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• Mauricio Díaz

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MEB-9400A MEB-9400K

EMG/EP MEASURING SYSTEM MEB-9400A/K

If you have any comments or suggestions on this manual, please contact us at: www.nihonkohden.com

0614-009836

CONTENTS

Contents GENERAL HANDLING PRECAUTIONS ................................................................................. i WARRANTY POLICY ............................................................................................................. ii EMC RELATED CAUTION ..................................................................................................... iii Conventions Used in this Manual and Instrument ................................................................... v Warnings, Cautions and Notes ..................................................................................... v Explanations of the Symbols in this Manual and Instrument ....................................... vi

Section 1

General ...................................................................................1C.1 Introduction ......................................................................................................................... 1.1 Examination Programs ........................................................................................................ 1.2 Standard Programs ........................................................................................ 1.2 Optional Programs .......................................................................................... 1.2 Important Safety Information ............................................................................................... 1.3 General ..................................................................................................................... 1.3 Installation ................................................................................................................. 1.4 Cable Connection ..................................................................................................... 1.5 KD-026A Cart ........................................................................................................... 1.6 KD-019A Cart ........................................................................................................... 1.6 LCD Display .............................................................................................................. 1.7 Printer ....................................................................................................................... 1.7 PC Unit ..................................................................................................................... 1.8 Electrode Junction Box ............................................................................................. 1.8 Operation .................................................................................................................. 1.9 Floppy Disk/Magneto Optical Disk/CD-ROM Disk Handling and Storing ................ 1.12 Panel Descriptions ............................................................................................................ 1.13 Components ........................................................................................................... 1.13 Main Unit, DC-940B ................................................................................................ 1.14 Operation Panel ............................................................................................ 1.14 Right Side Panel ........................................................................................... 1.17 Rear Panel .................................................................................................... 1.18 Isolation Unit, SM-930AA/AJ/AK (option) ................................................................ 1.20 Electrode Junction Box, JB-942BK, JB-944BK ....................................................... 1.21 Foot Switch, RY-482B ............................................................................................. 1.22 Somato Control Box, RY-441B (option) ................................................................... 1.23 Operation Flow .................................................................................................................. 1.24 General Functions and Windows ...................................................................................... 1.25 Npk Menu ............................................................................................................... 1.25 Properties Dialog Box ................................................................................... 1.25 System Condition Dialog Box ....................................................................... 1.25 File Management Dialog Box ........................................................................ 1.25 User Define Dialog Box ................................................................................ 1.26 Main Menu Window ...................................................................................... 1.26 Basic Measurement Windows ...................................................................... 1.26 Waveform Types ................................................................................................................ 1.28

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C.1

CONTENTS

Section 2

Installation ..............................................................................2C.1

Section 2-1

Installation (for MEB-9400 with a Desktop PC Unit) ......................... 2-1C.1 Introduction ...................................................................................................................... 2-1.1 MEB-9400 System Composition (Example) ................................................ 2-1.1 Warnings and Cautions for Installation ............................................................................ 2-1.3 General .................................................................................................................. 2-1.3 Cable Connection .................................................................................................. 2-1.4 KD-026A Cart ........................................................................................................ 2-1.5 PC Unit .................................................................................................................. 2-1.5 LCD Display ........................................................................................................... 2-1.6 Printer .................................................................................................................... 2-1.6 Electrode Junction Box .......................................................................................... 2-1.7 System Location .............................................................................................................. 2-1.8 Setting Flow ..................................................................................................................... 2-1.9 Connection Diagram ...................................................................................................... 2-1.10 Removing the Rear Cover ............................................................................................. 2-1.11 Attaching the Handle Assy ................................................................................... 2-1.11 Removing the Rear Cover ................................................................................... 2-1.11 Setting the System Components on the Cart ................................................................. 2-1.12 Setting the Isolation Unit ...................................................................................... 2-1.12 Setting the PC Unit .............................................................................................. 2-1.13 Setting the Main Unit ........................................................................................... 2-1.14 Setting the Keyboard and Mouse ......................................................................... 2-1.15 Connecting the Cables ................................................................................................... 2-1.16 Connecting the Power Cords to the Isolation Unit ............................................... 2-1.16 Connecting the PC Unit, Main Unit and Isolation Unit .......................................... 2-1.16 Connecting the Keyboard and Mouse .................................................................. 2-1.17 Connecting the Foot Switch ................................................................................. 2-1.17 Setting the LCD Display ................................................................................................. 2-1.18 Attaching the LCD Holder .................................................................................... 2-1.18 Attaching the LCD Display to the Pillar ................................................................ 2-1.18 Adjusting the Tilt .................................................................................................. 2-1.20 Connecting the Cables ........................................................................................ 2-1.20 Setting the Electrode Junction Box ................................................................................ 2-1.22 Setting the Printer .......................................................................................................... 2-1.23 Connecting the Cables ........................................................................................ 2-1.24 Reattaching the Rear Cover .......................................................................................... 2-1.25 Binding the Cables ............................................................................................... 2-1.25 Attaching the Rear Cover ..................................................................................... 2-1.25 Attaching the Tray and Basket ............................................................................. 2-1.26

Section 2-2

Installation (for MEB-9400 with a Laptop PC Unit)............................ 2-2C.1 Introduction ...................................................................................................................... 2-2.1 MEB-9400 with a laptop PC System Composition (Example) ..................... 2-2.1 Warnings and Cautions for Installation ............................................................................ 2-2.3 General .................................................................................................................. 2-2.3 Cable Connection .................................................................................................. 2-2.4 KD-019A Cart ........................................................................................................ 2-2.5 PC Unit .................................................................................................................. 2-2.5

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CONTENTS Printer .................................................................................................................... 2-2.6 Electrode Junction Box .......................................................................................... 2-2.6 System Location .............................................................................................................. 2-2.7 Setting Flow ..................................................................................................................... 2-2.8 Connection Diagram ........................................................................................................ 2-2.9 Assembling the Cart ...................................................................................................... 2-2.10 Attaching the Handle Assy and Connector Guard ............................................... 2-2.10 Attaching the Tray and Basket ............................................................................. 2-2.10 Setting the System Components on the Cart ................................................................. 2-2.11 Removing the Rear Cover ................................................................................... 2-2.11 Setting the Main Unit ........................................................................................... 2-2.11 Setting the PC Unit .............................................................................................. 2-2.12 Setting the Isolation Unit ...................................................................................... 2-2.13 Setting the Printer ................................................................................................ 2-2.14 Connecting the Cables ................................................................................................... 2-2.15 Connecting the Power Cords to the Isolation Unit ............................................... 2-2.15 Connecting the PC Unit, Main Unit and Isolation Unit .......................................... 2-2.15 Connecting the Printer ......................................................................................... 2-2.16 Connecting the Mouse ......................................................................................... 2-2.17 Connecting the Foot Switch ................................................................................. 2-2.17 Setting the Electrode Junction Box ................................................................................ 2-2.18 Reattaching the Rear Cover .......................................................................................... 2-2.19

Section 2-3

Installation (for Both Models) ............................................................. 2-3C.1 Connecting the Power Cord ............................................................................................. 2-3.2 Equipotential Grounding .............................................................................. 2-3.2 Necessity of Equipotential Grounding .......................................................... 2-3.2 Connecting the Stimulators and Probe ............................................................................ 2-3.3 Connecting the Electric Stimulation Electrode ....................................................... 2-3.3 Connecting the Surface Stimulation Electrode (Option) .............................. 2-3.3 Connecting the Finger Electrode (Option) ................................................... 2-3.4 Connecting the Somato Control Box (Option) .............................................. 2-3.4 Connecting the Headphone or Earphone (Option) ................................................ 2-3.5 Connecting the LED Goggles (Option) .................................................................. 2-3.5 Connecting the CRT Monitor (Option) ................................................................... 2-3.6 Power On Procedure ........................................................................................................ 2-3.7 Power Off Procedure ........................................................................................................ 2-3.9 Installing the Software and USB Driver .......................................................................... 2-3.10 Before Starting Installation ................................................................................... 2-3.10 Entering the Serial Number ................................................................................. 2-3.10 Installing the Software ......................................................................................... 2-3.10 Installing the USB Driver ...................................................................................... 2-3.12 Registering the Examination Program ................................................................. 2-3.14 Obtaining the Optional Software Key Code ......................................................... 2-3.14 Entering the Software Key ................................................................................... 2-3.15 Changing the AC Interference Filter Setting ................................................................... 2-3.16 General Requirements for Connecting Medical Electrical System ................................. 2-3.17 KEY TO TABLE .......................................................................................... 2-3.18

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CONTENTS

Section 3

Operating the MEB-9200/9300...............................................3C.1 Windows Basics .................................................................................................................. 3.1 Using the Mouse ....................................................................................................... 3.1 Windows Desktop ..................................................................................................... 3.1 Basic Explanation of a Window ................................................................................. 3.3 Working with a Window ............................................................................................. 3.5 Using a Pull Down Menu ........................................................................................... 3.6 Using a Dialog Box ................................................................................................... 3.7 Explanation of Menu Command and Buttons on the Tool Bar ........................................... 3.10 Main Menu Window ................................................................................................ 3.10 Examination Window .............................................................................................. 3.12 MEB-9400 Basics ............................................................................................................. 3.18 Entering the Patient Information ............................................................................. 3.18 Selecting an Examination Program ......................................................................... 3.20 Entering the Examination Information ..................................................................... 3.21 Checking and Changing the Measurement Settings ............................................... 3.23 Checking Skin-Electrode Contact Impedance ........................................................ 3.24 Operations during Examination .............................................................................. 3.25 Selecting the Function Button on the Bottom of the Screen ......................... 3.25 Displaying the Calibration Waveform ............................................................ 3.25 Returning the Waveform to the Baseline Position ......................................... 3.25 Turning the AC Interference Filter On/Off ..................................................... 3.25 Displaying the Acquired Raw Waveform ....................................................... 3.25 Displaying the Evoked Waveform or Acquired Waveform which Exceeds the Trigger Threshold .......................................................................................... 3.25 Starting the Waveform Averaging ................................................................. 3.25 Stopping the Waveform Acquisition or Averaging ......................................... 3.26 Changing the Waveform Sensitivity .............................................................. 3.26 Changing the Waveform Sweep Time ........................................................... 3.26 Selecting Waveforms .................................................................................... 3.26 Changing the Waveform Display Position (Moving the Waveform) ............... 3.26 Displaying or Not Displaying the Waveform .................................................. 3.27 Measuring the Latency of the Waveform ...................................................... 3.27 Measuring the Amplitude of the Waveform ................................................... 3.27 Displaying the Latency and Amplitude of the Waveform ............................... 3.27 Changing the Stimulation Settings ................................................................ 3.28 Calling Up Previous Waveforms .............................................................................. 3.29 Saving Waveforms .................................................................................................. 3.30 Deleting Waveforms from the Display ..................................................................... 3.30 Printing ................................................................................................................... 3.30 Printing the Measurement (Monitor, Sweep or Average) Window (Hard Copy) .................................................................................................. 3.30 Printing the Waveforms and Data on the Stop, Saved or Gather Window (Review Printing) .......................................................................................... 3.31 Printing a Report .......................................................................................... 3.31 Saving a File ........................................................................................................... 3.31 Shortcut Keys ......................................................................................................... 3.32 Using the Footswitch ......................................................................................................... 3.33

