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Epoxide- and oxetane-α,ω-telechelic (co)polyolefins have been successfully synthesized by the tandem ring-opening metathesis polymerization (ROMP)/cross-metathesis (CM) of cyclic olefins using Grubbs’ second-generation catalyst (G2) in the presence of a bifunctional symmetric alkene epoxide- or oxetane-functionalized chain-transfer agent (CTA). From cyclooctene (COE), trans,trans,cis-1,5,9-cyclododecatriene (CDT), norbornene (NB), and methyl 5-norbornene-2-carboxylate (NBCOOMe), with bis(oxiran-2-ylmethyl) maleate (CTA 1), bis(oxetane-2-ylmethyl) maleate (CTA 2), or bis(oxetane-2-ylmethyl) (E)-hex-3-enedioate (CTA 3), well-defined α,ω-di(epoxide or oxetane) telechelic PCOEs, P(COE-co-NB or -NBCOOMe)s, and P(NB-co-CDT)s were isolated under mild operating conditions (40 or 60 °C, 24 h). The oxetane CTA 3 and the epoxide CTA 1 were revealed to be significantly more efficient in the CM step than CTA 2, which apparently inhibits the reaction. Quantitative dithiocarbonatation (CS2/LiBr, 40 °C, THF) of an α,ω-di(epoxide) telechelic P(NB-co-CDT) afforded a convenient approach to the analogous α,ω-bis(dithiocarbonate) telechelic P(NB-co-CDT). The nature of the end-capping function of the epoxide/oxetane/dithiocarbonate telechelic P(NB-co-CDT)s did not impact their thermal signature, as measured by DSC. These copolymers also displayed a low viscosity liquid-like behavior and a shear thinning rheological behavior.

The gold standard of neuromuscular monitoring is mechanomyography (MMG). Phonomyography (PMG) and kinemyography (KMG) are new methods of neuromuscular monitoring. In this study, all three methods were compared to determine neuromuscular blockade at the adductor pollicis muscle. In 14 patients, phonomyography was recorded via a microphone taped to the thenar region. A standard mechanomyographic device was applied to the same thumb, and attached to the force transducer. On the contralateral side, a NMT-Mechanosensor(R) probe was attached to the thumb and forefinger (KMG). After induction of general anaesthesia, the ulnar nerves were stimulated supramaximally using superficial electrodes at the wrists using train-of-four (TOF) stimulation every 12 sec. Onset and recovery indices measured by the three methods after mivacurium 0.2 mg x kg(-1) iv were compared using ANOVA-multiple group comparisons. Agreement between methods was determined using Lin's concordance correlation coefficient. Onset time and peak effect measured via MMG and PMG were similar. Recovery times from neuromuscular blockade (NMB) as measured via the three methods were not different. Agreement between PMG and MMG was excellent for onset and offset of NMB but unsatisfactory for peak effect. Agreement between MMG and KMG was satisfactory for TOF 0.25 and 0.50, and excellent for TOF 0.75 and 0.90 (onset and peak effect not determined for KMG). Agreement between PMG and KMG was satisfactory for TOF 0.25, 0.50 and 0.75, and excellent for TOF 0.90. Mechanomyography, PMG and KMG show satisfactory agreement for determination of recovery of NMB for clinical purposes.

This study investigates how a change in the physical relation between objects (two-dimensional, 2-D, angles) and a subject, as well as scanning conditions, modify the ability to discriminate small changes in 2-D shape. Subjects scanned pairs of angles (90 masculine standard; 91 masculine-103 masculine comparison angles) with the right index finger of the out-stretched arm, identifying the larger of each pair. When joint rotation was restricted to the shoulder, the discrimination threshold significantly increased when the angles were explored with the shoulder in a more eccentric position rather than closer to the midline (60 masculine versus 30 masculine to the right). This result was attributed to changes in proprioceptive sensitivity, since explorations restricted to distal joints (wrist/second metacarpophalangeal joint) showed no change with shoulder position. The results showed, moreover, that discrimination threshold was similar for distal and proximal joints when the delay between scanning the pairs of angles was long (15 s). This observation suggests that regional variations in proprioceptive acuity (proximal>distal) may reflect an adaptation to generate an invariant central representation of haptic shape. Using a shorter interscan delay (5 s), a position-dependent increase in discrimination threshold was revealed for distal explorations, an effect that disappeared when the head was turned in the direction of the unseen angle (vision occluded). We suggest that these results can be explained by the existence of two competing egocentric frames of reference with different time courses, one of short duration that is centred on the arm/hand, and a second of longer duration centred on the head. At the short delay, the reference frames interacted to distort the haptic representation when they were misaligned. This distortion was resolved at the long delay, possibly through suppression of the arm/hand-centred reference frame.

