Biomaterials and biophysical stimuli for bone regeneration

First, we review basic concepts of Tissue Engineering, that is, how the tensegrity is able to modulate the cell behavior. Then, we review our experimental results regarding the bone tissue engineering via biomaterials and bioreactors.

Fetal Heart Rate Variability due to Vibroacoustic Stimulation: Linear and Nonlinear Contribution

Objectives: This work aims at characterizing the variation of fetal heart rate (FHR) provoked by vibro-acoustic stimulation (VAS). The FHR signal is analyzed by means of a multiparametric approach consisting of linear and nonlinear indices.

Methods: The FHR signals of 13 fetuses were collected through a US standard CTG monitor (HP1351A) and were sampled at a frequency of 2 Hz. The VAS was provided after a period of quiet of 10 minutes. The analysis was performed on the quiet period and on two successive time windows of 10 minutes each, after the stimulation. FHR classical parameters (delta, short term variability, long term irregularity, accelerations and decelerations) as well as power spectral density (PSD) and approximate entropy (ApEn) were computed for each period.

Results: Results confirm that there is a significant change in fetal conditions after the stimulus is applied. This change can be clearly observed either in time domain parameters and in the regularity index (ApEn). Individual data are all consistent with an increase of variability and a decrease of regularity after VAS.

Conclusions: The obtained results give further strength to the hypothesis that vibratory stimuli tests represent a reliable method for monitoring the neural development of the fetus during pregnancy.

Comparison of data mining techniques applied to fetal heart rate parameters for the early identification of IUGR fetuses

The onset of fetal pathologies can be screened during pregnancy by means of Fetal Heart Rate (FHR) monitoring and analysis. Noticeable advances in understanding FHR variations were obtained in the last twenty years, thanks to the introduction of quantitative indices extracted from the FHR signal. This study searches for discriminating Normal and Intra Uterine Growth Restricted (IUGR) fetuses by applying data mining techniques to FHR parameters, obtained from recordings in a population of 122 fetuses (61 healthy and 61 IUGRs), through standard CTG non-stress test. We computed N=12 indices (N=4 related to time domain FHR analysis, N=4 to frequency domain and N=4 to non-linear analysis) and normalized them with respect to the gestational week. We compared, through a 10-fold crossvalidation procedure, 15 data mining techniques in order to select the more reliable approach for identifying IUGR fetuses. The results of this comparison highlight that two techniques (Random Forest and Logistic Regression) show the best classification accuracy and that both outperform the best single parameter in terms of mean AUROC on the test sets.

Multivariate analysis based on linear and non-linear FHR parameters for the identification of IUGR fetuses

Fetal Heart Rate (FHR) monitoring represents a powerful tool for checking the arousal of pathological fetal conditions during pregnancy. This paper proposes a multivariate approach for the discrimination of Normal and Intra Uterine Growth Restricted (IUGR) fetuses based on a small set of parameters computed on the FHR signal. We collected FHR recordings in a population of 120 fetuses (60 normals and 60 IUGRs) at approximately the same gestational week through a standard CTG non-stress test. A set of 8 linear and non-linear indices were selected and computed on each recording, on the basis of their "stand-alone" discriminative properties, demonstrated in previous studies. By using the Orange® data mining suite we checked various multivariate discrimination models. The results show that a Logistic Regression performed on a limited set of only 4 parameters can reach 92.5% accuracy in the correct identification of fetuses, with 93% sensitivity and 91.5% specificity.

AUTOCOUNTER, an ImageJ JavaScript to analyze LC3B-GFP expression dynamics in autophagy-induced astrocytoma cells

An ImageJ JavaScript, AUTOCOUNTER, was specifically developed to monitor and measure LC3B-GFP expression in living human astrocytoma cells, namely T98G and U373-MG. Discrete intracellular GFP fluorescent spots derived from transduction of a Baculovirus replication-defective vector (BacMam LC3B-GFP), followed by microscope examinations at different times. After viral transgene expression, autophagy was induced by Rapamycin administration and assayed in ph-p70S6K/ p70S6K and LC3B immunoblotting expression as well as by electron microscopy examinations. A mutated transgene, defective in LC3B lipidation, was employed as a negative control to further exclude fluorescent dots derived from protein intracellular aggregation. The ImageJ JavaScript was then employed to evaluate and score the dynamics changes of the number and area of LC3B-GFP puncta per cell in time course assays and in complex microscope examinations. In conclusion, AUTOCOUNTER enabled to quantify LC3B-GFP expression and to monitor dynamics changes in number and shapes of autophagosomal-like vesicles: it might therefore represent a suitable algorithmic tool for in vitro autophagy modulation studies.