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Operator's Manual MEB-9400

CONTENTS

Section 4

Working with the Main Menu Window ..................................4C.1 General ............................................................................................................................... 4.1 Operating the Examination Program File ............................................................................ 4.2 Selecting the Examination Program .......................................................................... 4.2 Opening the Main Menu Window Saved in the Examination File .............................. 4.2 Opening the Examination Program in Preset Order ................................................. 4.3 Displaying the Patient Information When the Examination Program is Changed ...... 4.3 Using the Patient Information for All Examination Programs .................................... 4.3 Changing the Main Menu Window Display Format ................................................... 4.4 Minimizing the Main Menu Window ........................................................................... 4.5 Displaying the Online Operator’s Manual .................................................................. 4.5 Examination Program Operator’s Manual ....................................................... 4.5 Operator’s Manual .......................................................................................... 4.5 Displaying the Installed Optional Program Information ............................................. 4.5 Calling Up a Patient File ...................................................................................................... 4.6 Saving Changed Settings ................................................................................................... 4.7 Saving the Changed Settings as a New Examination Program File ......................... 4.7 Saving the Changed Settings in the Existing Examination Program File .................. 4.7 Editing the Main Menu Window ........................................................................................... 4.8 Opening the Select Category Dialog Box ................................................................. 4.8 Copying the Category Name .................................................................................... 4.8 Moving the Category Name ...................................................................................... 4.8 Closing the Select Category Dialog Box ................................................................... 4.8 Opening the Edit Category Dialog Box ..................................................................... 4.9 Changing the Category Name ................................................................................ 4.10 Copying the Examination Program Name ............................................................... 4.10 Moving the Examination Program Name in the Edit Category Area ....................... 4.10 Deleting the Examination Program Name in the Edit Category Area ...................... 4.10 Checking the Examination Program Settings in the Set Conditions Window .......... 4.11 Changing the Examination Program Name and Comment ..................................... 4.11 Closing the Edit Category Dialog Box ..................................................................... 4.12

Section 5

Selecting the Measurement Settings ...................................5C.1 General ............................................................................................................................... 5.1 Condition Pages ........................................................................................................ 5.1 Opening the Set Conditions Window and Selecting a Condition Page ...................... 5.2 Changing Settings in a Table .................................................................................... 5.3 Changing a Setting for One Channel .............................................................. 5.3 Changing a Setting for Two or More Consecutive Channels ........................... 5.3 Changing a Setting for All Channels ............................................................... 5.3 Saving or Undoing Setting Changes ......................................................................... 5.3 Saving Settings ............................................................................................... 5.3 Undoing Setting Changes ............................................................................... 5.3 Closing the Set Conditions Window .......................................................................... 5.3 Amp Page ........................................................................................................................... 5.4 Acquisition Page ................................................................................................................. 5.7 Trigger Page ...................................................................................................................... 5.10 Electric Page ..................................................................................................................... 5.15

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CONTENTS Auditory Stim Page ........................................................................................................... Visual Page ....................................................................................................................... Display Page ..................................................................................................................... Labeling Page ................................................................................................................... Table Page ........................................................................................................................ Misc Page .........................................................................................................................

Section 6

5.17 5.20 5.22 5.24 5.27 5.28

Processing the Waveform......................................................6C.1 General ............................................................................................................................... 6.1 Using the Edit Window ........................................................................................................ 6.2 Averaging the Waveforms ................................................................................................... 6.4 Moving a Waveform Display Position ........................................................................ 6.5 Superimposing All the Waveforms ............................................................................ 6.5 Canceling Averaging ................................................................................................. 6.6 Saving the Averaged Waveform ................................................................................ 6.6 Closing the Processing [Average] Window ............................................................... 6.6 Subtracting One Waveform from Another ........................................................................... 6.7 Moving a Waveform Display Position ........................................................................ 6.8 Superimposing All Waveforms .................................................................................. 6.8 Canceling Subtraction ............................................................................................... 6.9 Saving the Subtracted Waveform .............................................................................. 6.9 Closing the Processing [Subtract] Window ............................................................... 6.9 Reversing the Polarity of the Waveform ............................................................................ 6.10 Moving a Waveform Display Position ...................................................................... 6.11 Superimposing All Waveforms ................................................................................ 6.11 Canceling Reversing ............................................................................................... 6.11 Saving the Waveform Which Polarity is Reversed ................................................... 6.12 Closing the Processing [Reverse] Window ............................................................. 6.12 Rectifying the Waveform from a Waveform Trace .............................................................. 6.13 Superimposing All Waveforms ................................................................................ 6.15 Canceling Rectification ........................................................................................... 6.15 Saving the Rectified Waveform ............................................................................... 6.15 Closing the Processing [Rectify] Window ............................................................... 6.15 Expanding a Waveform ..................................................................................................... 6.16 Superimposing All Waveforms ................................................................................ 6.18 Canceling Expanding .............................................................................................. 6.18 Saving the Expanded Waveform ............................................................................. 6.18 Closing the Processing [Expand] Window .............................................................. 6.18 Digital Filter Processing .................................................................................................... 6.19 Superimposing All Waveforms ................................................................................ 6.22 Canceling Filtering .................................................................................................. 6.22 Saving the Filtered Waveform ................................................................................. 6.23 Closing the Processing [Digital Filtering] Window ................................................... 6.23 Reaveraging the Waveforms ............................................................................................. 6.24 Canceling Reaveraging ........................................................................................... 6.25 Saving the Reaveraged Waveform .......................................................................... 6.26 Closing the Processing [Reaverage] Window ......................................................... 6.26

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CONTENTS

Section 7

Filing .......................................................................................7C.1 General ............................................................................................................................... 7.1 Opening a Patient File ......................................................................................................... 7.2 Opening the Open Dialog Box .................................................................................. 7.2 Selecting a File Type ................................................................................................. 7.2 Searching for a File ................................................................................................... 7.3 Changing the File Information Layout in the File List ................................................ 7.6 Saving the Measurement Result and Patient Information ................................................... 7.7 Saving Data in a New File ......................................................................................... 7.7 Saving Data in an Existing File ................................................................................. 7.9 File Management .............................................................................................................. 7.10 General ................................................................................................................... 7.10 Copying, Moving and Deleting Patient Files ............................................................ 7.11

Section 8

Printing ...................................................................................8C.1 General ............................................................................................................................... 8.1 Printing the Measurement (Monitor, Sweep, Average or Stop) Window (Hard Copy) ......... 8.2 Printing the Stop, Saved or Gather Window Waveforms and Data ...................................... 8.3 Printing One Page of Waveforms from the Stop or Saved Window ........................... 8.4 Printing All Waveforms on the Stop or Saved Window .............................................. 8.6 Printing ABR Threshold Test Waveforms .................................................................. 8.8 Printing Waveforms on the Gather Window ............................................................ 8.11 Printing Raw Waveforms on the Stop Window ........................................................ 8.14 Printing Waveforms for All Sites on the Stop Window ............................................. 8.19 Printing a Report .............................................................................................................. 8.21 General ................................................................................................................... 8.21 Outline of the Report Printing ................................................................................. 8.21 Composition of the Report ...................................................................................... 8.22 Report Printing Procedure (Microsoft Word) ........................................................... 8.22 Changing Word Security Setting ................................................................... 8.22 Printing ......................................................................................................... 8.23 Report Printing Procedure (Microsoft Excel) .......................................................... 8.27 Selecting the Excel Installation Folder .......................................................... 8.27 Changing Excel Security Setting .................................................................. 8.28 Printing ......................................................................................................... 8.29 Editing the Title of Each Item on the Report ................................................. 8.30

Section 9

System Settings .....................................................................9C.1 General ............................................................................................................................... 9.1 Changing the Settings in the User Define Dialog Box ......................................................... 9.2 Opening the User Settings Dialog Box ..................................................................... 9.2 Registering a User Name ......................................................................................... 9.2 Changing the Muscle Name Displayed in the Muscle List Box on the EMG Findings Window and File Search Dialog Box ......................................................................... 9.3 Changing the Nerve Name Displayed in the Nerve List Box on the Nerve Input Window and File Search Dialog Box ......................................................................... 9.4 Changing the EMG Findings in the EMG Findings Table Dialog Box ........................ 9.6

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CONTENTS Adding the Names and Comments for Entering a Patient Information and Examination Information ........................................................................................... 9.7 Default Settings of the Names and Comments ............................................... 9.9 Selecting the Tool Buttons Displayed on the Examination Window ......................... 9.12 Customizing the Window ................................................................................................... 9.13 Setting the Report Format ................................................................................................ 9.15 Setting the System Condition ............................................................................................ 9.18

Section 10

Troubleshooting ...................................................................10C.1 System .............................................................................................................................. Waveform Acquisition ....................................................................................................... Printing .............................................................................................................................. Data Storage ..................................................................................................................... Acquiring Clear Waveforms ............................................................................................... AC Interference ....................................................................................................... Spike Noise ............................................................................................................. Other Noise ............................................................................................................

