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Electromyographic activity and strength during maximum isometric pronation and supination efforts in healthy adults. Author(s): Gordon KD, Pardo RD, Johnson JA, King GJ, Miller TA. Source: Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society. 2004 January; 22(1): 208-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14656682&dopt=Abstract
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Electromyographic analysis of abdominal muscle activity using portable abdominal exercise devices and a traditional crunch. Author(s): Sternlicht E, Rugg S. Source: Journal of Strength and Conditioning Research / National Strength & Conditioning Association. 2003 August; 17(3): 463-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12930170&dopt=Abstract
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Electromyographic analysis of internal rotational motion of the shoulder in various arm positions. Author(s): Suenaga N, Minami A, Fujisawa H. Source: Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons. [et Al.]. 2003 September-October; 12(5): 501-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14564277&dopt=Abstract
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Electromyographic analysis of the arm muscles in “front support” exercises. Author(s): Dias GA, Guazzelli Filho J, Rodrigues JA, Goncalves M, Bull ML. Source: Electromyogr Clin Neurophysiol. 2003 December; 43(8): 465-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14717027&dopt=Abstract
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Electromyographic analysis of the pectoralis major and deltoideus anterior muscles in horizontal “flyer” exercises with loads. Author(s): Rodrigues JA, Bull ML, Dias GA, Goncalves M, Guazzelli JF. Source: Electromyogr Clin Neurophysiol. 2003 October-November; 43(7): 413-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14626721&dopt=Abstract
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Electromyographic analysis of the upper and lower fascicles of the orbicular oris muscle, in edentulous patients, before and after complete denture implantation. Author(s): Santos CM, Vitti M, de Mattos Mda G, Semprini M, Paranhos Hde F, Regalo SC. Source: Electromyogr Clin Neurophysiol. 2003 July-August; 43(5): 315-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12964260&dopt=Abstract
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Electromyographic approach to neuromuscular junction disorders repetitive nerve stimulation and single-fiber electromyography. Author(s): Chiou-Tan FY. Source: Phys Med Rehabil Clin N Am. 2003 May; 14(2): 387-401. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795522&dopt=Abstract
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Electromyographic assessment of rectus abdominis muscle function after deep inferior epigastric perforator flap surgery. Author(s): Bottero L, Lefaucheur JP, Fadhul S, Raulo Y, Collins ED, Lantieri L. Source: Plastic and Reconstructive Surgery. 2004 January; 113(1): 156-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14707633&dopt=Abstract
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Electromyographic biofeedback in the treatment of the hemiplegic hand: a placebocontrolled study. Author(s): Armagan O, Tascioglu F, Oner C. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 2003 November; 82(11): 856-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14566153&dopt=Abstract
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Electromyographic comparison of the upper and lower rectus abdominis during abdominal exercises. Author(s): Clark KM, Holt LE, Sinyard J. Source: Journal of Strength and Conditioning Research / National Strength & Conditioning Association. 2003 August; 17(3): 475-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12930172&dopt=Abstract
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Electromyographic fatigue threshold of erector spinae muscle induced by a muscular endurance test in health men. Author(s): Cardozo AC, Goncalves M. Source: Electromyogr Clin Neurophysiol. 2003 September; 43(6): 377-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14535051&dopt=Abstract
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Electromyographic findings of paradoxical puborectalis contraction correlate poorly with cinedefecography. Author(s): Yeh CY, Pikarsky A, Wexner SD, Baig MK, Jain A, Weiss EG, Nogueras JJ, Vernava AM 3rd. Source: Techniques in Coloproctology. 2003 July; 7(2): 77-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14605924&dopt=Abstract
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Electromyographic validation of the mouth pressure-time index: a noninvasive assessment of inspiratory muscle load. Author(s): de Torres JP, Talamo C, Aguirre-Jaime A, Rassulo J, Celli B. Source: Respiratory Medicine. 2003 September; 97(9): 1006-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14509554&dopt=Abstract
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Electromyography activity of vastus lateralis muscle during whole-body vibrations of different frequencies. Author(s): Cardinale M, Lim J. Source: Journal of Strength and Conditioning Research / National Strength & Conditioning Association. 2003 August; 17(3): 621-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12930196&dopt=Abstract
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Electromyography in the paediatric intensive care unit (ICU). Author(s): Bolton CF. Source: Suppl Clin Neurophysiol. 2000; 53: 38-43. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740975&dopt=Abstract
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Electromyography in urinary retention and obstructed voiding in women. Author(s): Fowler CJ, Dasgupta R. Source: Scand J Urol Nephrol Suppl. 2002; (210): 55-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12475018&dopt=Abstract
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Electromyography of human cricopharyngeal muscle of the upper esophageal sphincter. Author(s): Ertekin C, Aydogdu I. Source: Muscle & Nerve. 2002 December; 26(6): 729-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12451598&dopt=Abstract
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Electromyography of scoliotic patients treated with a brace. Author(s): Odermatt D, Mathieu PA, Beausejour M, Labelle H, Aubin CE. Source: Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society. 2003 September; 21(5): 931-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919883&dopt=Abstract
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Electromyography of the anal sphincter: which muscle to examine? Author(s): Podnar S. Source: Muscle & Nerve. 2003 September; 28(3): 377-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12929200&dopt=Abstract
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Electromyography of the quadriceps in patellofemoral pain with patellar subluxation. Author(s): Mohr KJ, Kvitne RS, Pink MM, Fideler B, Perry J. Source: Clinical Orthopaedics and Related Research. 2003 October; (415): 261-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14612655&dopt=Abstract
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Electromyography response of the iliocostalis lumborum muscle during flexion, extension and rotation movements of the trunk in orthostatic and seated position. Author(s): de Moraes AC, Bankoff AD. Source: Electromyogr Clin Neurophysiol. 2003 June; 43(4): 241-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12836590&dopt=Abstract
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Food-borne botulism cases in Van region in eastern Turkey: importance of electromyography in the diagnosis. Author(s): Anlar O, Irmak H, Tombul T, Akdeniz H, Caksen H, Kose D, Ceylan A. Source: Electromyogr Clin Neurophysiol. 2003 September; 43(6): 373-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14535050&dopt=Abstract
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Functional and electromyographic results after open rotator cuff repair. Author(s): Fokter SK, Cicak N, Skorja J. Source: Clinical Orthopaedics and Related Research. 2003 October; (415): 121-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14612638&dopt=Abstract
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High spatial resolution electromyography and video-assisted movement analysis in children with obstetric brachial plexus palsy. Author(s): Bahm J, Meinecke L, Brandenbusch V, Rau G, Disselhorst-Klug C. Source: Hand Clin. 2003 August; 19(3): 393-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12945636&dopt=Abstract
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Iatrogenic complications and risks of nerve conduction studies and needle electromyography. Author(s): Al-Shekhlee A, Shapiro BE, Preston DC. Source: Muscle & Nerve. 2003 May; 27(5): 517-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707972&dopt=Abstract
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Increased creatine kinase and spontaneous activity on electromyography, in amyotrophic lateral sclerosis. Author(s): Lima AF, Evangelista T, de Carvalho M. Source: Electromyogr Clin Neurophysiol. 2003 April-May; 43(3): 189-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712806&dopt=Abstract
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Intranasal electromyography in evaluation of the nasal valve. Author(s): Vaiman M, Eviatar E, Segal S. Source: Rhinology. 2003 September; 41(3): 134-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14579653&dopt=Abstract
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Intraoperative electromyography. Author(s): Holland NR. Source: Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society. 2002 October; 19(5): 444-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477989&dopt=Abstract
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Kinematic and electromyographic analysis of the push movement in tai chi. Author(s): Chan SP, Luk TC, Hong Y. Source: British Journal of Sports Medicine. 2003 August; 37(4): 339-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893721&dopt=Abstract
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Large-array surface electromyography in low back pain: a pilot study. Author(s): Finneran MT, Mazanec D, Marsolais ME, Marsolais EB, Pease WS. Source: Spine. 2003 July 1; 28(13): 1447-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12838104&dopt=Abstract
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Laryngeal electromyography: an evidence-based review. Author(s): AAEM Laryngeal Task Force. Source: Muscle & Nerve. 2003 December; 28(6): 767-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14639595&dopt=Abstract
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Late-onset mitochondrial disorder with electromyographic evidence of myotonia. Author(s): Howse ML, Wardell TM, Fisher CJ, Tilley PJ, Chinnery PF, Bindoff L. Source: Muscle & Nerve. 2003 December; 28(6): 757-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14639592&dopt=Abstract
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Lumbar muscle fatigue and recovery in patients with long-term low-back trouble-electromyography and health-related factors. Author(s): Elfving B, Dedering A, Nemeth G. Source: Clinical Biomechanics (Bristol, Avon). 2003 August; 18(7): 619-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880709&dopt=Abstract
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Lung function and surface electromyography of intercostal muscles in cement mill workers. Author(s): Meo SA, Azeem MA, Ghori MG, Subhan MM. Source: International Journal of Occupational Medicine and Environmental Health. 2002; 15(3): 279-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462455&dopt=Abstract
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Mechanomyographic and electromyographic responses of the triceps surae during maximal voluntary contractions. Author(s): Miyamoto N, Oda S. Source: Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology. 2003 October; 13(5): 451-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12932419&dopt=Abstract
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Monitoring neuromuscular blockade in diabetic patients using electromyography: an opportunity missed. Author(s): Hemmerling TM, Michaud G, Deschamps S, Trager G. Source: British Journal of Anaesthesia. 2003 October; 91(4): 608-9; Author Reply 609. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14504173&dopt=Abstract
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Multiple motor unit recordings of laryngeal muscles: the technique of vector laryngeal electromyography. Author(s): Roark RM, Li JC, Schaefer SD, Adam A, De Luca CJ. Source: The Laryngoscope. 2002 December; 112(12): 2196-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461341&dopt=Abstract
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Muscle ultrasonography and electromyography correlation for evaluation of floppy infants. Author(s): Aydinli N, Baslo B, Caliskan M, Ertas M, Ozmen M. Source: Brain & Development. 2003 January; 25(1): 22-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12536029&dopt=Abstract
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Muscle-fiber conduction velocity and electromyography as diagnostic tools in patients with suspected inflammatory myopathy: a prospective study. Author(s): Blijham PJ, Hengstman GJ, Ter Laak HJ, Van Engelen BG, Zwarts MJ. Source: Muscle & Nerve. 2004 January; 29(1): 46-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14694497&dopt=Abstract
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Needle electromyography in the horse compared with its principles in man: a review. Author(s): Wijnberg ID, van der Kolk JH, Franssen H, Breukink HJ. Source: Equine Veterinary Journal. 2003 January; 35(1): 9-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553457&dopt=Abstract
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Nerve conduction studies, electromyography and sympathetic skin response in Fabry's disease. Author(s): Gomes I, Nora DB, Becker J, Ehlers JA, Schwartz IV, Giugliani R, AshtonProlla P, Jardim L. Source: Journal of the Neurological Sciences. 2003 October 15; 214(1-2): 21-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12972384&dopt=Abstract
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Optimum trace count necessary for jitter calculation in single-fiber electromyography. Author(s): Baslo MB, Yalinay P, Yildiz N, Ertas M. Source: Acta Neurologica Scandinavica. 2003 October; 108(4): 262-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956860&dopt=Abstract
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Paraspinal electromyography that compares concentric with monopolar needles: a blinded study. Author(s): Tong HC, Young IA, Koch J, Haig AJ, Yamakawa KS, Wallbom A. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 2003 December; 82(12): 917-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14627928&dopt=Abstract
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Pearls and pitfalls in the use of electromyography and nerve conduction studies. Author(s): Gutmann L. Source: Seminars in Neurology. 2003 March; 23(1): 77-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870108&dopt=Abstract
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Pediatric electromyography in the acute care setting. Author(s): Jones HR Jr. Source: Suppl Clin Neurophysiol. 2000; 53: 44-52. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740976&dopt=Abstract
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Physiology and electromyography of swallowing and its disorders. Author(s): Ertekin C, Palmer JB. Source: Suppl Clin Neurophysiol. 2000; 53: 148-54. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740989&dopt=Abstract
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Precision of a needle localization technic in the lumbosacral multifidus muscles for segmental specific needle electromyographic study: a cadaveric study. Author(s): Chinsethagij K, Wongphaet P, Su-archawaratana S, Dangprasert T. Source: J Med Assoc Thai. 2003 August; 86(8): 722-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12948270&dopt=Abstract
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Predicting term and preterm delivery with transabdominal uterine electromyography. Author(s): Maner WL, Garfield RE, Maul H, Olson G, Saade G. Source: Obstetrics and Gynecology. 2003 June; 101(6): 1254-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798533&dopt=Abstract
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Quantitative electromyography. Author(s): Phongsamart G, Wertsch JJ. Source: Phys Med Rehabil Clin N Am. 2003 May; 14(2): 231-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795514&dopt=Abstract
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Reliability of electromyographic and torque measures during isometric axial rotation exertions of the trunk. Author(s): Ng JK, Parnianpour M, Kippers V, Richardson CA. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003 December; 114(12): 2355-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14652095&dopt=Abstract
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Significance of anode location for stimulus-evoked electromyography during iliosacral screw placement. Author(s): Moed BR. Source: Journal of Orthopaedic Trauma. 2003 September; 17(8): 597-8; Author Reply 5989. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14504588&dopt=Abstract
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Single-fiber electromyography. Author(s): Tanhehco JL. Source: Phys Med Rehabil Clin N Am. 2003 May; 14(2): 207-29. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795513&dopt=Abstract
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Sphincter electromyography and multiple system atrophy. Author(s): Nahm F, Freeman R. Source: Muscle & Nerve. 2003 July; 28(1): 18-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12811769&dopt=Abstract
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Sphincter electromyography in diagnosis of multiple system atrophy: technical issues. Author(s): Podnar S, Fowler CJ. Source: Muscle & Nerve. 2004 January; 29(1): 151-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14694513&dopt=Abstract
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Surface and wire electromyographic. Recording during fatiguing exercise. Author(s): Pease WS, Elinski MA. Source: Electromyogr Clin Neurophysiol. 2003 July-August; 43(5): 267-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12964253&dopt=Abstract
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Surface electromyography and mechanomyography recording: a new differential composite probe. Author(s): Gregori B, Galie E, Accornero N. Source: Medical & Biological Engineering & Computing. 2003 November; 41(6): 665-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14686592&dopt=Abstract
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Surface electromyography assessment of back muscle intrinsic properties. Author(s): Lariviere C, Arsenault AB, Gravel D, Gagnon D, Loisel P. Source: Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology. 2003 August; 13(4): 305-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832162&dopt=Abstract
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The belly-press test for the physical examination of the subscapularis muscle: electromyographic validation and comparison to the lift-off test. Author(s): Tokish JM, Decker MJ, Ellis HB, Torry MR, Hawkins RJ. Source: Journal of Shoulder and Elbow Surgery / American Shoulder and Elbow Surgeons. [et Al.]. 2003 September-October; 12(5): 427-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14564261&dopt=Abstract
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The effectiveness of neuromuscular facial retraining combined with electromyography in facial paralysis rehabilitation. Author(s): Cronin GW, Steenerson RL. Source: Otolaryngology and Head and Neck Surgery. 2003 April; 128(4): 534-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707657&dopt=Abstract
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The effects of antagonist prefatigue on agonist torque and electromyography. Author(s): Maynard J, Ebben WP. Source: Journal of Strength and Conditioning Research / National Strength & Conditioning Association. 2003 August; 17(3): 469-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12930171&dopt=Abstract
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The effects of taste and consistency on swallow physiology in younger and older healthy individuals: a surface electromyographic study. Author(s): Ding R, Logemann JA, Larson CR, Rademaker AW. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2003 August; 46(4): 977-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959474&dopt=Abstract
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The history of surface electromyography. Author(s): Cram JR. Source: Applied Psychophysiology and Biofeedback. 2003 June; 28(2): 81-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12827987&dopt=Abstract
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The importance of electromyographic guidance and electrical stimulation for injection of botulinum toxin. Author(s): Childers MK. Source: Phys Med Rehabil Clin N Am. 2003 November; 14(4): 781-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14580037&dopt=Abstract
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The influence of dynamic polyelectromyography in formulating a surgical plan in treatment of spastic elbow flexion deformity. Author(s): Keenan MA, Fuller DA, Whyte J, Mayer N, Esquenazi A, Fidler-Sheppard R. Source: Archives of Physical Medicine and Rehabilitation. 2003 February; 84(2): 291-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601663&dopt=Abstract
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The integration of electromyography (SEMG) at the workstation: assessment, treatment, and prevention of repetitive strain injury (RSI). Author(s): Peper E, Wilson VS, Gibney KH, Huber K, Harvey R, Shumay DM. Source: Applied Psychophysiology and Biofeedback. 2003 June; 28(2): 167-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12827995&dopt=Abstract
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The significance of anode location for stimulus-evoked electromyography during iliosacral screw placement. Author(s): Ricci WM, Padberg AM, Borrelli J. Source: Journal of Orthopaedic Trauma. 2003 February; 17(2): 95-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571497&dopt=Abstract
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The value of corpus cavernosum electromyography in erectile dysfunction: current status and future prospect. Author(s): Jiang XG, Speel TG, Wagner G, Meuleman EJ, Wijkstra H; COST Action B18 project. Source: European Urology. 2003 March; 43(3): 211-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12600422&dopt=Abstract
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Using weights in abdominal exercises: electromyography response of the Rectus Abdominis and Rectus Femoris muscles. Author(s): Moraes AC, Bankoff AD, Almeida TL, Simoes EC, Rodrigues CE, Okano AH. Source: Electromyogr Clin Neurophysiol. 2003 December; 43(8): 487-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14717029&dopt=Abstract
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Utility of laryngeal electromyography in predicting recovery after vocal fold paralysis. Author(s): Munin MC, Rosen CA, Zullo T. Source: Archives of Physical Medicine and Rehabilitation. 2003 August; 84(8): 1150-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917853&dopt=Abstract
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Vertical jaw separation and masseter muscle electromyographic activity: a comparative study between asymptomatic controls & patients with temporomandibular pain & dysfunction. Author(s): Suvinen TI, Reade PC, Kononen M, Kemppainen P. Source: Journal of Oral Rehabilitation. 2003 August; 30(8): 765-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880397&dopt=Abstract
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Vocal fold paralysis and electromyography. Author(s): Sulica L. Source: Archives of Physical Medicine and Rehabilitation. 2003 December; 84(12): 1906; Author Reply 1906. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14669202&dopt=Abstract
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Vocal fold paralysis following radiotherapy for nasopharyngeal carcinoma: laryngeal electromyography findings. Author(s): Lau DP, Lo YL, Wee J, Tan NG, Low WK. Source: Journal of Voice : Official Journal of the Voice Foundation. 2003 March; 17(1): 827. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705821&dopt=Abstract
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CHAPTER 2. NUTRITION AND ELECTROMYOGRAPHY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and electromyography.
Finding Nutrition Studies on Electromyography The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “electromyography” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “electromyography” (or a synonym): •
A cross-over clinical and electromyographic assessment of treatment for parkinsonian tremor. Author(s): University Neurological Hospital, St. Naum III Neurological Clinic, Blvd. Tzarigradsko shosse-IV km, 1113 Sofia, Bulgaria.
[email protected] Source: MilaNovember, I Parkinsonism-Relat-Disord. 2001 September; 8(1): 67-73 13538020
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Effects of experimental muscle pain on electromyographic activity of masticatory muscles in the rat. Author(s): Department of Oral and Craniofacial Biological Sciences, University of Maryland Baltimore School of Dentistry, 666 West Baltimore Street, Baltimore, Maryland 21201, USA.
[email protected] Source: Ro, Jin Y Svensson, Peter Capra, Norman Muscle-Nerve. 2002 Apr; 25(4): 576-84 0148-639X
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Force production in the primate masticatory system: electromyographic tests of biomechanical hypotheses. Author(s): Department of Biological Anthropology and Anatomy, Duke University Medical Center, Durham, North Carolina 27710, USA.
[email protected] Source: Spencer, M A J-Hum-Evol. 1998 January; 34(1): 25-54 0047-2484
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to electromyography; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Food and Diet Low Back Pain Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND ELECTROMYOGRAPHY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to electromyography. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to electromyography and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “electromyography” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to electromyography: •
A guide for use and interpretation of kinesiologic electromyographic data. Author(s): Soderberg GL, Knutson LM. Source: Physical Therapy. 2000 May; 80(5): 485-98. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10792859&dopt=Abstract
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A preliminary study of modification of gait in real-time using surface electromyography. Author(s): Bolek JE. Source: Applied Psychophysiology and Biofeedback. 2003 June; 28(2): 129-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12827991&dopt=Abstract
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A quantitative electromyographic analysis of masticatory muscle activity in usual daily life. Author(s): Saifuddin M, Miyamoto K, Ueda HM, Shikata N, Tanne K. Source: Oral Diseases. 2001 March; 7(2): 94-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11355445&dopt=Abstract
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A study of pelvic floor function pre- and postradical prostatectomy using clinical neurourological investigations, urodynamics and electromyography. Author(s): Zermann DH, Ishigooka M, Wunderlich H, Reichelt O, Schubert J. Source: European Urology. 2000 January; 37(1): 72-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10671789&dopt=Abstract
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An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Author(s): Falla D, Jull G, Dall'Alba P, Rainoldi A, Merletti R. Source: Physical Therapy. 2003 October; 83(10): 899-906. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14519061&dopt=Abstract
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Cervical flexion: a study of dynamic surface electromyography and range of motion. Author(s): Nicholson WR. Source: Journal of Manipulative and Physiological Therapeutics. 2000 July-August; 23(6): 435-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10951315&dopt=Abstract
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Cervical flexion: a study of dynamic surface electromyography and range of motion. Author(s): Cram JR, Kneebone WJ. Source: Journal of Manipulative and Physiological Therapeutics. 1999 NovemberDecember; 22(9): 570-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10626699&dopt=Abstract
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Chronic motor dysfunction after stroke: recovering wrist and finger extension by electromyography-triggered neuromuscular stimulation. Author(s): Cauraugh J, Light K, Kim S, Thigpen M, Behrman A. Source: Stroke; a Journal of Cerebral Circulation. 2000 June; 31(6): 1360-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10835457&dopt=Abstract
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Clinical considerations in the use of surface electromyography: three experimental studies. Author(s): Lehman GJ. Source: Journal of Manipulative and Physiological Therapeutics. 2002 June; 25(5): 293-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12072849&dopt=Abstract
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Clinical, anorectal manometry and surface electromyography in the study of patients with fecal incontinence. Author(s): Munoz Yague T, Alvarez Sanchez V, Ibanez Pinto A, Solis- Herruzo JA. Source: Rev Esp Enferm Dig. 2003 September; 95(9): 635-9, 629-34. English, Spanish. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14738408&dopt=Abstract
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Control engineering and electromyographic kinesiology analyses of normal human gait. Author(s): Hashimoto F, Ogawa R, Kameyama O. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. 2000; 5(2): 139-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10982648&dopt=Abstract
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Effect of fatigue on torque output and electromyographic measures of trunk muscles during isometric axial rotation. Author(s): Ng JK, Parnianpour M, Richardson CA, Kippers V. Source: Archives of Physical Medicine and Rehabilitation. 2003 March; 84(3): 374-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638105&dopt=Abstract
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Effects of positive and negative affect on electromyographic activity over zygomaticus major and corrugator supercilii. Author(s): Larsen JT, Norris CJ, Cacioppo JT. Source: Psychophysiology. 2003 September; 40(5): 776-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14696731&dopt=Abstract
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Electromyographic (EMG) biofeedback in the comprehensive treatment of central pain and ataxic tremor following thalamic stroke. Author(s): Edwards CL, Sudhakar S, Scales MT, Applegate KL, Webster W, Dunn RH. Source: Applied Psychophysiology and Biofeedback. 2000 December; 25(4): 229-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11218924&dopt=Abstract
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Electromyographic and kinematic analysis of therapeutic knee exercises under water. Author(s): Poyhonen T, Kyrolainen H, Keskinen KL, Hautala A, Savolainen J, Malkia E. Source: Clinical Biomechanics (Bristol, Avon). 2001 July; 16(6): 496-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11427292&dopt=Abstract
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Electromyographic biofeedback in the treatment of the hemiplegic hand: a placebocontrolled study. Author(s): Armagan O, Tascioglu F, Oner C. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 2003 November; 82(11): 856-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14566153&dopt=Abstract
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Electromyographic biofeedback-assisted relaxation training in juvenile episodic tension-type headache: clinical outcome at three-year follow-up. Author(s): Grazzi L, Andrasik F, D'Amico D, Leone M, Moschiano F, Bussone G. Source: Cephalalgia : an International Journal of Headache. 2001 October; 21(8): 798-803. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11737004&dopt=Abstract
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Electromyographic biofeedback-controlled exercise versus conservative care for patellofemoral pain syndrome. Author(s): Dursun N, Dursun E, Kilic Z. Source: Archives of Physical Medicine and Rehabilitation. 2001 December; 82(12): 16925. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11733884&dopt=Abstract
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Electromyographic changes of motor unit activity in horses with induced hypocalcemia and hypomagnesemia. Author(s): Wijnberg ID, van der Kolk JH, Franssen H, Breukink HJ. Source: Am J Vet Res. 2002 June; 63(6): 849-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12061532&dopt=Abstract
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Electromyographic evidence of reduced muscle activity when ULF-TENS is applied to the Vth and VIIth cranial nerves. Author(s): Kamyszek G, Ketcham R, Garcia R Jr, Radke J. Source: Cranio. 2001 July; 19(3): 162-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11482827&dopt=Abstract
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Electromyographic reflex responses to mechanical force, manually assisted spinal manipulative therapy. Author(s): Colloca CJ, Keller TS. Source: Spine. 2001 May 15; 26(10): 1117-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11413422&dopt=Abstract
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Electromyographic studies of structural abnormalities. 1941. Author(s): Denslow JS, Clough GH. Source: J Am Osteopath Assoc. 2001 February; 101(2): 101-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11296808&dopt=Abstract
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Electromyographical differentiation between the acoustic blink and startle reflex. Implications for studies investigating startle behavior. Author(s): Meincke U, Morth D, Voss T, Gouzoulis-Mayfrank E. Source: European Archives of Psychiatry and Clinical Neuroscience. 2002 June; 252(3): 141-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12192473&dopt=Abstract
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Electromyography as a recording system for eyeblink conditioning with functional magnetic resonance imaging. Author(s): Knuttinen MG, Parrish TB, Weiss C, LaBar KS, Gitelman DR, Power JM, Mesulam MM, Disterhoft JF. Source: Neuroimage. 2002 October; 17(2): 977-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377171&dopt=Abstract
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Electromyography of the pelvic floor musculature in the assessment of obstructed defecation symptoms. Author(s): Fucini C, Ronchi O, Elbetti C. Source: Diseases of the Colon and Rectum. 2001 August; 44(8): 1168-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11535858&dopt=Abstract
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Functional recovery and electromyographic/electroneurography evaluation in Bell's and Ramsay-Hunt's palsy patients undergoing physical training. Author(s): Dalla Toffola E, Ricotti S, Petrucci L, Carenzio G, Bilucaglia E, Salvini G, Zandrini C, Moglia A. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1994 December; : S127-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10774331&dopt=Abstract
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Instrumentation methodology for recording and feeding-back surface electromyographic (SEMG) signals. Author(s): Sherman RA. Source: Applied Psychophysiology and Biofeedback. 2003 June; 28(2): 107-19. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12827989&dopt=Abstract
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Integrated electromyography of the masseter on incremental opening and closing with audio biofeedback: a study on mandibular posture. Author(s): Gross MD, Ormianer Z, Moshe K, Gazit E. Source: Int J Prosthodont. 1999 September-October; 12(5): 419-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10709523&dopt=Abstract
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Intramuscular versus surface electromyography of the diaphragm for determining neuromuscular blockade. Author(s): Hemmerling TM, Schmidt J, Wolf T, Hanusa C, Siebzehnruebl E, Schmitt H. Source: Anesthesia and Analgesia. 2001 January; 92(1): 106-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11133610&dopt=Abstract
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Kinematic and electromyographic analysis of the push movement in tai chi. Author(s): Chan SP, Luk TC, Hong Y.
