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The purpose of this study is to investigate the effects of posture on morphologic changes on the lumbar spine during various weight bearing postures (sitting, standing, flexion and extension) compared with supine posture. In addition, it was planned to develop a non-invasive method for measuring nucleus pulposus (NP) water content and to apply that method to assessing the influence of the same postures on NP water content. According to the results of the study, adopting each examined posture caused noticeable gross lumbar deformation and several small but significant changes in spinal structures compared with the supine posture. Posture changed the size of IVD foramen and the extent of these changes was greater at the L4-L5 level than other levels. The study also characterised macro and micro anatomic deformations of the IVD in response to adopting posture. The shape and length of IVD and NP changed with spine motion (sitting, standing, flexion and extension). But the CSA of NP did not show statistically significant change. The water content of the NP was affected by adopting posture that would cause a variation in the mechanical properties of the IVD. In general, water content of the NP was sensitive to posture and load while posture had relatively large effects on NP water content. This study showed that sagittal spine balance and anatomic curvature influences postural loading and the load balance of the intervertebral disc in healthy male subjects. The posture affects the way the lumbar spine resists the loads applied to it but has little effect on the magnitude of these loads. This study provides new experimental evidence on the effect of complex postures on the lumbar spine from physiologic and biomechanical point of view and may have clinical implications for the rehabilitation of the back pain patients.

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Between 1960 and 1961 anthropometric measurements, including skinfold thicknesses, were recorded on offspring aged 2 to 15 years in 330 families. Between 1976 and 1977 repeat skinfold measurements have been made on 318 (88%) of the male offspring and 303 (86%) of the female offspring, who now range in age from 17 to 30 years. Skinfold measurements were taken at the triceps, subscapular, suprailiac and biceps sites. The prediction from childhood values of adult individual skinfold measurements was found to vary from age to age in childhood and from site to site. No obvious pattern appeared and no one skinfold emerged as a more reliable predictor than any other. Where prediction was possible, the accuracies of the predictions were estimated to lie in 95% of cases between 13.1% and 24.2% in the males and between 10.6% and 26.2% in the females. Calculations were repeated using the four skinfold measurements combined. The prediction from childhood values of the adult combined measurements, while more consistent than for the individual skinfolds, continued to vary from age to age in childhood. Where prediction was possible, the accuracies of the predictions were estimated to lie in 95% of cases between 10.6% and 18.0% in the males and between 8.0% and 18.0% in the females. No greater relationship between childhood and adult skinfold measurements was found in the group selected with a childhood triceps or subscapular skinfold on or above the 75th centile. The overall correlations between childhood and adult fatness levels calculated from standardised scores, were 0.56 and 0.45 in the males and females respectively. It is concluded that there is a moderate relationship between fatness levels in childhood and in adult life; a relationship in which room is left to manoeuvre. This is also a family study in which resemblances in body fatness have been assessed between 186 fathers, 211 mothers, 378 sons and 372 daughters. Amongst the offspring were 206 twin pairs. No resemblances were found between parents and their offspring either as children or as adults. Mid-parent-offspring correlations were also not significant. In this study, parents and offspring at the time of measurement were not, largely, sharing common family environments. This suggests the common family environment to have been an important factor in determining resemblances previously noted between relatives. The adult monozygotic twins resembled one another closely, as had been the case in childhood. The adult dizygotic male twins tended to resemble one another more closely than had been the case in childhood. The adult dizygotic female twins, by contrast, did not resemble one another at all. The similarities and differences found between the twins mirrored the similarities and differences noted between their lifestyles and habits. That the resemblances found were largely environmentally determined was supported by the finding that while the twins resembled one another, they did not resemble their singleton brothers or sisters. The family data are considered to indicate the importance of environmental factors in the determination of body fatness levels.