Section 11

Maintenance .........................................................................11C.1 After-Use Inspection ......................................................................................................... Check After Turning the Power Off .......................................................................... Disposing of Disposable Products .......................................................................... Cleaning, Disinfecting and Sterilizing the System Components ........................................ Cleaning .................................................................................................................. Disinfecting and Sterilizing ...................................................................................... Cleaning, Disinfecting and Sterilizing the Electrode and Cables ....................................... Electrode Leads and Extension Cables ........................................................ EMG Needle electrode ................................................................................. Disk Type Recording Electrode .................................................................... Grounding Electrode ..................................................................................... Skin Surface Stimulation Electrode ............................................................... Somato Control Box ...................................................................................... ERG Contact Lens Electrode ....................................................................... Periodic Check .................................................................................................................. Repair Parts Availability Policy ..........................................................................................

Section 12

11.1 11.1 11.1 11.2 11.2 11.2 11.3 11.3 11.3 11.4 11.5 11.5 11.6 11.6 11.7 11.8

Reference..............................................................................12C.1 Specifications .................................................................................................................... Amplifiers ...................................................................................................... Averager ....................................................................................................... Stimulator Common Functions ..................................................................... Dimensions and Weight ................................................................................ Power Requirements .................................................................................... Environment ................................................................................................. Safety ........................................................................................................... Electromagnetic Compatibility ......................................................................

C.8

10.2 10.3 10.4 10.4 10.5 10.5 10.6 10.7

12.1 12.1 12.1 12.1 12.3 12.3 12.3 12.3 12.5

Operator's Manual MEB-9400

CONTENTS Standard Accessories ....................................................................................................... 12.8 Options ............................................................................................................................. 12.9 Connector Pin Assignment ............................................................................................. 12.14 Main Unit Right Side Panel ................................................................................... 12.14 Main Unit Rear Panel ............................................................................................ 12.15 Electrode Junction Box ......................................................................................... 12.16

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C.9

GENERAL HANDLING PRECAUTIONS This device is intended for use only by qualified medical personnel. Use only Nihon Kohden approved products with this device. Use of non-approved products or in a non-approved manner may affect the performance specifications of the device. This includes, but is not limited to, batteries, recording paper, pens, extension cables, electrode leads, input boxes and AC power. Please read these precautions thoroughly before attempting to operate the instrument. 1. To safely and effectively use the instrument, its operation must be fully understood. 2. When installing or storing the instrument, take the following precautions: (1) Avoid moisture or contact with water, dust, extreme atmospheric pressure, excessive humidity and temperatures, poorly ventilated areas, and saline or sulphuric air. (2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock, even during transport. (3) Avoid placing in an area where chemicals are stored or where there is danger of gas leakage. (4) The power line source to be applied to the instrument must correspond in frequency and voltage to product specifications, and have sufficient current capacity. (5) Choose a room where a proper grounding facility is available. 3. Before Operation (1) Check that the instrument is in perfect operating order. (2) Check that the instrument is grounded properly. (3) Check that all cords are connected properly. (4) Pay extra attention when the instrument is in combination with other instruments to avoid misdiagnosis or other problems. (5) All circuitry used for direct patient connection must be doubly checked. (6) Check that battery level is acceptable and battery condition is good when using battery-operated models. 4. During Operation (1) Both the instrument and the patient must receive continual, careful attention. (2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient’s safety. (3) Avoid direct contact between the instrument housing and the patient. 5. To Shutdown After Use (1) Turn power off with all controls returned to their original positions. (2) Remove the cords gently; do not use force to remove them. (3) Clean the instrument together with all accessories for their next use. 6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument is not functioning properly, it should be clearly marked to avoid operation while it is out of order. 7. The instrument must not be altered or modified in any way. 8. Maintenance and Inspection: (1) The instrument and parts must undergo regular maintenance inspection at least every 6 months. (2) If stored for extended periods without being used, make sure prior to operation that the instrument is in perfect operating condition. Operator's Manual MEB-9400

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(3) Technical information such as parts list, descriptions, calibration instructions or other information is available for qualified user technical personnel upon request from your Nihon Kohden distributor. 9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or location of electrodes and/or transducers to avoid possible burn to the patient. 10. When the instrument is used with a defibrillator, make sure that the instrument is protected against defibrillator discharge. If not, remove patient cables and/or transducers from the instrument to avoid possible damage.

WARRANTY POLICY Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and workmanship for one year from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded from the warranty. NKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period, provided these products are used as prescribed by the operating instructions given in the operator’s and service manuals. No other party is authorized to make any warranty or assume liability for NKC’s products. NKC will not recognize any other warranty, either implied or in writing. In addition, service, technical modification or any other product change performed by someone other than NKC or its authorized agents without prior consent of NKC may be cause for voiding this warranty. Defective products or parts must be returned to NKC or its authorized agents, along with an explanation of the failure. Shipping costs must be pre-paid. This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Nihon Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism, water or other casualty, improper installation or application, or on which the original identification marks have been removed. In the USA and Canada other warranty policies may apply.

CAUTION United States law restricts this device to sale by or on the order of a physician.

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Operator's Manual MEB-9400

EMC RELATED CAUTION This equipment and/or system complies with IEC 60601-2 International Standard for electromagnetic compatibility for medical electrical equipment and/or system. However, an electromagnetic environment that exceeds the limits or levels stipulated in IEC 60601-1-2, can cause harmful interference to the equipment and/or system or cause the equipment and/or system to fail to perform its intended function or degrade its intended performance. Therefore, during the operation of the equipment and/or system, if there is any undesired deviation from its intended operational performance, you must avoid, identify and resolve the adverse electromagnetic effect before continuing to use the equipment and/or system. The following describes some common interference sources and remedial actions: 1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station or cellular phone: Install the equipment and/or system at another location. Keep the emitter source such as cellular phone away from the equipment and/or system, or turn off the cellular phone. 2. Radio-frequency interference from other equipment through the AC power supply of the equipment and/or system: Identify the cause of this interference and if possible remove this interference source. If this is not possible, use a different power supply. 3. Effect of direct or indirect electrostatic discharge: Make sure all users and patients in contact with the equipment and/or system are free from direct or indirect electrostatic energy before using it. A humid room can help lessen this problem. 4. Electromagnetic interference with any radio wave receiver such as radio or television: If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or system as far as possible from the radio wave receiver. 5. Interference of lightning When lightning occurs near the location where the equipment and/or system is installed, it may induce an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord from the equipment and/or system and operate the equipment and/or system by battery power, or use an uninterruptible power supply. 6. Use with other equipment When the equipment and/or system is adjacent to or stacked with other equipment, the equipment and/ or system may affect the other equipment. Before use, check that the equipment and/or system operates normally with the other equipment. 7. Use of unspecified accessory, transducer and/or cable When an unspecified accessory, transducer and/or cable is connected to this equipment and/or system, it may cause increased electromagnetic emission or decreased electromagnetic immunity. The specified configuration of this equipment and/or system complies with the electromagnetic requirements with the specified configuration. Only use this equipment and/or system with the specified configuration.

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Caution - continued 8. Use of unspecified configuration When the equipment and/or system is used with the unspecified system configuration different than the configuration of EMC testing, it may cause increased electromagnetic emission or decreased electromagnetic immunity. Only use this equipment and/or system with the specified configuration. 9. Measurement with excessive sensitivity The equipment and/or system is designed to measure bioelectrical signals with a specified sensitivity. If the equipment and/or system is used with excessive sensitivity, artifact may appear by electromagnetic interference and this may cause mis-diagnosis. When unexpected artifact appears, inspect the surrounding electromagnetic conditions and remove this artifact source. If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden distributor or representative for additional suggestions.

For EMC compliance, refer to “Specification - Electromagnetic Compatibility” in the Reference section. The CE mark is a protected conformity mark of the European Community. The products herewith comply with the requirements of the Medical Device Directive 93/42/EEC. The CE mark is only applied to the MEB-9400K EMG/EP Measuring System. This equipment complies with International Standard IEC 60601-1-2: 2001.

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Operator's Manual MEB-9400

Conventions Used in this Manual and Instrument Warnings, Cautions and Notes Warnings, cautions and notes are used in this manual to alert or signal the reader to specific information.

WARNING A warning alerts the user to the possible injury or death associated with the use or misuse of the instrument.

CAUTION A caution alerts the user to possible injury or problems with the instrument associated with its use or misuse such as instrument malfunction, instrument failure, damage to the instrument, or damage to other property.

NOTE A note provides specific information, in the form of recommendations, prerequirements, alternative methods or supplemental information.

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Explanations of the Symbols in this Manual and Instrument The following symbols found in this manual/instrument bear the respective descriptions as given. Main unit

Symbol

Description

Description

Alternating current

Electrode junction box

Loudspeaker

Input/output connector

Intensity control

Equipotential terminal

Electric stimulation

Protective earth

Headphone connector

Type B applied part

Goggles

Type BF applied part

Pattern Reversal

Fuse

USB connector

Attention, consult operator’s manual

Foot switch

Serial number

Power on

Date of manufacture

Power off

vi

Symbol

The CE Mark is a protected conformity mark of European Community. The products herewith comply with the requirements of the Medical Device Directive 93/42/EEC

Operator's Manual MEB-9400

Elerctrode junction box

Symbol

Description

Symbol

Description

Type BF applied part

Attention consult Operator’s manual

Serial number

Date of manufacture

Somato control box

Symbol

Description

Symbol

Description

Electric stimulation

Date of manufacture

Plus: positive polarity

Serial number

Minus: negative polarity

On screen

Symbol

Description

Symbol

Description

Display of list box

Warning query that displays a warning or caution for operation.

Scrolling of data, list and others

Warning message that displays a warning or caution for operation you to do something.