Telefetalcare: a first prototype of a wearable fetal electrocardiograph

Fetal heart rate monitoring is fundamental to infer information about fetal health state during pregnancy. The cardiotocography (CTG) is the most common antepartum monitoring technique. Abdominal ECG recording represents the most valuable alternative to cardiotocography, as it allows passive, non invasive and long term fetal monitoring. Unluckily fetal ECG has low SNR and needs to be extracted from abdominal recordings using ad hoc algorithms. This work describes a prototype of a wearable fetal ECG electrocardiograph. The system has flat band frequency response between 1-60 Hz and guarantees good signal quality. It was tested on pregnant women between the 30(th) and 34(th) gestational week. Several electrodes configurations were tested, in order to identify the best solution. Implementation of a simple algorithm for FECG extraction permitted the reliable detection of maternal and fetal QRS complexes. The system will allow continuative and deep screening of fetal heart rate, introducing the possibility of home fetal monitoring.

Advances in monitoring cardiovascular signals. Contribution of nonlinear signal processing

Monitoring procedures are the basis to evaluate the clinical state of patients and to assess changes in their status, thus providing necessary interventions in time. To obtain this important objective it is necessary to integrate technological development with systems performing biomedical knowledge extraction and classification. Methods extracting non linear characteristics from HRV signal are presented and discussed to stress that integrated and multiparametric signal processing approaches can contribute to new diagnostic and classification indices. Examples report heart rate variability analysis in long periods in patients with cardiovascular disease. Fetal ECG monitoring is another example. In this case, coupling nonlinear parameters and linear time and frequency techniques increases diagnostic power and reliability of the monitoring. The paper shows that integrated signal analysis is very helpful to describe pathophysiological mechanisms involved in the cardiovascular and neural system control. It is a reliable basis to set up knowledge-based monitoring systems.

Electromagnetic stimulation to optimize the bone regeneration capacity of gelatin-based cryogels

One of the key challenges in reconstructive bone surgery is to provide living constructs that possess the ability to integrate in the surrounding host tissue. Bone graft substitutes and biomaterials have already been widely used to heal critical-size bone defects due to trauma, tumor resection and tissue degeneration. In the present study, gelatin-based cryogels have been seeded with human SAOS-2 osteoblasts followed by the in vitro culture of the cells. In order to overcome the drawbacks associated with static culture systems, including limited diffusion and in homogeneous cell-matrix distribution, the present work describes the application of a bioreactor to physically enhance the cell culture in vitro using an electromagnetic stimulus. The results indicate that the physical stimulation of cell-seeded gelatin-based cryogels upregulates the bone matrix production. We anticipate that the scaffolds developed consisting of human bone proteins and cells could be applied for clinical purposes related to bone repair.

Biosensing and environmental sensing for emergency and protection e-Textiles

The ProeTEX project introduced for the first time a complete set of smart garments integrating sensors for the physiological and environmental monitoring of emergency operators. These "smart" garments have been deeply tested in emergency-like contexts by professional rescuers, in order to assess real-time acquisition, processing and transmission of data from moving subjects while operating in harsh conditions. Here we report an overview of the main results obtained during field trials performed in 2010 by Italian and French professional firefighters, in specialized training centers, while dressing the ProeTEX prototypes. Results clearly demonstrate the benefit and step forward of such a system in order to monitor and coordinate rescuers even during intervention far away from the emergency headquarter.

The differentiation of human adipose-derived stem cells (hASCs) into osteoblasts is promoted by low amplitude, high frequency vibration treatment

Several studies have demonstrated that tissue culture conditions influence the differentiation of human adipose-derived stem cells (hASCs). Recently, studies performed on SAOS-2 and bone marrow stromal cells (BMSCs) have shown the effectiveness of high frequency vibration treatment on cell differentiation to osteoblasts. The aim of this study was to evaluate the effects of low amplitude, high frequency vibrations on the differentiation of hASCs toward bone tissue. In view of this goal, hASCs were cultured in proliferative or osteogenic media and stimulated daily at 30Hz for 45min for 28days. The state of calcification of the extracellular matrix was determined using the alizarin assay, while the expression of extracellular matrix and associated mRNA was determined by ELISA assays and quantitative RT-PCR (qRT-PCR). The results showed the osteogenic effect of high frequency vibration treatment in the early stages of hASC differentiation (after 14 and 21days). On the contrary, no additional significant differences were observed after 28days cell culture. Transmission Electron Microscopy (TEM) images performed on 21day samples showed evidence of structured collagen fibers in the treated samples. All together, these results demonstrate the effectiveness of high frequency vibration treatment on hASC differentiation toward osteoblasts.