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Source: British Journal of Sports Medicine. 2003 August; 37(4): 339-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893721&dopt=Abstract •
Long-term results of electromyographic biofeedback training for fecal incontinence. Author(s): Ryn AK, Morren GL, Hallbook O, Sjodahl R. Source: Diseases of the Colon and Rectum. 2000 September; 43(9): 1262-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11005494&dopt=Abstract
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Mechanical force spinal manipulation increases trunk muscle strength assessed by electromyography: a comparative clinical trial. Author(s): Perle SM. Source: Journal of Manipulative and Physiological Therapeutics. 2002 June; 25(5): 345; Author Reply 345-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12072858&dopt=Abstract
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Mechanical force spinal manipulation increases trunk muscle strength assessed by electromyography: a comparative clinical trial. Author(s): Keller TS, Colloca CJ. Source: Journal of Manipulative and Physiological Therapeutics. 2000 NovemberDecember; 23(9): 585-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11145798&dopt=Abstract
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On the inter- and intra-subject variability of the electromyographic signal in isometric contractions. Author(s): Araujo RC, Duarte M, Amadio AC. Source: Electromyogr Clin Neurophysiol. 2000 June; 40(4): 225-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10907600&dopt=Abstract
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Spinal manipulation causes variable spine kinematic and trunk muscle electromyographic responses. Author(s): Lehman GJ, McGill SM. Source: Clinical Biomechanics (Bristol, Avon). 2001 May; 16(4): 293-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11358616&dopt=Abstract
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The effect of aging on the electromyographic activity of pelvic floor muscles. A comparative study among stress incontinent patients and asymptomatic women. Author(s): Aukee P, Penttinen J, Airaksinen O. Source: Maturitas. 2003 April 25; 44(4): 253-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12697365&dopt=Abstract
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The effects of a progressive exercise program with surface electromyographic biofeedback on an adult with fecal incontinence. Author(s): Coffey SW, Wilder E, Majsak MJ, Stolove R, Quinn L.
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Source: Physical Therapy. 2002 August; 82(8): 798-811. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12147009&dopt=Abstract •
The importance of normalization in the interpretation of surface electromyography: a proof of principle. Author(s): Nicholson WR. Source: Journal of Manipulative and Physiological Therapeutics. 2000 June; 23(5): 369-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10863264&dopt=Abstract
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The importance of normalization in the interpretation of surface electromyography: a proof of principle. Author(s): Lehman GJ, McGill SM. Source: Journal of Manipulative and Physiological Therapeutics. 1999 September; 22(7): 444-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10519560&dopt=Abstract
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The influence of a chiropractic manipulation on lumbar kinematics and electromyography during simple and complex tasks: a case study. Author(s): Seaman DR. Source: Journal of Manipulative and Physiological Therapeutics. 2000 July-August; 23(6): 437-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10951319&dopt=Abstract
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The influence of a chiropractic manipulation on lumbar kinematics and electromyography during simple and complex tasks: a case study. Author(s): Lehman GJ, McGill SM. Source: Journal of Manipulative and Physiological Therapeutics. 1999 NovemberDecember; 22(9): 576-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10626700&dopt=Abstract
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The integration of electromyography (SEMG) at the workstation: assessment, treatment, and prevention of repetitive strain injury (RSI). Author(s): Peper E, Wilson VS, Gibney KH, Huber K, Harvey R, Shumay DM. Source: Applied Psychophysiology and Biofeedback. 2003 June; 28(2): 167-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12827995&dopt=Abstract
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The role of the monopolar electromyographic pin in myofascial pain therapy: automated twitch-obtaining intramuscular stimulation (ATOIMS) and electrical twitch-obtaining intramuscular stimulation (ETOIMS). Author(s): Chu J. Source: Electromyogr Clin Neurophysiol. 1999 December; 39(8): 503-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10627937&dopt=Abstract
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Treating vulvar vestibulitis with electromyographic biofeedback of pelvic floor musculature. Author(s): McKay E, Kaufman RH, Doctor U, Berkova Z, Glazer H, Redko V. Source: J Reprod Med. 2001 April; 46(4): 337-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11354833&dopt=Abstract
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Treatment of erectile dysfunction by perineal exercise, electromyographic biofeedback, and electrical stimulation. Author(s): Van Kampen M, De Weerdt W, Claes H, Feys H, De Maeyer M, Van Poppel H. Source: Physical Therapy. 2003 June; 83(6): 536-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775199&dopt=Abstract
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Treatment of facial paralysis using electromyographic feedback--a case study. Author(s): Diels HJ. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1994 December; : S129-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10774332&dopt=Abstract
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Vertical jaw separation and masseter muscle electromyographic activity: a comparative study between asymptomatic controls & patients with temporomandibular pain & dysfunction. Author(s): Suvinen TI, Reade PC, Kononen M, Kemppainen P. Source: Journal of Oral Rehabilitation. 2003 August; 30(8): 765-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880397&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMD®Health: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to electromyography; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Bell's Palsy Source: Healthnotes, Inc.; www.healthnotes.com Carpal Tunnel Syndrome Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com Tension Headache Source: Healthnotes, Inc.; www.healthnotes.com
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Alternative Therapy Biofeedback Source: Integrative Medicine Communications; www.drkoop.com
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Herbs and Supplements Glycyrrhiza Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON ELECTROMYOGRAPHY Overview In this chapter, we will give you a bibliography on recent dissertations relating to electromyography. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “electromyography” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on electromyography, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Electromyography ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to electromyography. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Comparison of Two Shoulder Exercises Utilizing Isotonic, Isokinetic, and Electromyographic Analyses (Exercise) by Durbin, David Lindsay, DA from Middle Tennessee State University, 1993, 169 pages http://wwwlib.umi.com/dissertations/fullcit/9401183
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A Postural Model for the Reduction of Neck Tension (VDT, Electromyography, Workstation, Ergonomics) by Hamilton, Nancy Patricia, PhD from University of Illinois at Urbana-champaign, 1986, 119 pages http://wwwlib.umi.com/dissertations/fullcit/8623311
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A Study of the Speaking Behavior of Stutterers and Nonstutterers by Means of Multichannel Electromyography by Shrum, William Frederick, PhD from The University of Iowa, 1967, 113 pages http://wwwlib.umi.com/dissertations/fullcit/6709103
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Acquisition and Functional Significance of the Pre-motor Silent Period in Active Skeletal Muscle (Limb Control, Stretch-Shorten Cycle, Ballistic Movement, Trajectory
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Formation, Electromyography) by Walter, Charles Bryant, PhD from University of California, Los Angeles, 1985, 99 pages http://wwwlib.umi.com/dissertations/fullcit/8601915 •
An Electromyographic Examination of Wrist Motion While Executing Selected Drumstick Techniques with Matched Grip by Johnson, Todd Alan, DMA from The University of Oklahoma, 1999, 104 pages http://wwwlib.umi.com/dissertations/fullcit/9934637
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An Electromyographic Investigation of the Stretch-Shortening Cycle in Tumbling Take-Offs by McNeal, Jeni R.; PhD from The University of Utah, 2000, 111 pages http://wwwlib.umi.com/dissertations/fullcit/9961770
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An Exploratory Study of the Functioning of Selected Masticatory Muscles during Clarinet Playing As Observed Through Electromyography by Campbell, Bonnie Heather; DM from Indiana University, 1999, 320 pages http://wwwlib.umi.com/dissertations/fullcit/9982776
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Analysis and Interpretation of Long-Term Intramuscular Electromyography Signals during Prolonged Computer Work by Zennaro, Daniel Heiko; Drsctech from Eidgenoessische Technische Hochschule Zuerich (Switzerland), 2003, 129 pages http://wwwlib.umi.com/dissertations/fullcit/f240897
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Electromyographic Analysis of the Lumbar Erector Spinae Muscles: Influence of Position, a History of Low Back Pain, Gender and Muscle Location on Fatigue and Recovery by Fall, Michael Paul; PhD from The University of Connecticut, 2001, 104 pages http://wwwlib.umi.com/dissertations/fullcit/3030666
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Electromyographic Feedback and Relaxation Training with Elementary-Aged Students Exhibiting Behavioral and Learning Difficulties (Behavioral Difficulties) by Al-Shamari, Taresh M., PhD from Indiana University, 1991, 115 pages http://wwwlib.umi.com/dissertations/fullcit/9217376
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Electromyographic Investigation of Abdominal Musculature during Measured Active Expiration by Peterson, Ken Doty; DA from University of Northern Colorado, 2001, 101 pages http://wwwlib.umi.com/dissertations/fullcit/3025104
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Human Muscular Contraction: Role of the Mechanical Components (Electromyography, Series Elasticity) by Robertson, Richard Niell, PhD from University of Illinois at Urbana-Champaign, 1985, 212 pages http://wwwlib.umi.com/dissertations/fullcit/8521870
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Pressure-Lung Volume Relationship and Electromyography of Inspiratory Muscles in Man during Partial Curarization by Buick, Fred; PhD from McMaster University (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NK66170
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Psychological Preparation for Electromyography: A Comparison of Methods by Nemann, Molly W., EDD from University of Cincinnati, 1988, 170 pages http://wwwlib.umi.com/dissertations/fullcit/8822837
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Skeletal Muscle Response during the Isometric Phase of an Unrestricted Isotonic Contraction (Electromyography, Electromechanical Delay) by Grabiner, Mark Dean, PhD from University of Illinois at Urbana-Champaign, 1985, 198 pages http://wwwlib.umi.com/dissertations/fullcit/8600196
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Some Comparative Analyses in Electromyography by Styles, Douglas Eugene, EDD from The University of Tennessee, 1972, 52 pages http://wwwlib.umi.com/dissertations/fullcit/7227500
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The Activity of Certain Facial Muscles in the B-Flat Soprano Clarinet Embouchure: An Exploratory Study Utilizing Electromyography. by Newton, William Jackson, EDD from University of North Texas, 1972, 98 pages http://wwwlib.umi.com/dissertations/fullcit/7302921
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The Acute Effects of Static Stretching on Peak Torque, Mean Power Output, Mechanomyography, and Electromyography during Maximal, Eccentric Isokinetic Muscle Actions by Cramer, Joel Timothy; PhD from The University of Nebraska Lincoln, 2003, 92 pages http://wwwlib.umi.com/dissertations/fullcit/3092535
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The Effects of Concentric Isokinetic Strength Training of the Quadriceps Femoris on Electromyography, Mechanomyography, and Muscle Strength by Evetovich, Tammy Kay, PhD from The University of Nebraska - Lincoln, 1998, 80 pages http://wwwlib.umi.com/dissertations/fullcit/9829516
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The Effects of Cryotherapy and Static Stretching on Residual Muscle Tension As Determined by Electromyography. by Dudley, Patrick Hardy, PhD from Texas A&M University, 1975, 100 pages http://wwwlib.umi.com/dissertations/fullcit/7525092
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The Effects of Isometric Strength Training of the Quadriceps Femoris on Electromyography, Mechanomyography, and Peak Torque by Smith, Douglas Boyd; PhD from The University of Nebraska - Lincoln, 2001, 72 pages http://wwwlib.umi.com/dissertations/fullcit/3009737
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The Efficacy of Two Treatment Techniques for Children with Spastic Cerebral Palsy As Measured by Electromyography and Thermal Information by Finn, David Michael, EDD from The University of Alabama, 1986, 177 pages http://wwwlib.umi.com/dissertations/fullcit/8620114
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The Use of Electromyography in the Calculation of Dynamic Joint Torque. by Norman, Robert William Ker, PhD from The Pennsylvania State University, 1977, 266 pages http://wwwlib.umi.com/dissertations/fullcit/7717713
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND ELECTROMYOGRAPHY Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning electromyography.
Recent Trials on Electromyography The following is a list of recent trials dedicated to electromyography.8 Further information on a trial is available at the Web site indicated. •
Electromyography to Diagnose Neuromuscular Disorders Condition(s): Healthy; Neuromuscular Disease; Postpoliomyelitis Syndrome Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: This study will investigate problems with muscle weakness and control using electromyography-a test of nerve-muscle cell communication. Advanced techniques called single fiber electromyography and macro-electromyography, which evaluate individual muscle fibers, will be used. Besides aiding in diagnosis, these tests provide information about disease progression that may be useful in guiding therapy. Adult patients with suspected neurological disorders of muscle control and weakness may be eligible for this study. Normal volunteers may also participate. For the electromyography procedure, a special needle is inserted into a muscle. The patient will slightly tense the muscle and maintain the tension while electrical signals from the muscle fibers are being recorded. The electrical signals are played through a loudspeaker, providing feedback to help the patient tense the muscle the appropriate amount. The test, which is usually done for only one muscle, takes 1 to 2 hours. If needed, short breaks can be taken. If the patient cannot maintain tension in the muscle for the entire test period, a nerve will be stimulated to activate the muscle. A thin needle is inserted near the nerve, and a series of small electrical shocks are given to activate a nerve fiber. The electromyography needle is inserted into the muscle to measure the response, as described above. A neurologist receiving specialized training in clinical
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These are listed at www.ClinicalTrials.gov.
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neurophysiology will do the electromyography procedure under the direct supervision of an experienced neurologist. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004553
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “electromyography” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON ELECTROMYOGRAPHY Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “electromyography” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on electromyography, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Electromyography By performing a patent search focusing on electromyography, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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The following is an example of the type of information that you can expect to obtain from a patent search on electromyography: •
Anorectal probe apparatus having at least one muscular activity sensor Inventor(s): Rao; Satish (Iowa City, IA) Assignee(s): University of Iowa Research Foundation (iowa City, Ia) Patent Number: 5,924,984 Date filed: January 30, 1997 Abstract: An apparatus for sensing muscular activity of the rectosigmoid region, rectum, and the anorectal canal of a subject is disclosed. This apparatus includes an elongate probe having a distal end opposing a proximal end which is configured for insertion into the patient's anorectal canal and includes a pressure sensor, an electromyography sensor, and a stimulus balloon. Multiple pressure sensors may be included to evaluate muscular activity in the anorectal canal. In addition, pressure sensors may be distributed along the length of the probe to simultaneously measure the response of other portions of the anorectal canal besides the anal sphincter muscle. A pressure sensor is also located inside the stimulus balloon for monitoring intraballoon pressure. Excerpt(s): The present invention relates to probes for assessing and treating medical conditions, and more particularly, but not exclusively, relates to multi-sensor probes for defecation disorders. Defecation disorders, such as constipation and fecal incontinence, affect as many as 20% of the population. Evaluating muscle activity of the defecation unit, including those of the anus, rectum, and rectosigmoid regions, is generally an effective way to diagnose these disorders and plan appropriate treatment. Various treatments, such as biofeedback therapy, also utilize an anorectal probe or catheter having these capabilities. U.S. Pat. Nos. 5,533,515 to Coller et al, and 4,887,610 to Mittal provide background information concerning devices to monitor selected aspects of sphincter muscle activity. However, there remains a need for a comprehensive probe to simultaneously monitor pressure and electrical activity of anorectal muscles at different locations in order to fully assess and treat various defecation disorders. Furthermore, a way to controllably stimulate appropriate anorectal muscles relative to the desired monitoring locations is needed. Web site: http://www.delphion.com/details?pn=US05924984__
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Combination neuromuscular stimulator and electromyograph system Inventor(s): Reiss; Hans W. (Encinitas, CA) Assignee(s): Med Serve Group, Inc. (encinitas, Ca) Patent Number: 5,549,656 Date filed: May 15, 1995 Abstract: A combined dual channel electromuscular stimulator for directing electrical pulses into the skin and a dual channel electromyograph for detecting electrical signals generated in muscles. The electromuscular stimulator includes electronic circuitry for generating electrical pulses, controlling the pulse rate and intensity and controlling various pulse characteristics. The pulses are administered by skin contacting electrodes. The electromyograph includes skin contacting electrodes for receiving input signals from the skin and electronic circuitry for receiving detected signals without interference
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with the stimulator output signals, amplifying, filtering and displaying the input signals. A control panel includes switches and controls for varying the various system parameters. Excerpt(s): This invention relates in general to electrotherapy apparatus and, more specifically, to a device that combines a neuromuscular stimulator for electrically stimulating muscles and an electromyograph for measuring the stimulation and its affects. A wide variety of devices have been developed for applying a low intensity direct alternating current to the skin to stimulate muscles or nerves, to relieve pain, etc. Typical of these are the nerve stimulation devices described by Hudleson et al. in U.S. Pat. No. 4,232,680, Takeuchi et al. in U.S. Pat. 4,895,153 and Kenyon et al. in U.S. Pat. No. 4,723,552. Electrical energy has also been introduced into the skin to relieve sinus and nasal congestion as described by Claude et al. in U.S. Pat. No. 4,926,880 and to treat skin ulcers, infections and the like as described by Ellis in U.S. Pat. No. 4,019,510. Means have been provided to measure resistance of skin areas to determine those most susceptible to treatment by light electrical or magnetic energy, as described by Tomecek in U.S. Pat. No. 4,112,923. The prior devices administer electrical energy at a variety of frequencies and in different patterns. Typical of these is the system disclosed by Rossen in U.S. Pat. No. 4,989,605 which applies a carrier signal to the skin through an electrode. The signal is in the form of D.C. bursts in the frequency range of 10,000 to 19,000 Hz which is modulated on and off at a lower frequency. Other typical devices include the microprocessor controlled device for applying a low frequency pulse train and a modulated high frequency pulse train to a patient through an electrode as disclosed by Padjen et al in U.S. Pat. No. 4,719,922, a device in which a constant current square wave signal is directed into the body between two electrodes as described by Hudleson et al in U.S. Pat. 4,232,680 and a device in which a high frequency low amperage current is applied to a body through an electrode as described by Liss et al in U.S. Pat. 3,902,502. Web site: http://www.delphion.com/details?pn=US05549656__ •
Disposable electrodes for electromyography (EMG) and nerve conduction velocity (NCV) and kit containing same Inventor(s): Blumenfeld; Arthur (Brewster, NY), Pedersen; Finn (Stenlose, DK), Schaefer; Alan J. (Spring Valley, NY), Stabell; Carsten (Bronshoj, DK) Assignee(s): Vickers Plc (london, Gb2) Patent Number: 5,203,330 Date filed: February 26, 1991 Abstract: A disposable electrode for use in electromyography and/or nerve conduction velocity testing has a tab for connection to a cable connector and is laminated of a plurality of layers including first and second outer layers. The first layer is a backing member with exposed adhesive, a hydrogel layer intermediate the outer layers and a conductive foil layer between the hydrogel layer and the second outer layer. The electrode may be a disc electrode, a ground electrode or an elongated flexible digital ring electrode. The disc electrode includes two identical disc electrode elements having circular portions separably joined to each other at a central portion and the tab of each element is remote from the central portion. A kit contains a plurality of disposable electrodes packaged in a blister pack, the packaged electrodes including a plurality of such disc electrodes, a plurality of such ground electrodes and a plurality of such elongated flexible digital ring electrodes.
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Excerpt(s): This invention relates to electrodes, particularly for use in Electromyography (EMG) and Nerve Conduction Velocity (NCV) measurement, and more particularly to such electrodes that are disposable. The invention further relates to a kit containing such electrodes. The invention presents a disposable disc electrode, a disposable ground electrode and a disposable digital ring electrode and a kit containing same. 1. Needle EMG: This portion of the examination is a volitional recording made from within the muscle, utilizing a needle electrode--sometimes with a surface reference electrode--and requiring a grounding electrode for grounding the patient. Web site: http://www.delphion.com/details?pn=US05203330__ •
Electrode and method for laryngeal electromyography Inventor(s): Davis; William E. (807 Stadium Rd., Columbia, MO 65201), Rea; James L. (807 Stadium Rd., Columbia, MO 65201), Templer; Jerry W. (807 Stadium Rd., Columbia, MO 65201) Assignee(s): None Reported Patent Number: 4,155,353 Date filed: December 19, 1977 Abstract: An electrode for laryngeal electromyography comprises an insulator body having a pair of rigid conductors or posts mounted in a spaced apart relation therein. A pair of flexible electrical wires have one end connected with an associated post, and the other end adapted for connection to an electrical signal monitor. A tab projects outwardly of the insulator body, and is shaped for insertion into a laryngeal ventricle portion of the patient and prevents inadvertent removal of the electrode from a vocalis muscle thereof. The free ends of the posts are embedded into the patients vocalis muscle, and a signal generating probe is applied to surgically exposed internal tissue in the area surrounding the recurrent laryngeal nerve, whereby contact between the probe and the laryngeal nerve excites the vocalis muscle and the monitor, thereby indicating to the surgeon the exact location of the nerve. Excerpt(s): This invention relates to electrodes, and in particular to an electrode and method for locating the recurrent laryngeal nerve in a surgery patient. A quite serious and recurring problem for otolaryngologists is the post operative side effect of vocal cord paralysis following thyroid surgery. Even the best and most experienced surgeons, using the most sophisticated equipment heretofore available, encounter a substantial hazard that the recurrent laryngeal nerve (RLN) will be severed, stretched or bruised during surgery on or about the thyroid gland. This surgical hazard is a result of several factors, including the fact that the recurrent laryngeal nerve lies just posterior to the most inferior portion of the thyroid gland, and is very small and delicate. Further, it is quite difficult to distinguish this nerve from the background tissue when the area about the thyroid is inflammed, as well as covered with blood following the initial incision. As the result of these aforementioned complications, the risk of vocal cord damage following thyroid surgery is very high, and also is quite serious in that it can result in the patient's complete loss of speech. Even if the laryngeal nerve is simply been stretched or bruised, the loss of speech may last for several months. In the unfortunate cases where the nerve is completely severed, the paralysis is permanent, and surgical attempts to prepare the same have not yet proven successful. The principal object of the present invention are: to provide an electrode and method for laryngeal electromyography to locate a recurrent laryngeal nerve; to provide such an electrode and method for continuous, intraoperative laryngeal nerve location during thyroid
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surgery; to provide such an electrode and method which is easily inserted in the patient and adapted for reliable operation; to provide such an electrode and method which is simply and accurate in operation whereby surgeons without extensive experience in thyroid surgery may conduct said surgery, yet avoid damage to the laryngeal nerve; to provide such an electrode having an insulator body and tab connected therewith adapted for insertion into a laryngeal ventricle portion of the patient for preventing inadvertent removal of the electrode from the patient's vocalis muscle; to provide such an electrode and method including an audio monitor, whereby the location of the laryngeal nerve may be determined while the surgeon maintains continuous sight observation of the area of surgery; to provide such an electrode and method including an insertion device for accurately and securely placing the electrode in the patient's vocalis muscle without interfering with other equipment; and to provide such an electrode which is economical to manufacture, efficient in use, and particularly well adapted for the proposed use. Web site: http://www.delphion.com/details?pn=US04155353__ •
Electromyograph with data transmission comprising no metallic conductors Inventor(s): Dellacorna; Alberto (03, Cisliano, IT) Assignee(s): None Reported Patent Number: 5,233,999 Date filed: December 26, 1991 Abstract: An electromyograph includes a patient portable unit to pick up data derived by detecting electrodes and to transmit them to a fixed base unit which receives the data, processes them further, and makes them available to a known reading unit. The signals between the two units are exchanged in digital form through at least one optical fiber cable or a radio communication device, which allows a wide freedom of movement to the patient and guarantees absolute electric insulation. Excerpt(s): The present invention concerns an electromyograph wherein the data detected on the patient is transmitted to the receiving unit without the use of metallic conductors, for instance by optical means or by radio communication. The electromyograph is a medical instrument used to detect the electric muscular activity by means of surface electrodes applied on the patient's skin, or by means of needle electrodes inserted into the patient's muscle in the body parts of which the muscular functionality needs to be studied. The instrument is used more and more frequently to study the physiology of the muscular apparatus in healthy subjects and to thus acquire data for use in the study and treatment of muscular pathologies and, in particular, in therapies to recover the muscular functionality of previously injured parts. The electromyograph of known technique uses the same technology of the already known and tested instruments for detecting the electric activity of other organs of the human body, as for instance the electroencephalograph or the electrocardiograph, and it hence consists of a table instrument from which a plurality of electric cables are connected to electrodes suitably fixed to the patient's body. This technique, which has given and still gives satisfactory results in the study of the heart and brain functions, has instead not given equally satisfactory results in the study of the muscular functions. This technique depends on a variety of factors, all however substantially leading to the fact that the muscular functions have to be measured while the muscle is contracting and thus in a dynamic condition, as opposed to the previously cited functions which can be taken in a fully static condition.