Check box Maximize Restore Minimize

Option button

Window maximize/resize minimize button

Close button

Foot Switch

Symbol

IPX 1

Operator's Manual MEB-9400

Description Protected against dripping water

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Description Serial number

vii

Section 1 General

Introduction ........................................................................................................................ 1.1 Examination Programs ....................................................................................................... 1.2 Standard Programs ....................................................................................... 1.2 Optional Programs ......................................................................................... 1.2 Important Safety Information .............................................................................................. 1.3 General .................................................................................................................... 1.3 Installation ................................................................................................................ 1.4 Cable Connection .................................................................................................... 1.5 KD-026A Cart .......................................................................................................... 1.6 KD-019A Cart .......................................................................................................... 1.6 LCD Display ............................................................................................................. 1.7 Printer ...................................................................................................................... 1.7 PC Unit .................................................................................................................... 1.8 Electrode Junction Box ............................................................................................ 1.8 Operation ................................................................................................................. 1.9 Floppy Disk/Magneto Optical Disk/CD-ROM Disk Handling and Storing ............... 1.12 Panel Descriptions ........................................................................................................... 1.13 Components .......................................................................................................... 1.13 Main Unit, DC-940B ............................................................................................... 1.14 Operation Panel ........................................................................................... 1.14 Right Side Panel .......................................................................................... 1.17 Rear Panel ................................................................................................... 1.18 Isolation Unit, SM-930AA/AJ/AK (option) ............................................................... 1.20 Electrode Junction Box, JB-942BK, JB-944BK ...................................................... 1.21 Foot Switch, RY-482B ............................................................................................ 1.22 Somato Control Box, RY-441B (option) .................................................................. 1.23 Operation Flow ................................................................................................................. 1.24 General Functions and Windows ..................................................................................... 1.25 Npk Menu .............................................................................................................. 1.25 Properties Dialog Box .................................................................................. 1.25 System Condition Dialog Box ...................................................................... 1.25 File Management Dialog Box ....................................................................... 1.25 User Define Dialog Box ............................................................................... 1.26 Main Menu Window ..................................................................................... 1.26 Basic Measurement Windows ..................................................................... 1.26 Waveform Types ............................................................................................................... 1.28 Operator’s Manual MEB-9400

1C.1

1. GENERAL

Introduction The Neuropack MEB-9400A/K EMG/EP Measuring System (hereafter referred to as the system) measures and averages EMG, electric/auditory/visual evoked potential and nerve conduction. The MEB-9400 system software operates on Microsoft Windows. • Main menu The Main menu lets you easily select and perform examinations. • Electrode junction box 2 types of electrode junction boxes can be used. JB-942BK (2 channel without montage function) JB-944BK (4 channel without montage function) • Waveform processing After measurement, the waveforms can be processed in different ways. • Data saving in a built-in hard disk, CD-ROM disk or magneto optical disk Measured waveforms and data can be saved in the built-in hard disk or on CDROM or magneto optical disk. Saved waveforms and data can be displayed on the screen. • Data compatibility among Neuropack series instruments The system can read floppy disk data from any other Neuropack series instrument - MEB-5504/5508 version 3.0 or later, MEB/MEM-4200 version 4.8 or later, MEB-2200, MEB-9100, MEB-9200/9300 and MEB-9400. • Various options for expanding the system’s function See Section 11. Section 1 provides a general overview of the system and how to operate it. • Examination programs • System components • Operation flow

NOTE Use Nihon Kohden parts and accessories to assure maximum performance from your system.

Trademarks Microsoft and Windows are registered trademarks of Microsoft Corporation. HP is a registered trademark of Hewlett Packard Corporation. EIZO is a registered trademark of NANAO Corporation

Operator's Manual MEB-9400

1.1

1. GENERAL

Examination Programs Standard Programs Somatosensory Evoked Potential Measurement • Somatosensory evoked potential (SEP) measurement • Short-latency somatosensory evoked potential (SSEP) measurement • ECG triggered SSEP (ECG-SSEP) measurement • Evoked spinal cord potential (ESCP) measurement • Customizable somatosensory protocol (ELECTRIC) Auditory Evoked Potential Measurement • Auditory brainstem response (ABR) measurement • Middle latency response (MLR) measurement • Slow vertex response (SVR) measurement • Electrocochleogram (ECOCHG) measurement • Customizable auditory protocol (AUDITORY)

Optional Programs QP-946BK Quantitative EMG software QP-947BK Single Fiber (SF EMG) and Macro EMG Software QP-948BK Autonomic Nervous System Testing Software • Microneurogram (MICRO-N) measurement • Sympathetic skin response (SSR) measurement • R-R interval analysis

Visual Evoked Potential Measurement • Pattern reversal - Visual evoked potential (Pattern-VEP) measurement • Flash LED goggles - Visual evoked potential (LED-VEP) measurement • External stimulator - Visual evoked potential (EXT-VEP) measurement • Electroretinogram (ERG) measurement • Electrooculogram (EOG) measurement • Customizable visual control (VISUAL) EMG (Electromyogram) Measurement Nerve Conduction Study • Motor nerve conduction study (MCS) • Sensory nerve conduction study (SCS) • Repetitive stimulation (REP. STIM) • F-wave measurement (F-WAVE) • Monosynaptic reflex H-wave (H-REFLEX) measurement • Polysynaptic reflex (orbicularis oculi muscle reflex) measurement (BLINK) • Nerve conduction studies (NCS)

1.2

Operator's Manual MEB-9400

1. GENERAL

Important Safety Information General WARNING • Never use the system in the presence of any flammable anesthetic gas or high concentration oxygen atmosphere. Failure to follow this warning may cause explosion or fire. • Never use this system in an MRI examination room. The system may not operate properly due to high frequency magnetic noise from the MRI. • Never use the system in a high pressure oxygen medical care tank. Failure to follow this warning may cause explosion or fire. MRI examination • Before MRI examination, remove all electrodes and transducers from the patient which are connected to this system. Failure to follow this warning may cause serious electrical burn on the patient due to local heating caused by dielectric electromotive force. For details, refer to the MRI Operator’s manual. Using with an electrical surgical unit (ESU) • Never use this system near the ESU. The system may malfunction due to high-frequency noise from the ESU. • When using this system with an ESU, refer to the instruction manual for the ESU. Before measurement, check that the return plate is correctly attached to the patient and that the system operates correctly when using with the ESU. If the return plate is not attached correctly, it may burn the patient’s skin where the electrodes are attached. • Before using the ESU, remove all needle electrodes and silver ball electrodes from the patient. Failure to follow this warning may cause burn on the patient. Using with shortwave or microwave therapy equipment • Operation in close proximity (for example 1 m) to shortwave or microwave therapy equipment may cause instability in the ELECTRICAL STIMULATOR output. Using with a defibrillator • Before defibrillation, make sure all persons keep clear of the bed and must not touch the patient or any equipment connected to the patient. Failure to follow this warning may cause electrical shock or other injury. • Before defibrillation, remove all electrodes from the patient which are connected to this system. If the defibrillator paddle directly contacts these materials, the discharged energy may cause serious electrical burn to the patient.

Operator's Manual MEB-9400

1.3

1. GENERAL

Installation WARNING • Only use a 3-prong power cord with the system. Failure to follow this warning may cause electrical shock to the patient and operator. • Equipotential grounding may be required for electrical safety. Consult with a qualified biomedical engineer. • When connecting the cables, make sure that all equipment is turned off. • When connecting external equipment to this system, ensure that the external equipment complies with the IEC60601-1 safety standard for medical equipment and CISPR11 Second Edition 1990-1999 Group 1 and Class B standard, or the equivalent. When the external equipment does not comply with the IEC60601-1 safety standard, use a locally available medical use isolation transformer unit between the external equipment and the AC outlet. • When connecting an external instrument to the connectors marked with of the system, the external instrument and system must be connected according to the IEC60601-1-1 “Medical electrical equipment - Part 1-1: General requirements for safety - Collateral standard: Safety requirements for medical electrical systems”. Failure to follow this warning may cause electrical shock to the patient and operator. • When the system is connected to a network, electrically isolate the network components with an isolation transformer or use a wireless LAN system. Only use a hub which complies with IEC 950 Safety Information Technology Equipment.

CAUTION • Use the YS-004A9 tool set for cart assembly. • Select an installation location where patient information cannot be seen or accessed by unauthorized personnel. • Do not install the system near equipment with a high power consumption, such as large X-ray equipment. • Do not install the system where it will be exposed to water or chemical solutions. Avoid direct sprinkling, spray or moist air from the nebulizer or humidifier. These cause malfunction and shorten the life of the system. • Do not install the system near a power line, dynamo or motor which has electromagnetic induction. • Select a room with no excessive noise, vibration, sunlight, high humidity or water splashes. • Make sure that there is no influence from a cellular phone. • Select a room with a 3-prong outlet with a ground third contact. • Avoid locations where the system may receive strong electromagnetic interference and high-frequency electric interference such as radio or TV stations, cellular phones or mobile two-way radios. Otherwise, the display may flicker or the displayed waveform trace may be thicker. 1.4

Operator's Manual MEB-9400

1. GENERAL • When the external noise is too large, install the system in a shielded room. • A sudden loss of power or extreme power surge can damage data and the computer. To assure an uninterrupted power supply, use an uninterruptable power supply (UPS). • Only install the specified software in the system. Otherwise the system may malfunction. • Do not delete any files in the hard disk. The system may not start. • Be careful not to pinch your fingers between the PC unit, main unit, isolation unit, printer and cart. • Only use a cart which complies with IEC 60601-1 safety standard. Otherwise, the system components may fall off and cause injury, or the connection cable may be disconnected and cause electrical shock to the patient and operator. • When moving the system, select a flat path and move the system carefully to prevent tipping over, components falling or impact. • Do not hold the arm when moving the system. • Do not carelessly touch connectors on the system components. The system may malfunction due to electrostatic energy. Everyone who uses this system must be trained in the prevention of electrostatic discharge (ESD).

Cable Connection WARNING • When connecting the cables, make sure that all equipment is turned off. • Only use a 3-prong power cord with the system. Failure to follow this warning may cause electrical shock to the patient and operator. • Do not connect any equipment except the main unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator. • Equipotential grounding is required for electrical safety. Consult with a qualified biomedical engineer. • When connecting external equipment to this system, ensure that the external equipment complies with the IEC60601-1 safety standard for medical equipment and CISPR11 Second Edition 1990-1999 Group 1 and Class B standard, or the equivalent. When the external equipment does not comply with the IEC60601-1 safety standard, use a locally available medical use isolation transformer unit between the external equipment and the AC outlet. • When connecting an external instrument to the connectors marked of the system, the external instrument and system must be with connected according to the IEC60601-1-1 “Medical electrical equipment - Part 1-1: General requirements for safety - Collateral standard: Safety requirements for medical electrical systems”. Failure to follow this warning may cause electrical shock to the patient and operator. Operator's Manual MEB-9400

1.5

1. GENERAL Warning - continued • Connect only the specified equipment to the connector marked with by following the specified procedure. Otherwise, electrical leakage current may harm the patient and operator. • Periodically check that all cables are correctly connected to the specified connector. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION Do not disconnect the USB cable between the main unit and PC unit when the system power is on. Data of the current measurement is lost.