Effects of Electromagnetic Stimulation on Osteogenic Differentiation of Human Mesenchymal Stromal Cells Seeded onto Gelatin Cryogel

Bone tissue engineering typically uses biomaterial scaffolds, osteoblasts or cells that can become osteoblasts, and biophysical stimulations to promote cell attachment and differentiation. In this study, we investigated the effects of an electromagnetic wave on mesenchymal stromal cells isolated from the bone marrow and seeded upon gelatin cryogel disks. In comparison with control conditions without electromagnetic stimulus, the electromagnetic treatment (magnetic field, 2 mT; frequency, 75 Hz) increased the cell proliferation and differentiation and enhanced the biomaterial surface coating with bone extracellular matrix proteins. Using this tissue-engineering approach, the gelatin biomaterial, coated with differentiated cells and their extracellular matrix proteins, may be used in clinical applications as an implant for bone defect repair.

Modeling and simulation of ultrasound fields generated by 2D phased array transducers for medical applications

Modern ultrasound imaging instrumentation for clinical applications allows real-time volumetric scanning of the patients' body. 4D imaging has been made possible thanks to the development of new echographic probes which consist in 2D phased arrays of piezoelectric transducers. In these new devices it is the system electronics which properly drives the matrix elements and focuses the beam in order to obtain a sequence of volumetric images. This paper introduces an ultrasound field simulator based on the Spatial Impulse Response method which is being properly developed to analyze the characteristics of the ultrasound field generated by a 2D phased array of transducers. Thanks to its high configurability by the user, it will represent a very useful tool for electronics designers in developing 4D ultrasound imaging systems components.

Bio-inspired controller for a dexterous prosthetic hand based on Principal Components Analysis

Controlling a dexterous myoelectric prosthetic hand with many degrees of freedom (DoFs) could be a very demanding task, which requires the amputee for high concentration and ability in modulating many different muscular contraction signals. In this work a new approach to multi-DoF control is proposed, which makes use of Principal Component Analysis (PCA) to reduce the DoFs space dimensionality and allow to drive a 15 DoFs hand by means of a 2 DoFs signal. This approach has been tested and properly adapted to work onto the underactuated robotic hand named CyberHand, using mouse cursor coordinates as input signals and a principal components (PCs) matrix taken from the literature. First trials show the feasibility of performing grasps using this method. Further tests with real EMG signals are foreseen.

An internal model of self-motion based on inertial signals

The question of how the central nervous system can distinguish tilt with respect to gravity from inertial acceleration due to translation in a horizontal plane using vestibular information has long been debated by the scientific community over the past ten years. Recently, it was hypothesized that such discrimination may be based on the multisensory integration of information provided by the otolith organs and the semicircular canals. Some evidence of such processing was found in the neural activity of cells in the fastigial nuclei and vestibular nuclei. To investigate the ability of the central nervous system to build an internal model of self motion based on vestibular signals, we developed an artificial vestibular sensor composed of accelerometers and gyroscopes providing movement data of the same nature as that transduced by the otoliths and canals, respectively. Here we show that the processing of these signals based on the multisensory integration hypothesis can be successfully used to discriminate tilt from translation and that the internal model based on such processing can successfully track angular and linear displacements over short periods of time.

Automatic classification of heartbeats using neural network classifier based on a Bayesian framework

This paper presents a method of automatic processing the electrocardiogram (ECG) signal for the classification of heart beats. Data were obtained from 48 records of the MIT-BIH arrhythmia database (only one lead). Five types of arrhythmic beats were classified using our method, Premature Ventricular Conduction beat (PVC), Atrial Premature Conduction beat (APC), Right Bundle Branch Block beat (RBBB), Left Bundle Branch Block beat (LBBB), and Paced Rhythm Beat (PRB), in addition to the Normal Beat (NB). A learning dataset for the neural network was obtained from a five records set (124, 214, 111, 100, and 107) which were manually classified using MIT-BIH Arrhythmia Database Directory and documentation, taking advantage of the professional experience of a cardiologist. Feature set was based on ECG morphology and time intervals. Our system resulted in a minimal sensitivity of 86% and minimal specificity of 90%