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Web site: http://www.delphion.com/details?pn=US05233999__ •
Electromyographic feedback monitor system Inventor(s): Hoover; Jan C. (Bainbridge, WA) Assignee(s): J&j Engineering (poulsbo, Wa) Patent Number: 6,076,011 Date filed: February 2, 1999 Abstract: A system to monitor surface electromyographic (EMG) activity of a user and provide appropriate feedback to the user includes an EMG feedback monitor sized and configured to be worn by the user. In the depicted embodiment, surface EMG activity is measured with electrodes integrally affixed to a housing of the system. Feedback is typically provided using vibrations of certain duration and repetition. The system operates under various user selectable operational modes. Each operational mode is associated with particular electromyographic feedback criteria used to determine appropriate feedback for the user. The electromyographic feedback criteria is related to signal levels and time measurements associated with surface EMG activity level measured of the user. The depicted embodiment includes a computer interface allowing EMG signal data recorded by the EMG feedback monitor to be sent to a computer system. The computer system is also used to adjust and download desired operational modes into the EMG feedback monitor. Excerpt(s): Electromyographic (EMG) activity at various locations on the skin surface of an individual person is an indicator of many physiological conditions related to the individual's level of fitness or health. Through muscle activity, weak electrical currents are generated. An EMG signal is measured from these currents in a microvolt range having a frequency range of 20 to 400 Hz. The EMG signal measurement is taken on the surface of the individual using electrodes of a certain impedance. Many examples of how EMG signal measurement correlates to health and fitness conditions involve repetitive motions including such activities as typing or manufacturing assembly with repetitive motion involving wrists, hands, arms, and shoulders. These repetitive motions may all cause health problems if done improperly. Studies have shown that those that properly undertake repetitive motion take brief rests that are oftentimes unnoticeable to the trained eye. Fortunately, activity with repetitive motion interrupted by brief rests has corresponding surface EMG activity with recognizable patterns related to signal strength versus time measurements. Attempts have been made to use these patterns to train individuals to properly practice repetitive motions to either unlearn or avoid improper habits. The effectiveness of prior art systems unfortunately has been limited due to restrictions imposed by these systems. For instance, users are restricted to certain locations and activities by the prior art systems. Also, the devices and methods providing feedback to users are cumbersome and indirect so that the prior art systems do not provide the type of demonstrative and meaningful feedback to dramatically encourage positive changes in behavior by the users. Posture is another area in which surface EMG activity has been used with limited success to help correct conditions. Those with proper posture have certain surface EMG activity patterns at certain locations on the surface of their body, whereas those with improper posture have other patterns at the same locations. The limited success again has been due to prior art systems. The effort required to use prior art systems is as great or greater than that required to modify behavior. Oftentimes, the extra burden is too much for a user to reach desired goals and health benefits. Other situations conductive to surface EMG
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activity monitoring involve bruxism. Here an individual grinds their teeth while sleeping so has little awareness by natural means of the problem while it is occurring. Headaches, neck and shoulder pain, back pain, and other states of inappropriate muscle activation causing pain or muscle problem are also candidates for monitoring surface EMG activity. Web site: http://www.delphion.com/details?pn=US06076011__ •
Electromyographic treatment device Inventor(s): Fields; R. Wayne (6490 Chessington La., Gladstone, OR 97027), Hall; H. Eugene (10029 NE. 27th St., Bellevue, WA 98004), Munday; William A. (6503 57th Ave. NE., Seattle, WA 98115), Tillman; James E. (1462 38th Ave., Seattle, WA 98122) Assignee(s): None Reported Patent Number: 5,300,096 Date filed: June 3, 1992 Abstract: An electrical muscle stimulator converts electromyographic (EMG) signals to digital words for analysis and display by a computer program. The therapist selects a variety of different parameters appropriate for the individual patient, and instructs the device to initiate stimulating signals on command, or upon detection of a suitable EMG signal from the patient. The device that converts digital words representing the selected parameters into complex, bipolar therapeutic pulses. The device can digitally model a wide variety of wave forms and graphically assist the therapist in developing and shaping various wave pulse trains. Excerpt(s): The invention relates generally to electrical stimulation of muscles in rehabilitation therapy. Specifically, the invention relates to methods and techniques for applying electrical muscle stimulation in the presence or absence of a natural myographic signal. The application of electrical stimulus to neuromuscular structure for beneficial purposes is well known. Treatment of this type is employed for pain and edema reduction, neuromuscular re-education, and reduction of spasticity. The electrical and biochemical aspects of muscle contraction are relatively well known, and are described in detail by Benton et al. "Functional Electrical Stimulation--A Practical Clinical Guide", second edition, Ranchos Los Amigos Rehabilitation Engineering Center, Downey, Calif., which is incorporated herein by reference. Electrical muscle stimulation (EMS) has significantly enhanced muscle function in individuals suffering from neurological impairment due to stroke, cerebal palsy, and other conditions which effect the muscular system. Web site: http://www.delphion.com/details?pn=US05300096__
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Electromyographic virtual reality system Inventor(s): Reddy; Narender P. (Akron, OH), Sukthankar; Sujat M. (Akron, OH) Assignee(s): The University of Akron (akron, Oh) Patent Number: 5,482,051 Date filed: March 10, 1994 Abstract: A finite element model of a structure is manipulated according to electromyographic signal from the musculature of an operator. The resulting forces are
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fed back to the operator and a display provides visual feedback of the resulting displacements. Excerpt(s): The present invention relates to interactive computer modelling of realworld structures and particularly to the deformation of modeled objects in response to forces exerted by an operator. Virtual reality involves the idea of immersing an operator in a world of computer generated dynamically changing images, and allowing the operator to actively modify this virtual environment. Virtual reality systems have been built that provide operator inputs to the computer created environment by various position sensors. These sensors may be position sensors such as mechanical linkages or optical trackers that determine the location of all or part of the operator's body. In response to these sensors, the computer generated image is manipulated. Web site: http://www.delphion.com/details?pn=US05482051__ •
EMG assistant: a method for the automated localization of root/plexus/nerve/branchdamage, using the routine clinical (needle) electromyographic study results Inventor(s): Yaar; Israel (53 Lantern La., Sharon, MA 02067) Assignee(s): Yaar; Israel (sharon, Ma) Patent Number: 6,366,806 Date filed: March 18, 2000 Abstract: A novel computerized method for automatic diagnosis of clinical electromyographic (EMG) studies is presented. The elecromyographer (EMGer) performs a routine EMG study and assigns graded levels of pathology to each of the muscles examine. This data is input into the program. A priori, the program computes all the possible combinations (sets) of nerve damage, translates them to all possible combinations (sets) of muscle damage. Once the data is input, the program checks the input against all these muscle-sets for goodness of fit. Once the muscle-sets that best fit the EMGer's input are found, they are translated to the nerve-sets that produced them. Among the latter, only the nerve-sets that include the minimum number of damaged nerve-segments are retained and output as the best explanation for the EMGer's findings--the diagnosis. Excerpt(s): This invention relates to medical diagnostic devices and methods and in particular to the electromyographical diagnosis of nerve damage. Electromyography, as used clinically to diagnose nerve and muscle disorders, involves recording electrical signals (the electromyogram or EMG) from muscles by means of needle electrodes. These signals may be interpreted as normal or as abnormal for each muscle. The abnormal muscles are also graded for their level of abnormality. Usually, many muscles are sampled in order to make a comprehensive diagnosis. The EMG abnormalities may indicate muscle specific disease and nerve specific disease. In the latter, it may indicate a general (diffuse) disorder and focal or multi-focal disorders. The proposed method, henceforth called the EMGAssistant is dedicated to the latter two. The interpretation of an EMG study as it pertains to the localization of root/plexus/nerve/branch-damage-or, in generality, nerve-segment damage--is an important part of the neurophysiological evaluation of patients. The current practice is based on established nerve-to-muscle wiring tables* and the slow, thinking-it-through, mental reasoning-process on the part of the physician (electromyographer or EMGer). As such, the current practice is far from perfect. It relies heavily on the individual physician capability to memorize complicated wiring tables, the physician's deducing capabilities and the time allocated to the task.
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This is especially true when the nerve damage involves more than one segment of one nerve, and/or when there are extraneous abnormalities on the EMG study that do not relate to the nerve damage at hand. These situations can confuse even the best electromyographer and render his diagnosis worthless. This situation is corrected by the EMGAssistant that makes the diagnostic process completely objective, precise, fast and with the ability of checking all possible answers. Web site: http://www.delphion.com/details?pn=US06366806__ •
Emotional response analyzer system with multimedia display Inventor(s): Zawilinski; Kenneth Michael (7800 Kincheon Ct., Austin, TX 78749) Assignee(s): None Reported Patent Number: 5,676,138 Date filed: March 15, 1996 Abstract: A multimedia computerized system for detecting emotional responses of human beings and the changes therein over time. The system includes a stimulus presentation device for presenting a stimulus, such as a television commercial, occurring over a predetermined period of time to each of one or more individuals forming a population sample; measuring devices for measuring and recording a plurality of values associated with each of a plurality of physiological variables, such as heartrate, electromyography and electrodermal activity, each associated with one or more individuals; software programmed for receiving and translating each value measured by statistical calculation into a unitless statistical measure known as a z-score, then graphing the z-score on an interaction index, and then associating automatically the zscore with a semantic descriptor for an associated emotion or state of feeling, more particularly,; and, an interactive multimedia computer for electronically storing, displaying and retrieving information and capable of at least visually displaying one or more stimuli presented at a given time interval, at least one semantic descriptor associated with the stimulus presented, and an interaction index associated with the semantic descriptor associated with the stimulus presented. Excerpt(s): The present invention relates to an apparatus for use in the field of research regarding emotional responses of human beings, more particularly, a system including measurement devices of physiological variables operably connected to a computerized analyzer and having a multimedia display for displaying resulting data, such as each of a plurality of semantic descriptors associated with each of a plurality of emotional responses of a human at a given moment over a preselected time period during the presentation of a stimulus. As the study of clinical psychology advances, the tools used to analyze emotional responses to various stimuli presented to a subject likewise advance. Physiological variables have been traditionally used to measure changes in emotions, typically employing devices to measure galvanic skin response (GSR), blood pressure, heart rate, respiration, as well as, electromyography (EMG) and electrocardiography (EKG). The prior art reveals a wide range of applications using such typical monitoring devices, their application in large part depending upon the underlying research goal the inventor or researcher was trying to achieve while measuring one or more physiological variables. For example, a first group of devices was developed when the field of response analysis was in its infancy. For example, U.S. Pat. No. 2,535,249 issued Dec. 26, 1950 to Wilhelm et al. describes an electric psychometer comprising simple circuitry including a Wheatstone bridge and electrodes for testing skin conductivity or resistance. A small progressive step was then taken to
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combine individual reactions into a group; U.S. Pat. No. 3,034,500 issued May 15, 1962 to Backster, Jr. describes an apparatus for measuring group reactions by measuring the skin conductivity of each of a plurality of individuals with a plurality of electrodes operably connected using a Wheatstone circuit to a plurality of recording arms and a chart. More recently, a galvanometrically based method has been described in U.S. Pat. No. 4,331,160 issued May 25, 1982 to Zito, Sr., which method measures variations in galvanic skin response using a pair of electrodes or polygraph in which the output device is periodically "zeroed" during interrogation of the subject. Web site: http://www.delphion.com/details?pn=US05676138__ •
Implant device for internal-external electromyographic recording, particularly for the in vivo study of electromotor activity of the digestive system Inventor(s): Cigaina; Valerio (Via IV Novembre 3/a, 1-3150 Villobra (Treviso), Ferraro; Francesco (Via Magnano 21, 1-10100 Piverone (Torino) Assignee(s): None Reported Patent Number: 6,411,842 Date filed: November 24, 1999 Abstract: Implant device for internal-external electromyographic recording of the electromotor activity of the digestive system, being of the type that comprises at least one sensor implanted in the viscera to record its electric activity and to provide a device for analysis in vivo of the electric activity of the tract, capable of giving the patient normal freedom of movement. Excerpt(s): The invention relates to a new implant device for internal-external electromyographic recording, particularly for in vivo study of the electromotor activity of the digestive system. Almost 70% of the diseases of the gastroenteric system are classified as functional, which is to say that the cause of the patient's problem is secondary to a malfunction of the gastroenteric canal, whether in digestive or motor terms. The histological characteristic of a muscular component present along the entire length of the digestive system, which is responsible for its motor activity, has as its counterpart an associated electric activity that is secondary to the depolarization of the musculature itself. Web site: http://www.delphion.com/details?pn=US06411842__
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Inspiratory proportional pressure assist ventilation controlled by a diaphragm electromyographic signal Inventor(s): Friberg; Sven (Molndal, SE), Grassino; Alejandro (Westmount, CA), Lindstrom; Lars (Molndal, SE), Sinderby; Christer (Montreal, CA) Assignee(s): Universite DE Montreal () Patent Number: 5,820,560 Date filed: April 29, 1997 Abstract: To control a lung ventilator comprising an inspiratory implement to be worn by the patient, an air supply system for supplying air to the inspiratory implement, and a control unit for controlling the air supply system, electromyographic signals produced by the patient's diaphragm are detected by an array of electrodes passing through the
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center of the patient's diaphragm depolarizing region. The position of the center of the patient's diaphragm depolarizing region is determined through detection of a reversal of polarity of the electromyographic component of the electrode-detected electromyographic signals. First and second electromyographic signals detected by the electrodes of the array on opposite sides of the patient's diaphragm depolarizing region are subtracted from each other, this subtraction cancelling the noise components of the first and second electromyographic signals but adding the respective electromyographic components of these first and second signals together to produce an electromyographic signal having an improved signal-to-noise ratio, having a reduced electrode-position-induced filter effect, and being representative of a demand to inspire from the patient's brain. The electromyographic signal of improved signal-to-noise ratio is finally supplied as input signal to the control unit of the lung ventilator for controlling the air supply system and therefore the inspiration assist in relation to the electromyographic signal of improved signal-to-noise ratio and of reduced electrodeposition-induced filter effect, and therefore in relation to the demand to inspire from the patient's brain. Excerpt(s): The present invention relates to the control of a lung ventilator by means of an electromyographic (EMG) signal produced by detecting EMGdi signals of reverse polarities on opposite sides of the center of the diaphragm depolarizing region and by subtracting these EMGdi signals to improve the signal-to-noise ratio and to reduce an electrode-position-induced filter effect. The physiological mechanisms which generate myoelectrical activity when a muscle contracts have been known and understood for a long time. In particular, how to record signals from the muscles is one of the most extensively, theoretically described topics in physiology. Although the theoretical understanding is impressive, the bio-physiological application of these theories is, in practice, still deficient. As an example, no standardized analysis procedure has been developed for recording signals produced by activation of several, different motor units, the so called interference wave pattern. The interference wave pattern signal (EMG signal) contains an immense quantity of bio-physiological information about the given neuro-muscular function. However, as this EMG signal is very low in amplitude, it is sensitive to numerous artifacts. The influence of these artifacts varies in relation to the configuration of recording electrodes, the digitizing rate of the signal, and the type of recording technique. Prior art analysis of interference wave pattern signals usually comprises a time consuming, tedious manual determination of the quality of the signal through visual inspection of this signal in the time domain. This determination is performed by a "subjective" investigator. Most of the prior art references describe how to calculate comparison estimates, but present very few comments on the signal quality. It is therefore not surprising to find that, in this technical field, independent studies evaluating the same questions have lead to different or even contradictory results. Web site: http://www.delphion.com/details?pn=US05820560__ •
Integrated movement analyziing system Inventor(s): Cusimano; MaryRose (1050 Whitney Ranch Dr. #3023, Henderson, NV 89014) Assignee(s): None Reported Patent Number: 5,462,065 Date filed: August 17, 1994
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Abstract: An integrated movement analyzing system (10) that utilizes surface electromyography in combination with range of motion and functional capacity testing to monitor any muscle group in the human body (80). The system (10) consists of an integrated movement analyzer (18) that receives inputs from up to 32 channels of surface EMG electrodes (12), a range of motion arm (ROMA) (14) having six degrees of freedom, and a functional capacity sensor (FCS) (16) having one output channel. When performing upper and lower back protocol testing, the ROMA (14) is connected between the patient's upper back and lower back by a shoulder harness (40) and a waist belt (42). For cervical testing, the ROMA (14) is connected between the patient's head and upper back by a cervical cap (44) and the shoulder harness (40). The output of the IMA (18) is provided via an analog to digital converter (30) to a computer (34). The computer (34) in combination with a software program (36) produces comparative analytical data which is primarily in the form of graphic plots. Excerpt(s): The invention pertains to the general field of electro-diagnostic equipment and more particularly to an integrated movement analyzing system that combines electromyography with range of motion and functional capacity measurements, to provide a non-invasive and non-loading method for analyzing myofascial injuries. Unresolved myofascial injuries represent the second largest medical problem today, with back pain alone accounting for the largest medical visits. Carpal tunnel syndrome (CTS), repetitive stress injuries (RSI) account for the most days lost and are predicted to become the most costly health problem of our time. With the implementation of the American's with disability (ADA) law worker's compensation claims such as CIS can now sue in the federal court system allowing for the initiation of suits in excess of 10 million dollars. These claims could damage the economy and force employers to go outside of the United States. A recent study in the New England Journal of Medicine indicates that over 58% of asymptomatic low back pain patients who underwent an MRI found evidence of disc pathology. How reliable is an MRI--it appears to have no correlation to pain, impairment and may not be clinically significant. Web site: http://www.delphion.com/details?pn=US05462065__ •
Linear electromyographic biofeedback system Inventor(s): Howson; David C. (R.D. 2, Trumansburg, NY 14886), Scattergood; Mark G. (R.D. 2, Trumansburg, NY 14886) Assignee(s): None Reported Patent Number: 4,136,684 Date filed: February 7, 1977 Abstract: A linear electromyographic biofeedback system operates over a dynamic range of at least one thousand to one. That is, the system remains linear from input levels of approximately one microvolt to input levels in excess of one millivolt. The linear electromyographic biofeedback system includes a sensitive transducer which is followed by a protection circuit and connected to a differential amplifier for eliminating common mode noise. The output of the differential amplifier is filtered and amplified to further eliminate unwanted signals. This filtered signal is rectified and averaged in a third order averaging filter to obtain a close approximation of a time averaging without the necessity of discrete timing periods. The output signal from the averaging filter is then used to control a current controlled oscillator which provides a series of audible pulses at a rate which varies linearly with the value of the input voltage detected by the
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transducer, the repetition rate range being from approximately one hertz to greater than five thousand hertz. Excerpt(s): The present invention relates to bioelectronic systems and more particularly, to electromyographic biofeedback systems. There are in the prior art, many systems which measure human muscle activity and provide an output signal which corresponds to the muscle activity. However, most of these prior art systems are limited in the range of operation and are basically digital in nature in that they do not provide any response below a preset threshold level. Therefore, the patient or the therapist gets no information relative to small muscle movements. In some cases, it is the small muscle movements which are most important since these are the movements which indicate the earliest signs of progress in rehabilitation. Examples of the prior are threshold systems are U.S. Pat. No. 3,656,474 to Gentry, et al, and U.S. Pat. No. 3,657,646 to Zmyslowski, et al. Web site: http://www.delphion.com/details?pn=US04136684__ •
Method and an apparatus for use in electromyography to determine risk of muscular disorder Inventor(s): Kadefors; Roland (Goteborg, SE), Oberg; Tommy (Eksjo, SE), Sandsjo; Leif (Goteborg, SE) Assignee(s): Synectics Medical AB (stockholm, Se) Patent Number: 5,645,073 Date filed: June 7, 1994 Abstract: The invention relates to a method and an apparatus for detecting muscular status. The apparatus includes an electrode (7) for taking up analog myoelectric signals, an amplifier (1) which is followed by an A/D converter to which is connected a signal processing unit (3). A signal (4) is connected to the signal processing unit.The analog signals collected by the electrode (7) are converted, after amplification, into binary signals which are analyzed in the signal processing unit (3). This calculates the occurrences of muscle activity below a certain muscle activity level related to an initial muscle activity determined on commencement of the detection. Signals relating to the occurrences of muscle activities below said level are emitted from the signal (4) or stored in a storage device. Excerpt(s): The present invention relates to a method and an apparatus for collection, analysis and presentation of myoelectric signals (EMG-signals) for determination of muscular status to make it possible to identify risk of muscular disorder. In many contexts, there is a manifest interest in establishing muscular status, by which is taken to mean both the status of muscle at rest and the status of muscle at work. It is of particular interest to be able to follow the change in the status of the muscle during work and, in such instance, preferably to obtain a continuous and/or immediate information on status with the possibility of recording this for subsequent follow-up. Such establishment of muscular status is, of course, interesting in purely scientific contexts and in the event of illnesses, but is also of considerable value in many practical applications, for example of people carrying out industrial assembly work or certain types of office work (e.g. terminal work at computers). By establishing muscular status, the possibility will be created, for example, for studying the effect of the design and layout of the workplace and the working position, respectively, on muscle loading, and
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for analyzing the consequences of prolonged monotonous muscle loading. This latter working situation occurs in both the assembly industry and in office work. Web site: http://www.delphion.com/details?pn=US05645073__ •
Method and apparatus for micturition analysis Inventor(s): Buuck; Robert E. (Golden Valley, MN), Graves; Wayne H. (Minnetonka, MN), Klatt; William M. (Robbinsdale, MN) Assignee(s): American Medical Systems, Inc. (golden Valley, Mn) Patent Number: 4,063,548 Date filed: April 7, 1975 Abstract: A method and apparatus for analyzing micturition disturbances are provided. The apparatus comprises a gas cystometry system for monitoring bladder detrusor reflexes and an electromyographic monitoring system which, in the preferred form of this invention, are combined within a unitary enclosure. The cystometry system further compromises a catheter for injecting fluid interiorly of the bladder and associated electronic circuitry for deriving interior bladder pressure. The electromyographic system comprises one or more electrodes for sensing sphincter electrical activity and electronic circuitry interconnected with the electrodes for amplifying sphincter electrical outputs. A dual trace strip chart recorder interconnected with the cystometry apparatus and the electromyography apparatus provides simultaneous display of bladder detrusor reflexes and related sphincter electrical activity for correlated analysis by the attendant physician. In the preferred embodiment of this invention the electromyographic electrodes are operably mounted at the bladder-engaging end of a cystometric catheter.A method disclosed herein for diagnosing micturition dysfunction comprises the steps of generating a cystometrogram, generating a sphincter electromyogram, and simultaneously displaying the cystometrogram and the electromyogram to thereby correlate micturition neurological responses. Excerpt(s): The micturition reflex is comprised of a plurality of interrelated neurological reflexes involved in urination. The function of the lower urinary tract includes maintenance of urinary continence and periodic expulsion of urine during voiding. The latter functions involve sympathetic, parasympathetic and somatic nerves. Continence is maintainable by sphincter muscles, which preferably controllably contract the bladder urethra, acting as a valve. Discharge of urine is facilitated by sphincter relaxation. Urination also requires coordinated operation of the detrusor muscle which surrounds the bladder. Impairment of one or more of the neurological reflexes associated with proper sphincter or detrusor action can result in inefficient or impaired bladder operation. Damage can occur to the urinary tract as a result of injury or diseases, such as multiple sclerosis. Effective medical treatment can consist of repair or treatment of damaged functional parts by surgical or pharmacological techniques in an attempt to restore the natural sequence of micturition events. Complete restoration of function of course includes returning volitional control of the micturition reflex to the patient. Electronic stimulation techniques are known whereby muscular contractions can be induced in a manner mimicking the natural sequence of events. Thus, knowledge of normal micturition function, including neurological understanding of the lower urinary tract, coupled with an assessment of the damage incurred by the individual patient, facilitates medical treatment of and restoration of function to the neurologically disabled bladder. Diagnosis of a particular patient's micturition characteristics is greatly facilitated through the techniques of gas cystometry and sphincter electromyography.