The vastus medialis muscle has been recently proposed as a new site for monitoring neuromuscular blockade (NMB). The purpose of this study is to compare NMB at the vastus medialis with the adductor pollicis muscle using phonomyography (PMG). Fifteen patients were enrolled in the study. Anesthesia was induced with remifentanil 0.25 to 0.5 microg x kg(-1) x min(-1), followed by propofol 2 to 2.5 mg(-1) x kg(-1) iv. Analgesia was provided by remifentanil 0.05 to 0.25 microg x kg (-1) x min(-1) iv throughout surgery. A small piezo-electric microphone was attached to the middle of the thenar mass of the right hand to record acoustic signals produced by the contraction of the adductor pollicis muscle. A second microphone was fixed to the medial part of the thigh, 10 cm over the patella, to record the response from the vastus medialis muscle. The ulnar nerve and the im branches of the femoral nerve were stimulated using train-of-four stimulation every 12 sec. Onset, maximum effect, and offset of neuromuscular block were measured after mivacurium 0.2 mg x kg(-1) iv and compared. At the vastus medialis muscle, the onset of NMB was significantly shorter at 1.9 +/- 0.6 min vs 2.8 +/- 0.7 min, the maximum effect less pronounced at 85 +/- 11% vs 96 +/- 2% and recovery of NMB to 25%, 75%, 90% of twitch control height more rapid than at the adductor pollicis muscle at 17 +/- 2.2 min vs 21.6 +/- 4.2 min, 26.7 +/- 6.5 vs 21 +/- 4.1 min and 30.7 +/- 6.6 vs 35.9 +/- 7.1 min, respectively. PMG can be used to measure NMB at the vastus medialis muscle. We found a shorter onset time, less pronounced maximum effect and more rapid recovery of NMB at the vastus medialis muscle than at the adductor pollicis muscle.

Phonomyography consists of recording low frequency sounds created during muscle contraction. In this study, phonomyography of three regions of the hand was compared to mechanomyography of the adductor pollicis. In 12 patients, phonomyography was recorded via small condenser microphones taped over the thenar mass, the hypothenar eminence, and the dorsal groove between the first and second metacarpal bones to record the acoustic signals of adductor pollicis and the hypothenar and first dorsal interosseus muscles, respectively. Mechanomyography of the adductor pollicis was recorded simultaneously using a force transducer. After induction of anesthesia, the ulnar nerve was stimulated supramaximally using train-of-four (TOF) stimulation every 12 sec. Onset, maximum effect, and offset of neuromuscular block after rocuronium 0.6 mg x kg(-1) were measured using phonomyography and compared to mechanomyography using ANOVA and the Bland-Altman test. Phonomyographic measurements of onset and maximum effect of neuromuscular blockade were not significantly different from mechanomyographic measurements. Phonomyographic measurements of offset (T25%, T75 %, TOF 0.8) of neuromuscular block at the thenar muscles and first dorsal interosseus muscles were not significantly different from mechanomyographic measurements at adductor pollicis; however, T50%, T75% and T90% phonomyographic measurements at the hypothenar muscle were significantly shorter than at any other muscle site. There was good agreement between mechanomyographic measurements at the adductor pollicis muscle and phonomyographic measurements at the thenar and the first dorsal interosseus muscles. Phonomyography of those two muscles could be used interchangeably with mechanomyography of adductor pollicis for clinical purposes.