Identification of fetal sufferance antepartum through a multiparametric analysis and a support vector machine

The present work is concerned with the automatic identification of fetal sufferance in intrauterine growth retarded (IUGR) fetuses, based on a multiparametric analysis of cardiotocographic recordings feeding a neural classifier. As classification tool, we propose a SVM (support vector machine), which receives the set of linear and nonlinear parameters extracted from the fetal heart rate signal (FHR) as input and gives the indication of fetal distress as output. SVM is a powerful supervised learning algorithm belonging to the statistical learning theory. It minimizes the structural risk performance in various classification problems. Three SVMs are built with different kernels. Their training set includes 70 cases: 35 normal and 35 IUGR suffering fetuses. Classification results obtained with a 2nd order polynomial kernel, on a test set of 30 unknown cases, show good values of accuracy, specificity and sensitivity. The SVM performance is very similar to that obtained with multilayer perceptron and neurofuzzy classifiers proposed in previous works. The introduction of a hybrid unsupervised/supervised learning scheme integrating independent component analysis (ICA) with SVM will be the natural development of this work with a further improvement of the diagnostic ability of the system.

Surface modification of a porous polyurethane through a culture of human osteoblasts and an electromagnetic bioreactor

There is increasing interest in new biomaterials and new culture methods for bone tissue engineering, in order to produce, in vitro, living constructs able to integrate in the surrounding tissue. Using an electromagnetic bioreactor (magnetic field intensity, 2 mT; frequency, 75 Hz), we investigated the effects of electromagnetic stimulation on SAOS-2 human osteoblasts seeded onto a porous polyurethane. In comparison with control conditions, the electromagnetic stimulation caused higher cell proliferation, increased surface coating with decorin and type-I collagen, and higher calcium deposition. The immunolocalization of decorin and type-I collagen showed their colocalization in the cell-rich areas. The use of an electromagnetic bioreactor aimed at obtaining the surface modification of the porous polyurethane in terms of cell colonization and coating with calcified matrix. The superficially modified biomaterial could be used, in clinical applications, as an implant for bone repair.

Comparison between fetal heart rate standard parameters and complexity indexes for the identification of severe intrauterine growth restriction

OBJECTIVES

The intrauterine growth restriction (IUGR) is a pathological state: the fetus is at risk of hypoxia and this condition is associated with increased perinatal morbidity and mortality. However, evidence-based guidelines for clinical surveillance are poor and lack reliable indexes. This study introduces new procedures to extract parameters from the fetal heart rate signal in order to identify severe intrauterine growth restricted (IUGR) fetuses

METHODS

Standard parameters (time domain and frequency domain indexes) are compared to a new parameter, the Lempel Ziv complexity, and to two regularity estimators (approximate entropy and sample entropy). The paper analyzes the robustness of the indexes coming from the parameter extraction procedure.

RESULTS AND CONCLUSIONS

The results show that the LZ complexity is a stable parameter and it is able to significantly discriminate the severe IUGR (preterm delivered) from moderate IUGR (at term delivered) and from healthy fetuses.

Self-similarity behavior characterization of fetal heart rate signal in healthy and intrauterine growth retarded fetuses

In this paper we deal with the problem of the interpretation of the fetal heart rate (FHR) signal. From literature is known that FHR contains both linear and non linear components. Starting from this consideration we analyzed FHR as a fractal time series and we evaluated its self similarity behavior using the Hurst's coefficient (H). We first evaluated the stationarity of FHR time series and then we estimated H with Detrend fluctuation analysis (DFA) method. We calculated Hurst's coefficient for healthy fetuses and for fetuses affected by Intrauterine grow retardation (IUGR). Results provided H = 0.350 +/- 0.064 (avg +/- std) for healthy patients and H = 0.461 +/- 0.059 for IUGR. It is also shown that IUGR patients exhibit a "less non-stationary" and longer-memory behavior than normals with a reduced information content of FHR signal. We propose for this phenomenon a physiological explanation connected with the abnormal autonomic nervous system development of IUGR patients.