KD-026A Cart CAUTION • Only use the KD-026A Cart for the MEB-9200A/G/J/K EP/EMG Measuring System or MEB-9400A/K EMG/EP Measuring System with the desktop PC unit. • Do not sit or lean on the cart because it may tip over. • Do not apply over 8 kg of force on the mouse table of the KD-026A Cart. It may break and cause injury. • Do not sit or put your weight on the keyboard table. If weight is placed on the table, it may break and cause injury. • When moving the system, select a flat path and move the system carefully to prevent tipping over, components falling or impact. • When moving the cart, check the following: - Secure the printer to the cart with the belt. - Close the keyboard table by pushing it in all the way. - Release the casters and move the cart by holding handle. • When storing the system, lock the casters. • Periodically check that the caster rotates smoothly and that no screw or knob bolt is loose.

KD-019A Cart CAUTION • Only use the KD-019A Cart for the MEB-9100A/J/K EP/EMG Measuring System and MEB-9400A/K EMG/EP Measuring System. • Do not sit or lean on the cart because it may tip over. • Do not apply over 8 kg of force on the mouse table of the KD-019A Cart. It may break and cause injury. • When moving the system, select a flat path and move the system carefully to prevent tipping over, components falling or impact. 1.6

Operator's Manual MEB-9400

1. GENERAL Caution - continued • When moving the cart, check the following: - Close the LCD display - Release the casters and move the cart by holding handle. • When storing the system, lock the casters. • Periodically check that the caster rotates smoothly and that no screw or knob bolt is loose.

LCD Display WARNING Only supply AC power from the isolation unit or medical-use isolation transformer. Do not connect the display to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use EIZO FlexScan L685EX or compatible display. • The display must comply with the IEC950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard, or the equivalent. • Do not put your weight on the support arm. Otherwise the support arm may fall off. • Make sure that the stopper and free stopper are attached to the channel. Otherwise the support arm may fall off. • Secure the LCD display with the knobs on the LCD mounting bracket. Otherwise the LCD display may fall off the pivot block. Periodically check that the set screw on the pivot block is not loose.

Printer WARNING Only supply AC power from the isolation unit or medical-use isolation transformer. Do not connect the printer to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use a HP Deskjet 5850 or compatible printer. • The printer must comply with the IEC60950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard, or the equivalent. Operator's Manual MEB-9400

1.7

1. GENERAL Caution - continued • Use a USB cable which does not emit an unwanted radio frequency signal (EMC protected).

PC Unit WARNING Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Do not connect the PC unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use DELL GX270 or compatible for a desktop PC. • Only use DELL lattitudeD505 or compatible for a laptop PC. • The PC must comply with the IEC950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard or the equivalent. • Do not place anything on the PC unit or give impact to the PC unit.

Electrode Junction Box WARNING • Do not install the electrode junction box above the patient. Failure to follow this warning may cause the electrode junction box to fall off and cause serious injury to the patient. • Do not place the electrode junction box on the floor. Dirt or water may damage the electrode and it may cause electrical shock to the patient and operator.

CAUTION Hold the electrode junction box when tightening or loosening the knob or screw of the electrode junction box arm to prevent the electrode junction box falling off. When adjusting the arm, loosen the knob and screw.

1.8

Operator's Manual MEB-9400

1. GENERAL

Operation WARNING Unused connectors on the electrode junction box • During measurement, do not touch any connector that an electrode is not connected to. If an instrument that is connected to the patient is faulty, the patient and operator may get electrical shock. Using a cup containing water • Do not put a cup containing water on any component of the system. Spilt water may cause electrical shock to the patient and operator, and damage the component. Using a needle electrode • Do not use a needle electrode for electric stimulation. Failure to follow this warning injures the patient because the needle electrode is damaged by electrolyzation inside the body. • To prevent infection, discard needle electrodes after using on a contagious patient (e.g. hepatitis). Discard electrodes according to your local regulations. • To prevent infection, autoclave the needle electrodes before and after use. Applying stimulation to the patient • All stimulation (activation) must be applied under the supervision of the physician in charge. When the patient has an implanted device such as a pacemaker, electric stimulation can cause the implanted device to fail to perform its intended function. When the patient has seizure or history of seizures, visual stimulation may induce seizure activity. • For visual stimulation always prepare mouth gags, tongue depressors and gauze sponges to prevent the patient from biting his tongue or injuring himself during testing. Visual stimulation may induce seizure activity. • Do not apply photic stimulation continuously for more than 5 minutes in any mode. After applying 5 minutes of photic stimulation to the patient, wait at least 20 minutes before another photic stimulation. • When electrical stimulation is continuously performed for a long period, the felt pads and the EEG paste get dry and the electrical stimulation may cause skin burn because the dried felt pad or paste increases the skin-electrode contact impedance. Therefore, always check that the felt pads are sufficiently moistened with water and that the paste is moist. Using the SLS-3100 stimulator • Do not touch the flash lamp assembly because it gets very hot and can burn the skin. Using a contact lens electrode • Apply the contact lens electrode to the patient’s eye under dark red lighting supervised by a physician. When attaching a contact lens electrode, follow the contact lens electrode operator’s manual. Operator's Manual MEB-9400

1.9

1. GENERAL Warning - continued • Remove the contact lens electrode from the patient’s eye after approximately every 45 minutes and give the patient a 10 minute rest. If the electrode is applied for more than 45 minutes, it causes a lack of oxygen to the cornea. • When the monitored waveform is abnormal (for example, the waveform is flat or hum is overlapping), remove the contact lens electrode from the patient immediately. • Never check the skin-electrode contact impedance while using a contact lens electrode. Failure to follow this warning injures the patient’s eyes because impedance check electrical current will be applied. Using a collodion electrode • If redness, swelling, itch, or rash appears on the patient’s skin, immediately remove the collodion from the skin and perform medical treatment. • Never allow collodion/celloidin or acetone to get in the patient’s eyes. If collodion/celloidin or acetone accidentally gets in the eyes, immediately and thoroughly wash eyes with clean water and perform medical treatment immediately. • If collodion is swallowed, have the person drink water and vomit collodion. Perform medical treatment immediately. • Collodion is a volatile solvent. Both patients and medical staff must take extreme care not to inhale collodion fumes. When using collodion, make sure there is adequate ventilation. If excess collodion fumes are inhaled, have the person lie quietly and keep warm in fresh air. Perform medical treatment immediately. • Keep collodion/celloidin and acetone away from fire because they are flammable. For the electrocochleogram examination • Attach the electrodes under the supervision of a physician in charge. Using a skin surface stimulating electrode • When electrical stimulation is continuously performed for a long period, the felt pads and the EEG paste get dry and the electrical stimulation may cause skin burn because the dried felt pad or paste increases the skin-electrode contact impedance. Therefore, always check that the felt pads are sufficiently moistened with water and that the paste is moist.

CAUTION • When using the system for brain death diagnosis, before examination, check and adjust the date and time of the system. The date and time on the screen and on the recording result are important information for the medical record. 1.10

Operator's Manual MEB-9400

1. GENERAL • During measurement, do not change the date and time. This makes the order of the saved event data and the time of the saved waveforms incorrect. • Do not use the NE-224S sub-dermal straight needle electrode as a measurement electrode for the EEG or evoked potential measurement for more than one hour. When measuring the EEG or evoked potential for more than one hour, use the EEG disk electrode. • Never check the skin-electrode contact impedance while using a needle electrode. Failure to follow this caution causes electrical burn where electrodes are inserted. • Before disposing of the needle electrode, check with your local solid waste officials about proper disposal. • Do not turn the power off when any program is running. When turning the system off, follow the procedure in “Power Off Procedure” in Section 2. • Do not use the Windows remote desktop function. Otherwise, unauthorized people can remotely access this system. • Fuses cut the power off when an abnormality occurs in the systems. Solve the cause of the malfunction before replacing the fuse. Use the correct fuse only. The fuse rating is shown on the holder. • Turn off the stimulator and the MEB-9400 system power before connecting or disconnecting the stimulator for the visual evoked potential examination. • The LED goggles contain dry natural rubber. Natural rubber may cause allergic reaction with symptoms such as itching, redness, urticaria, swelling, fever, dyspnea, symptoms similar to asthma, reduced blood pressure and shock. If the patient shows any of the above symptoms, immediately stop using the LED goggles and perform appropriate medical treatment. • After touching the stimulation probe of the somato control box to the patient, start the stimulation intensity from 0 mA and increase gradually. Failure to follow this caution may apply a high 100 mA constant current to the patient. • Take care not to increase the intensity excessively. Excessive stimulation to the periphery causes pain to the patient. • Do not connect/disconnect the somato control box cord when the power of the system is on. • Do not use water to clean the somato control box because it contains electrical parts. • If the somato control box gets wet, stop use and contact your Nihon Kohden representative. • The sterilizer temperature must not exceed 70oC (158oF). The electrode(s) and accessories may deform or melt above this temperature. • Do not wipe an electrode lead or cable with alcohol. If the electrode is wiped with alcohol, the lead and cable vinyl cover will harden. • Do not use alcohol or benzine as the contact lens electrode cleaner. These solutions will deform the electrode.

Operator's Manual MEB-9400

1.11

1. GENERAL Caution - continued • Do not leave the strap type ground electrode in water or physiological salt solution. It will rust and correct measurement cannot be performed.

NOTE • When using the MEB-9400 application program, close all other programs. Otherwise, the system program may not function properly. • Turn off any screen saver before opening the MEB-9400 application program. • Periodically back up data in the system. Otherwise you may lose data if the computer crashes.

Floppy Disk/Magneto Optical Disk/CD-ROM Disk Handling and Storing

WARNING The QP-945BK System Program is protected by copyright law and international treaties. Unauthorized reproduction or distribution of this software, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under law.