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Cystometry is a diagnostic procedure for evaluating bladder function whereby an accurate picture of normal and abnormal micturition physiology is derived. Cystometric evaluation of micturition disturbances permits an orderly system of classification of neurogenic bladders. The procedure involves distension of the bladder by filling it with a gas or liquid through an inserted catheter. As fluid is inserted interiorly of the bladder, the relation between intravesical bladder pressure and inputted volume of fluid is graphically determined. The principal observation made from the cystometrogram which results in the presence or absence of a detrusor reflex. Where a detrusor reflex is evoked by bladder filling, the patient may be asked to suppress the reflex as a test of detrusor volitional control. The patient's response will be graphically characterized by the cystometrogram (CMG). Cystometry may also be used to test the urodynamics of voiding. The latter technique provides for simultaneous measurement of urinary flow rate with intravesical pressures as voiding occurs concurrently with a detrusor reflex. Sphinctor electromyography is a diagnostic technique in which micturition electrical responses of the urinary sphincters are graphically displayed. Electromyography has been used in detecting lesions of the lower motor neurons and peripheral nerves and in diagnosing primary skeletal muscle disease. The sphincter response is sensed by utilization of externally contacting electrodes. Usually, electronic amplifying apparatus is provided to process the sphincter signals sensed by the electrodes such that the signal may be displayed; for example, on a strip chart recorder. The electromyogram (EMG) produced by the technique provides a useful graphical monitor of sphincter electrical activity, particularly where a patient is unable to control voiding. Web site: http://www.delphion.com/details?pn=US04063548__ •
Method and apparatus for use in temporal analysis of waveforms Inventor(s): Brown; Thomas I. H. (Melbourne, AU), Davis; Graham R. (Gillingham, GB2) Assignee(s): National Research Development Corp. (london, Gb2) Patent Number: 4,592,369 Date filed: July 8, 1983 Abstract: In single fibre electromyography it is useful to be able to measure intervals between waveforms (obtained from needle electrodes inserted into muscle fibres) reaching certain levels. A circuit is described, which is of general application, and which allows such intervals to be measured. First and second comparators which have adjustable reference levels receive an incoming waveform and, by means of polarity select circuits, provide outputs only when the reference levels are passed by waveform portions changing in selected respective directions. The time at which the first comparator is satisfied is available from a counter 33 but it is only passed to a computer interface when the second comparator has also been satisfied. Enable circuits prevent an output to the computer unless the comparators are satisfied within selectable time intervals. Excerpt(s): The present invention relates to a method and apparatus for determining when waveforms satisfy predetermined conditions relating, for example, to level and increasing or decreasing value. Such information is useful in analyzing single fibre electromyographic (SFEMG) waveforms. Single fibre electromyography is concerned with the study of electrical activity in individual nerve and muscle fibres. Signals are recorded using a hypodermic needle containing one or more electrodes. Each electrode can usually monitor electrical activity in two to three muscle fibres, depending on the fibre density. Information is transmitted around the nervous system as a series of
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voltage waveform spikes, called action potentials. These spikes propagate along nerve and muscle fibres, using a form of rate modulation to convey information. The propagation of action potentials along a muscle fibre stimulates the force generation process, with increasing force being associated with an increasing pulse frequency. Action potentials in muscle fibres are stimulated by nerve fibres, with one nerve fibre "driving" a number of muscle fibres. A group of muscle fibres connected to a single nerve fibre is called a motor unit. Needle electrodes usually pick up action potentials from two or three muscle fibres in the same motor unit. This means that a number of spikes will be seen synchronised with each other but separated in time due to a difference in propagation delay. The size and shape of action potentials is usually insignificant since all the information is contained in the timing of the spikes or pulses. Thus the study of single fibre electromyography is concerned with the measurement of time intervals only. The two main measurements are the inter-discharge interval (IDI) and the inter-potential interval (IPI). The inter-discharge interval is the time between consecutive action potentials in a single fibre. The inter-potential interval is the time difference between synchronized action potentials in two fibres of the same motor unit. The IDI varies from about 10 ms to 200 ms for most muscles and the IPI varies up to about 3 ms in normal cases and up to 20 to 30 ms in extreme cases of disease. A useful measurement is the variability of the inter-potential interval called the jitter. The jitter can be used as a measure of the extent of neuromuscular disorder in diseased patients, and the way in which jitter changes with changing conditions, fatigue and temperature for example, can be useful in diagnosis. At the moment measurement techniques in this field are limited and so there is a need for instrumentation capable of extracting temporal data from analogue signals. Web site: http://www.delphion.com/details?pn=US04592369__ •
Method for measuring the function of joints and associated muscles Inventor(s): Sihvonen; Teuvo (Lampaankuja 10, FIN-70780 Kuopio, FI) Assignee(s): None Reported Patent Number: 5,755,675 Date filed: July 17, 1995 Abstract: The invention relates to a method for measuring the function of joints and associated muscles. The method comprises measuring, on the one hand, the mobility of a person in a desired area and, on the other hand, simultaneously by means of electromyography (EMG) measuring the electrical activity of muscles in the same area, and evaluating the abnormality in the mobility and in the function of the muscles of said area, caused especially by pain, by comparing the measured values with reference values compiled in advance. Excerpt(s): The invention relates to a method for measuring the function of joints and associated muscles. The causes of various joint disorders are mainly unknown, and it is often impossible to detect them objectively. It seems, for example, that back pain of even short duration leads to a decline in the muscular activity, functional disorders of the back, and restrictions of motion. The aim of treatment is usually to restore declined muscle function and improve the functional protection and mobility of the back, and thereby to reduce mechanical load and pain-giving stimuli. When evaluating the change in the functional state and the degree of disability in connection with examination and treatment of patients suffering from joint disorders, a doctor must largely draw on the visual impression that he gets. Doctors have always tried to analyze functional disability
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subjectively by evaluating, for instance, the effortlessness of movements of the back, and muscular reactions. They have tried to get an impression of the functional state by evaluating the mobility and the maximum muscle forces. There have also been attempts to correlate back pain with changes in the spinal structure and the ranges of motion determined in extreme positions. Recently the maximum forces of body torsions have been measured to provide support for treatment. Web site: http://www.delphion.com/details?pn=US05755675__ •
Method of measuring consumer reaction Inventor(s): Hill; Daniel A. (1268 Pennsylvania Ave., Apt. 2, San Diego, CA 92103) Assignee(s): None Reported Patent Number: 6,422,999 Date filed: May 10, 2000 Abstract: A method of assessing consumer reaction to a marketing stimulus, involving the steps of (a) exposing a sample population to a marketing stimulus for an exposure period, (b) measuring surface electromyography signals from a zygomatic muscle of each member of the sample population during an exposure period, (c) optionally measuring surface electromyography signals from a corrugator facial muscle of each member of the sample population during the exposure period and combining the measured surface electromyography signals from the zygomatic and corrugator facial muscle of each member of the sample population to produce combined electromyography signals, (d) measuring electrodermography signals of each member of the sample population during the exposure period, (e) equating or translating the electromyography signals to an appeal value for each member, (f) equating or translating the electrodermography signals to an impact value for each member, and (g) visually representing each of the appeal and impact values identified by the marketing stimulus to which the members were exposed when the measurements were taken. Excerpt(s): The invention relates to methods of measuring consumer reaction to marketing stimuli. Consumer reaction to a marketing stimulus (e.g., a television commercial) is typically assessed by means of exposing members of a focus group to the marketing stimulus (e.g., having the focus group watch the commercial) and obtaining the reactions and comments of the members immediately after exposure to the marketing stimulus by means of a written questionnaire and/or a personal interview. While generally effective, such a technique suffers from several drawbacks, including a tendency for members of a focus group to express inaccurately their reaction to marketing stimuli due to social pressure and limited self-awareness. Hence, a longstanding need exists for a more reliable, scientific technique and methodology for measuring consumer reaction to marketing stimuli. Web site: http://www.delphion.com/details?pn=US06422999__
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Method of measuring consumer reaction while participating in a consumer activity Inventor(s): Hill; Daniel A. (1268 Pennsylvania Ave., Apt. 2, San Diego, CA 92103) Assignee(s): None Reported Patent Number: 6,453,194 Date filed: March 27, 2001 Abstract: A sample population including a plurality of members participate in a consumer activity for a participation period to assess consumer reaction to the consumer activity. Surface electromyography signals from a zygomatic muscle and electrodermography signals of each member of the sample population are measured during the participation period. Data is recorded including at least a description of a stimulus experienced by each member during the participation period and a description of the interaction between the member and the stimulus. The recorded data is synchronized with the measurements of electromyography signals and electrodermography signals for each member to allow association of the recorded data with the measurements. The electromyography signals are equated or translated to an appeal value and the electrodermography signals are equated or translated to an impact value for each member. At least one of the appeal and impact values are visually represented, identified with the synchronously recorded stimulus. Excerpt(s): The invention relates to methods of measuring consumer reaction to participation in a consumer activity. Consumer reaction to a marketing stimulus (e.g., a television commercial) is typically assessed by means of exposing members of a focus group to the marketing stimulus (e.g., having the focus group watch the commercial) and obtaining the reactions and comments of the members immediately after exposure to the marketing stimulus by means of a written questionnaire and/or a personal interview. While generally effective, such a technique suffers from several drawbacks, including a tendency for members of a focus group to express inaccurately or imprecisely their reaction to the marketing stimulus. The study of consumer reaction is generally restricted to exposing members of a focus group to predetermined marketing stimuli (i.e., forced selection) in order to ensure that the feed-back from the member corresponds to the defined marketing stimuli. It has long been recognized that the data obtained from such forced selection testing does not accurately reflect consumer experience as the member is not allowed to selectively interact with the marketing stimuli. Web site: http://www.delphion.com/details?pn=US06453194__
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Methods and apparatus for use in alpha training, EMG training and dichotic learning Inventor(s): Trachtman; Joseph N. (26 Schermerhorn St., Brooklyn, NY 11201) Assignee(s): None Reported Patent Number: 5,374,193 Date filed: May 21, 1990 Abstract: Accommodation training apparatus is modified to include electroencephalography apparatus for monitoring the patient's brainwaves. This permits a patient to be trained to enter, and to remain in, the alpha state, even with the eyes open and with something to look at.A two-dimensional CCD matrix is used to receive reflected-back radiation from the eye. A computer is connected to the matrix and
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permits the patient to be trained for correction of conditions such as strabismus, nystagmus and eccentric fixation by identifying whether the patient's eye is moving or whether the patient's state of accommodation is changing.An LCD matrix is used to present variable visual information to the patient's eye. This facilitates training the patient for dichotic learning.Advantageously, electromyography apparatus is used to monitor the tension of one of the patient's muscles, advantageously the frontalis muscle. Excerpt(s): The invention relates to brainwave training, electromyography training, dichotic learning and accommodation training. It is known that then a subject is in the alpha state (i.e. is in the state in which the brain emits alpha waves), the subject's performance improves; nervous tension is reduced, reaction times decrease, attention becomes heightened, etc. Alpha training has consequent been investigated as a technique by which, e.g., athletic performance can be improved. However, alpha training has heretofore been carried out with the subject's eyes closed. This is because it has generally been believed that a subject cannot enter the alpha state then the subject has open eyes and something to look at. As a result, persons those performance depends upon vision (e.g. fighter pilots, target shooters etc.) have heretofore been unable to benefit from open-eye alpha training. Web site: http://www.delphion.com/details?pn=US05374193__ •
Paraspinal electromyography scanning Inventor(s): Brody; Stanley R. (R.F.D. #1, Wurtsboro, NY 12790) Assignee(s): None Reported Patent Number: 5,058,602 Date filed: October 4, 1989 Abstract: A method of electromyographic scanning paravertebral muscles comprising measuring electrical potential across a persons's spinous process bilaterally across segments of the spinous process. Excerpt(s): 7. Development of instrumentation and protocols which can be used to demonstrate soft tissue involvement to third parties, including attorneys and insurance companies. It is well-known, that the electrical potentials associated with muscular activity may be measured and recorded. This technique is known as electromyography ("EMG"). The use of electromyography in patients suffering from low back pain is commonly accepted in the medical community. The osteopathic profession has used electromyography to verify the presence of palpable lesion of the spine. Generally, EMG electrodes are placed on the surface of the skin overlying the muscles being evaluated, or needle electrodes are employed which penetrate the tissue being studied. In addition to the active electrodes, a ground reference electrode is also applied to the patient. The signal from these electrodes is very feeble and is typically measured in microvolts. A preamplifier, followed by one or more additional stages of amplification boosts the signal to a usable level. Filters minimize the effects of interference arising from sources other than the muscles being studied. The amplified and filtered signal can be measured and/or displayed on a cathode ray tube. In addition, some machines are equipped with recorders which store the information on paper or magnetic media. Older vacuum tube equipment has largely been replaced by solid state apparatus. Web site: http://www.delphion.com/details?pn=US05058602__
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Relative electromyographic muscle reflex activity during motion Inventor(s): Johnson; Michael T. V. (Minneapolis, MN), Kipnis; Alexander (Minneapolis, MN) Assignee(s): Empi, Inc. (st. Paul, Mn) Patent Number: 5,263,489 Date filed: June 27, 1989 Abstract: A method for treating electromyographic signals obtained from one or more muscles in the body which are subject to both volitional motion and externally forced motion to provide one or more indices which indicate the relative control signal energy provided to such a muscle or muscles during contractions and lengthenings thereof. Excerpt(s): The present invention relates to determinations of relative muscular reflex activity during contractions and lengthenings of the body muscle involved as reflected in corresponding electromyographic signals and, more particularly, to such determinations made when the muscular contractions and extensions are involved with rotations of skeletal joints. The control of the contracting and lengthening of muscles in the human body has long been known to have both a volitional aspect involving the central portions of the central nervous system and a reflex aspect involving peripheral portions of the central nervous system. In this latter aspect, the stretching of a typical muscle is sensed by a muscle spindle embedded therein and signals indicating such stretching are provided over afferent neurons to the system of spinal neurons. From there, return signals are provided over the alpha motor neurons, or efferent neurons, to the muscle body causing it to contract to counteract the initial stretching. This "local" feedback loop is the basis of reflex actions in the muscle involved. In the former, or volitional, control aspect, a first mode of control has signals from the central portion of the central nervous system provided along the spinal nerve complex into the peripheral portion of the central nervous system. From there they are transmitted over alpha motor neurons to the muscle body to again cause it to contract. Web site: http://www.delphion.com/details?pn=US05263489__
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Uterine activity monitor and method of the same Inventor(s): Huey; Raymond J. (Orange, CT), Kosturko; William (Milford, CT), Reynolds; Charles A. (West Haven, CT) Assignee(s): GE Medical Systems Information Technologies, Inc. (waukesha, Wi) Patent Number: 6,421,558 Date filed: June 29, 2000 Abstract: A method and apparatus for generating a signal representing uterine activity. The method including the acts of obtaining a uterine electromyography (EMG) signal, and processing the uterine EMG signal to produce a signal representative of uterine activity. The apparatus including a sensor for acquiring a uterine electromyography (EMG) signal, and a signal processor for generating a signal representative of uterine activity in response to the uterine EMG signal. Excerpt(s): The invention relates to a method and apparatus for generating a signal representing uterine activity, and particularly to a monitor for obtaining and processing a uterine electromyography signal to produce a signal representative of uterine activity. Uterine contractions are the result of coordinated contractions by individual myometrial
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cells of the uterus. At the cellular level, the contractions are triggered by an action potential. The action potential is a voltage signal that can be measured as an electromyography (hereinafter referred to as "EMG") signal. During pregnancy, cellular electrical connectivity increases such that the action potential propagates to produce a coordinated contraction involving the entire uterus. The action potential during a uterine contraction can be measured with electrodes placed on the maternal abdomen resulting in a uterine EMG signal. The EMG signal is then processed to produce a signal that is functionally equivalent to a uterine activity signal created by a toco. The equivalent uterine activity signal provides contraction frequency and contraction duration information. In addition, the EMG signal approximates at least one component that would be acquired by an IUP sensor. Accordingly, the invention provides a monitor. The monitor includes a sensor for acquiring a uterine EMG signal and a signal processor for generating a signal representative of uterine activity in response to the uterine EMG signal. The signal representative of uterine activity indicates uterine contraction frequency and contraction duration information. Additionally, the signal representative of uterine activity approximates a signal that would be acquired using either a toco or approximates at least one component of a signal that would be acquired using an IUP sensor. Web site: http://www.delphion.com/details?pn=US06421558__ •
Wireless transmitter for needle electrodes as used in electromyography Inventor(s): Cooke; Thomas H. (651 Strander Blvd., No. 100, Seattle, WA 98188) Assignee(s): None Reported Patent Number: 5,579,781 Date filed: October 13, 1994 Abstract: A self-contained, battery powered, hand-held transmitter usable with mono or bipolar needle electrodes to sense electrochemical nerve impulses as transmitted through the nervous system and muscles of humans and animals. The hand-held transmitter is of miniaturized, generally rectangular form and comprises electronics developing and transmitting a VHF signal receivable by conventional FM receiver means. Being wireless, the transmitter avoids the possible signal distortions and restrictions of patient and physician movements which are inherent when using cable interconnections between electromyographic sensors and associated analytical equipment. Excerpt(s): The present invention relates to improved medical instrumentation usable in the field of electromyography (EMG), i.e. for the sensing, selective development and recordation of electrochemical nerve impulses as transmitted through the nervous systems and muscles of humans and animals. Specifically, the invention involves a wireless transmitter to which mono or bipolar medical electrodes are directly connectable and from which electrical signals are transmitted by radiant energy to remote but associated receiver and audio or visual display or recorder equipment. It is well known that human and animal muscle k5 activities are controlled by nerve impulses transmitted electrochemically through the nervous system. Electrical signals related to muscle and nerve activity can be detected through use of medical electrodes applied to the surface of the skin or through electrodes which penetrate the skin, commonly known as needle electrodes. The electrical signals thus detected after suitable amplification can be displayed on an oscilloscope or recorded on a chart recorder or the like or may be applied to a speaker to provide audio representations of such signals.
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Since the electrical signals on the surface of the skin tend to represent a mixing of electrical signals over an undesirably large area, it is often preferable to employ subcutaneously applied needle electrodes to obtain signals from a particular location in the body, and also to obtain the electrical voltage level of the body in general as a reference voltage base. Concentric bipolar electrodes are used when the field of interest is more restricted. With concentric electrodes, the referenced area of the needle is separated by an insulated area from an active detection area on the same needle, and the active detection area often is typically quite small, 0.03 to 0.06 inch in length, for example. Several problems have been encountered in use of prior art subcutaneous electrical signal sensing and amplification and display systems. The voltage amplitude of the signals detected by needle electrode sensors is very low and in a conventional prior art system the signal must be conveyed to signal amplifier and recording or display instrument by cable means, i.e. the overall system is a so-called "wired" system. Wire cables are subject to triboelectric phenomena whereby small electrode potentials are caused by physical movements of the signal carrying electrical cable. The triboelectric potentials can be of sufficient magnitude to mask or at least distort the desired electromyographic signals from the needle sensor. While the effect may be reduced by using cable that has been manufactured in such a way as to reduce triboelectric effects, the problem generally necessitates careful placement of the cables and attachment thereof to associated equipment, by means of tape for example, in order to minimize movement of the cables during medical procedures. This obviously can be inconvenient and can take up the time of the health care practitioner using the equipment. Web site: http://www.delphion.com/details?pn=US05579781__
Patent Applications on Electromyography As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to electromyography: •
Apparatus for positioning and marking a location of an EMG electrode Inventor(s): Choi, Jin Sung; (Daejeon, KR), Ghyme, Sang Won; (Jeju-do, KR), Jeong, Hyuk; (Daejeon, KR), Kim, Hong Kee; (Daejeon, KR), Kim, Hyun Bin; (Daejeon, KR), Kim, Ki Ho; (Daejeon, KR), Kim, Ki Hong; (Daejeon, KR), Kim, Yong Wan; (Daejeon, KR), Lee, Ki Suk; (Seoul, KR), Myung, Hyun; (Daejeon, KR) Correspondence: Jacobson Holman Pllc; 400 Seventh Street N.W.; Suite 600; Washington; DC; 20004; US Patent Application Number: 20030125636 Date filed: March 13, 2002 Abstract: An apparatus for positioning and marking a location of an electromyography (EMG) electrode includes a housing having a back surface, an EMG sensor for receiving the EMG signal, an amplifying circuit for amplifying the EMG signal to generate an amplified EMG signal and an audio output terminal for outputting the amplified EMG signal as the audio EMG signal. The examinee may directly position and mark the
10
This has been a common practice outside the United States prior to December 2000.
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location of the EMG electrode and may easily detect the fatigue rate of the muscle or the abnormal condition of the muscle by using the sound of the audio equipment. Excerpt(s): The present invention relates to an apparatus for positioning and marking a location of an electromyography (EMG) electrode, and, more particularly, to an apparatus for converting an EMG signal to an audio EMG signal to easily position a location of an EMG electrode and to easily mark the location thereof on a skin of a human body. The EMG signal represents an electrical signal associated with an activity of a skeletal muscular fiber and has been used to control a prosthesis or to develop a human computer interface (HCI) technology. In order to control the prosthesis to develop an EMG based HCI technology, a sensor to detect the EMG signal must be attached around a portion, e.g., an arm, of a body. Since the inaccurate location of the EMG electrode results in a malfunction of the prosthesis or the HCI due to a noise of the body itself, the location of the EMG electrode must be precisely detected depending on the motion of the body, e.g., a bending of an arm. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Apparatus for routing electromyography signals Inventor(s): Brody, Lee Richard; (Somerville, MA) Correspondence: Cesari And Mckenna, Llp; 88 Black Falcon Avenue; Boston; MA; 02210; US Patent Application Number: 20030069514 Date filed: April 10, 2002 Abstract: An EMG monitoring system includes a matrix of detection electrode arrays that is positioned on the patient along his or her spine. The arrays are electrically connected through a switching mechanism to EMG amplifiers that are included in conventional monitoring instrumentation. A switch controller operates the switches to provide signals to the EMG amplifiers from selected sets of detection electrode arrays. The controller controls the switches to provide signals simultaneously to each EMG amplifier. If the monitoring instrumentation includes four EMG amplifiers, the matrix of electrode arrays and the switching mechanism may be used to take simultaneous measurements at two different spinal levels. If additional EMG amplifiers are included, simultaneous measurements at additional spinal levels may also be made. The matrix may also include redundant arrays and/or electrodes, such that the clinician can select the sets of electrodes that conform to the size of the patient. Excerpt(s): The present application claims the benefit of U.S. Provisional Patent Application Serial No. 60/327,324, which was filed on Oct. 5, 2001, by Lee Richard Brody for a APPARATUS FOR ROUTING ELECTROMYOGRAPHY SIGNALS and is hereby incorporated by reference. The invention relates generally to systems for monitoring electromyography signals. Electromyography (EMG) signals are bioelectric signals that are generated during muscle contraction, and the energy of the EMG signals is proportional to muscle tone. Chiropractors and other healthcare clinicians currently monitor surface EMG signals to evaluate paraspinal muscle tone. Each EMG signal is detected using a detection electrode array that is held on the skin above the muscle. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Combined physiological monitoring system Inventor(s): Cusimano, MaryRose; (Fort Lauderdale, FL), Zeff, Scott J.; (Fort Lauderdale, FL) Correspondence: Albert O Cota; 5460 White Oak Ave; Suite A-331; Encino; CA; 91316; US Patent Application Number: 20030135129 Date filed: November 15, 2001 Abstract: A combined physiological monitoring system (CPMS) (10) which Provides an electrodiagnostic functional assessment (EFA) to determine the relative age and severity of a myofasical injury. The EFA utilizes data serviced by electromyography (EMG) sensors which measures the amplitude and frequency of a muscle group; functional capacity evaluation (FOE) sensors, which measure the lift, pull and push capability; range-of-motion (ROM) sensors, which measure the range of motion in the cervical, thoraic, lubosacral, upper and lower extremities; and a grip and pinch sensor, which measures a person's grip and pinch strength. The CPMS (10), allows the measurement to be conducted individually or be integrated and conducted simultaneously in combination with EKG activity, blood flow and nerve conduction velocity. The CPMS (10) which can be designed to be portable, operates in combination with a software program (80) which resides in a dedicated laptop computer (82). Excerpt(s): This invention pertains to the general field of electro-diagnostic systems and more particularly to a system which monitors muscles in various ranges of motion such as lifting, pulling, pushing, gripping and pinching while simultaneously monitoring physiological functions such as temperature, heart rate and skin response. Many physicians encounter patients with complaints that involve injuries of the soft tissues, particularly those soft tissues of the paraspinal muscles. In many cases objective findings are obvious, but a percentage of patients have injuries that, while subtle, still cause symptoms that bring them to the attention of a care provider or specialist. In other cases, the injuries many be less recent, which provide no apparent physical findings. Direct palpation of soft tissues can, in some cases, reveal the nature or type of injury, but this manner of diagnosis relies on static testing. For some subject, problems may only be encountered during activity. Quantifying these dynamic condition of the soft tissues is problematic. Range of motion testing is often relied upon to determine the cause, yet measuring the muscle activity during range of Motion testing is difficult. The extent to which a patient exerts him or herself also presents a subjective bias. If muscle activity could be recorded during range of motion testing, the extent to which the muscles or muscle groups are activated and to what degree would provide helpful information about the nature of the soft tissue injury. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Device and system for remote for in-clinic trans-abdominal/vaginal/cervica- l acquisition, and detection, analysis, and communication of maternal uterine and maternal and fetal cardiac and fetal brain activity from electrical signals Inventor(s): Garfield, Robert E.; (Friendswood, TX), Maner, William L.; (Galveston, TX) Correspondence: Locke Liddell & Sapp Llp; 600 Travis; 3400 Chase Tower; Houston; TX; 77002-3095; US Patent Application Number: 20020193670 Date filed: May 28, 2002 Abstract: The present invention presents a method and apparatus for recording and analyzing uterine electrical activity, or electromyography (EMG), from the surface of the abdomen, vagina, or cervix of a patient for the purpose of diagnosing contractile patterns of the uterus in pregnant and non-pregnant women, as well as for monitoring maternal and fetal ECG and fetal brain activity. The method and apparatus described include methods for the systematic detection, analysis, characterization and communication of information about electrical signals recorded from the abdominal/vaginal/cervical surface. The present invention provides data analysis techniques for analyzing the electrical data measured from the surface of a patient to characterize their uterine, abdominal, and cardiac muscle activity, as well as cardiac and brain activity of the fetus simultaneously or separately. These techniques and apparatus are appropriate for use in a clinic or through landline or wireless communication for use as a remote or home uterine/fetal monitoring system. Excerpt(s): This application claims the benefit of U.S. Provisional Application Serial No. 60/294,391, filed May 29, 2001. The present invention relates to measurements of electrical activity in a body. More particularly, the invention relates to measurement and analysis of the measurements to predict the condition of a portion of a body. Presently there is no objective manner with which to evaluate the contractility of the uterus. This is true either in non-pregnant patients where hypercontractility is associated with dysmenorrhea or in pregnant patients where the uterus is sometimes active prior to term. Normally the uterus is quiescent in non-pregnant women and during most of pregnancy. However, at the end of pregnancy, the myometrium undergoes a series of changes that lead to synchronous, rhythmic uterine contractions (labor). The diagnosis of labor is the most significant problem faced by obstetricians. In addition, pre-term labor, which occurs in about 10% of pregnant patients, is difficult to diagnose. Frequently, term or pre-term labor requires adjuvant therapy to either stimulate or inhibit contractility of the uterus. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Electrostimulation system with electromyographic and visual biofeeback Inventor(s): Kotlik, Ben-Zion; (Shlomi, IL), Zuker, Morris; (Kiriat Bielk, IL) Correspondence: William H Dippeit; Reed Smith; 29th Floor; 599 Lexington Avenue; New York; NY; 10022; US Patent Application Number: 20030208246 Date filed: March 21, 2003 Abstract: The device of the present invention provided an electrostimulation system with electromyographic and visual biofeed-back for sensing electromyographic
