Caractérisation tridimensionnelle de l’amplitude articulaire de l’épaule

L’épaule est l’articulation la plus mobile et la plus instable du corps humain dû à la faible quantité de contraintes osseuses et au rôle des tissus mous qui lui confèrent au moins une dizaine de degrés de liberté. La mobilité de l’épaule est un facteur de performance dans plusieurs sports. Mais son instabilité engendre des troubles musculo-squelettiques, dont les déchirures de la coiffe des rotateurs sont fréquentes et les plus handicapantes. L’évaluation de l’amplitude articulaire est un indice commun de la fonction de l’épaule, toutefois elle est souvent limitée à quelques mesures planaires pour lesquelles les degrés de liberté varient indépendamment les uns des autres. Ces valeurs utilisées dans les modèles de simulation musculo-squelettiques peuvent amener à des solutions non physiologiques. L’objectif de cette thèse était de développer des outils pour la caractérisation de la mobilité articulaire tri-dimensionnelle de l’épaule, en passant par i) fournir une méthode et son approche expérimentale pour évaluer l’amplitude articulaire tridimensionnelle de l’épaule incluant des interactions entre les degrés de liberté ; ii) proposer une représentation permettant d’interpréter les données tri-dimensionnelles obtenues; iii) présenter des amplitudes articulaires normalisées, iv) implémenter une amplitude articulaire tridimensionnelle au sein d’un modèle de simulation numérique afin de générer des mouvements sportifs optimaux plus réalistes; v) prédire des amplitudes articulaires sécuritaires et vi) des exercices de rééducation sécuritaires pour des patients ayant subi une réparation de la coiffe des rotateurs. i) Seize sujets ont été réalisé séries de mouvements d’amplitudes maximales actifs avec des combinaisons entre les différents degrés de liberté de l’épaule. Un système d’analyse du mouvement couplé à un modèle cinématique du membre supérieur a été utilisé pour estimer les cinématiques articulaires tridimensionnelles. ii) L’ensemble des orientations définies par une séquence de trois angles a été inclus dans un polyèdre non convexe représentant l’espace de mobilité articulaire prenant en compte les interactions entre les degrés de liberté. La combinaison des séries d’élévation et de rotation est recommandée pour évaluer l’amplitude articulaire complète de l’épaule. iii) Un espace de mobilité normalisé a également été défini en englobant les positions atteintes par au moins 50% des sujets et de volume moyen. iv) Cet espace moyen, définissant la mobilité physiologiques, a été utilisé au sein d’un modèle de simulation cinématique utilisé pour optimiser la technique d’un élément acrobatique de lâcher de barres réalisée par des gymnastes. Avec l’utilisation régulière de limites articulaires planaires pour contraindre la mobilité de l’épaule, seulement 17% des solutions optimales sont physiologiques. En plus, d’assurer le réalisme des solutions, notre contrainte articulaire tridimensionnelle n’a pas affecté le coût de calculs de l’optimisation. v) et vi) Les seize participants ont également réalisé des séries d’amplitudes articulaires passives et des exercices de rééducation passifs. La contrainte dans l’ensemble des muscles de la coiffe des rotateurs au cours de ces mouvements a été estimée à l’aide d’un modèle musculo-squelettique reproduisant différents types et tailles de déchirures. Des seuils de contrainte sécuritaires ont été utilisés pour distinguer les amplitudes de mouvements risquées ou non pour l’intégrité de la réparation chirurgicale. Une taille de déchirure plus grande ainsi que les déchirures affectant plusieurs muscles ont contribué à réduire l’espace de mobilité articulaire sécuritaire. Principalement les élévations gléno-humérales inférieures à 38° et supérieures à 65°, ou réalisées avec le bras maintenu en rotation interne engendrent des contraintes excessives pour la plupart des types et des tailles de blessure lors de mouvements d’abduction, de scaption ou de flexion. Cette thèse a développé une représentation innovante de la mobilité de l’épaule, qui tient compte des interactions entre les degrés de liberté. Grâce à cette représentation, l’évaluation clinique pourra être plus exhaustive et donc élargir les possibilités de diagnostiquer les troubles de l’épaule. La simulation de mouvement peut maintenant être plus réaliste. Finalement, nous avons montré l’importance de personnaliser la rééducation des patients en termes d’amplitude articulaire, puisque des exercices passifs de rééducation précoces peuvent contribuer à une re-déchirure à cause d’une contrainte trop importante qu’ils imposent aux tendons.

Human physiology in space : a curriculum supplement for secondary schools /

Mode of access: Internet.

Human physiology in space : a curriculum supplement for secondary schools /

Mode of access: Internet.