Calcified Matrix Production by SAOS-2 Cells Inside a Polyurethane Porous Scaffold, Using a Perfusion Bioreactor

The repair and regeneration of damaged or resected bone are problematic. Bone autografts show optimal skeletal incorporation, but often bring about complications. Hence, there is increasing interest in designing new biomaterials that could potentially be used in the form of scaffolds as bone substitutes. In this study we used a hydrophobic cross-linked polyurethane in a typical tissue-engineering approach, that is, the seeding and in vitro culturing of cells within a porous scaffold. The polyurethane porous scaffold had an average pore diameter of 624 microm. Using a perfusion bioreactor, we investigated the effect of shear stress on SAOS-2 human osteoblast proliferation and calcified matrix production. The physical, morphological, and compressive properties of the polyurethane foam were characterized. At a scaffold perfusion rate of 3 mL/min, in comparison with static conditions without perfusion, we observed 33% higher cell proliferation; higher secretion of osteopontin, osteocalcin, decorin, and type I collagen (9.16-fold, 71.9-fold, 30.6-fold, and 18.12-fold, respectively); and 10-fold increased calcium deposition. The design of the bioreactor and the design of the polyurethane foam aimed at obtaining cell colonization and calcified matrix deposition. This cultured biomaterial could be used, in clinical applications, as an osteoinductive implant for bone repair.

Fetal heart rate variability due to vibroacoustic stimulation: linear and nonlinear contribution

OBJECTIVES

This work aims at characterizing the variation of fetal heart rate (FHR) provoked by vibroacoustic stimulation (VAS). The FHR signal is analyzed by means of a multiparametric approach consisting of linear and nonlinear indices.

METHODS

The FHR signals of 13 fetuses were collected through a US standard CTG monitor (HP1351A) and were sampled at a frequency of 2 Hz. The VAS was provided after a period of quiet of 10 minutes. The analysis was performed on the quiet period and on two successive time windows of 10 minutes each, after the stimulation. FHR classical parameters (delta, short term variability, long term irregularity, accelerations and decelerations) as well as power spectral density (PSD) and approximate entropy (ApEn) were computed for each period.

RESULTS

Results confirm that there is a significant change in fetal conditions after the stimulus is applied. This change can be clearly observed either in time domain parameters and in the regularity index (ApEn). Individual data are all consistent with an increase of variability and a decrease of regularity after VAS.

CONCLUSIONS

The obtained results give further strength to the hypothesis that vibratory stimuli tests represent a reliable method for monitoring the neural development of the fetus during pregnancy.

Absence of vestibular habituation of the vestibulo-ocular reflex in the vertical plane in the cat

The effect of exposure to repeated angular velocity steps about the earth-vertical axis on the vertical vestibulo-ocular reflex (VOR) during onside pitch rotation was investigated in normal cats. By contrast with the VOR in the horizontal plane, the amplitude and duration of the vertical VOR did not progressively decrease throughout the repetition of velocity steps alternated in both directions. Instead, the amplitude of VOR decreased by about 40% during the very first trials in naive cats and then stayed unchanged with repeated stimuli. Habituation of the amplitude of the vertical VOR was observed when the velocity steps were always directed in the same direction. However, the duration of the vertical VOR did not show any signs of habituation. The habituation of the amplitude of the vertical VOR during unidirectional training was due to the progressive development of an initial inhibition of the VOR. This initial inhibition appeared much earlier during the bidirectional protocol, and was presumably responsible for the larger reduction in VOR amplitude observed during the very first session. These results support the model of two distinct mechanisms for VOR habituation, one producing an increasing inhibition of nystagmus, and the other depressing the response duration, and suggest that only the first mechanism is generated during repeated stimulation in the vertical plane. The low-frequency information provided by the velocity storage mechanism during onside pitch rotation, when the otoliths are positioned so they do not signal head tilt relative to gravity, could prevent a decrease in the overall response by the second mechanism.

Eye-head-hand coordination in pointing at visual targets: spatial and temporal analysis