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impulses and facilitating muscular activity. The electrostimulation system comprises stimulator that is adapted to generate an electric impulse and at least one pair of electrodes adapted to transmit the electric impulse or to receive electromyographic impulses. The system further comprises an amplifier electrically communicating with the pair of electrodes, the amplifier is adapted to amplify the received electromyographic impulses and a filtering unit electrically communicating with the amplifier and is adapted to remove artifacts from the received electromyographic impulse. A commutation block is electrically communicating with the pair of electrodes and is adapted to alternately transfer the electromyographic impulses to the amplifier or to transfer the generated electric impulse from the stimulator. A display for displaying the received electromyographic impulses and a predetermined threshold value is also provided as well as a control unit that is adapted to receive the electromyographic impulses from the amplifier and to activate the stimulator in a predetermined manner. The stimulator incorporated in the present invention is triggered to transmit impulses to the rehabilitated muscle when the electromyographic impulse substantially equals or exceeds the predetermined threshold value. Excerpt(s): The present invention relates to electrotherapy. More particularly, the present invention relates to a system for electrostimulation with electromyographic and visual feedback. Functional electrical stimulation (FES), in which stimulation of nerves is conducted, is a method known for several decades and has been used for activating paralyzed muscles. The conventional treatment methods of rehabilitation movement functions of post CVA patients are based on electrostimulation, while the patient plays a passive role in the process of therapy. Electrical massage is known by the term TENS (transcutaneous electrical nerve stimulation). TENS acts as a pain reducer. The stimulation of the muscles causes a higher blood flow to the area, hence a massage effect. TENS causes also the release of endorphins for further ease of the pain. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for designing a workstation Inventor(s): Flugger, Ray T.; (Forestville, CA), Madill, Peter V.; (Sebastopol, CA) Correspondence: Robert B. Chickering, ESQ.; Flehr Hohbach Test Albritton & Herbert Llp; Suite 3400; Four Embarcadero Center; San Francisco; CA; 94111-4187; US Patent Application Number: 20020111557 Date filed: February 9, 2001 Abstract: An electrophysiological monitoring apparatus for designing a workstation (21, 21p) for use in performing a task. The monitoring apparatus preferably is a surface electromyography apparatus which includes pairs of electromyography electrodes sensors (31a, 31b; 32a, 32b; 33a, 33b) with appropriate grounding formed for attachment to a worker (24), a signal processor (37) connected to the electrodes and formed to process output signals from the electrodes and produce muscle loading profiles (101, 111, 121, 131) therefrom during performance of the task by the worker. The apparatus further includes a workstation (21, 21p) having an adjustable physical geometry capable of variation so as to change the manner of movement of the worker's muscles during performance of the task. The adjustable workstation (21, 21p) and surface electromyography apparatus (37) are used in a method to select a workstation configuration most desirable for extended use by the worker. Preferably the optimized overall workstation (21p) is further customized to an individual worker (24) and most
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preferably the individual worker (24) is further trained at the workstation (21p) to lower his or her muscle loading profiles during performance of the task. Excerpt(s): The present invention relates, in general, to the use of electrophysiological monitoring devices, such as surface electromyography apparatus, to sense muscle loading, and more particularly, relates to the ergonomic design of the human operator interface of workstations at which workers perform repetitive tasks using such apparatus. Repetitive tasks, for example, those performed in industrial or manufacturing settings at workstations, frequently cause worker injuries which are serious enough to result in the need for the worker to take sick leave and undergo physical and other medical and manipulative therapies in order to attempt to rehabilitate damage caused by chronic muscle overloading or fatigue. Neck, pectoral girdle, upper extremity, forearm, hand and back injuries regularly occur, with the result that the worker must seek medical assistance and the employer is faced with considerable worker downtime. Some professionals in the field worry that there is an epidemic of upper extremity work related repetitive motion disorders. The electrical input from the muscles to the surface electromyography unit, obtained via the sensing electrodes, allows one to visually observe the degree of both resting muscle tone and muscle loading when performing repetitive tasks. The muscles being measured by such apparatus are those that are determined by prior physical examination and ergonomic analysis to be most critically involved in the repetitive motion tasks the worker is performing at his workstation. The visual feedback offered by such measuring apparatus also enables the worker to observe the relationship between muscle tone and loading and his particular industrial injury and resultant pain syndrome. Recent research is validating that the retraining offered by this electromyographic "biofeedback", in terms of its ability to promote and facilitate the workers learning of the voluntary ability to reduce muscle tone and task specific muscle loading, offers a pathway to the rehabilitation of the injured worker that results in improved recovery rates over and above that afforded by traditional physical and manipulative rehabilitative therapies. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for treating poor laryngeal-elevation disorder with sequentialhigh voltage electrical stimulation Inventor(s): Geater, Alan; (Hatyai, TH), Leelamanit, Vitoon; (Hatyai, TH), Limsakul, Chusak; (Hatyai, TH) Correspondence: Reed Smith Hazel & Thomas Llp; Suite 1400; 3110 Fairview Park Drive; Falls Church; VA; 22042; US Patent Application Number: 20020133194 Date filed: January 29, 2001 Abstract: The sequential stimulator for the treatment of dysphagic patients incorporates a unit which is capable of detecting a swallowing signal from the glossal or temporalis surface electromyography (SEMG). When a swallowing signal is recognized, a trigger signal is sent to the stimulation generation unit to release high voltage stimuli sequentially to the suprahyoid muscles or the masseter muscles and the pharyngeal muscles in order to assist in the elevation of the larynx. This enables the pharyngeal lumen to open more widely so that food can pass through the patient's pharynx and into the oesophagus more easily during swallowing. Thus the sequential stimulator is a device for assisting swallowing in patients with dysphagia due to a variety of causes, for
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instance, brain injury, cerebrovascular accident, injury of the cervical nerves, muscles weakness, or old age. The stimulator is operative only when the patient attempts to swallow and provides a physiologic stimulus and provides a means of immediate relief of the swallowing difficulty. The device is also useful for physical therapy whereby the muscles under the chin, the masseter muscles and the pharyngeal muscles can be reeducated to contract in the normal coordinated sequence. Excerpt(s): The present invention relates generally to a method and an apparatus for treating poor laryngeal-elevation disorder with sequential-high voltage electrical stimulation. Phase 1: is the oral phase, during which food in the oral cavity is masticated and mixed. Phase 2: is the pharyngeal phase, during which the masticated and mixed food bolus is propelled from the oral cavity into the pharyngeal lumen and thence into the upper oesophagus. The second phase of swallowing involves the use of the glossal muscles and the pharyngeal muscles (suprahyoid and thyrohyoid) and a lowering of the base of the tongue. The tongue muscles then propel food bolus from the oral cavity into the pharyngeal lumen. At this stage, the muscles of the pharynx contract in sequence, raising elevating the larynx and moving it forward in order to open the pharyngeal lumen and the upper oesophageal sphincter so that the bolus can pass readily into the upper oesophagus. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Mobile terminal capable of measuring a biological signal Inventor(s): Hiraiwa, Akira; (Yokohama-shi, JP), Manabe, Hiroyuki; (Yokosuka-shi, JP), Nakano, Hirotaka; (Tokyo, JP), Sugimura, Toshiaki; (Yokohama-shi, JP) Correspondence: Oblon, Spivak, Mcclelland, Maier & Neustadt, P.C.; 1940 Duke Street; Alexandria; VA; 22314; US Patent Application Number: 20040034645 Date filed: June 16, 2003 Abstract: A mobile terminal capable of measuring a biological signal is provided. The terminal comprises a terminal body; an electrode for human body earth or system reference, placed on an outer surface of the terminal body so as to be contactable with the skin of a user of the mobile terminal; and differential electrodes. The measured biological signals include an electromyography signal and an electroencephalogram signal. The differential electrodes can be external to the terminal body and be connected via lead lines to the terminal body. Excerpt(s): The present invention generally relates to mobile terminals capable of measuring biological signals, and specifically relates to such a mobile terminal having an electrode for human body earth or system reference, placed on an outer surface of a terminal body. For example, when a handicapped person such as a person having no laryngopharynx or the oral part of pharynx after undergoing a laryngectomy tries to speak in vain, what the person is trying to speak can be determined by detecting perioral muscle activities. Then a speech synthesizer is driven to produce synthetic speech in place of the person's voice. One good example of such research works is published in Noboru Sugie et. al., A Speech Prosthesis Employing a Speech Synthesizer-Vowel Discrimination from Perioral Muscle Activities and Vowel Production, IEEE transactions on Biomedical Engineering, Vol. 32, No. 7, pp 485-490, the entire contents of which are hereby incorporated by reference. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Targeting method and apparatus for the magnetic stimulation of the brain Inventor(s): Ruohonen, Jarmo; (Vantaa, FI) Correspondence: Smith-hill And Bedell; 12670 N W Barnes Road; Suite 104; Portland; OR; 97229 Patent Application Number: 20040039279 Date filed: May 30, 2003 Abstract: The invention relates to a method and apparatus for targeting electromagnetic stimulation on the human brain. According to the method, pulse-like electromagnetic fields are formed, which have a strong local electromagnetic maximum, the electromagnetic maximum of the field is targeted on the brain (2), the distribution, direction, and strength of the electromagnetic field arising in the brain are defined, and some physiological or biological response, such as, for example, a muscular response measured using electromyography, is measured. According to the invention, the position of the brain is defined in three-dimensional space and the position data is received in electrical form in a data-processing apparatus (8), the position data of the electromagnetic fields are received in the data-processing apparatus (8) in the same three-dimensional set of co-ordinates as the brain, the position data of the electromagnetic fields are combined with the position data of the brain (2), and a graphical presentation (9) of the position data of the electromagnetic fields and of the position data of the brain is formed with the aid of the data-processing apparatus (8). Excerpt(s): The present invention relates to a method according to the preamble of claim 1 and an apparatus according to the preamble of claim 12. Methods and apparatuses of this kind are used for the measurement of and research into biological tissue, and for therapy by stimulating the tissue electromagnetically. A suitable electric field can stimulate the human brain and the peripheral nerves or muscles. In magnetic stimulation, an electric field is induced painlessly and safely by means of a variable magnetic field. In magnetic stimulation, a coil made of electrically conductive material is placed above the target tissue. A powerful pulse of electrical current, the duration of which is typically 100-1000.mu.s, is led through the coil. A varying magnetic field arises around the coil, with a magnitude of up to 3 Teslas, and which in accordance with Faraday's Law induces an electric field in the electrically conductive tissue in the vicinity of the coil. The magnetic and electric fields weaken rapidly as the distance from the coil increases. In stimulation, the coil is generally placed as close to the target as possible. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Therapeutic methods using electromagnetic radiation Inventor(s): D.C., Constance Haber; (Murrysville, PA), Gardiner, Allan; (Kensington, CA) Correspondence: Sheldon R. Meyer, ESQ.; Fliesler Dubb Meyer & Lovejoy Llp; Fourth Floor; Four Embarcadero Center; San Francisco; CA; 94111-4156; US Patent Application Number: 20030130709 Date filed: June 26, 2002 Abstract: This invention provides methods for treating a variety of disorders using electromagnetic radiation directed at excitable tissues, including nerves, muscles and
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blood vessels. By controlling the wavelength, the wavelength bandpass, pulse duration, intensity, pulse frequency, and/or variations of those characteristics over time, and by selecting sites of exposure to electromagnetic radiation, improvements in the function of different tissues and organs can be provided. By monitoring physiological variables such as muscle tone and activity, temperature gradients, surface electromyography, blood flow and others, the practitioner can optimize a therapeutic regimen suited for the individual patient. Excerpt(s): This U.S. Utility Patent Application claims priority to U.S. Provisional Patent Application, Serial No. 60/301,319, entitled "Therapeutic Methods Using Electromagnetic Radiation," filed Jun. 26, 2001, and U.S. Provisional Patent Application Serial No. 60/301,376, entitled "Multiple Wavelength Illuminator," filed Jun. 26, 2001. This U.S. Utility Patent Application is related to U.S. Utility Patent Application Serial No. ______, entitled "Multiple Wavelength Illuminator," Allan Gardiner and Constance Haber, inventors, filed Jun. 26, 2002. Each of the above applications is incorporated herein by reference. This invention relates to methods for treating pathophysiological conditions using electromagnetic radiation. More particularly, this invention relates to applying electromagnetic radiation having controlled wavelengths, bandwidths, pulse durations, pulse frequencies and/or intensities applied to areas of the body associated with a disorder to treat disorders of the musculature, nerves, blood vessels and other organs and tissues. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Wireless electromyography sensor and system Inventor(s): Babin, Thomas S.; (Lake Zurich, IL), Ghaem, Sanjar; (Chesapeake, VA), Hong, Di-An; (Barrington, IL), Mok, Swee; (Schaumburg, IL) Correspondence: Motorola, INC.; 1303 East Algonquin Road; Il01/3rd; Schaumburg; IL; 60196 Patent Application Number: 20030109905 Date filed: December 7, 2001 Abstract: A wireless biopotential sensor includes an adhesive strip having a lower surface for placement against the skin of a patient and an upper surface. A pair of conductive electrodes are applied to the lower surface of the adhesive strip. A sensor substrate is applied to the upper surface. The sensor substrate includes first and second conductive contact pads that are placed in registry with the pair of conductive electrodes, with the contact pads arranged in electrical contact with the conductive electrodes. An electronics module is applied to the sensor substrate and arranged in electrical contact with the contact pads. The electronics module comprises a power supply and electronics for generating a wireless signal containing biopotential signals detected by the pair of conductive electrodes. Excerpt(s): This relates to application Ser. No. 09/551,718 and application Ser. No. 09/551,719, both filed on filed Apr. 18, 2000, the contents of both are incorporated herein by reference. This invention relates generally to the field of devices used to measure and display bio-potential signals generated by the body. More particularly, the invention relates to a wireless, remotely programmable electrode transceiver assembly that sends electromyography (EMG) signals via wireless transmission to a base unit. The base unit obtains a patient's EMG signal from the wireless transceiver and supplies the signal to a monitor unit for display. Electromyography is technique by which electrical activity
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associated with functioning skeletal muscle is converted to a perceptible, usually visual, record. The technique is used to help diagnose certain neuromuscular disorders, such as Parkinson's disease, and in biofeedback training. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with electromyography, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “electromyography” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on electromyography. You can also use this procedure to view pending patent applications concerning electromyography. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON ELECTROMYOGRAPHY Overview This chapter provides bibliographic book references relating to electromyography. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on electromyography include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “electromyography” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on electromyography: •
Dysphagia: A Continuum of Care Source: Gaithersburg, MD: Aspen Publishers, Inc. 1997. 202 p. Contact: Available from Aspen Publishers, Inc. 7201 McKinney Circle, Frederick, MD 21704. (800) 234-1660 or (301) 698-7155. PRICE: $49.00 each. ISBN: 0834207850. Summary: This medical textbook on dysphagia presents the diagnosis and treatment of patients with dysphagia in a wider context of health care services. The authors emphasize the importance of team approaches to the ethical management of patients with dysphagia. Collaboration across settings is particularly important, as patients move from acute, to subacute, to outpatient or residential rehabilitation programs. The authors provide case history examples and vignettes which bring to life problems likely to be encountered in clinical care. Detailed information is provided regarding the assessment of oral, laryngeal, and pharyngeal swallowing function, including the alternative
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techniques that can be applied. Alternative techniques covered are videofluoroscopy, flexible fiberoptic endoscopy, ultrasound, electromyography, electroglottography, and measurement of the association between respiration and swallowing. Nine chapters are included in the text: critical decisions regarding service delivery across the health care continuum; a team approach to the ethical management of an elderly patient with dysphagia; pediatric dysphagia and related medical, behavioral, and developmental issues; legal implications in dysphagia practice; secular and sacred ethical considerations in dysphagia treatment and research; the effects of medications on swallowing; professional education and training in this field; the application of instrumental procedures to the evaluation and treatment of dysphagia; and instrumental imaging technologies and procedures. A subject index concludes the text.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “electromyography” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “electromyography” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “electromyography” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Anatomic guide for the electromyographer: the limbs; ISBN: 0398032955; http://www.amazon.com/exec/obidos/ASIN/0398032955/icongroupinterna
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Anatomical Correlates of Clinical Electromyography; ISBN: 0683035789; http://www.amazon.com/exec/obidos/ASIN/0683035789/icongroupinterna
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Anatomical Guide for the Electromyographer; ISBN: 0398039518; http://www.amazon.com/exec/obidos/ASIN/0398039518/icongroupinterna
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Anatomical Guide for the Electromyographer: The Limbs and Trunk by Aldo O. Perotto, Edward F. Delagi; ISBN: 0398059004; http://www.amazon.com/exec/obidos/ASIN/0398059004/icongroupinterna
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Atlas of Electromyography by A. Arturo Leis, et al; ISBN: 0195112504; http://www.amazon.com/exec/obidos/ASIN/0195112504/icongroupinterna
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Clinical Applications in Surface Electromyography: Chronic Musculoskeletal Pain by Glenn S. Kasman, et al; ISBN: 0834207524; http://www.amazon.com/exec/obidos/ASIN/0834207524/icongroupinterna
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Clinical Electromyography by William F. Brown; ISBN: 0409951633; http://www.amazon.com/exec/obidos/ASIN/0409951633/icongroupinterna
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Clinical Electromyography by J. A. Lenman (Editor), A. E. Ritchie (Editor); ISBN: 0272797081; http://www.amazon.com/exec/obidos/ASIN/0272797081/icongroupinterna
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Clinical Electromyography: Nerve Conduction Studies by Shin J. Oh, Shin J., Md. Oh; ISBN: 0781736811; http://www.amazon.com/exec/obidos/ASIN/0781736811/icongroupinterna
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Computer Aided Electromyography and Expert Systems (Clinical Neurophysiology Updates, Vol 2) by J.E. Desmedt (Editor); ISBN: 0444811060; http://www.amazon.com/exec/obidos/ASIN/0444811060/icongroupinterna
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Computer-Aided Electromyography by Desmedt J.E. (Editor), J. E. Desmedt (Editor); ISBN: 3805537484; http://www.amazon.com/exec/obidos/ASIN/3805537484/icongroupinterna
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Computers in electromyography; ISBN: 0407500057; http://www.amazon.com/exec/obidos/ASIN/0407500057/icongroupinterna
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Current Practice of Clinical Electromyography by C. Goor, et al; ISBN: 0444805672; http://www.amazon.com/exec/obidos/ASIN/0444805672/icongroupinterna
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Electromyographer's Handbook; ISBN: 0316841854; http://www.amazon.com/exec/obidos/ASIN/0316841854/icongroupinterna
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Electromyographer's Handbook by Lowerly Lee Thompson; ISBN: 0316841870; http://www.amazon.com/exec/obidos/ASIN/0316841870/icongroupinterna
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Electromyographical Kinesiology: Proceedings of the 8th Congress of the International Society of Electrophysiological Kinesiology, Held in Baltimore by Paul A. Anderson, et al; ISBN: 0444812024; http://www.amazon.com/exec/obidos/ASIN/0444812024/icongroupinterna
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Electromyography by H.P. Ludin (Editor); ISBN: 0444812563; http://www.amazon.com/exec/obidos/ASIN/0444812563/icongroupinterna
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Electromyography and Evoked Potentials: Theories and Applications (Advances in Applied Neurological Sciences 1) by A. Struppler, A. Weindl (Editor); ISBN: 0387139737; http://www.amazon.com/exec/obidos/ASIN/0387139737/icongroupinterna
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Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations by David C. Preston, Barbara E. Shapiro; ISBN: 0750697245; http://www.amazon.com/exec/obidos/ASIN/0750697245/icongroupinterna
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Electromyography for Experimentalists by Carl Gans (Photographer), Gerald E. Loeb; ISBN: 0226490157; http://www.amazon.com/exec/obidos/ASIN/0226490157/icongroupinterna
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Electromyography in Clinical Practice: A Case Study Approach by Bashar Katirji, Bashar Katirij; ISBN: 0815149719; http://www.amazon.com/exec/obidos/ASIN/0815149719/icongroupinterna
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Electromyography in Clinical Practice: Clinical and Electrodiagnostic Aspects of Neuromuscular Disease by Michael J., Md. Aminoff; ISBN: 0443076812; http://www.amazon.com/exec/obidos/ASIN/0443076812/icongroupinterna
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Electromyography in Clinical Practice: Electrodiagnostic Aspects of Neuromuscular Disease by Michael Jeffrey Aminoff; ISBN: 044308419X; http://www.amazon.com/exec/obidos/ASIN/044308419X/icongroupinterna
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Electromyography in Cns Disorders: Central Emg by Bhagwan T. Shahani (Editor); ISBN: 0409951447; http://www.amazon.com/exec/obidos/ASIN/0409951447/icongroupinterna
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Electromyography in Ergonomics by Shrawan Kumar (Editor), Anil Mital (Editor); ISBN: 074840130X; http://www.amazon.com/exec/obidos/ASIN/074840130X/icongroupinterna
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Electromyography in the Diagnosis and Management of Peripheral Nerve Injuries by Giuseppe Caruso, Hans-Peter Ludin (Editor); ISBN: 3456812892; http://www.amazon.com/exec/obidos/ASIN/3456812892/icongroupinterna
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Emg Primer: A Guide to Practical Electromyography and Electroneurography by Frieder Lahoda, et al; ISBN: 0387069925; http://www.amazon.com/exec/obidos/ASIN/0387069925/icongroupinterna
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Introduction to Electromyography and Nerve Conduction Testing (Introduction to Electromyography and Nerve Conduction Testing) by John L. Echternach; ISBN: 1556425295; http://www.amazon.com/exec/obidos/ASIN/1556425295/icongroupinterna
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Introduction to Surface Electromyography by Jeffrey R., Ph.D. Cram; ISBN: 0763732745; http://www.amazon.com/exec/obidos/ASIN/0763732745/icongroupinterna
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Laryngeal Electromyography by Robert Thayer Sataloff (Editor), et al; ISBN: 0769301681; http://www.amazon.com/exec/obidos/ASIN/0769301681/icongroupinterna
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Muscles Alive: Their Functions Revealed by Electromyography by John V. Basmajian (Photographer), et al; ISBN: 068300414X; http://www.amazon.com/exec/obidos/ASIN/068300414X/icongroupinterna
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New Developments in Electromyography and Clinical Neurophysiology by John E. Desmedt; ISBN: 3805514093; http://www.amazon.com/exec/obidos/ASIN/3805514093/icongroupinterna
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Pathological Conduction in Nerve Fibres: Electromyography of Sphincter Muscles; Automatic Analysis of Electromyogram with Computers by John E. Desmedt; ISBN: 3805514522; http://www.amazon.com/exec/obidos/ASIN/3805514522/icongroupinterna
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Pediatric Clinical Electromyography by H. Royden, Jr, Md Jones, et al; ISBN: 0781702887; http://www.amazon.com/exec/obidos/ASIN/0781702887/icongroupinterna
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Practical Electromyography by Ernest W., Md. Johnson (Editor), William S., Md. Pease (Editor); ISBN: 0683044575; http://www.amazon.com/exec/obidos/ASIN/0683044575/icongroupinterna
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Preconditioning electromyographic data for an upper extremity model using neural networks (SuDoc NAS 1.26:196877) by NASA; ISBN: B00010MZTI; http://www.amazon.com/exec/obidos/ASIN/B00010MZTI/icongroupinterna
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Principles of Clinical Electromyography: Case Studies by Shin J. Oh; ISBN: 0683181068; http://www.amazon.com/exec/obidos/ASIN/0683181068/icongroupinterna
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Selected topics in surface electromyography for use in the occupational setting : expert perspectives (SuDoc HE 20.7102:SU 7) by U.S. Dept of Health and Human Services; ISBN: B000109HGM; http://www.amazon.com/exec/obidos/ASIN/B000109HGM/icongroupinterna
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Single Fiber Electromyography: Studies in Healthy and Diseased Muscle by Erik Stalberg, Joze V. Trontelj; ISBN: 0781702127; http://www.amazon.com/exec/obidos/ASIN/0781702127/icongroupinterna
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Surface Anatomy for Clinical Needle Electromyography by Hang J. Lee, Joel A. Delisa; ISBN: 1888799412; http://www.amazon.com/exec/obidos/ASIN/1888799412/icongroupinterna
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The efficacy of two treatment techniques for children with spastic cerebral palsy as measured by electromyography and thermal information (SuDoc ED 1.310/2:270918) by David Michael Finn; ISBN: B000104GO0; http://www.amazon.com/exec/obidos/ASIN/B000104GO0/icongroupinterna
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The Physiological and Technical Basis of Electromyography by William Frederick Brown; ISBN: 0409950424; http://www.amazon.com/exec/obidos/ASIN/0409950424/icongroupinterna
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Velopharyngeal function and speech : electromyography, pharyngoscopy and speech analysis in subjects with normal speech, patients with rhinolalia aperta and patients treated with a pharyngeal flap by Johannes Wilhelmus Franciscus Mulder; ISBN: 9023213904; http://www.amazon.com/exec/obidos/ASIN/9023213904/icongroupinterna
Chapters on Electromyography In order to find chapters that specifically relate to electromyography, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and electromyography using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “electromyography” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on electromyography: •
Laryngeal Electromyography Source: in Sataloff, R.T., ed. Professional Voice: The Science and Art of Clinical Care. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1997. p. 245-255. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $325.00 plus shipping and handling. ISBN: 1565937287. Summary: This chapter on laryngeal electromyography is from a book on the clinical care of the professional voice. Electromyography (EMG) evaluates the integrity of the motor system by recording action potentials generated in the muscle fibers. EMG is particularly useful for evaluating disorders affecting the lower motor neuron, peripheral nerves, neuromuscular junction, and muscle. The authors review the application of EMG in the evaluation of patients with laryngeal disorders. The authors stress that EMG should be considered an extension of the physical examination rather than solely a laboratory procedure. Topics include technique and neurophysiological basis, common abnormal laryngeal EMG findings, and laryngeal EMG abnormalities in specific disease categories, including lower motor neuron and laryngeal nerve disorders, basal ganglia disorders, muscle disorders, disorders of neuromuscular junction, and upper motor neuron disorders. 11 figures. 27 references.
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CHAPTER 8. MULTIMEDIA ON ELECTROMYOGRAPHY Overview In this chapter, we show you how to keep current on multimedia sources of information on electromyography. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on electromyography is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “electromyography” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “electromyography” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on electromyography: •
Dysphagia: The Latest in Instrumental Diagnostic Procedures and Service Delivery Issues Source: Rockville, MD: American Speech-Language-Hearing Association (ASHA). 1995. (videocassette, audiotape, manual). Contact: Available from American Speech-Language-Hearing Association (ASHA). Product Sales, 10801 Rockville Pike, Rockville, MD 20852. (888) 498-6699. TTY (301) 8970157. Website: www.asha.org. PRICE: $65.00 each. Item Number 0112019. Summary: This continuing education program describes the instrumental diagnostic procedures and service delivery issues for dysphagia (swallowing disorders). The program includes a manual, videotape, and audiotapes created in preparation for, and from a teleseminar held in July 1995. The three-hour seminar included a teleconference session on the anatomy and physiology of swallowing, an introduction of the diagnostic techniques that will be covered, a viewing of the videotape, a discussion of the
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techniques and procedures covered in the video, a presentation on the application of techniques to special populations and age groups, and two question-and-answer periods. Topics include the events in the pharyngeal stage of swallowing, oropharyngeal swallow physiology, the bedside examination, the use of the modified barium swallow in videofluoroscopy, purchasing sources for equipment for positioning patients during the radiographic procedure, simultaneous fluoroscopy and manometry, endoscopy, surface electromyography, ultrasound, and scintigraphy. The manual includes illustrations of some of the procedures, reprints of related medical journal articles, and the posttest with which participants can obtain continuing medical education credits. The program comes packaged in a plastic case that holds the audios, video, and manual. •
Pain Control Source: Princeton, NJ: Films for the Humanities and Sciences. 199x. (videocassette). Contact: Available from Films for the Humanities and Sciences. P. O. Box 2053, Princeton, NJ 08543-2053. (800) 257-5126; (609) 452-1128. PRICE: $149.00 for purchase; $75.00 for rental. Order Number TF-2368. Summary: This videotape looks at some of the available treatments for the most serious types of pain. The program discusses treatment modalities including injections, infusions, topical sprays, inhalants, pills, acupressure and acupuncture, electromyography, and a number of other ways to relieve muscle spasms. (AA-M).
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CHAPTER 9. PERIODICALS AND NEWS ON ELECTROMYOGRAPHY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover electromyography.
News Services and Press Releases One of the simplest ways of tracking press releases on electromyography is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “electromyography” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to electromyography. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “electromyography” (or synonyms). The following was recently listed in this archive for electromyography: •
Surface electromyography useful in diagnosing chronic low back pain Source: Reuters Medical News Date: July 06, 2000
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “electromyography” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “electromyography” (or synonyms). If you know the name of a company that is relevant to electromyography, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “electromyography” (or synonyms).
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Newsletters on Electromyography Find newsletters on electromyography using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “electromyography.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “electromyography” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •
Myopathic Diseases Source: Bulletin on the Rheumatic Diseases. 51(3): 1-4. 2002. Contact: Available from Arthritis Foundation. 1330 West Peachtree Street, Atlanta, GA 30309. (800) 268-6942 or (404) 872-7100. Fax (404) 872-9559. Website: www.arthritis.org. Summary: This newsletter provides health professionals with information on myopathic diseases. Various diseases and conditions affect skeletal muscle and result in symptoms, including weakness, fatigue, and muscle cramping. Myopathies can be classified as idiopathic inflammatory myopathies (IIMs) and metabolic myopathies. IIMs are a heterogeneous group of disorders characterized by symmetric proximal muscle weakness and elevated serum levels of enzymes derived from skeletal muscle. IIMs include polymyositis and dermatomyositis in adults, juvenile dermatomyositis, IIM with an associated malignancy, and inclusion body myositis. Metabolic myopathies are the result of known biochemical defects that alter the ability of muscle to maintain adequate levels of adenosine triphosphate. Eleven different diseases caused by an underlying defect in glycogen synthesis, glycogenolysis, or glycolysis have been identified, including McArdle's disease, phosphofructokinase deficiency, and acid maltase deficiency. Various disorders of fatty acid and mitochondrial metabolism can cause myopathy. Other causes of myopathic symptoms include neuropathic infectious agents, neoplasms, and certain drugs. Tests may be needed to diagnose a patient with myopathic symptoms. Tests that measure serum levels of creatine phosphokinase, aldolase, SGOT, SGPT, and LDH may be useful. Electromyography can be used to determine the classification, distribution, and severity of diseases affecting skeletal muscle. Other useful tests include forearm ischemic exercise testing, imaging techniques, and muscle biopsy. Treatment of a myopathic process is dependent on the diagnosis. Glucocorticoids are the standard treatment for the inflammatory myopathies. Other drugs that may be used include methotrexate, azathioprine, cyclosporine, cyclophosphamide, and cholorambucil. 1 table and 16 references.