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One hundred cases of children in Edinburgh who underwent ventricular pressure monitoring for diverse indications have been discussed in detail and examples of their pressure tracings illustrated. This and other studies have now established that I.C.P. monitoring is a useful clinical tool. The technique employed has been justified from both a theoretical and practical standpoint and other methods of monitoring I.C.P. reviewed from the medical literature with their relative advantages and disadvantages. There is a place for I.C.P. measurement in suspect neonates by means of fontanometry; in hydrocephalic children by monitoring from ventriculostomy reservoirs; in head injury by way of the epidural or subarachnoid space; in childhood encephalopathies and other causes of brain swelling by epidural monitoring and for the continual assessment of the child in whom R.I.C.P. may be an on-going problem by means of a teletransducer. This work has afforded me the opportunity also to report related areas of interest. Firstly, the effect of I.C.P. on monoamine metabolites in children's C.S.F. with little correlation being found but a probable additional increase in one metabolite. Secondly, the effect of various types of seizures increasing the I.C.P. had not been previously reported. And, thirdly, the fascinating effect of sleep in I.C.P. with cyclical pressure variations occurring in all cases and exaggerated pressure responses and wave forms when there is existing R.I.C.P. I have put forward an hypothesis for this sleep effect based on pressure and polygraphic recordings. Lastly the chapter on anaesthesia adds some weight to other studies that caution the use of ketamine in cases of R.I.C.P., but confirms its use otherwise. These studies have however raised doubts about its convulsant action and I have shown the previously overlooked effect of intubation on I.C.P. and described a momentary pressure reflex associated with spreading the vocal cords, which together with the sleep effect, may be related to the Sudden Infant Death Syndrome.

The thesis describes the development and assessment of a clinical chemistry computer system based on the Elliott 903C computer obtained for the on-line monitoring of automated equipment and the subsequent processing of the data derived. The special hardware required for interfacing the automated equipment with the computer was designed and constructed by Elliott Medical Automation Limited. All the software required for the operation of the system was written by the manufacturer's programming staff and my part was to be closely involved with general systems analysis. A detailed account is given of the evaluation of all the parameters required for the on-line monitoring of AutoAnalyzers and the provision of information required for calculation routines, checking quality control results, defining ranges for the automatic flagging of abnormal results, etc. The development work, including the testing, proving and where necessary, the modification of programs, was carried out in the Royal Infirmary, Edinburgh, with the assistance of the technical staff of the laboratory. In the initial stages of development the computer system was run in parallel with the existing laboratory equipment to enable a full assessment of the system to be carried out. This included assessing the performance of process control functions and the chemical acceptability of the system. At a later stage an assessment was made of the routine operation of the computer system when interest was focused on the time taken to perform individual tasks and the reliability of the hardware components. With the exception of one aspect of peak detection, the data acquisition programs were found to operate in a satisfactory manner, and the accuracy and precision of the computer system was at least as good as that of the routine laboratory methods; these latter involved manual reading and interpretation of recorder charts. The individual data processing programs were validated but when the programs were integrated to form a total software system, considerable delays in processing were encountered. Despite several attempts to reduce the time taken to perform processing routines, it was found impracticable to carry out the data handling activities of the laboratory within an acceptable time scale using the existing hardware configuration. The computer system is currently in use on a seven-day week basis for monitoring analytical equipment and performing the following functions (1) Acquisition of raw data from as many as 19 different determinations on up to 12 AutoAnalyzer channels at one time. (2) Peak detection and validation. (3) Calculation of results after correction for instrumental drift. (4) Output of results identified by cup number. (5) Calculation of mean and standard deviation of patient specimens. The present mode of operation removes the need for manual reading of AutoAnalyzer charts and hence reading errors, but it involves the transcription of results from the computer print-out to manually prepared work sheets, and the further transcription of results from work sheets to patient reports. The benefits derived from the Elliott 903 computer in its present form of operation can be summarised as follows: (1) It has been possible to increase the laboratory throughput without a substantial increase in staff in spite of an increase in the numbers of technical staff attending classes of further education during working hours. This has resulted in an increase in productivity and a decrease in the average cost per determination. (2) There is a decrease in the number of human errors by the elimination of reading of recorder charts. (3) Quality control statistics are available while they are still relevant to the current situation. The extension or modification of the hardware configuration and the additional software required to meet the needs of this laboratory have been investigated. Consideration has been given to the possibility of completely replacing the present computer system and to the feasibility of linking the laboratory system to a remotely situated data processing computer system.

No description available.

No description available.