CAUTION • Keep the disk away from strong magnetic objects such as a magnet, TV set or speaker. Otherwise, data in the disk may be lost. • Do not insert or remove a disk while the lamp on the disk unit is lit. • Do not touch the disk surface of the recorded side (CD-ROM: opposite side of the label side). If the surface of the disk becomes contaminated with any foreign substances such as fingerprints, reading data may be impossible. • Keep the disk away from direct sunlight and high temperature. Otherwise, the disk may become deformed. • Do not handle the disk while smoking or eating. • Do not get the disk wet. • Do not put a label on top of another label. Remove the old label before applying a new label. • Do not write on the label after the label is attached on the disk. Otherwise, the disk may be damaged and reading may be impossible. • Do not bend the disk, put heavy material on the disk, or give a strong impact to the disk. • Clean the disk with a disk cleaner. Do not use organic solvents such as acetone. • This CD–ROM is not an audio CD and cannot be played with an audio CD player.

1.12

Operator's Manual MEB-9400

1. GENERAL

Panel Descriptions Components MEB-9400 with a desktop PC LCD display (Locally purchase)

Printer (Locally purchase)

Electrode junction box Example: JB-944BK

Main unit Mouse

Keyboard PC unit

Isolation unit

MEB-9400 with a laptop PC Electrode junction box Example: JB-944BK

PC unit

Main unit

Printer (Locally purchase)

Isolation unit

Operator's Manual MEB-9400

1.13

1. GENERAL

Main Unit, DC-940B Operation Panel 3

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Functions

1. SIDE/SET key

Selects the measurement side in EMG and NCS program. Selects an examination program on the Main Menu window.

2. MENU key

Opens the Main Menu window to select the examination program.

3. PRINT key

Prints the waveforms in the preset format (Review printing). Refer to Section 8 “Printing”.

4. MUSCLE/TEST ↑↓ key

Selects the muscle name in the Muscle List dialog box in EMG program. Selects the examination program in NCS program. Selects the examination category on the Main Menu window.

5. POWER LED

Power-on indicator.

6. MONITOR key

Opens the Monitor window and starts waveform acquisition. The acquired waveforms are displayed in this window.

7. STIM/SWEEP key

Opens the Sweep window. Depending on the examination, starts stimulation and/ or acquisition of triggered waveforms. The acquired, triggered or evoked waveforms are displayed in this window.

8. ANALYSIS key

Opens the Average window and starts waveform averaging or analysis. The averaged waveform is displayed in this window. The function of this key differs according to examination programs.

9. STOP key

Opens the Stop window and stops waveform acquisition, stimulation and averaging. The latest acquired or averaged waveform(s) are displayed.

1.14

Operator's Manual MEB-9400

1. GENERAL Name

Functions

10. STORE key

Stores waveforms.

11. ERASE key

Deletes the selected waveform.

12. TIME SCALE ← → key VERTICAL RANGE ↑ ↓ key

Changes the sweep time of waveform and sensitivity of the selected waveform on the measurement. To change the sweep time, press the TIME SCALE ← or → key. To change the sensitivity, press the VERTICAL RANGE ↑ or ↓ key.

13. LAT/AMP/TRIG key

Selects the cursor type. Any one pair of cursors is available at a time. Latency cursors: Displays the two vertical cursors to measure the latency. Amplifier cursors: Displays the two horizontal cursors to measure the amplitude. Trigger cursor(s): Displays the one or two horizontal cursors for selecting the trigger level.

14. A/B key

Selects cursor A or B. Each operation changes the selection as follows; A → B→ A

15. CURSOR dial

Moves the selected cursor(s).

16. ALL/INDV key

Selects one or more waveforms. Tool buttons on a window change according to the selection. Each operation changes the selection as follows. All → Channel → Individual → All All: All waveforms in one stage or site are selected. Channel: All waveforms in one channel are selected. Individual: One individual waveform is selected.

17. SELECT ↓ ↑ key

Selects the waveforms on one stage, one channel or individual waveform.

18. WAVE dial

Moves the selected waveform(s) up or down. Use the ALL/INDV key and SELECT ↓ ↑ key to select the waveform.

19. STIM DURATION ↓ ↑ key

Selects the electric stimulation duration.

20. STIM RATE ↓ ↑ key

Selects the stimulation rate.

21. Trigger lamp

Blinks in synchronization with a trigger signal.

22. L/R key

Changes the output stimulation site in auditory/visual stimulation.

23. RESET key

Sets the stimulation intensity to zero.

Operator's Manual MEB-9400

1.15

1. GENERAL Name

Functions

24. Stimulation intensity dial

Sets the electric and auditory stimulation intensity. For pattern reversal stimulation, selects the number of checkers and stripes.

NOTE For patient safety, the combination of the stimulation rate, pulse width and intensity are limited in electric stimulation.

25. Sound volume dial

Adjusts the monitor sound volume.

26. Monitor speaker

For monitoring EMG sound.

1.16

Operator's Manual MEB-9400

1. GENERAL Right Side Panel

WARNING When connecting an external instrument to the connectors marked with of the system, the external instrument and system must be connected according to the IEC60601-1-1 “Medical electrical equipment Part 1-1: General requirements for safety - Collateral standard: Safety requirements for medical electrical systems”. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION When the cords and cables are not used or when moving the system, disconnect the cords and cables from the system.

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Name

Functions

1. SOMATO connector

Connects to the somato control box for electric stimulation.

2. AUDITORY connector

Connects to the headphones or earphones for auditory stimulation.

3. GOGGLE connector

Connects to the LED goggles for visual stimulation.

4. PATTERN connector

Connects to the CRT monitor for pattern reversal stimulation.

Operator's Manual MEB-9400

1.17

1. GENERAL Rear Panel

WARNING When connecting an external instrument to the connectors marked with of the system, the external instrument and system must be connected according to the IEC60601-1-1 “Medical electrical equipment Part 1-1: General requirements for safety - Collateral standard: Safety requirements for medical electrical systems”. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION When the cords and cables are not used or when moving the system, disconnect the cords and cables from the system.

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Name

Functions

1. External speaker connector

An external speaker can be connected here to monitor EMG sound. Use a speaker with 8Ω impedance and rating of 2W or more.

2. Junction box connector

Connects to the electrode junction box.

CAUTION When the power is turned on, do not disconnect the electrode junction box. Otherwise, the electrode junction box may be damaged.

3. TRIGGER IN/OUT connector

Inputs the trigger signal from an external stimulator or other trigger signal. Outputs the trigger signal to an external stimulator.

4. Protective earth terminal 5. USB connector

Connects to the PC unit with a USB cable.

CAUTION Do not disconnect the USB cable between the main unit and PC unit when the system power is on. Data of the current measurement is lost.

6. Equipotential ground terminal 1.18

Operator's Manual MEB-9400

1. GENERAL 7. Foot switch connector

Connects to the foot switch.

8. AC SOURCE socket

Connects to the 3-prong AC outlet on the wall to supply AC power to the main unit.

9. FUSE holder

Contains the power line protection fuses.

CAUTION Fuses cut the power off when an abnormality occurs in the systems. Solve the cause of the malfunction before replacing the fuse. Use the correct fuse only. The fuse rating is shown on the holder.

10. Power switch

Operator's Manual MEB-9400

1.19

1. GENERAL

Isolation Unit, SM-930AA/AJ/AK (option)

WARNING Connect only the specified instruments to the connectors or socket marked with , by following the specified procedure. Otherwise, electrical leakage current may harm the patient and operator.

5

1 OUTPUT AC 110 - 127 V TOTAL 750 VA MAX.

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Name

Functions

1. OUTPUT (AC outlet)

Connects the AC power cord of the PC unit, printer and display. These outlets are isolated. Maximum power supply: 750 VA.

2. Protective ground terminal

When using an MO disk drive which AC inlet does not have ground terminal, connect the material part of the MO disk drive to this terminal with the protective ground lead.

3. AC SOURCE socket

Connects the AC power cord of the isolation unit.

4. Equipotential ground terminal

Connect this terminal to the equipotential ground terminal on the wall with the ground lead when the equipotential grounding is required to ensure electrical safety.

5. BREAKER

Turns off when the output current exceeds 10 A.

1.20

Operator's Manual MEB-9400

1. GENERAL

Electrode Junction Box, JB-942BK, JB-944BK WARNING Connect only the specified equipment to the connectors marked with by following the specified procedure. Otherwise, electrical leakage current may harm the patient and operator.

JB-944BK

JB-942BK

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Name

Function

1. IMP (kΩ) key (Impedance preset key)

Selects a preset impedance (threshold) for evaluation. The selected LED indicates the selected impedance.

2. IMP TEST key (Impedance check key)

Measures skin-electrode contact impedance at the electrode junction box. Press for about one second. The check result is displayed on the screen and a green lit LED on the electrode junction box indicates an electrode impedance equal to or less than the preset value.

3. Input ON/OFF key/lamp

Turn the amplifiers on/off. When the system power is turned on, the amplifiers are turned on. The lamp lights while the amplifiers are on.

4. Electrode impedance display LED

After the skin-electrode contact impedance check, a green lit LED indicates an electrode impedance equal to or less than the preset value.

5. Electrode jack (DIN type)

Connects to the disk electrode

6. Electrode lead jack

Connects the extension cord for EMG needle electrode.

7. EXT connector

Connects the BM-911B ABR Extension Cable.

WARNING During measurement, do not touch the connector. If an instrument that is connected to the patient is faulty, the patient and operator may get electrical shock.

8. E jack (patient ground, 2-pin jack) (DIN type)

Operator's Manual MEB-9400

Connects the lead of a grounding electrode with a 2-pin plug.

1.21

1. GENERAL 9. Patient ground (1-pin jack) (DIN type)

Connects the lead of a grounding electrode with a 1-pin plug.

10. Cord hanger

Hang electrode leads and cables.

11. Needle electrode holder

Holds a needle electrode tube.

12. Electrode junction box connector

Connects to the main unit.

Foot Switch, RY-482B

1 2

Name

Functions

1. Foot switch R, L

You can assign the operation for each foot switch. Refer to “Foot Switches” (Set Conditions window → Misc Page) .

2. Main unit connector

Connects to the main unit.