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “electromyography” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on electromyography:
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Neurological Tests of the Colon, Rectum, and Anus Source: Participate. 2(1): 2-4. Spring 1993. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail:
[email protected]. Website: www.iffgd.org. Summary: This article, from a newsletter for people affected by bowel dysfunction or incontinence, is the second of a two-part series describing common diagnostic tests to determine treatments for incontinence, constipation, pain, or irritable bowel syndrome (IBS). The author describes neurological tests of the colon, rectum, and anus, including pudendal nerve terminal motor latency, electromyography, concentric needle EMG, single fiber EMG, and sensory evoked potentials. A final section discusses colonic and transit tests, including transit time, scintigraphic emptying and transit, defecating proctography, and anorectal ultrasound.
Academic Periodicals covering Electromyography Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to electromyography. In addition to these sources, you can search for articles covering electromyography that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
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These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
12
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “electromyography” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 47854 456 56 24 119 48509
HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “electromyography” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
14
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
15
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
19 Adapted 20
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on electromyography can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to electromyography. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to electromyography. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “electromyography”:
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Other guides Amyotrophic Lateral Sclerosis http://www.nlm.nih.gov/medlineplus/amyotrophiclateralsclerosis.html Bladder Diseases http://www.nlm.nih.gov/medlineplus/bladderdiseases.html Charcot-Marie-Tooth Disease http://www.nlm.nih.gov/medlineplus/charcotmarietoothdisease.html Degenerative Nerve Diseases http://www.nlm.nih.gov/medlineplus/degenerativenervediseases.html Migraine http://www.nlm.nih.gov/medlineplus/migraine.html Movement Disorders http://www.nlm.nih.gov/medlineplus/movementdisorders.html Neuromuscular Disorders http://www.nlm.nih.gov/medlineplus/neuromusculardisorders.html Phenylketonuria http://www.nlm.nih.gov/medlineplus/phenylketonuria.html
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on electromyography. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Electromyography and Nerve Conduction Studies Source: San Bruno, CA: StayWell Company. 1999. 6 p. Contact: Available from StayWell Company. 1100 Grundy Lane, San Bruno, CA 940663030. (800) 333-3032. Website: www.staywell.com. PRICE: Call or write for current pricing on single and bulk orders. Summary: This illustrated brochure provides people who have nerve and muscle problems with information on electromyography (EMG) and nerve condition (NCS) studies. These tests measure muscle and nerve function. NCS involves applying mild electrical currents to the skin on some parts of the body to determine how quickly
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impulses travel between nerves. EMG uses a fine needle placed under the skin into a muscle to measure muscular electrical activity. The brochure offers suggestions on how people should prepare for the test and how to ensure that it is safe and successful. In addition, the brochure explains both procedures and what to expect afterward. 5 figures. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
What to Expect During Your EMG Test Summary: This fact sheet provides an overview of EMG (electromyography) testing and explains its usefulness in evaluating the causes of numbness, tingling, pain, weakness, fatigue, and muscle cramping. Source: American Association of Electrodiagnostic Medicine http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4849 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to electromyography. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMD®Health: http://my.webmd.com/health_topics
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to electromyography. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with electromyography. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about electromyography. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “electromyography” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “electromyography”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “electromyography” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “electromyography” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
22
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
23
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on electromyography: •
Basic Guidelines for Electromyography Electromyography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003929.htm
•
Signs & Symptoms for Electromyography Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Muscle weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm
•
Diagnostics and Tests for Electromyography Creatine kinase Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003503.htm
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Denervation (reduced nervous stimulation) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003927.htm Muscle biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003924.htm Nerve conduction velocity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003927.htm •
Background Topics for Electromyography Adolescent test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002054.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Infant test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002055.htm Preschooler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002057.htm Schoolage test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002058.htm Toddler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002056.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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ELECTROMYOGRAPHY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abducens: A striated, extrinsic muscle of the eyeball that originates from the annulus of Zinn. [NIH] Abducens Nerve: The 6th cranial nerve. The abducens nerve originates in the abducens nucleus of the pons and sends motor fibers to the lateral rectus muscles of the eye. Damage to the nerve or its nucleus disrupts horizontal eye movement control. [NIH] Abduction: Forcible pulling of a limb away from its natural position, a risk in road accidents and disasters; move outwards away from middle line. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abscess: A localized, circumscribed collection of pus. [NIH] Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acoustic: Having to do with sound or hearing. [NIH] Actin: Essential component of the cell skeleton. [NIH] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adduction: The rotation of an eye toward the midline (nasally). [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine
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derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adjuvant Therapy: Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, or hormone therapy. [NIH]
Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Ageing: A physiological or morphological change in the life of an organism or its parts, generally irreversible and typically associated with a decline in growth and reproductive vigor. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH]
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Airway Resistance: Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alternative Splicing: A process whereby multiple protein isoforms are generated from a single gene. Alternative splicing involves the splicing together of nonconsecutive exons during the processing of some, but not all, transcripts of the gene. Thus a particular exon may be connected to any one of several alternative exons to form messenger RNA. The alternative forms produce proteins in which one part is common while the other part is different. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amnesia: Lack or loss of memory; inability to remember past experiences. [EU] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH]
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Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Ankle Joint: The joint that is formed by the inferior articular and malleolar articular surfaces of the tibia, the malleolar articular surface of the fibula, and the medial malleolar, lateral malleolar, and superior surfaces of the talus. [NIH] Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anoxia: Clinical manifestation of respiratory distress consisting of a relatively complete absence of oxygen. [NIH] Anterior Cruciate Ligament: A strong ligament of the knee that originates from the posteromedial portion of the lateral condyle of the femur, passes anteriorly and inferiorly
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between the condyles, and attaches to the depression in front of the intercondylar eminence of the tibia. [NIH] Anterograde: Moving or extending forward; called also antegrade. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH]
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Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Articulator: A mechanical device that represents the temporo-mandibular joints and jaw members, to which maxillary and mandibular casts may be attached. [NIH] Artifacts: Any visible result of a procedure which is caused by the procedure itself and not by the entity being analyzed. Common examples include histological structures introduced by tissue processing, radiographic images of structures that are not naturally present in living tissue, and products of chemical reactions that occur during analysis. [NIH] Artificial Intelligence: The study and implementation of techniques and methods for designing computer systems to perform functions normally associated with human intelligence, such as understanding language, learning, reasoning, problem solving, etc. [NIH]
Asphyxia: A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Auditory Cortex: Area of the temporal lobe concerned with hearing. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autopsy: Postmortem examination of the body. [NIH]
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Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axilla: The underarm or armpit. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Back Injuries: General or unspecified injuries to the posterior part of the trunk. It includes injuries to the muscles of the back. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium swallow: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called an esophagram. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Binaural: Used of the two ears functioning together. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biomechanics: The study of the application of mechanical laws and the action of forces to living structures. [NIH]
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Biomedical Engineering: Application of principles and practices of engineering science to biomedical research and health care. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biphasic: Having two phases; having both a sporophytic and a gametophytic phase in the life cycle. [EU] Bladder: The organ that stores urine. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH] Blister pack: A package consisting of a clear plastic overlay affixed to a cardboard backing for protecting and displaying a product. [EU] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brace: Any form of splint or appliance used to support the limbs or trunk. [NIH]
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Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Bruxism: A disorder characterized by grinding and clenching of the teeth. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Channel Agonists: Agents that increase calcium influx into calcium channels of excitable tissues. This causes vasoconstriction in vascular smooth muscle and/or cardiac muscle cells as well as stimulation of insulin release from pancreatic islets. Therefore, tissueselective calcium agonists have the potential to combat cardiac failure and endocrinological disorders. They have been used primarily in experimental studies in cell and tissue culture. [NIH]
Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Calibration: Determination, by measurement or comparison with a standard, of the correct value of each scale reading on a meter or other measuring instrument; or determination of the settings of a control device that correspond to particular values of voltage, current, frequency, or other output. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH]
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Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotid Body: A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Communication: Any of several ways in which living cells of an organism communicate with one another, whether by direct contact between cells or by means of
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chemical signals carried by neurotransmitter substances, hormones, and cyclic AMP. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU]
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Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chiropractic: A system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Claudication: Limping or lameness. [EU] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH]
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Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Nerve: The cochlear part of the 8th cranial nerve (vestibulocochlear nerve). The cochlear nerve fibers originate from neurons of the spiral ganglion and project peripherally to cochlear hair cells and centrally to the cochlear nuclei (cochlear nucleus) of the brain stem. They mediate the sense of hearing. [NIH] Cochlear Nucleus: The brain stem nucleus that receives the central input from the cochlear nerve. The cochlear nucleus is located lateral and dorsolateral to the inferior cerebellar peduncles and is functionally divided into dorsal and ventral parts. It is tonotopically organized, performs the first stage of central auditory processing, and projects (directly or indirectly) to higher auditory areas including the superior olivary nuclei, the medial geniculi, the inferior colliculi, and the auditory cortex. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials
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including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Computer Systems: Systems composed of a computer or computers, peripheral equipment, such as disks, printers, and terminals, and telecommunications capabilities. [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective
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tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Continence: The ability to hold in a bowel movement or urine. [NIH] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]
Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH]
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Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cranial Nerves: Twelve pairs of nerves that carry general afferent, visceral afferent, special afferent, somatic efferent, and autonomic efferent fibers. [NIH] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]
Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cystometrogram: A line graph that records urinary bladder pressure at various volumes. [NIH]
Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a
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continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deglutition: The process or the act of swallowing. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Deoxyglucose: 2-Deoxy-D-arabino-hexose. An antimetabolite of glucose with antiviral activity. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Equipment: Nonexpendable items used in examinination. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the
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abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diurnal: Occurring during the day. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended
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effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duke: A lamp which produces ultraviolet radiations for certain ophthalmologic therapy. [NIH]
Duodenum: The first part of the small intestine. [NIH] Dynamometer: An instrument for measuring the force of muscular contraction. [NIH] Dysmenorrhea: Painful menstruation. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysphonia: Difficulty or pain in speaking; impairment of the voice. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Electrocardiograph: Apparatus which, by means of currents produced by contractions of the cardiac muscle, records heart movements as electro-cardiograms. [NIH] Electrocardiography: Recording of the moment-to-moment electromotive forces of the heart as projected onto various sites on the body's surface, delineated as a scalar function of time. [NIH]
Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electroencephalography: Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromagnetic Fields: Fields representing the joint interplay of electric and magnetic forces. [NIH] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH] Electronystagmography: Recording of nystagmus based on changes in the electrical field surrounding the eye produced by the difference in potential between the cornea and the retina. [NIH]
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Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Electroporation: A technique in which electric pulses of intensity in kilovolts per centimeter and of microsecond-to-millisecond duration cause a temporary loss of the semipermeability of cell membranes, thus leading to ion leakage, escape of metabolites, and increased uptake by cells of drugs, molecular probes, and DNA. Some applications of electroporation include introduction of plasmids or foreign DNA into living cells for transfection, fusion of cells to prepare hybridomas, and insertion of proteins into cell membranes. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]
Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Energetic: Exhibiting energy : strenuous; operating with force, vigour, or effect. [EU] Enkephalins: One of the three major families of endogenous opioid peptides. The
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enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epiglottis: Thin leaf-shaped cartilage, covered with mucous membrane, at the root of the tongue, which folds back over the entrance to the larynx, covering it, during the act of swallowing. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Ergometer: An instrument for measuring the force of muscular contraction. [NIH] Ergonomics: Study of the relationships between man and machines; adjusting the design of machines to the need and capacities of man; study of the effect of machines on man's behavior. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagram: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called a barium swallow. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Esotropia: A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a
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peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acid Agonists: Drugs that bind to and activate excitatory amino acid receptors. [NIH] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotropia: A form of ocular misalignment where the visual axes diverge inappropriately. For example, medial rectus muscle weakness may produce this condition as the affected eye will deviate laterally upon attempted forward gaze. An exotropia occurs due to the relatively unopposed force exerted on the eye by the lateral rectus muscle, which pulls the eye in an outward direction. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]
Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraocular: External to or outside of the eye. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU]
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Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial paralysis or paresis. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fetal Monitoring: Physiologic or biochemical monitoring of the fetus. It is usually done during labor and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Finite Element Analysis: A computer based method of simulating or analyzing the behavior of structures or components. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed
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silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Flexor: Muscles which flex a joint. [NIH] Fluoroscopy: Production of an image when X-rays strike a fluorescent screen. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fractionation: Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]
Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Gait: Manner or style of walking. [NIH] Gait Ataxia: Impairment of the ability to coordinate the movements required for normal ambulation which may result from impairments of motor function or sensory feedback. This condition may be associated with brain diseases (including cerebellar diseases and basal ganglia diseases); spinal cord diseases; or peripheral nervous system diseases. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Galvanic Skin Response: A change in electrical resistance of the skin, occurring in emotion and in certain other conditions. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU]
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Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH]
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Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Hammer: The largest of the three ossicles of the ear. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Head Movements: Voluntary or involuntary motion of head that may be relative to or independent of body; includes animals and humans. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hemiparesis: The weakness or paralysis affecting one side of the body. [NIH] Hemiplegia: Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical spinal cord diseases; peripheral nervous system diseases; and other conditions may manifest
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as hemiplegia. The term hemiparesis (see paresis) refers to mild to moderate weakness involving one side of the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogenic: Derived from a different source or species. Also called heterogenous. [NIH] Heterogenous: Derived from a different source or species. Also called heterogenic. [NIH] Heterotropia: One in which the angle of squint remains relatively unaltered on conjugate movement of the eyes. [NIH] Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H,
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atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hypercapnia: A clinical manifestation of abnormal increase in the amount of carbon dioxide in arterial blood. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertonia: Or hypertony n, pl. hypertonias or hypertonies : hypertonicity. n. Pathology: increased rigidity, tension and spasticity of the muscles. [EU] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypocapnia: Clinical manifestation consisting of a deficiency of carbon dioxide in arterial blood. [NIH] Hypodermic: Applied or administered beneath the skin. [EU] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoventilation: A reduction in the amount of air entering the pulmonary alveoli. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hypoxic: Having too little oxygen. [NIH] Ibotenic Acid: Neurotoxic isoxazole substance found in Amanita muscaria and A. pantherina. It causes motor depression, ataxia, and changes in mood, perceptions and feelings, and is a potent excitatory amino acid agonist. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immersion: The placing of a body or a part thereof into a liquid. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and
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disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical
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signs of pain, heat, redness, swelling, and loss of function. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Intercostal: Situated between the ribs. [EU] Interneurons: Most generally any neurons which are not motor or sensory. Interneurons may also refer to neurons whose axons remain within a particular brain region as contrasted with projection neurons which have axons projecting to other brain regions. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intravenous Anesthetics: The systemic administration of an anesthetic drug via an injection into the vein. [NIH] Intravesical: Within the bladder. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intrinsic Factor: A glycoprotein secreted by the cells of the gastric glands that is required for the absorption of vitamin B 12. Deficiency of intrinsic factor results in pernicious anemia. [NIH]
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Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ipsilateral: Having to do with the same side of the body. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isometric Contraction: Muscular contractions characterized by increase in tension without change in length. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kainic Acid: (2S-(2 alpha,3 beta,4 beta))-2-Carboxy-4-(1-methylethenyl)-3-pyrrolidineacetic acid. Ascaricide obtained from the red alga Digenea simplex. It is a potent excitatory amino acid agonist at some types of excitatory amino acid receptors and has been used to discriminate among receptor types. Like many excitatory amino acid agonists it can cause neurotoxicity and has been used experimentally for that purpose. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lacrimal: Pertaining to the tears. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Laryngeal Muscles: The intrinsic muscles of the larynx are the aryepiglottic(us), arytenoid(eus), cricoarytenoid(eus), cricothyroid(eus), thyroarytenoid(eus), thyroepiglottic(us), and vocal(is). [NIH]
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Laryngectomy: Total or partial excision of the larynx. [NIH] Laryngitis: Inflammation of the larynx. This condition presents itself with dryness and soreness of the throat, difficulty in swallowing, cough, and hoarseness. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Lingual Nerve: A sensory branch of the mandibular nerve, which is part of the trigeminal (5th cranial) nerve. The lingual nerve carries general afferent fibers from the anterior twothirds of the tongue, the floor of the mouth, and the mandibular gingivae. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified
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who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]
Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lung volume: The amount of air the lungs hold. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Manometry: Tests that measure muscle pressure and movements in the GI tract. [NIH]
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Masseter Muscle: A masticatory muscle whose action is closing the jaws. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Masticatory: 1. subserving or pertaining to mastication; affecting the muscles of mastication. 2. a remedy to be chewed but not swallowed. [EU] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maxillary Nerve: The intermediate sensory division of the trigeminal (5th cranial) nerve. The maxillary nerve carries general afferents from the intermediate region of the face including the lower eyelid, nose and upper lip, the maxillary teeth, and parts of the dura. [NIH]
Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Mechanoreceptors: Cells specialized to transduce mechanical stimuli and relay that information centrally in the nervous system. Mechanoreceptors include hair cells, which mediate hearing and balance, and the various somatosensory receptors, often with nonneural accessory structures. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Assistance: Financing of medical care provided to public assistance recipients. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Memory Disorders: Disturbances in registering an impression, in the retention of an acquired impression, or in the recall of an impression. Memory impairments are associated with dementia; craniocerebraltrauma; encephalitis; alcoholism (see also alcohol amnestic disorder); schizophrenia; and other conditions. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the
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adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mesencephalic: Ipsilateral oculomotor paralysis and contralateral tremor, spasm. or choreic movements of the face and limbs. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Micrography: Examination with the microscope. [EU] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]
labeled
with
Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Micturition: The passage of urine; urination. [EU] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Probes: A group of atoms or molecules attached to other molecules or cellular structures and used in studying the properties of these molecules and structures. Radioactive DNA or RNA sequences are used in molecular genetics to detect the presence of a complementary sequence by molecular hybridization. [NIH]
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Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Motor Cortex: Area of the frontal lobe concerned with primary motor control. It lies anterior to the central sulcus. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Motor Neurons: Neurons which activate muscle cells. [NIH] Motor Skills: Performance of complex motor acts. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables. [NIH] Muscimol: Neurotoxic isoxazole isolated from Amanita muscaria and A. phalloides and also obtained by decarboxylation of ibotenic acid. It is a potent agonist at GABA-A receptors and is used mainly as an experimental tool in animal and tissue studies. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Denervation: The resection or removal of the innervation of a muscle or muscle tissue. [NIH] Muscle Fatigue: A state arrived at through prolonged and strong contraction of a muscle. Studies in athletes during prolonged submaximal exercise have shown that muscle fatigue increases in almost direct proportion to the rate of muscle glycogen depletion. Muscle fatigue in short-term maximal exercise is associated with oxygen lack and an increased level of blood and muscle lactic acid, and an accompanying increase in hydrogen-ion concentration in the exercised muscle. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting
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at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle Spindles: Mechanoreceptors found between skeletal muscle fibers. Muscle spindles are arranged in parallel with muscle fibers and respond to the passive stretch of the muscle, but cease to discharge if the muscle contracts isotonically, thus signaling muscle length. The muscle spindles are the receptors responsible for the stretch or myotactic reflex. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Musculoskeletal System: Themuscles, bones, and cartilage of the body. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myometrium: The smooth muscle coat of the uterus, which forms the main mass of the organ. [NIH] Myopathy: Any disease of a muscle. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Septum: The partition separating the two nasal cavities in the midplane, composed of cartilaginous, membranous and bony parts. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis,
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prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]
Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurologist: A doctor who specializes in the diagnosis and treatment of disorders of the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Blockade: The intentional interruption of transmission at the neuromuscular junction by external agents, usually neuromuscular blocking agents. It is distinguished from nerve block in which nerve conduction is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce muscle relaxation as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system.