Phonomyography is based on the creation of low frequency sounds during muscle contraction, which can be recorded and used for neuromuscular monitoring. In this study, balloon pressure mechanomyography, a novel method to measure the force of contraction via pressure changes in an air-filled balloon, was compared with phonomyography to determine neuromuscular blockade at the corrugator supercilii muscle. After approval of the Ethics Committee and informed consent, 15 patients were studied. A small condenser microphone was taped to the area just above the eyebrow for phonomyography; an air-filled balloon was taped to the area just above the opposite eyebrow. After induction of anesthesia using remifentanil and propofol, a laryngeal mask airway was inserted without the aid of neuromuscular blocking agents. The facial nerve was stimulated supramaximally with single-twitch stimulation (0.1 Hz) using superficial electrodes placed on both temporal areas for onset and train-of-four stimulation every 12 sec during offset of neuromuscular blockade produced by mivacurium 0.1 mg.kg(-1). Onset and recovery measured by the two methods were compared using the t test and agreement between phonomyography and balloon pressure mechanomyography was examined using the Bland-Altman method. Onset, peak effect, and time to reach 25%, 75%, and 90% of control twitch response for phonomyography vs balloon pressure method were 83 +/- 16 sec vs 81 +/- 15 sec, 80 +/- 15% vs 82 +/- 17%, 7.7 +/- 2.3 min vs 7.5 +/- 2.4 min, 9.9 +/- 4.1 min vs 10.5 +/- 4 min, and 12.6 +/- 4.3 min vs 13.1 +/- 4.5 min respectively without being significantly different. Mean bias was 1% with limits of agreement of -9 and +9% of twitch height (T1). We applied a balloon pressure method to measure the force at the corrugator supercilii. Phonomyography at the corrugator supercilii shows good agreement with this modified version of mechanomyography.

RésuméObjectifLe muscle vaste interne du membre inférieur a été proposé récemment comme nouveau site de monitorage du bloc neuromusculaire (BNM). Notre but est de comparer le BNM au muscle vaste interne et à ľadducteur du pouce en utilisant la phonomyographie (PMG).MéthodeQuinze patients ont été recrutés. Ľanesthésie a été induite avec 0,25 à 0,5 μg·kg-1·min-1 de rémifentanil suivi de 2 à 2,5 mg-1·kg-1 de propofol iv. Ľanalgésie a été produite avec 0,05 à 0,25 μg·kg-1·min-1 de rémifentanil iv tout au long de ľopération. Un petit microphone piézo-électrique a été attaché au milieu de ľéminence thénar de la main droite pour enregistrer les signaux acoustiques produits par la contraction de ľadducteur du pouce. Un second microphone a été fixé à la partie interne de la cuisse, 10 cm au-dessus de la rotule pour enregistrer la réponse du muscle vaste interne. Le nerf cubital et les branches im du nerf fémoral ont été stimulés en train-de-quatre à toutes les 12 s. Le délai ďinstallation, ľeffet maximal et la cessation du bloc neuromusculaire ont été mesurés et comparés après ľadministration iv de 0,2 mg·kg-1 de mivacurium.RésultatsAu muscle vaste interne, le délai ďinstallation du BNM a été significativement plus court à 1,9 ± 0,6 min vs 2,8 ± 0,7 min, ľeffet maximal moins prononcé à 85 ± 11 % vs 96 ± 2 % et la récupération du BNM, à 25 %, 75 %, 90 % ďintensité de la stimulation témoin, plus rapide qu’à ľadducteur du pouce à 17 ± 2,2 min vs 21,6 ± 4,2 min, 26,7 ± 6,5vs 21 ± 4,1 min et 30,7 ± 6,6 vs 35,9 ± 7,1 min, respectivement.ConclusionLa PMG peut être utilisée pour mesurer le BNM au muscle vaste interne du membre inférieur. Le délai ďinstallation était plus court, ľeffet maximal moins prononcé et la récupération plus rapide du BNM au muscle vaste interne du membre inférieur qu’au muscle adducteur du pouce.