This study investigated whether the execution of an accurate pointing response depends on a prior saccade orientation towards the target, independent of the vision of the limb. A comparison was made between the accuracy of sequential responses (in which the starting position of the hand is known and the eye centred on the target prior to the onset of the hand pointing movement) and synergetic responses (where both hand and gaze motions are simultaneously initiated on the basis of unique peripheral retinal information). The experiments were conducted in visual closed-loop (hand visible during the pointing movement) and in visual open-loop conditions (vision of hand interrupted as the hand started to move). The latter condition eliminated the possibility of a direct visual evaluation of the error between hand and target during pointing. Three main observations were derived from the present work: (a) the timing of coordinated eye-head-hand pointing at visual targets can be modified, depending on the executed task, without a deterioration in the accuracy of hand pointing; (b) mechanical constraints or instructions such as preventing eye, head or trunk motion, which limit the redundancy of degrees of freedom, lead to a decrease in accuracy; (c) the synergetic movement of eye, head and hand for pointing at a visible target is not trivially the superposition of eye and head shifts added to hand pointing. Indeed, the strategy of such a coordinated action can modify the kinematics of the head in order to make the movements of both head and hand terminate at approximately the same time. The main conclusion is that eye-head coordination is carried out optimally by a parallel processing in which both gaze and hand motor responses are initiated on the basis of a poorly defined retinal signal. The accuracy in hand pointing is not conditioned by head movement per se and does not depend on the relative timing of eye, head and hand movements (synergetic vs sequential responses). However, a decrease in the accuracy of hand pointing was observed in the synergetic condition, when target fixation was not stabilised before the target was extinguished. This suggests that when the orienting saccade reaches the target before hand movement onset, visual updating of the hand motor control signal may occur. A rapid processing of this final input allows a sharper redefinition of the hand landing point.

Anatomical segregation of different adaptative processes within the vestibulocerebellum of the cat

Bilateral surgical lesions of the flocculus or the nodulo-uvular lobes were performed in the cat. Effects of these lesions on optokinetic and optokinetic afternystagmus OKAN), vestibulo-ocular reflex (VOR), visual suppression, and adaptation and habituation of VOR were studied using an identical experimental protocol. After flocculectomy, all these functions were impaired, except for habituation. Long-term postoperative recordings only revealed a recovery of the suppression of VOR, suggesting a limited contribution of the flocculus to this function. After nodulo-uvulectomy, only habituation and OKAN were modified. When the lesion was restricted to part of the uvula, OKAN duration was decreased. For other lesions involving the uvula together with the nodulus and/or the lobules VII-VIII,OKAN duration was increased. Habituation was lost after destruction of the nodulo-uvular lobes. When this latter structure was damaged, the retention component of habituation was selectively impaired, sparing the acquisition. Additional lesions outside the vestibulocerebellum appeared necessary to suppress the two components. Comparison of results obtained after flocculectomy and after nodulouvulectomy confirms and extends to non-primate species the concept of a "differential control" of adaptation and habituation by distinct vestibulocerebellar structures.

The role of smooth pursuit in suppression of post-rotational nystagmus

Some authors have suggested that the smooth pursuit system (SPS) may be responsible for nystagmus suppression when a small visual target--stationary with respect to a subject receiving vestibular stimulation in the dark--is presented. Under five experimental conditions, post-rotational vestibular stimulations were combined in different ways with the presentation of a small visual target. The oculomotor responses of 15 normal subjects were recorded and analyzed. The characteristics of nystagmus suppression (latency, dynamics, and nonlinear behaviour) seem to be consistent with the hypothesis of SPS participation. A nonlinear mathematical model of the interaction between vestibulo-ocular reflex and SPS is presented. Computer simulation of the experimental conditions considered in this study provides theoretical results which closely approximate the actual experimental data.

Expert systems as a diagnostic aid in otoneurology

Expert systems (ES) are a new tool for information processing developed by the branch of computer science known as artificial intelligence. ES are capable of solving problems in a given domain by using the knowledge and emulating the behaviour of specialists in that field. ES can be used as powerful tools for education since they are able to justify their own conclusions and to make the underlying reasoning explicit. This paper presents 'Vertigo', an ES aimed at the classification and diagnosis of different forms of dizziness. It has been conceived mainly as a teaching tool in otoneurological departments. The rationale of this project, its development, the structure and the use of the system are described. So far, 'Vertigo' has been tested on more than 200 cases of dizziness and is presently being used by ENT residents during their otoneurology stage.

[T-Scan tracing of the arches. Computerized analysis]

This work deals with a quality control of the dental arch reconstructing software developed for T-Scan. We have developed an original system that employs computer controlled optical acquisition of data. This system behaves satisfactorily following our metodology.

Saccadic responses evoked by presentation of visual and auditory targets

Saccadic eye movements evoked by the presentation of visual and auditory targets were examined and compared. Differences were found either in the pattern of the saccadic response and in the characteristics of single saccades of the same amplitude. The longer latency and the higher percentage of multiple saccade responses in the auditory case were attributed to a more complex central processing, whereas the longer duration and the lower peak velocity of the saccades to auditory targets were attributed to reduced performances of the execution mechanism in the absence of vision.