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[NIH]
Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral
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striatum, a composite structure considered part of the basal ganglia. [NIH] Nystagmus: Rhythmical oscillation of the eyeballs, either pendular or jerky. [NIH] Occipital Lobe: Posterior part of the cerebral hemisphere. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oculi: Globe or ball of the eye. [NIH] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Oculomotor Nerve: The 3d cranial nerve. The oculomotor nerve sends motor fibers to the levator muscles of the eyelid and to the superior rectus, inferior rectus, and inferior oblique muscles of the eye. It also sends parasympathetic efferents (via the ciliary ganglion) to the muscles controlling pupillary constriction and accommodation. The motor fibers originate in the oculomotor nuclei of the midbrain. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmologic: Pertaining to ophthalmology (= the branch of medicine dealing with the eye). [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Ophthalmoplegia: Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic cup: The white, cup-like area in the center of the optic disc. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orbicularis: A thin layer of fibers that originates at the posterior lacrimal crest and passes outward and forward, dividing into two slips which surround the canaliculi. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Orderly: A male hospital attendant. [NIH]
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Orofacial: Of or relating to the mouth and face. [EU] Orthostatic: Pertaining to or caused by standing erect. [EU] Ossicles: The hammer, anvil and stirrup, the small bones of the middle ear, which transmit the vibrations from the tympanic membrane to the oval window. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Otolith: A complex calcareous concretion in the inner ear which controls man's sense of balance and reactions to acceleration. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxytocin: A nonapeptide posterior pituitary hormone that causes uterine contractions and stimulates lactation. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Paradoxical: Occurring at variance with the normal rule. [EU] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute
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hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Peak flow: The maximum amount of air breathed out; the power needed to produce this amount. [EU] Pedicle: Embryonic link between the optic vesicle or optic cup and the forebrain or diencephalon, which becomes the optic nerve. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perceptual Defense: Selective perceiving such that the individual protects himself from becoming aware of something unpleasant or threatening, e.g., obscene words are not heard correctly, or violent acts are not seen accurately. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU]
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Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Perioral: Situated or occurring around the mouth. [EU] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharyngeal Muscles: The muscles of the pharynx are the inferior, middle and superior constrictors, salpingopharyngeus, and stylopharyngeus. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phosphorous: Having to do with or containing the element phosphorus. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase
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"physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]
Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasmids: Any extrachromosomal hereditary determinant. Plasmids are self-replicating circular molecules of DNA that are found in a variety of bacterial, archaeal, fungal, algal, and plant species. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Polygraph: An instrument for making a graphic record of the changes in blood pressure and pulse and respiration rate of someone being questioned under or as if under suspicion of guilt. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of
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the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [NIH] Postural: Pertaining to posture or position. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Preoperative: Preceding an operation. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Pronation: Applies to movements of the forearm in turning the palm backward or downward or when applied to the foot, a combination of eversion and abduction movements in the tarsal and metatarsal joints, (turning the foot up and in toward the midline of the body). [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Proprioception: The mechanism involved in the self-regulation of posture and movement through stimuli originating in the receptors imbedded in the joints, tendons, muscles, and labyrinth. [NIH]
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Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Isoforms: Different forms of a protein that may be produced from different genes, or from the same gene by alternative splicing. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychotomimetic: Psychosis miming. [NIH]
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Ptosis: 1. Prolapse of an organ or part. 2. Drooping of the upper eyelid from paralysis of the third nerve or from sympathetic innervation. [EU] Public Assistance: Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Alveoli: Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can
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also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Raphe Nuclei: Collections of small neurons centrally scattered among many fibers from the level of the trochlear nucleus in the midbrain to the hypoglossal area in the medulla oblongata. [NIH] Reaction Time: The time from the onset of a stimulus until the organism responds. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrent Laryngeal Nerve: Branches of the vagus (tenth cranial) nerve. The recurrent laryngeal nerves originate more caudally than the superior laryngeal nerves and follow different paths on the right and left sides. They carry efferents to all muscles of the larynx except the cricothyroid and carry sensory and autonomic fibers to the laryngeal, pharyngeal, tracheal, and cardiac regions. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH]
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Reference Values: The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. [NIH] Reflective: Capable of throwing back light, images, sound waves : reflecting. [EU] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Repressor: Any of the specific allosteric protein molecules, products of regulator genes, which bind to the operator of operons and prevent RNA polymerase from proceeding into the operon to transcribe messenger RNA. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Respiratory Muscles: These include the muscles of the diaphragm and the intercostal muscles. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes
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such measures as artificial respiration and cardiac massage. [EU] Reticular: Coarse-fibered, netlike dermis layer. [NIH] Reticular Formation: A region extending from the pons & medulla oblongata through the mesencephalon, characterized by a diversity of neurons of various sizes and shapes, arranged in different aggregations and enmeshed in a complicated fiber network. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rotator: A muscle by which a part can be turned circularly. [NIH] Rotator Cuff: The musculotendinous sheath formed by the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. These help stabilize the head of the humerus in the glenoid fossa and allow for rotation of the shoulder joint about its longitudinal axis. [NIH] Ruminants: A suborder of the order Artiodactyla whose members have the distinguishing feature of a four-chambered stomach. Horns or antlers are usually present, at least in males. [NIH]
Sagittal: The line of direction passing through the body from back to front, or any vertical plane parallel to the medial plane of the body and inclusive of that plane; often restricted to the medial plane, the plane of the sagittal suture. [NIH]
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Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoplasmic Reticulum: A network of tubules and sacs in the cytoplasm of skeletal muscles that assist with muscle contraction and relaxation by releasing and storing calcium ions. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septum: A dividing wall or partition; a general term for such a structure. The term is often used alone to refer to the septal area or to the septum pellucidum. [EU] Septum Pellucidum: A triangular double membrane separating the anterior horns of the lateral ventricles of the brain. It is situated in the median plane and bounded by the corpus callosum and the body and columns of the fornix. [NIH]
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Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Shedding: Release of infectious particles (e. g., bacteria, viruses) into the environment, for example by sneezing, by fecal excretion, or from an open lesion. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicon: A trace element that constitutes about 27.6% of the earth's crust in the form of silicon dioxide. It does not occur free in nature. Silicon has the atomic symbol Si, atomic number 14, and atomic weight 28.09. [NIH] Silicon Dioxide: Silica. Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, quartz, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Sleep Deprivation: The state of being deprived of sleep under experimental conditions, due to life events, or from a wide variety of pathophysiologic causes such as medication effect, chronic illness, psychiatric illness, or sleep disorder. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Behavior: Any behavior caused by or affecting another individual, usually of the same species. [NIH]
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Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social pressure: A strategy used in behavior therapy in which individuals are told that they possess the basic self-control ability to lose weight, but that coming to group meetings will strengthen their abilities. The group is asked to listen and give advice, similar to the way many self-help groups, based on social support, operate. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectroscopic: The recognition of elements through their emission spectra. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or
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dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spinal Stenosis: Narrowing of the spinal canal. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spiral Lamina: The bony plate which extends outwards from the modiolus. It is part of the structure which divides trhe cochlea into sections. [NIH] Splint: A rigid appliance used for the immobilization of a part or for the correction of deformity. [NIH] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Stabilization: The creation of a stable state. [EU] Standardize: To compare with or conform to a standard; to establish standards. [EU] Stapedius: The stapedius muscle arises from the wall of the middle ear and is inserted into the neck of the stapes. Its action is to pull the head of the stapes backward. [NIH] Stapes: One of the three ossicles of the middle ear. It transmits sound vibrations from the incus to the internal ear. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strabismus: Deviation of the eye which the patient cannot overcome. The visual axes assume a position relative to each other different from that required by the physiological conditions. The various forms of strabismus are spoken of as tropias, their direction being indicated by the appropriate prefix, as cyclo tropia, esotropia, exotropia, hypertropia, and hypotropia. Called also cast, heterotropia, manifest deviation, and squint. [EU] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH]
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Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Supination: Applies to the movements of the forearm in turning the palm forward or upward and when applied to the foot, a combination of adduction and inversion of the foot. [NIH]
Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Surgical Instruments: Hand-held tools or implements used by health professionals for the performance of surgical tasks. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or
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secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Talus: The second largest of the tarsal bones and occupies the middle and upper part of the tarsus. [NIH] Telecommunications: Transmission of information over distances via electronic means. [NIH]
Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Tenotomy: The cutting of a tendon. [NIH] Tensor Tympani: Two muscles which operate on the hammer and stirrup. They contract in response to loud sounds. Their action reduces the amplitude of movement of the ossicles, thus limiting the sound intensity delivered to the inner ear. [NIH] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH]
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Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Tibia: The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the fibula laterally, the talus distally, and the femur proximally. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tissue Survival: The span of viability of a tissue or an organ. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU]
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Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcutaneous: Transdermal. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translating: Conversion from one language to another language. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trigeminal Nerve: The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the trigeminal ganglion and project to the trigeminal nucleus of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication. [NIH] Trigeminal Nuclei: Nuclei of the trigeminal nerve situated in the brain stem. They include the nucleus of the spinal trigeminal tract (spinal trigeminal nucleus), the principal sensory nucleus, the mesencephalic nucleus, and the motor nucleus. [NIH] Tropomyosin: A protein found in the thin filaments of muscle fibers. It inhibits contraction of the muscle unless its position is modified by troponin. [NIH] Troponin: One of the minor protein components of skeletal muscle. Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH]
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Tubercle: A rounded elevation on a bone or other structure. [NIH] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [NIH] Tympani: The part of the cochlea below the spiral lamina. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Ultraviolet radiation: Invisible rays that are part of the energy that comes from the sun. UV radiation can damage the skin and cause melanoma and other types of skin cancer. UV radiation that reaches the earth's surface is made up of two types of rays, called UVA and UVB rays. UVB rays are more likely than UVA rays to cause sunburn, but UVA rays pass deeper into the skin. Scientists have long thought that UVB radiation can cause melanoma and other types of skin cancer. They now think that UVA radiation also may add to skin damage that can lead to skin cancer and cause premature aging. For this reason, skin specialists recommend that people use sunscreens that reflect, absorb, or scatter both kinds of UV radiation. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urodynamics: The mechanical laws of fluid dynamics as they apply to urine transport. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH]
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Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venter: Belly. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventilator: A breathing machine that is used to treat respiratory failure by promoting ventilation; also called a respirator. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH]
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Vibrissae: Stiff hairs projecting from the face around the nose of most mammals, acting as touch receptors. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visual Cortex: Area of the occipital lobe concerned with vision. [NIH] Visual Perception: The selecting and organizing of visual stimuli based on the individual's past experience. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] Weight-Bearing: The physical state of supporting an applied load. This often refers to the weight-bearing bones or joints that support the body's weight, especially those in the spine, hip, knee, and foot. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Work Capacity Evaluation: Assessment of physiological capacities in relation to job requirements. It is usually done by measuring certain physiological (e.g., circulatory and respiratory) variables during a gradually increasing workload until specific limitations occur with respect to those variables. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]
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INDEX A Abdomen, 121, 125, 167, 174, 187, 196, 198, 208, 220, 222, 226 Abdominal, 8, 24, 66, 68, 76, 94, 125, 167, 184, 207 Abducens, 29, 46, 167 Abducens Nerve, 29, 46, 167 Abduction, 167, 211 Aberrant, 44, 167 Abscess, 167, 217 Academic Medical Centers, 36, 167 Accommodation, 118, 119, 167, 206 Acetylcholine, 60, 167, 178, 205 Acidosis, 17, 167 Acoustic, 14, 38, 86, 167 Actin, 42, 167, 202, 203, 224 Action Potentials, 27, 30, 57, 116, 137, 167 Activities of Daily Living, 34, 40, 167 Adaptation, 39, 42, 167, 210 Adduction, 6, 32, 167, 221 Adenine, 167, 168 Adenosine, 143, 167, 168, 209 Adenosine Triphosphate, 143, 168, 209 Adjustment, 167, 168 Adjuvant, 125, 168 Adjuvant Therapy, 125, 168 Adrenal Cortex, 168, 182, 193 Adrenal Medulla, 168, 176, 187, 205 Adrenergic, 168, 184, 187, 221 Adverse Effect, 168, 218 Aerobic, 168, 188 Afferent, 6, 15, 42, 44, 47, 52, 120, 168, 182, 198 Affinity, 168 Age Groups, 140, 168 Aged, 80 and Over, 168 Ageing, 30, 168 Agonist, 37, 44, 56, 75, 168, 184, 194, 197, 202, 205 Airway, 8, 13, 21, 27, 37, 54, 168, 169, 218 Airway Resistance, 8, 169 Alertness, 46, 55, 169 Algorithms, 169, 174 Alkaline, 167, 169, 173, 175, 222 Alkaloid, 169, 175, 178, 205 Allergen, 169, 217 Alopecia, 169, 182 Alpha Particles, 169, 213
Alternative medicine, 142, 169 Alternative Splicing, 169, 212 Alveoli, 169, 226 Amino acid, 169, 171, 182, 188, 191, 194, 197, 208, 212, 216, 218, 224, 225 Amnesia, 46, 169 Amnestic, 169, 200 Amphetamine, 46, 169, 183 Amplification, 113, 119, 121, 169 Ampulla, 170, 186 Amygdala, 12, 15, 170, 173, 198, 222 Anaesthesia, 71, 170, 195 Anal, 65, 69, 102, 170, 189, 198, 202 Analgesic, 170, 186, 206 Analog, 53, 112, 113, 170 Analysis of Variance, 24, 170 Anaphylatoxins, 170, 180 Anaplasia, 170, 204 Anatomical, 14, 46, 49, 134, 170, 172, 178, 195, 217 Anemia, 170, 192, 209 Anesthesia, 51, 64, 87, 168, 170, 182, 204 Anesthetics, 51, 170, 187 Anginal, 170, 205 Animal model, 5, 27, 33, 37, 170 Ankle, 5, 7, 10, 39, 170 Ankle Joint, 10, 39, 170 Anode, 73, 76, 170 Anorectal, 85, 102, 144, 170 Anoxia, 46, 170 Anterior Cruciate Ligament, 5, 23, 170 Anterograde, 14, 47, 171 Antibacterial, 171, 219 Antibiotic, 171, 219 Antibody, 168, 171, 179, 192, 193, 195, 200, 213, 214, 217, 219 Antidepressant, 15, 171 Antigen, 168, 171, 179, 193, 194, 195, 200, 213, 217 Antigen-Antibody Complex, 171, 179 Antimetabolite, 171, 183, 201 Antineoplastic, 171, 182, 201 Antioxidants, 38, 171 Antiviral, 171, 183 Anus, 102, 144, 170, 171, 174, 179, 209 Anxiety, 23, 171 Aorta, 171, 226 Apnea, 28, 171
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Electromyography
Aponeurosis, 171, 190 Applicability, 59, 171 Aqueous, 171, 173, 183, 186, 198 Arginine, 170, 171, 205 Arterial, 7, 28, 171, 194, 212 Arteries, 171, 174, 181, 201 Arterioles, 171, 174 Artery, 64, 171, 172, 176, 182, 213, 215 Articular, 170, 172, 207 Articulator, 20, 172 Artifacts, 26, 111, 126, 172 Artificial Intelligence, 8, 30, 172 Asphyxia, 54, 172 Aspiration, 6, 172 Assay, 24, 38, 172, 213 Asymptomatic, 9, 32, 49, 76, 88, 90, 112, 172 Ataxia, 30, 35, 172, 194, 222 Atrium, 172, 226 Atrophy, 65, 74, 172 Attenuation, 52, 172 Atypical, 54, 172 Auditory, 12, 14, 172, 179, 188, 192, 226 Auditory Cortex, 172, 179 Autoimmune disease, 172, 202 Autonomic, 26, 50, 167, 172, 182, 205, 209, 214, 221 Autonomic Nervous System, 172, 209, 221 Autopsy, 21, 172 Autoradiography, 44, 173 Axilla, 173, 175 Axonal, 44, 52, 173 Axons, 173, 196, 204, 206 B Back Injuries, 127, 173 Back Pain, 49, 107, 112, 116, 173 Bacteria, 171, 173, 189, 201, 218, 219, 223, 226 Bacterial Physiology, 167, 173 Barium, 140, 173, 187 Barium swallow, 140, 173, 187 Basal Ganglia, 137, 172, 173, 175, 190, 198, 206 Basal Ganglia Diseases, 172, 173, 190 Base, 50, 105, 122, 128, 130, 167, 173, 183, 197, 222 Behavior Therapy, 173, 219 Benign, 12, 173, 190, 192, 204, 214 Bilateral, 15, 61, 173, 207, 208 Bile, 173, 190, 191, 198, 220 Bile Acids, 173, 191, 220 Binaural, 61, 173
Biochemical, 38, 107, 143, 171, 173, 189, 207, 218 Biomechanics, 8, 31, 71, 85, 88, 173 Biomedical Engineering, 4, 7, 30, 128, 174 Biopsy, 65, 143, 166, 174, 208 Biotechnology, 61, 62, 142, 149, 174 Biphasic, 9, 174 Bladder, 3, 12, 52, 114, 154, 174, 182, 190, 195, 196, 202, 204, 212, 216, 225 Blister, 103, 174 Blister pack, 103, 174 Blood Cell Count, 174, 192, 209 Blood Coagulation, 174, 175 Blood Glucose, 174, 193 Blood Platelets, 174, 218 Blood pressure, 37, 109, 174, 176, 177, 194, 202, 205, 210 Blood vessel, 130, 174, 176, 177, 178, 186, 197, 209, 218, 219, 221, 222, 226 Body Image, 9, 174 Bolus, 6, 21, 128, 174 Bolus infusion, 174 Bone Marrow, 174, 182, 195, 199 Bowel, 144, 170, 174, 181, 184, 190, 196, 220 Bowel Movement, 174, 181, 184, 220 Brace, 69, 174 Brachial, 70, 175 Brachial Plexus, 70, 175 Bradykinin, 175, 205 Brain Diseases, 175, 190, 207 Brain Stem, 175, 177, 179, 224 Branch, 108, 163, 175, 186, 198, 199, 206, 208, 213, 219, 222 Breakdown, 175, 184, 191, 206 Bruxism, 107, 175 C Calcium, 12, 44, 175, 179, 205, 208, 217, 222, 224 Calcium Channel Agonists, 44, 175 Calcium Channels, 12, 175 Calibration, 39, 175 Cannula, 8, 175 Capsaicin, 6, 175 Carbohydrates, 175, 177 Carbon Dioxide, 176, 183, 189, 191, 194, 215 Carcinogenic, 176, 196, 220 Carcinoma, 77, 176 Cardiac, 125, 175, 176, 185, 187, 188, 203, 214, 216, 220, 221 Cardiopulmonary, 8, 28, 176
Index
Cardiorespiratory, 16, 176 Cardiovascular, 12, 48, 50, 169, 175, 176, 188, 218 Cardiovascular disease, 50, 176 Carotene, 176, 216 Carotid Body, 17, 176, 177 Carrier Proteins, 176, 213 Case report, 176, 178 Case series, 176, 178 Catecholamine, 176, 184, 209 Catheter, 102, 114, 115, 176 Cathode, 119, 170, 176 Caudal, 19, 38, 176, 184, 194, 205, 211 Caudate Nucleus, 173, 176, 205 Causal, 10, 50, 176 Cell, 11, 14, 19, 37, 38, 41, 52, 97, 167, 168, 170, 172, 173, 174, 175, 176, 177, 178, 180, 182, 183, 186, 188, 190, 191, 193, 195, 196, 200, 203, 205, 210, 211, 214, 215, 222, 223, 224 Cell Communication, 97, 176 Cell membrane, 11, 38, 175, 176, 177, 183, 186 Cell Respiration, 177, 215 Central Nervous System Infections, 177, 192 Centrifugation, 177, 192 Cerebellar, 30, 35, 172, 177, 179, 190, 214, 224 Cerebellar Diseases, 172, 177, 190, 224 Cerebellum, 35, 46, 175, 177, 210, 214 Cerebral Cortex, 54, 172, 175, 177, 187, 189 Cerebral Palsy, 7, 10, 44, 95, 137, 177, 219 Cerebrospinal, 17, 177 Cerebrospinal fluid, 17, 177 Cerebrovascular, 128, 173, 176, 177, 222 Cerebrum, 177, 222 Cervical, 63, 66, 84, 112, 124, 125, 128, 175, 177, 192 Cervix, 125, 177, 190 Character, 177, 183 Chemoreceptor, 17, 54, 177 Chemotactic Factors, 178, 180 Chemotherapy, 168, 178 Chin, 128, 178, 200 Chiropractic, 89, 178 Choline, 60, 178 Cholinergic, 11, 12, 178, 205 Chromosomal, 169, 178 Chromosome, 178, 198 Ciliary, 178, 206 CIS, 112, 178, 216
231
Claudication, 49, 178 Clinical Medicine, 178, 211 Clinical study, 26, 178, 181 Clinical trial, 4, 7, 10, 21, 27, 59, 88, 97, 98, 149, 178, 181, 182, 184, 208, 212, 214 Cloning, 29, 174, 178 Coca, 178 Cocaine, 45, 178 Cochlea, 14, 179, 196, 220, 225 Cochlear, 14, 179 Cochlear Nerve, 179 Cochlear Nucleus, 14, 179 Collagen, 169, 179, 193, 210 Collagen disease, 179, 193 Collapse, 175, 179, 218 Colon, 87, 88, 144, 179, 197 Colorectal, 48, 179 Combination Therapy, 4, 179 Complement, 46, 170, 179, 180, 191, 217 Complementary and alternative medicine, 83, 91, 180 Complementary medicine, 83, 180 Computational Biology, 149, 180 Computer Simulation, 58, 180 Computer Systems, 59, 172, 180 Concentric, 65, 66, 72, 95, 122, 144, 180 Conception, 180, 189, 220 Concomitant, 55, 180 Concretion, 180, 207 Conduction, 3, 49, 70, 72, 103, 104, 124, 134, 136, 154, 166, 180, 204 Cones, 180, 216 Confounding, 41, 180 Congenita, 65, 180 Congestion, 103, 180 Congestive heart failure, 13, 180 Conjunctiva, 180, 224 Connective Tissue, 43, 174, 179, 180, 181, 183, 189, 190, 199, 222 Connective Tissue Cells, 180, 181 Consciousness, 170, 181, 183, 212, 215 Constipation, 102, 144, 181, 190 Constitutional, 181, 203 Constriction, 181, 197, 206, 226 Consultation, 23, 181 Consumption, 37, 181, 207 Continence, 114, 181 Continuum, 133, 134, 181 Contractility, 13, 24, 42, 125, 181 Contracture, 41, 181 Contraindications, ii, 181 Contralateral, 23, 43, 181, 201, 214
232
Electromyography