Numerical modelling of thermal effects in rats due to high-field magnetic resonance imaging (0.5-1 GHz)

A finite-difference time-domain (FDTD) thermal model has been developed to compute the temperature elevation in the Sprague Dawley rat due to electromagnetic energy deposition in high-field magnetic resonance imaging (MRI). The field strengths examined ranged from 11.75-23.5 T (corresponding to H-1 resonances of 0.5-1 GHz) and an N-stub birdcage resonator was used to both transmit radio-frequency energy and receive the MRI signals. With an in-plane resolution of 1.95 mm, the inhomogeneous rat phantom forms a segmented model of 12 different tissue types, each having its electrical and thermal parameters assigned. The steady-state temperature distribution was calculated using a Pennes 'bioheat' approach. The numerical algorithm used to calculate the induced temperature distribution has been successfully validated against analytical solutions in the form of simplified spherical models with electrical and thermal properties of rat muscle. As well as assisting with the design of MRI experiments and apparatus, the numerical procedures developed in this study could help in future research and design of tumour-treating hyperthermia applicators to be used on rats in vivo.

A distributed equivalent magnetic current based FDTD method for the calculation of E-fields induced by gradient coils

This paper evaluates a new, low-frequency finite-difference time-domain method applied to the problem of induced E-fields/eddy currents in the human body resulting from the pulsed magnetic field gradients in MRI. In this algorithm, a distributed equivalent magnetic current is proposed as the electromagnetic source and is obtained by quasistatic calculation of the empty coil's vector potential or measurements therein. This technique circumvents the discretization of complicated gradient coil geometries into a mesh of Yee cells, and thereby enables any type of gradient coil modelling or other complex low frequency sources. The proposed method has been verified against an example with an analytical solution. Results are presented showing the spatial distribution of gradient-induced electric fields in a multi-layered spherical phantom model and a complete body model. (C) 2004 Elsevier Inc. All rights reserved.

Electromagnetic fields inside a lossy, multilayered spherical head phantom excited by MRI coils: models and methods

The precise evaluation of electromagnetic field (EMF) distributions inside biological samples is becoming an increasingly important design requirement for high field MRI systems. In evaluating the induced fields caused by magnetic field gradients and RF transmitter coils, a multilayered dielectric spherical head model is proposed to provide a better understanding of electromagnetic interactions when compared to a traditional homogeneous head phantom. This paper presents Debye potential (DP) and Dyadic Green's function (DGF)-based solutions of the EMFs inside a head-sized, stratified sphere with similar radial conductivity and permittivity profiles as a human head. The DP approach is formulated for the symmetric case in which the source is a circular loop carrying a harmonic-formed current over a wide frequency range. The DGF method is developed for generic cases in which the source may be any kind of RF coil whose current distribution can be evaluated using the method of moments. The calculated EMFs can then be used to deduce MRI imaging parameters. The proposed methods, while not representing the full complexity of a head model, offer advantages in rapid prototyping as the computation times are much lower than a full finite difference time domain calculation using a complex head model. Test examples demonstrate the capability of the proposed models/methods. It is anticipated that this model will be of particular value for high field MRI applications, especially the rapid evaluation of RF resonator (surface and volume coils) and high performance gradient set designs.

Muscle fiber and motor unit behavior in the longest human skeletal muscle

The sartorius muscle is the longest muscle in the human body. It is strap-like, up to 600 mm in length, and contains five to seven neurovascular compartments, each with a neuromuscular endplate zone. Some of its fibers terminate intrafascicularly, whereas others may run the full length of the muscle. To assess the location and timing of activation within motor units of this long muscle, we recorded electromyographic potentials from multiple intramuscular electrodes along sartorius muscle during steady voluntary contraction and analyzed their activity with spike-triggered averaging from a needle electrode inserted near the proximal end of the muscle. Approximately 30% of sartorius motor units included muscle fibers that ran the full length of the muscle, conducting action potentials at 3.9 +/- 0.1 m/s. Most motor units were innervated within a single muscle endplate zone that was not necessarily near the midpoint of the fiber. As a consequence, action potentials reached the distal end of a unit as late as 100 ms after initiation at an endplate zone. Thus, contractile activity is not synchronized along the length of single sartorius fibers. We postulate that lateral transmission of force from fiber to endomysium and a wide distribution of motor unit endplates along the muscle are critical for the efficient transmission of force from sarcomere to tendon and for the prevention of muscle injury caused by overextension of inactive regions of muscle fibers.