1.22

Operator's Manual MEB-9400

1. GENERAL

Somato Control Box, RY-441B (option)

1

2

3

4

Name

Functions

1. Stimulation probes

Touch the stimulation probes (+ and -) to the patient to apply electrical stimulation.

2. Stimulation on/off buttons

Stimulation on/off buttons are on both sides of the somato control box. To apply single electric stimulation, press the button on either side. To apply continuous electric stimulation, press the buttons on both sides.

3. Stimulation intensity adjust buttons

The electric stimulation intensity adjust buttons are provided on both sides of the somato control box. To increase the electric stimulation intensity, press the “

” button on either side.

To decrease the electric stimulation intensity, press the “ ” button on the either side.

CAUTION After touching the stimulation probe to the patient, start the stimulation intensity from 0 mA and increase gradually. Failure to follow this caution may apply maximum of 100 mA constant current to the patient.

4. Connector

Operator's Manual MEB-9400

Connects to the main unit.

1.23

1. GENERAL

Operation Flow You may not need to do all these. Operating procedures differ according to the examination item. 1. Select the examination. (Refer to Section 4.) 2. Enter the patient and examination information. (Refer to Section 3.) 3. Check and change the measurement settings 4. Attach electrodes to the patient. 5. Check the skin-electrode contact impedance. 6. Check the acquired raw waveform(s) on the display. 7. Start stimulation or triggering. The response waveform(s) are displayed on the Sweep window. 8. Start averaging of waveforms on the Average window. 9. Stop acquisition, stimulation or averaging and manage the measured data.

1.24

Operator's Manual MEB-9400

1. GENERAL

General Functions and Windows Npk Menu

The following programs are contained in the Npk menu. To open the Npk Menu, select Npk from the Start button menu.

Properties dialog box Use to change settings: • Changing the waveform and window color • Changing the font

System Condition dialog box

Use to change measurement settings: • Changing the AC interference filter • Changing the DC input sensitivity • Changing the CRT monitor scanning method • Changing the external input/output trigger signal polarity • Changing the external input/output trigger signal pulse width • Changing the settings when creating a backup file • Changing the setting for stimulation confirmation message

File Management dialog box

Use to manage the saved patient files: • Registering the patient data file to a database • Copying patient data files from one disk to another disk • Moving patient data files from one disk to another disk • Deleting patient data files from a disk

Operator's Manual MEB-9400

1.25

1. GENERAL User Define dialog box Use to change the settings: • Changing the user name printing position • Editing the muscle name list • Editing the nerves name list • Registering items for entering the patient information and examination information • Changing tool button settings

Main Menu window

Use to select the examination program

Basic Measurement Windows Monitor Window

1.26

Operator's Manual MEB-9400

1. GENERAL Sweep Window

Average Window

Stop Window

Operator's Manual MEB-9400

1.27

1. GENERAL

Waveform Types Waveforms on Nihon Kohden neurology equipment/systems are referred to by several different names. Raw waveforms are called monitor waves. Evoked waveforms or non-evoked waveforms which exceed a trigger threshold or are triggered by stimulation are sweep waves. Averaged waveforms are referred to as averaged waves. Sweep waves or gather waves are used to create averaged waves. Gather waves are the same as sweep waves.

Monitor Waves A monitor wave is a raw waveform. You cannot add marks to a monitor wave.

Sweep Waves For evoked waveforms:

The evoked waveform for a certain period after the stimulation as saved as a sweep wave. For EMG and non-evoked waveforms: When a raw waveform exceeds a trigger threshold, the portion of the raw waveform for a set time before and after that point is saved as a sweep wave. Usually, many sweep waves are acquired and averaged.

Gather Waves A gather wave is a sweep wave. There is no difference except that gather waves are saved and can be reviewed later.

1.28

Operator's Manual MEB-9400

Section 2 Installation

Operator’s Manual MEB-9400

2C.1

Section 2-1 Installation (for MEB9400 with a Desktop PC Unit) Introduction ..................................................................................................................... 2-1.1 MEB-9400 System Composition (Example) ............................................... 2-1.1 Warnings and Cautions for Installation ........................................................................... 2-1.3 General ................................................................................................................. 2-1.3 Cable Connection ................................................................................................. 2-1.4 KD-026A Cart ....................................................................................................... 2-1.5 PC Unit ................................................................................................................. 2-1.5 LCD Display .......................................................................................................... 2-1.6 Printer ................................................................................................................... 2-1.6 Electrode Junction Box ......................................................................................... 2-1.7 System Location ............................................................................................................. 2-1.8 Setting Flow .................................................................................................................... 2-1.9 Connection Diagram ..................................................................................................... 2-1.10 Removing the Rear Cover ............................................................................................ 2-1.11 Attaching the Handle Assy .................................................................................. 2-1.11 Removing the Rear Cover .................................................................................. 2-1.11 Setting the System Components on the Cart ................................................................ 2-1.12 Setting the Isolation Unit ..................................................................................... 2-1.12 Setting the PC Unit ............................................................................................. 2-1.13 Setting the Main Unit .......................................................................................... 2-1.14 Setting the Keyboard and Mouse ........................................................................ 2-1.15 Connecting the Cables .................................................................................................. 2-1.16 Connecting the Power Cords to the Isolation Unit .............................................. 2-1.16 Connecting the PC Unit, Main Unit and Isolation Unit ......................................... 2-1.16 Connecting the Keyboard and Mouse ................................................................. 2-1.17 Connecting the Foot Switch ................................................................................ 2-1.17 Setting the LCD Display ................................................................................................ 2-1.18 Attaching the LCD Holder ................................................................................... 2-1.18 Attaching the LCD Display to the Pillar ............................................................... 2-1.18 Adjusting the Tilt ................................................................................................. 2-1.20 Connecting the Cables ....................................................................................... 2-1.20 Setting the Electrode Junction Box ............................................................................... 2-1.22 Setting the Printer ......................................................................................................... 2-1.23 Connecting the Cables ....................................................................................... 2-1.24 Operator’s Manual MEB-9400

2-1C.1

Reattaching the Rear Cover ......................................................................................... 2-1.25 Binding the Cables .............................................................................................. 2-1.25 Attaching the Rear Cover .................................................................................... 2-1.25 Attaching the Tray and Basket ............................................................................ 2-1.26

2-1C.2

Operator’s Manual MEB-9400

2. INSTALLATION

Introduction This section explains how to set the components of the MEB-9400A/K EMG/EP Measuring System with a desktop PC (hereafter referred to as the system) on the KD-026A Cart and how to connect each component.

NOTE • Use only Nihon Kohden parts and accessories to assure maximum performance from your instrument. • Before installation, check that all ordered system components and cart components are present and not damaged. If there is any damage or missing component, contact your NK distributor or representative.

MEB-9400 System Composition (Example) • DC-940BK Main Unit • CC-941BK PC Unit • SM-930AA/AJ/AK Isolation Unit • 15 inch or 18 inch LCD display (locally purchased) • JB-942BK, JB-944BK Electrode Junction Box • Printer (locally purchased)

LCD display (Locally purchase)

Printer (Locally purchase)

Electrode junction box Example: JB-944BK

Main unit Mouse

Keyboard PC unit

Isolation unit

Operator's Manual MEB-9400

2-1.1

2. INSTALLATION

The KD-026A Cart consists of: Description

Description

Q'ty

Cart

1

Mouse table

1

Handle assy

1

Dimple knob

1

Arm holder

1

LCD pillar

1

Knob

1

Busing

1

4

Support arm

1

M6×35 hexagon socket head cap screw

2

UL clamp

1

Stopper

6

Cable binder

1

Main unit holder

1

Basket

1

M4×8 pan screw with spring washer

2

Tray

1

1/8” TENSION WRENCH

1

Velcro fastener (small)

4

M6×16 hexagon socket head cap screw

5/32” TENSION WRENCH

2-1.2

Q'ty

1

Velcro fastener (large)

4

Operator's Manual MEB-9400

2. INSTALLATION

Warnings and Cautions for Installation General WARNING • Never install the system in the presence of any flammable anesthetic gas or high concentration oxygen atmosphere. Failure to follow this warning may cause explosion or fire. • Never install this system in an MRI examination room. The system may not operate properly due to high frequency magnetic noise from the MRI. • Never install the system in a high pressure oxygen medical care tank. Failure to follow this warning may cause explosion or fire. • When the system is connected to a network, electrically isolate the network components with an isolation transformer or use a wireless LAN system. Only use a hub which complies with IEC 950 Safety Information Technology Equipment.

CAUTION • Use the YS-004A9 tool set for cart assembly. • Do not install the system near equipment with a high power consumption, such as large X-ray equipment. • Do not install the system where it will be exposed to water or chemical solutions. Avoid direct sprinkling, spray or moist air from the nebulizer or humidifier. These cause malfunction and shorten the life of the system. • Do not install the system near a power line, dynamo or motor which has electromagnetic induction. • Select a room with no excessive noise, vibration, sunlight, high humidity or water splashes. • Make sure that there is no influence from a cellular phone. • Select a room with a 3-prong outlet with a ground third contact. • Avoid locations where the system may receive strong electromagnetic interference and high-frequency electric interference such as radio or TV stations, cellular phones or mobile two-way radios. Otherwise, the display may flicker or the displayed waveform trace may be thicker. • When the external noise is too large, install the system in a shielded room. • A sudden loss of power or extreme power surge can damage data and the computer. To assure an uninterrupted power supply, use an uninterruptable power supply (UPS). • Only install the specified software in the system. Otherwise the system may malfunction. • Be careful not to pinch your fingers between the PC unit, main unit, isolation unit, printer and cart. Operator's Manual MEB-9400

2-1.3

2. INSTALLATION Caution - continued • Do not carelessly touch connectors on the system components. The system may malfunction due to electrostatic energy. Everyone who uses this system must be trained in the prevention of electrostatic discharge (ESD). • Only use a cart which complies with IEC 60601-1 safety standard. Otherwise, the system components may fall off and cause injury, or the connection cable may be disconnected and cause electrical shock to the patient and operator.