Control group, 32, 52, 181 Controlled clinical trial, 15, 181 Controlled study, 67, 85, 181 Conventional therapy, 181 Conventional treatment, 126, 181 Coordination, 16, 20, 21, 34, 41, 177, 181, 202 Cornea, 181, 185 Coronary, 176, 181, 182, 201 Coronary heart disease, 176, 181 Coronary Thrombosis, 182, 201 Corpus, 76, 182, 217 Cortex, 6, 12, 18, 21, 43, 54, 182, 188 Cortical, 9, 11, 19, 22, 40, 41, 43, 182, 188, 222 Cortisol, 24, 57, 182 Cranial, 10, 22, 29, 86, 167, 177, 179, 182, 192, 198, 199, 200, 206, 209, 214, 224, 226 Cranial Nerves, 86, 182 Craniocerebral Trauma, 173, 182, 192, 222 Creatine, 70, 143, 165, 182 Creatine Kinase, 70, 182 Creatinine, 182 Curare, 182, 203 Curative, 182, 222 Cutaneous, 48, 182 Cyclic, 177, 182, 192, 205 Cyclophosphamide, 143, 182 Cyclosporine, 143, 182 Cystitis, 52, 182 Cystometrogram, 114, 115, 182 Cytoplasm, 177, 182, 183, 186, 216, 217 Cytoskeleton, 183, 201 Cytotoxic, 175, 183, 213, 214 D Data Collection, 36, 58, 183 Decarboxylation, 183, 202 Defecation, 87, 102, 183 Degenerative, 35, 49, 154, 183, 207 Deglutition, 21, 183 Dementia, 51, 183, 200 Denaturation, 38, 183 Dendrites, 183, 204 Dendritic, 183, 219 Density, 115, 177, 183, 206, 219 Deoxyglucose, 44, 183 Depolarization, 110, 183 Deprivation, 45, 183 Dermis, 183, 216 Dextroamphetamine, 169, 183 Diabetes Mellitus, 183, 193, 196 Diagnostic Equipment, 112, 183
Diagnostic procedure, 101, 115, 139, 142, 183 Diaphragm, 87, 110, 111, 183, 215 Diarrhea, 184, 190 Diencephalon, 184, 194, 208, 222 Digestion, 173, 174, 184, 196, 198, 220 Digestive system, 99, 110, 184 Dilatation, 184, 211 Discrete, 112, 184, 222 Discrimination, 39, 128, 184 Disease Progression, 97, 184 Distal, 33, 58, 63, 102, 173, 184, 185, 191, 212 Diurnal, 55, 184 Dopamine, 46, 169, 178, 183, 184, 202, 205 Dorsal, 11, 44, 52, 58, 179, 184, 210 Double-blind, 44, 184 Double-blinded, 44, 184 Drive, ii, vi, 13, 54, 79, 184 Drug Interactions, 184 Drug Tolerance, 184, 223 Duct, 170, 175, 185, 217, 220 Duke, 80, 185 Duodenum, 173, 185, 186, 207, 220 Dynamometer, 32, 185 Dysmenorrhea, 125, 185 Dysphagia, 22, 127, 133, 139, 185 Dysphonia, 36, 185 Dystonia, 44, 185 E Eating Disorders, 9, 185 Edema, 107, 185 Effector, 167, 179, 185 Efferent, 14, 40, 42, 120, 182, 185, 202 Efficacy, 15, 17, 27, 32, 37, 38, 39, 95, 137, 185 Elastic, 33, 185, 219 Elasticity, 35, 94, 185 Electrocardiograph, 105, 185 Electrocardiography, 109, 185 Electroencephalography, 118, 185 Electrolyte, 185, 211 Electromagnetic Fields, 129, 185 Electronystagmography, 18, 185 Electrophysiological, 13, 63, 65, 71, 74, 126, 127, 135, 186 Electroporation, 38, 186 Elementary Particles, 186, 199, 205, 212 Embryo, 186, 195 Empirical, 35, 53, 186 Emulsion, 173, 186, 189 Encephalitis, 186, 200
Index
Endogenous, 38, 184, 186 Endorphin, 24, 186 Endoscope, 186 Endoscopic, 6, 186 Endoscopy, 134, 140, 186 Endothelium, 186, 205 Endothelium-derived, 186, 205 Endotoxins, 180, 186 Energetic, 35, 186 Enkephalins, 186, 205 Environmental Health, 71, 148, 150, 187 Enzymatic, 169, 175, 176, 180, 187, 216 Enzyme, 11, 60, 185, 187, 192, 197, 202, 210, 212, 214, 221, 227 Epidemic, 127, 187 Epidermis, 174, 183, 187 Epigastric, 67, 187, 207 Epiglottis, 21, 187 Epinephrine, 168, 184, 187, 205, 225 Erectile, 76, 90, 187 Erection, 187 Ergometer, 32, 187 Ergonomics, 25, 93, 135, 187 Erythrocytes, 170, 174, 187, 217 Esophageal, 6, 69, 187 Esophagram, 173, 187 Esophagus, 173, 184, 187, 191, 199, 209, 215, 220 Esotropia, 187, 220 Evacuation, 181, 187 Evoke, 11, 187, 220 Evoked Potentials, 3, 18, 135, 144, 188 Excitability, 12, 44, 188 Excitation, 12, 177, 188, 205 Excitatory, 14, 41, 48, 188, 191, 194, 197 Excitatory Amino Acid Agonists, 188, 197 Exercise Test, 143, 188 Exhaustion, 38, 188 Exogenous, 186, 188 Exotropia, 188, 220 Expiration, 94, 188, 215 Expiratory, 27, 188 Extensor, 32, 62, 188 Extracellular, 15, 180, 181, 188, 201, 222 Extracellular Matrix, 180, 181, 188 Extracellular Space, 188, 201 Extraocular, 27, 29, 188 Extrapyramidal, 184, 188 Extremity, 5, 31, 49, 62, 127, 136, 175, 188, 208 Eye Movements, 9, 28, 48, 189
233
F Facial, 10, 14, 22, 50, 52, 64, 75, 90, 95, 117, 189 Facial Expression, 22, 52, 189 Facial Paralysis, 75, 90, 189 Family Planning, 149, 189 Fat, 174, 176, 181, 189, 198, 202, 219 Fatigue, 24, 25, 64, 68, 85, 94, 116, 123, 127, 143, 155, 189, 192, 202 Fecal Incontinence, 85, 88, 102, 189, 195 Feces, 181, 189, 220 Femur, 170, 189, 223 Fentanyl, 64, 189 Fetal Monitoring, 125, 189 Fetus, 125, 189, 225 Fibrosis, 29, 181, 189, 217 Fibula, 170, 189, 223 Finite Element Analysis, 27, 189 Fixation, 119, 189, 217 Flatus, 189, 190, 191 Flexion, 24, 43, 49, 63, 69, 75, 84, 190 Flexor, 7, 32, 63, 84, 188, 190 Fluoroscopy, 140, 190 Fold, 36, 55, 76, 77, 190 Foramen, 178, 190 Forearm, 43, 65, 127, 143, 174, 190, 211, 221 Fossa, 177, 190, 216 Fovea, 189, 190 Fractionation, 41, 190 Friction, 169, 190 Frontal Lobe, 190, 202 Functional Disorders, 116, 190 Functional magnetic resonance imaging, 87, 190 Fundus, 190 G Gait, 7, 10, 16, 36, 39, 40, 48, 63, 83, 85, 177, 190 Gait Ataxia, 36, 177, 190 Gallbladder, 167, 184, 190 Galvanic Skin Response, 109, 190 Gamma Rays, 190, 213, 214 Ganglia, 167, 173, 190, 204, 209, 221 Ganglion, 11, 179, 190, 206, 224 Gas, 114, 176, 190, 191, 194, 205, 213, 215, 226 Gas exchange, 191, 213, 215, 226 Gastric, 191, 196 Gastrin, 191, 193 Gastroesophageal Reflux, 6, 191 Gastrointestinal, 144, 175, 187, 191, 218
234
Electromyography
Gastrointestinal tract, 191, 218 Gene, 29, 44, 58, 60, 169, 174, 191, 206, 210, 212 Genetic Engineering, 174, 178, 191 Genotype, 29, 191, 209 Gland, 104, 168, 191, 199, 207, 212, 220, 223 Glucocorticoid, 191, 193 Glucose, 174, 183, 191, 193, 196 Glutamate, 17, 47, 191 Glutamic Acid, 191, 205 Glycine, 169, 191, 205 Glycogen, 143, 191, 202 Glycolysis, 143, 191 Glycoprotein, 191, 196 Goats, 17, 33, 191 Governing Board, 191, 211 Grade, 33, 192 Graft, 23, 192 Grafting, 192, 195 Growth, 9, 24, 65, 168, 171, 192, 199, 204, 210, 223, 224, 225 Guanylate Cyclase, 192, 205 H Habitual, 53, 177, 192 Hair Cells, 179, 192, 200 Hammer, 192, 207, 222 Haptens, 168, 192, 213 Head Movements, 54, 192 Headache, 86, 91, 192 Headache Disorders, 192 Heart attack, 176, 192 Heart failure, 13, 192 Heartbeat, 192, 221 Hematocrit, 24, 174, 192 Hemiparesis, 192, 193 Hemiplegia, 26, 192 Hemoglobin, 24, 170, 174, 187, 193 Hemorrhage, 35, 182, 192, 193, 221 Hemostasis, 193, 218 Heredity, 191, 193 Heterogenic, 193 Heterogenous, 55, 193 Heterotropia, 193, 220 Hoarseness, 193, 198 Homeostasis, 12, 193 Homogeneous, 33, 181, 193 Homologous, 193, 217, 221 Hormonal, 24, 172, 193 Hormone, 38, 65, 168, 182, 187, 191, 193, 196, 207, 208, 223 Hormone therapy, 168, 193
Hybridomas, 186, 193 Hydrocortisone, 57, 193 Hydrogel, 103, 193 Hydrogen, 167, 173, 175, 183, 193, 202, 205, 207, 212 Hydrophilic, 193, 194 Hypercapnia, 13, 54, 194 Hyperplasia, 12, 194 Hypersensitivity, 52, 169, 194, 217 Hypertension, 176, 192, 194 Hypertonia, 41, 42, 194 Hypertrophy, 49, 194 Hyperventilation, 13, 194 Hypnotic, 51, 194 Hypocapnia, 13, 194 Hypodermic, 115, 194 Hypothalamic, 57, 194 Hypothalamus, 172, 175, 184, 194, 198 Hypoventilation, 17, 28, 194 Hypoxia, 13, 28, 54, 194, 222 Hypoxic, 13, 194 I Ibotenic Acid, 15, 194, 202 Id, 81, 90, 155, 162, 164, 194 Idiopathic, 143, 194 Immersion, 24, 194 Immune response, 168, 171, 172, 192, 194, 195, 217 Immune system, 194, 195, 202, 203, 226 Immunization, 195, 217 Immunogenic, 195, 213 Immunologic, 52, 178, 195, 214 Immunology, 168, 195 Immunosuppressant, 195, 201 Immunosuppressive, 182, 191, 195 Impairment, 7, 10, 15, 31, 36, 40, 57, 107, 112, 114, 172, 185, 190, 195, 201 Implantation, 23, 33, 67, 180, 195 Impotence, 187, 195 In vitro, 18, 30, 35, 46, 195, 223 In vivo, 5, 10, 18, 33, 35, 38, 47, 54, 56, 110, 195, 201 Incision, 104, 195, 197, 212 Incompetence, 191, 195 Incontinence, 144, 195 Indicative, 134, 195, 208, 226 Induction, 37, 44, 46, 53, 195 Infancy, 20, 109, 195 Infant, Newborn, 168, 195 Infarction, 182, 195, 201, 215 Infection, 178, 186, 195, 199, 204, 221
Index
Inflammation, 178, 182, 186, 189, 193, 195, 198, 203, 210 Initiation, 40, 48, 59, 112, 196 Inlay, 196, 215 Inner ear, 14, 196, 207, 222 Innervation, 175, 196, 202, 206, 213 Inotropic, 184, 196 Insight, 39, 45, 47, 196 Insomnia, 45, 196 Insulator, 104, 105, 196, 202 Insulin, 175, 196 Intensive Care, 68, 196 Intercostal, 54, 71, 196, 215 Interneurons, 14, 15, 40, 43, 196 Interstitial, 52, 188, 196 Intervertebral, 196, 199 Intervertebral Disk Displacement, 196, 199 Intestine, 174, 196, 197, 209 Intoxication, 196, 227 Intracellular, 11, 47, 60, 195, 196, 205, 211, 214 Intramuscular, 26, 32, 41, 87, 89, 94, 196 Intravenous, 38, 50, 196 Intravenous Anesthetics, 50, 196 Intravesical, 115, 196 Intrinsic, 11, 31, 35, 42, 53, 74, 168, 196, 197 Intrinsic Factor, 31, 196 Invasive, 5, 8, 112, 197, 199 Involuntary, 44, 173, 189, 192, 197, 203, 215, 218 Ion Channels, 12, 197, 222 Ionizing, 169, 197, 214 Ions, 173, 175, 185, 194, 197, 217 Ipsilateral, 22, 197, 201, 214 Ischemia, 39, 172, 197, 215 Isoenzyme, 182, 197 Isometric Contraction, 57, 88, 197 J Joint, 5, 10, 23, 24, 31, 32, 39, 42, 47, 56, 95, 116, 170, 172, 185, 190, 197, 207, 216, 220, 221 K Kainic Acid, 14, 197 Kb, 148, 197 Kinetic, 5, 24, 36, 197 L Labile, 179, 197 Labyrinth, 179, 196, 197, 211, 217, 226 Lacrimal, 197, 206 Lactation, 197, 207 Large Intestine, 184, 196, 197, 214, 218
235
Laryngeal, 6, 21, 30, 36, 54, 64, 71, 76, 77, 104, 127, 128, 133, 136, 137, 197, 214 Laryngeal Muscles, 30, 71, 197 Laryngectomy, 128, 198 Laryngitis, 6, 198 Larynx, 6, 22, 127, 128, 187, 197, 198, 214, 224, 226, 227 Latency, 49, 144, 198 Lens, 180, 198 Library Services, 162, 198 Life cycle, 174, 198 Ligament, 5, 23, 47, 170, 198, 212, 220 Limbic, 170, 198 Limbic System, 170, 198 Lingual Nerve, 54, 198 Linkage, 10, 29, 43, 198 Lip, 20, 198, 200 Lipid, 38, 178, 196, 198, 202 Liver, 167, 173, 182, 184, 186, 189, 190, 191, 198 Localization, 39, 73, 108, 198 Localized, 25, 27, 38, 167, 189, 192, 195, 198, 210 Locomotion, 4, 8, 31, 35, 39, 40, 62, 198, 210 Locomotor, 4, 33, 39, 46, 198 Longitudinal study, 26, 49, 198 Loop, 5, 41, 120, 199 Low Back Pain, 34, 49, 70, 81, 94, 112, 119, 141, 199 Lower Esophageal Sphincter, 191, 199 Lumbar, 71, 89, 94, 173, 196, 199 Lumen, 127, 128, 175, 199 Lung volume, 54, 199 Lymph, 177, 186, 199 Lymph node, 177, 199 Lymphatic, 186, 195, 199, 210 M Magnetic Resonance Imaging, 5, 199 Magnetic Resonance Spectroscopy, 21, 199 Malignancy, 143, 199 Malignant, 171, 199, 204, 214 Malnutrition, 172, 199, 203 Mandible, 20, 178, 199 Mandibular Nerve, 198, 199 Manifest, 113, 173, 192, 199, 220 Manometry, 85, 140, 199 Masseter Muscle, 76, 90, 127, 200 Mastication, 10, 199, 200, 224 Masticatory, 80, 84, 94, 200 Maxillary, 172, 200, 224
236
Electromyography
Maxillary Nerve, 200, 224 Mechanical ventilation, 13, 200 Mechanoreceptors, 13, 54, 192, 200, 203 Medial, 18, 46, 170, 179, 188, 200, 216, 223 Mediate, 12, 179, 184, 200 Mediator, 200, 218 Medical Assistance, 127, 200 Medical Staff, 184, 200 MEDLINE, 149, 200 Medullary, 17, 37, 48, 200 Meiosis, 200, 221 Membrane, 13, 38, 177, 180, 183, 187, 188, 197, 198, 200, 201, 207, 216, 217, 219 Memory, 46, 50, 169, 183, 200 Memory Disorders, 46, 200 Meninges, 177, 182, 200, 220 Menstruation, 185, 200 Mental, iv, 4, 20, 55, 99, 108, 148, 150, 177, 178, 183, 189, 195, 200, 201, 212, 213, 215, 217 Mental Disorders, 99, 200, 212 Mental Health, iv, 4, 99, 148, 150, 201, 213 Mental Processes, 201, 212 Mental Retardation, 55, 201 Mesencephalic, 201, 214, 224 Metastasis, 201, 204 Methotrexate, 143, 201 MI, 41, 66, 166, 201 Microbiology, 167, 172, 201 Microdialysis, 37, 201 Micrography, 18, 201 Microorganism, 201, 227 Microscopy, 18, 201 Microspheres, 35, 201 Microtubules, 17, 201 Micturition, 114, 201 Mobility, 10, 17, 31, 32, 39, 40, 116, 201 Modeling, 5, 21, 27, 35, 201 Modification, 39, 63, 66, 83, 169, 191, 201, 213 Molecular, 4, 13, 29, 42, 56, 149, 151, 174, 180, 186, 201, 214, 223, 225 Molecular Probes, 186, 201 Molecule, 171, 173, 179, 185, 186, 188, 202, 207, 214, 226 Monitor, 30, 102, 104, 105, 106, 112, 115, 119, 120, 123, 130, 182, 202, 205 Monoamine, 169, 183, 202 Morphological, 41, 47, 168, 186, 202 Morphology, 9, 202 Motility, 190, 202, 218 Motor Activity, 15, 27, 35, 110, 202
Motor Cortex, 18, 19, 21, 40, 41, 43, 202, 214 Motor nerve, 27, 49, 58, 202, 203, 206, 209 Motor Neurons, 21, 58, 115, 120, 202 Motor Skills, 41, 202 Mucinous, 190, 202 Multiple sclerosis, 114, 202 Multivariate Analysis, 36, 202 Muscimol, 54, 202 Muscle Contraction, 22, 107, 123, 202, 217 Muscle Denervation, 49, 202 Muscle Fatigue, 71, 202 Muscle Fibers, 42, 97, 137, 202, 203, 224 Muscle relaxant, 51, 202 Muscle Relaxation, 203, 204 Muscle Spindles, 56, 203 Muscle tension, 202, 203 Muscular Atrophy, 58, 203 Muscular Diseases, 189, 203, 207 Musculature, 54, 87, 90, 94, 107, 110, 130, 203, 220 Musculoskeletal System, 31, 203 Myasthenia, 63, 203 Myelin, 202, 203 Myocardium, 201, 203 Myometrium, 125, 203 Myopathy, 72, 143, 203 Myosin, 28, 42, 202, 203, 224 Myositis, 143, 203 Myotonia, 71, 203 N Naive, 36, 203 Narcolepsy, 12, 55, 183, 203 Narcotic, 189, 203 Nasal Septum, 10, 203 NCI, 1, 98, 147, 178, 203 Neoplasms, 143, 171, 204, 214, 222 Neoplastic, 170, 193, 204 Nerve Fibers, 175, 179, 204 Nervous System, 19, 24, 28, 39, 44, 56, 115, 120, 121, 167, 168, 169, 172, 175, 177, 178, 183, 185, 188, 190, 191, 192, 200, 202, 204, 206, 209, 210, 218, 221, 222 Networks, 136, 204 Neural, 4, 8, 17, 18, 19, 24, 26, 28, 33, 39, 43, 46, 52, 55, 62, 136, 168, 200, 204 Neuroanatomy, 4, 198, 204 Neurogenic, 49, 115, 204, 225 Neurologic, 16, 23, 204 Neurologist, 97, 204 Neuromuscular Blockade, 71, 87, 204
Index
Neuromuscular Junction, 67, 137, 167, 204, 206 Neuronal, 12, 15, 17, 32, 52, 60, 175, 204 Neuropathy, 61, 204 Neurophysiology, 4, 8, 16, 70, 73, 98, 135, 136, 183, 204 Neurotoxic, 17, 194, 202, 204 Neurotoxicity, 197, 204 Neurotoxin, 14, 17, 205 Neurotransmitter, 44, 55, 60, 167, 168, 169, 175, 177, 184, 191, 197, 205, 222 Neutrons, 169, 205, 213 Nicotine, 59, 205 Nifedipine, 44, 205 Nitric Oxide, 6, 11, 205 Nitrogen, 169, 182, 189, 205, 224 Norepinephrine, 46, 168, 184, 205 Normotensive, 51, 205 Nuclear, 38, 173, 190, 198, 205 Nuclei, 12, 15, 17, 169, 170, 179, 189, 191, 198, 199, 205, 206, 210, 212, 224 Nucleus Accumbens, 46, 205 Nystagmus, 119, 185, 206 O Occipital Lobe, 206, 227 Ocular, 48, 187, 188, 206 Oculi, 52, 206 Oculomotor, 19, 29, 201, 206 Oculomotor Nerve, 29, 206 Opacity, 183, 206 Operon, 206, 215 Ophthalmic, 206, 224 Ophthalmologic, 185, 206 Ophthalmology, 189, 206 Ophthalmoplegia, 29, 206 Opiate, 45, 64, 206 Opium, 206 Opsin, 206, 216 Optic cup, 206, 208 Optic Nerve, 206, 208, 216 Orbicularis, 20, 52, 206 Orbit, 206 Orbital, 28, 29, 206 Orderly, 115, 206 Orofacial, 20, 207 Orthostatic, 69, 207 Ossicles, 192, 207, 220, 222 Osteoarthritis, 47, 207 Otolith, 48, 207 Outpatient, 133, 207 Oxidation, 171, 207 Oxygen Consumption, 188, 207, 215
237
Oxytocin, 24, 207 P Paediatric, 68, 207 Palliative, 207, 222 Palpation, 124, 207 Palsy, 42, 70, 87, 91, 107, 207 Pancreas, 167, 184, 196, 207 Pancreatic, 175, 191, 207 Pancreatic Juice, 191, 207 Paradoxical, 53, 68, 207 Paralysis, 12, 36, 76, 77, 104, 182, 187, 189, 192, 201, 206, 207, 208, 213, 219 Paraplegia, 32, 207 Parathyroid, 64, 207, 208, 222 Parathyroid Glands, 207, 208 Paresis, 189, 193, 208 Parietal, 54, 208 Parietal Lobe, 208 Patch, 11, 208 Pathogenesis, 21, 37, 44, 208 Pathologic, 167, 174, 175, 181, 194, 208, 219, 226 Pathologies, 29, 59, 105, 208 Pathologist, 36, 208 Pathophysiology, 10, 42, 51, 208 Patient Education, 154, 160, 162, 166, 208 Patient Selection, 36, 208 Peak flow, 27, 208 Pedicle, 64, 208 Pelvic, 84, 87, 88, 90, 208, 212 Pelvis, 167, 199, 208, 225 Peptide, 169, 208, 212 Perception, 11, 56, 208, 217 Perceptual Defense, 50, 208 Percutaneous, 26, 208 Perfusion, 10, 13, 194, 209 Perineal, 90, 209 Perineum, 209 Perioral, 128, 209 Peripheral Nervous System, 187, 190, 192, 205, 207, 209 Peripheral Nervous System Diseases, 190, 192, 207, 209 Peristalsis, 6, 209 Pernicious, 196, 209 Pernicious anemia, 196, 209 Phallic, 189, 209 Pharmacokinetic, 51, 209 Pharmacologic, 44, 170, 209, 223, 225 Pharmacotherapy, 16, 209 Pharyngeal Muscles, 127, 128, 209 Pharynx, 127, 128, 191, 209, 226
238
Electromyography
Phenotype, 29, 209 Phosphorous, 45, 209 Phosphorus, 175, 208, 209 Physical Examination, 49, 74, 127, 137, 209 Physical Therapy, 34, 35, 63, 65, 83, 84, 89, 90, 128, 209 Physiologic, 8, 14, 46, 128, 168, 189, 200, 209, 214, 224 Physiology, 7, 14, 17, 24, 27, 37, 41, 43, 53, 57, 73, 75, 105, 111, 115, 139, 186, 204, 210 Pigments, 176, 210, 216 Pilot study, 40, 42, 49, 63, 70, 210 Plants, 169, 176, 178, 191, 202, 205, 210, 223 Plasma, 24, 177, 193, 210, 217, 218 Plasmids, 186, 210 Plasticity, 4, 16, 32, 41, 210 Platelet Aggregation, 170, 205, 210 Platelets, 205, 210 Platinum, 199, 210 Pleomorphic, 205, 210 Plexus, 108, 175, 210 Pneumonia, 181, 210 Polygraph, 110, 210 Polymerase, 210, 215 Pons, 12, 167, 175, 189, 210, 216 Pontine, 12, 210 Posterior, 46, 104, 170, 172, 173, 177, 184, 206, 207, 210 Postoperative, 23, 36, 211 Postural, 24, 34, 40, 48, 61, 93, 211 Potassium, 13, 211 Potentiation, 9, 13, 211 Practice Guidelines, 150, 211 Preclinical, 30, 211 Precursor, 9, 178, 182, 184, 185, 187, 205, 211, 224, 225 Preoperative, 47, 211 Presynaptic, 44, 205, 211, 222 Prevalence, 13, 15, 55, 211 Probe, 9, 11, 74, 102, 104, 201, 211 Problem Solving, 172, 211 Progression, 58, 170, 211 Progressive, 7, 88, 109, 183, 184, 192, 207, 211, 225 Projection, 11, 40, 196, 205, 206, 211, 214 Pronation, 43, 66, 211 Prophase, 211, 221 Proportional, 39, 110, 123, 211 Proprioception, 56, 211 Prospective study, 72, 198, 212
Prostate, 12, 212, 224 Prostatectomy, 84, 212 Prosthesis, 123, 128, 212 Protease, 179, 212 Protein C, 212, 224 Protein Isoforms, 42, 169, 212 Protein S, 174, 212, 216 Proteins, 44, 169, 171, 176, 177, 179, 182, 186, 202, 205, 208, 210, 212, 214, 218 Proteolytic, 179, 212 Protocol, 36, 112, 212 Protons, 169, 194, 197, 199, 212, 213 Proximal, 33, 58, 65, 102, 143, 184, 211, 212, 217 Psychiatric, 23, 57, 200, 212, 218 Psychiatry, 15, 37, 86, 189, 212, 226 Psychic, 200, 212 Psychoactive, 212, 227 Psychogenic, 212, 225 Psychology, 22, 26, 45, 50, 51, 53, 54, 59, 109, 212 Psychotomimetic, 169, 183, 212 Ptosis, 29, 213 Public Assistance, 200, 213 Public Health, 15, 45, 150, 213 Public Policy, 149, 213 Pulmonary, 169, 174, 181, 188, 194, 213, 226 Pulmonary Alveoli, 194, 213 Pulmonary Artery, 174, 213, 226 Pulmonary Ventilation, 194, 213 Pulse, 8, 102, 103, 107, 116, 129, 130, 202, 210, 213 Q Quality of Life, 16, 26, 213 Quiescent, 125, 213 R Radiation, 118, 129, 130, 168, 173, 186, 190, 197, 213, 214, 225, 227 Radiation therapy, 168, 190, 213 Radioactive, 173, 194, 195, 201, 205, 213, 214 Radiography, 23, 47, 213 Radioimmunoassay, 24, 213 Radioimmunotherapy, 213, 214 Radioisotope, 214, 224 Radiolabeled, 27, 213, 214 Radiological, 208, 214 Radiopharmaceutical, 38, 214 Radiotherapy, 77, 213, 214 Randomized, 7, 10, 15, 26, 36, 47, 185, 214 Randomized clinical trial, 7, 36, 214
Index
Raphe Nuclei, 17, 214 Reaction Time, 59, 119, 214 Receptor, 11, 17, 28, 37, 47, 52, 56, 167, 171, 177, 184, 188, 197, 213, 214, 218 Receptors, Serotonin, 214, 218 Recombinant, 214, 226 Recovery of Function, 43, 214 Rectum, 87, 88, 102, 144, 170, 171, 174, 179, 183, 184, 190, 191, 195, 197, 212, 214 Recurrent Laryngeal Nerve, 36, 104, 214 Red Nucleus, 172, 214 Reductase, 201, 214 Refer, 1, 179, 189, 196, 198, 203, 205, 214, 217, 223, 226 Reference Values, 116, 215 Reflective, 20, 38, 215 Reflex, 6, 14, 16, 33, 41, 42, 46, 52, 57, 86, 114, 120, 189, 203, 215 Reflux, 6, 191, 215 Refraction, 215, 219 Regimen, 16, 130, 185, 209, 215 Regurgitation, 191, 215 Rehabilitative, 34, 35, 127, 215 Relapse, 37, 45, 215 Relaxant, 215 Reperfusion, 39, 215 Reperfusion Injury, 215 Repressor, 53, 206, 215 Resection, 202, 215, 224 Respiration, 12, 13, 15, 109, 134, 171, 176, 177, 182, 202, 210, 215, 216 Respirator, 200, 215, 226 Respiratory failure, 215, 226 Respiratory Muscles, 13, 215 Respiratory Physiology, 215, 226 Restoration, 23, 27, 32, 114, 209, 215 Resuscitation, 51, 215 Reticular, 18, 216 Reticular Formation, 18, 216 Retina, 180, 185, 198, 206, 216 Retinal, 11, 48, 206, 216 Retinol, 216 Retrograde, 14, 47, 216 Retropubic, 212, 216 Retrospective, 63, 216 Rhodopsin, 206, 216 Ribose, 167, 216 Ribosome, 216, 224 Rigidity, 194, 210, 216 Risk factor, 212, 216 Rotator, 69, 216 Rotator Cuff, 69, 216
239
Ruminants, 191, 216 S Sagittal, 32, 216 Salivary, 184, 217 Salivary glands, 184, 217 Sarcoplasmic Reticulum, 13, 217 Schizoid, 217, 227 Schizophrenia, 200, 217, 227 Schizotypal Personality Disorder, 217, 227 Sclerosis, 21, 58, 70, 154, 179, 202, 217 Screening, 178, 217 Sedative, 51, 217 Segmental, 31, 73, 217 Segmentation, 217 Self Care, 167, 217 Self-Help Groups, 217, 219 Semen, 212, 217 Semicircular canal, 48, 196, 217 Sensitization, 52, 217 Sensor, 30, 102, 110, 112, 120, 121, 122, 123, 124, 130, 217 Septal, 10, 198, 217 Septum, 10, 46, 217 Septum Pellucidum, 217 Serotonin, 17, 37, 205, 209, 214, 218, 224 Serum, 143, 170, 179, 182, 213, 218 Serum Albumin, 213, 218 Shedding, 45, 218 Shock, 38, 50, 193, 218, 224 Side effect, 104, 168, 182, 218, 223 Signs and Symptoms, 215, 218 Silicon, 30, 218 Silicon Dioxide, 218 Skeletal, 5, 12, 33, 35, 38, 93, 94, 115, 120, 123, 131, 143, 182, 203, 217, 218, 224 Skeleton, 167, 189, 197, 218, 223 Skull, 9, 182, 206, 218, 222 Sleep apnea, 17, 28, 218 Sleep Deprivation, 45, 60, 218 Small intestine, 185, 193, 196, 218 Smooth muscle, 12, 170, 175, 181, 203, 218 Sneezing, 218 Social Behavior, 50, 218 Social Environment, 213, 219 Social pressure, 117, 219 Social Support, 219 Soft tissue, 10, 42, 119, 124, 174, 206, 218, 219 Soma, 219 Somatic, 9, 50, 114, 182, 198, 200, 209, 219, 226 Sound wave, 180, 215, 219
240
Electromyography
Spastic, 7, 10, 33, 42, 75, 95, 137, 219 Spasticity, 7, 10, 42, 43, 107, 194, 219 Specialist, 124, 156, 219 Species, 46, 60, 175, 182, 187, 193, 200, 210, 218, 219, 221, 227 Specificity, 40, 168, 175, 219 Spectroscopic, 45, 199, 219 Spectrum, 8, 219 Sphincter, 3, 6, 65, 69, 74, 102, 114, 128, 136, 198, 219 Spike, 43, 219 Spinal Cord Diseases, 190, 192, 207, 219 Spinal Stenosis, 49, 220 Spinous, 119, 187, 220 Spiral Lamina, 220, 225 Splint, 63, 174, 220 Sprains and Strains, 199, 220 Stabilization, 34, 220 Standardize, 8, 220 Stapedius, 14, 220 Stapes, 220 Stenosis, 49, 220 Sterile, 207, 220 Sterility, 182, 220 Steroid, 182, 220 Stimulant, 45, 169, 183, 220 Stomach, 167, 184, 187, 190, 191, 193, 199, 209, 215, 216, 218, 220 Stool, 179, 195, 197, 220 Strabismus, 119, 220 Stress, 23, 57, 88, 112, 137, 172, 176, 182, 190, 220 Striatum, 46, 206, 220 Stricture, 220 Stroke, 25, 30, 35, 39, 42, 44, 56, 84, 85, 97, 99, 107, 148, 176, 221 Subacute, 133, 195, 221 Subarachnoid, 192, 221 Subclinical, 9, 195, 221 Subcutaneous, 122, 185, 221 Subspecies, 219, 221 Substrate, 130, 221 Sudden death, 38, 221 Supination, 43, 63, 66, 221 Suppression, 12, 26, 48, 53, 221 Supraspinal, 15, 16, 221 Surgical Instruments, 64, 221 Sympathetic Nervous System, 24, 172, 221 Sympathomimetic, 169, 183, 184, 187, 205, 221 Symphysis, 178, 212, 221 Symptomatic, 9, 49, 221
Synapse, 11, 168, 204, 211, 221, 222, 224 Synapsis, 221 Synaptic, 11, 41, 43, 45, 46, 205, 221 Synaptic Transmission, 205, 221 Synergistic, 43, 222 Systemic, 57, 171, 174, 179, 187, 195, 196, 213, 222 T Talus, 170, 222, 223 Telecommunications, 180, 222 Telencephalon, 173, 177, 222 Temporal, 19, 20, 115, 116, 170, 172, 192, 222 Temporal Lobe, 170, 172, 222 Tendon, 5, 33, 190, 219, 222 Tenotomy, 42, 222 Tensor Tympani, 14, 222 Tetany, 208, 222 Thalamic, 11, 85, 172, 222 Thalamic Diseases, 172, 222 Therapeutics, 84, 88, 89, 222 Thermal, 95, 137, 205, 222 Thoracic, 15, 27, 64, 173, 175, 183, 222, 227 Thorax, 167, 199, 222, 226 Threshold, 11, 13, 68, 113, 126, 188, 194, 222 Thrombosis, 212, 221, 222 Thyroid, 38, 64, 104, 207, 208, 223, 225 Thyroid Gland, 104, 207, 208, 223 Thyroid Hormones, 223, 225 Tibia, 170, 171, 189, 223 Tidal Volume, 194, 223 Tin, 155, 210, 223 Tissue Culture, 175, 223 Tissue Survival, 38, 223 Tolerance, 49, 53, 223 Tone, 6, 41, 42, 46, 123, 127, 130, 205, 219, 223 Tonic, 11, 33, 223 Tonicity, 185, 223 Tonus, 223 Tooth Preparation, 167, 223 Topical, 140, 223 Toxic, iv, 182, 204, 205, 223 Toxicity, 184, 223 Toxicology, 150, 223 Toxin, 10, 27, 37, 75, 223 Trace element, 218, 223, 224 Tracer, 14, 224 Trachea, 198, 209, 223, 224 Transcutaneous, 126, 224 Transfection, 174, 186, 224
Index
Translating, 61, 109, 117, 224 Translation, 47, 169, 224 Transmitter, 12, 121, 167, 184, 197, 200, 205, 224 Transurethral, 212, 224 Transurethral resection, 212, 224 Transurethral Resection of Prostate, 212, 224 Trauma, 4, 38, 51, 54, 73, 76, 214, 224 Tremor, 80, 85, 201, 224 Trigeminal, 14, 198, 199, 200, 224 Trigeminal Nerve, 14, 224 Trigeminal Nuclei, 14, 224 Tropomyosin, 224 Troponin, 42, 224 Tryptophan, 179, 218, 224 Tubercle, 205, 225 Tubulin, 201, 225 Tumour, 190, 225 Tungsten, 176, 225 Tympani, 14, 225 Tyrosine, 184, 225 U Ultrasonography, 72, 225 Ultraviolet radiation, 185, 225 Unconscious, 170, 194, 225 Ureters, 225 Urethra, 114, 212, 224, 225 Urinary, 12, 52, 68, 114, 182, 195, 212, 216, 225 Urinary Retention, 68, 225 Urinary tract, 114, 225 Urinate, 225 Urine, 114, 174, 181, 182, 195, 201, 225 Urodynamics, 84, 115, 225 Uterine Contraction, 121, 125, 207, 225 Uterus, 121, 125, 177, 182, 190, 200, 203, 225, 226 V Vaccine, 168, 212, 226 Vagal, 7, 15, 226 Vagina, 125, 177, 200, 226 Vaginal, 125, 226
241
Vagus Nerve, 226 Vascular, 10, 175, 183, 186, 192, 195, 205, 220, 223, 226 Vasoconstriction, 175, 187, 226 Vasodilator, 175, 184, 205, 226 Vasomotor, 19, 226 VE, 57, 226 Vector, 71, 226 Vein, 196, 205, 226 Venter, 226 Ventilation, 110, 226 Ventilator, 110, 111, 200, 215, 226 Ventral, 17, 27, 179, 194, 205, 206, 210, 226 Ventricle, 104, 105, 170, 176, 194, 205, 213, 226 Venules, 174, 226 Vertebrae, 196, 219, 226 Vesicular, 60, 226 Vestibular, 18, 48, 61, 192, 226 Vestibule, 179, 196, 217, 226 Veterinary Medicine, 149, 226 Vibrissae, 18, 227 Viruses, 171, 201, 218, 226, 227 Visceral, 15, 48, 52, 172, 182, 198, 226, 227 Visual Cortex, 11, 227 Visual Perception, 12, 227 Vitro, 46, 227 Vivo, 5, 33, 35, 39, 227 Vocal cord, 36, 104, 227 Volition, 197, 227 W Wakefulness, 12, 13, 37, 55, 60, 227 Weight-Bearing, 32, 227 Windpipe, 209, 223, 227 Withdrawal, 37, 45, 227 Womb, 225, 227 Work Capacity Evaluation, 16, 227 X Xenograft, 170, 227 X-ray, 173, 176, 187, 190, 205, 213, 214, 227 Y Yeasts, 209, 227
242
Electromyography
Index
243
244
Electromyography