Quantification of lean bodyweight

Background: Lean bodyweight (LBW) has been recommended for scaling drug doses. However, the current methods for predicting LBW are inconsistent at extremes of size and could be misleading with respect to interpreting weight-based regimens. Objective: The objective of the present study was to develop a semi-mechanistic model to predict fat-free mass (FFM) from subject characteristics in a population that includes extremes of size. FFM is considered to closely approximate LBW. There are several reference methods for assessing FFM, whereas there are no reference standards for LBW. Patients and methods: A total of 373 patients (168 male, 205 female) were included in the study. These data arose from two populations. Population A (index dataset) contained anthropometric characteristics, FFM estimated by dual-energy x-ray absorptiometry (DXA - a reference method) and bioelectrical impedance analysis (BIA) data. Population B (test dataset) contained the same anthropometric measures and FFM data as population A, but excluded BIA data. The patients in population A had a wide range of age (18-82 years), bodyweight (40.7-216.5kg) and BMI values (17.1-69.9 kg/m(2)). Patients in population B had BMI values of 18.7-38.4 kg/m(2). A two-stage semi-mechanistic model to predict FFM was developed from the demographics from population A. For stage 1 a model was developed to predict impedance and for stage 2 a model that incorporated predicted impedance was used to predict FFM. These two models were combined to provide an overall model to predict FFM from patient characteristics. The developed model for FFM was externally evaluated by predicting into population B. Results: The semi-mechanistic model to predict impedance incorporated sex, height and bodyweight. The developed model provides a good predictor of impedance for both males and females (r(2) = 0.78, mean error [ME] = 2.30 x 10(-3), root mean square error [RMSE] = 51.56 [approximately 10% of mean]). The final model for FFM incorporated sex, height and bodyweight. The developed model for FFM provided good predictive performance for both males and females (r(2) = 0.93, ME = -0.77, RMSE = 3.33 [approximately 6% of mean]). In addition, the model accurately predicted the FFM of subjects in population B (r(2) = 0.85, ME -0.04, RMSE = 4.39 [approximately 7% of mean]). Conclusions: A semi-mechanistic model has been developed to predict FFM (and therefore LBW) from easily accessible patient characteristics. This model has been prospectively evaluated and shown to have good predictive performance.

An object-oriented designed finite-difference time-domain simulator for electromagnetic analysis and design in MRI - application to high field analyses

This paper presents a finite-difference time-domain (FDTD) simulator for electromagnetic analysis and design applications in MRI. It is intended to be a complete FDTD model of an MRI system including all RF and low-frequency field generating units and electrical models of the patient. The pro-ram has been constructed in an object-oriented framework. The design procedure is detailed and the numerical solver has been verified against analytical solutions for simple cases and also applied to various field calculation problems. In particular, the simulator is demonstrated for inverse RF coil design, optimized source profile generation, and parallel imaging in high-frequency situations. The examples show new developments enabled by the simulator and demonstrate that the proposed FDTD framework can be used to analyze large-scale computational electromagnetic problems in modern MRI engineering. (C) 2004 Elsevier Inc. All rights reserved.

Young children's understanding of death

There is a long history of research on children's understanding of death. This article briefly reviews psychoanalytic and Piagetian literature on children's death concepts, then focuses on recent research in developmental psychology that examines children's understanding of death in the context of their developing folk theory of biology. This new research demonstrates that children first conceptualise death as a biological event around age 5 or 6 years, at the same time that they begin to construct a biological model of how the human body functions to maintain life. This detailed new account of children's developing biological knowledge has implications for practitioners who may be called on to communicate about death with young children.

An equivalent distributed magnetic current based FDTD method for the calculation of e-fields induced by gradient coils in MRI

This paper evaluates a low-frequency FDTD method applied to the problem of induced E-fields/eddy currents in the human body resulting from the pulsed magnetic field gradients in MRI. In this algorithm, a distributed equivalent magnetic current (DEMC) is proposed as the electromagnetic source and is obtained by quasistatic calculation of the empty coil's vector potential or measurements therein. This technique circumvents the discretizing of complicated gradient coil geometries into a mesh of Yee cells, and thereby enables any type of gradient coil modeling or other complex low frequency sources. The proposed method has been verified against an example with an analytical solution. Results are presented showing the spatial distribution of gradient-induced electric fields in a multilayered spherical phantom model and a complete body model.

The human immune system: Part 1

The immune system protects the human body against infectious and maligant disease. The concept of an immune system arose because of the observation that an attack of measles or mumps, two common childhood diseases, conferred an immunity on the individual, the immunity being specific to the disease. It was only much later that it was discovered that a system in the body conferred this immunity.

The human immune system: Part 1

The immune system protects the human body against infectious and malignant disease. The concept of an immune system arose because of the observation that an attack of measles or mumps, two common childhood disease, conferred an immunity on the individual, the immunity being specific to the disease. It was only much later that it was discovered that a system in the body conferred this immunity. This article discusses the various components of the immune system, how they develop and their action in conferring immunity.