Cable Connection WARNING • When connecting the cables, make sure that all equipment is turned off. • Only use a 3-prong power cord with the system. Failure to follow this warning may cause electrical shock to the patient and operator. • Do not connect any equipment except the main unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator. • Equipotential grounding is required for electrical safety. Consult with a qualified biomedical engineer. • When connecting external equipment to this system, ensure that the external equipment complies with the IEC60601-1 safety standard for medical equipment and CISPR11 Second Edition 1990-1999 Group 1 and Class B standard, or the equivalent. When the external equipment does not comply with the IEC60601-1 safety standard, use a locally available medical use isolation transformer unit between the external equipment and the AC outlet. • When connecting an external instrument to the connectors marked with of the system, the external instrument and system must be connected according to the IEC60601-1-1 “Medical electrical equipment - Part 1-1: General requirements for safety - Collateral standard: Safety requirements for medical electrical systems”. Failure to follow this warning may cause electrical shock to the patient and operator. • Connect only the specified equipment to the connector marked with by following the specified procedure. Otherwise, electrical leakage current may harm the patient and operator. • Periodically check that all cables are correctly connected to the specified connector. Failure to follow this warning may cause electrical shock to the patient and operator.

2-1.4

Operator's Manual MEB-9400

2. INSTALLATION

CAUTION Do not disconnect the USB cable between the main unit and PC unit when the system power is on. Data of the current measurement is lost.

KD-026A Cart CAUTION • Only use the KD-026A Cart for the MEB-9200A/G/J/K EP/EMG Measuring System or MEB-9400A/K EMG/EP Measuring System with the desktop PC unit. • Do not sit or lean on the cart because it may tip over. • Do not apply over 8 kg of force on the mouse table of the KD-026A Cart. It may break and cause injury. • Do not sit or put your weight on the keyboard table. If weight is placed on the table, it may break and cause injury. • When moving the system, select a flat path and move the system carefully to prevent tipping over, components falling or impact. • When moving the cart, check the following: - Secure the printer to the cart with the belt. - Close the keyboard table by pushing it in all the way. - Release the casters and move the cart by holding handle. • When storing the system, lock the casters. • Periodically check that the caster rotates smoothly and that no screw or knob bolt is loose.

PC Unit WARNING Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Do not connect the PC unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use DELL GX270 or compatible for a desktop PC. • The PC must comply with the IEC950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard or the equivalent. • Do not place anything on the PC unit or give impact to the PC unit.

Operator's Manual MEB-9400

2-1.5

2. INSTALLATION

LCD Display WARNING Only supply AC power from the isolation unit or medical-use isolation transformer. Do not connect the display to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use EIZO FlexScan L685EX or compatible display. • The display must comply with the IEC950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard, or the equivalent. • Do not put your weight on the support arm. Otherwise the support arm may fall off. • Make sure that the stopper and free stopper are attached to the channel. Otherwise the support arm may fall off. • Secure the LCD display with the knobs on the LCD mounting bracket. Otherwise the LCD display may fall off the pivot block. Periodically check that the set screw on the pivot block is not loose.

Printer WARNING Only supply AC power from the isolation unit or medical-use isolation transformer. Do not connect the printer to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use a HP Deskjet 5850 or compatible printer. • The printer must comply with the IEC60950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard, or the equivalent. • Use a USB cable which does not emit an unwanted radio frequency signal (EMC protected).

2-1.6

Operator's Manual MEB-9400

2. INSTALLATION

Electrode Junction Box WARNING • Do not install the electrode junction box above the patient. Failure to follow this warning may cause the electrode junction box to fall off and cause serious injury to the patient. • Do not place the electrode junction box on the floor. Dirt or water may damage the electrode and it may cause electrical shock to the patient and operator.

CAUTION Hold the electrode junction box when tightening or loosening the knob or screw of the electrode junction box arm to prevent the electrode junction box falling off. When adjusting the arm, loosen the knob and screw.

Operator's Manual MEB-9400

2-1.7

2. INSTALLATION

System Location The system measures very small electrical potential changes like evoked potentials (0.5 to 10 µV). Ideally the system should be installed in a shielded room which provides constant environmental conditions. Select the examination locations as follows and also refer to “GENERAL HANDLING PRECAUTIONS” and “Warnings and Cautions for Installation” in this section.

NOTE • Install the system where the screen can be seen clearly and does not reflect light. • Do not expose the system to direct sunlight. • Make sure that there is enough space between the system and the wall for adequate ventilation. Leave more than 5 cm of space between the wall and vent hole on the rear panel of the system. Otherwise the internal temperature of the system rises, which leads to inaccurate operation and shortens the system life. • Do not place blankets or cloth over the system. • Do not install the system in a dusty area. • Connect the power cable to an AC outlet which can supply enough AC current to the system. The system cannot function properly with low current. • Arrange the system and other equipment so that the radiation noise caused by other equipment with a CRT display is reduced as much as possible. • For warnings and cautions, installation, and operation of the PC unit, LCD display and printer, refer to the operator’s manual of each device. For external instrument connection and local area network connection, refer to “General Requirements for Connecting Medical Electrical Systems” in this section.

2-1.8

Operator's Manual MEB-9400

2. INSTALLATION

Setting Flow 1. Removing the rear cover 2. Setting the system components on the cart 1) Isolation unit 2) PC unit 3) Main unit 4) Keyboard and mouse 3. Connecting the Cables 1) Isolation unit 2) PC unit 3) Keyboard and mouse 4) Foot switch 4. Setting the LCD display 5. Setting the electrode junction box 6. Setting the printer 7. Reattaching the rear cover 1) Binding the cables 2) Attaching the rear cover 3) Attaching the tray and basket

Operator's Manual MEB-9400

2-1.9

2. INSTALLATION

Connection Diagram The shapes of the connection cable, connector, AC power cord differ according to the model.

LCD display (locally purchase)

Printer (locally purchase)

Main unit To AC outlet

To equipotential ground terminal PC unit

Electrode junction box Example: JB-944BK Mouse

Foot switch

To equipotential ground terminal

Keyboard

2-1.10

Isolation unit

To AC outlet

Operator's Manual MEB-9400

2. INSTALLATION

Removing the Rear Cover Attaching the Handle Assy CAUTION Use the YS-004A9 tool set for cart assembly.

M6×16 hexagon socket head cap screw

Handle assy Arm holder

1. Attach the handle assy to the top rack and secure it with the two M6×16 hexagon socket head cap screws at the left side of the top rack.

Knob

2. Secure the handle assy and arm holder with the two M6×35 hexagon socket head cap screws at the right side of the top rack. 3. Attach the knob to the arm holder.

Top rack

M6×35 hexagon socket head cap screw

Removing the Rear Cover 1. Remove the five M4 pan screws with spring washers and washers. Keep the screws for the assembly. 2. The rear cover is hooked on the rear of the top rack. Remove the rear cover by pulling it toward you, then pulling it down.

Hook

Rear cover

Operator's Manual MEB-9400

2-1.11

2. INSTALLATION

Setting the System Components on the Cart Setting the Isolation Unit CAUTION Be careful not to pinch your fingers between the isolation unit and base plate.

To set the Nihon Kohden isolation unit, the DI-941B bracket is required. The DI-941B bracket consists of a base plate, two end plates, two stoppers and two rubber sticks. 1. Secure the stoppers to the base plate with two PS3 screws.

2. Attach the two rubber sticks to the base plate.

3. Put the base plate on the cart so that the stoppers go into the holes on the cart.

2-1.12

Operator's Manual MEB-9400

2. INSTALLATION 4. Insert the end plates between the base plate and the cart at the front and back and secure them with four PS3 screws.

5. Put the isolation unit onto the base plate so that the four rubber feet fit into the holes.

Setting the PC Unit CAUTION PC unit

Be careful not to pinch your fingers between the PC unit and middle rack.

Stopper

1. Put the PC unit onto the middle rack and check the position of the PC unit. 2. Clean the middle rack with a cotton moistened with alcohol where the four stoppers will be attached. 3. Remove the backing paper from the stoppers. Middle rack

Operator's Manual MEB-9400

4. Attach the four stoppers as shown left to secure the PC unit. 2-1.13

2. INSTALLATION

Setting the Main Unit M4 screw with spring washer and washer

M4×8 pan screw with spring washer

Printer table

1. Remove the four M4 screws with spring washers and washers which secure the printer table to the top rack. Keep the screws for the assembly.

2. Attach the main unit holder to the bottom of the main unit and secure the main unit holder with the two M4×8 pan screws with spring washers.

Main unit holder

Hook

3. Put the main unit onto the top rack so that the two hooks of the main unit holder are inserted into the slot on the top rack.

Slot

NOTE Attach the printer table after cable connection is complete.

2-1.14

Operator's Manual MEB-9400

2. INSTALLATION

Setting the Keyboard and Mouse Stopper

1. Clean the keyboard table with a cotton moistened with alcohol where the two stoppers will be attached. 2. Put the keyboard on the keyboard table so that the front of the keyboard touches the stopper at the front of the keyboard table.

CAUTION Stopper

Use this keyboard table for the keyboard only. Do not sit or put your weight on the table. If weight is placed on the table, it may break and cause injury.

3. Remove the backing paper from the stopper and attach two stoppers to the keyboard table as shown left.

Dimple knob

4. Attach the mouse table to the top rack and secure the mouse table with the dimple knob. The mouse table can be attached to either the left or right side of the top rack.

Mouse table

5. Put the mouse on the table.

Operator's Manual MEB-9400

2-1.15

2. INSTALLATION

Connecting the Cables When connecting external equipment to the system, refer to the operator’s manual of the external equipment.

Connecting the Power Cords to the Isolation Unit

WARNING Do not connect any equipment except the main unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

Connecting the PC Unit, Main Unit and Isolation Unit

The connector positions and symbols of the PC unit differ according to model. Refer to the operator’s manual of the PC unit.

WARNING USB cable

Do not connect the PC unit to a wall AC outlet. Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Failure to follow this warning may cause electrical shock to the patient and operator. Ferrite core

CAUTION Main unit rear panel

Do not disconnect the USB cable between the main unit and PC unit when the system power is on. Data of the current measurement is lost.

USB connector

Isolation unit rear panel OUTPUT AC 110 - 127 V TOTAL 750 VA MAX.

1. Connect the USB cable to the USB connector on the rear of the PC unit. 2. Attach the ferrite core to the USB cable. 3. Connect the other side of the USB cable to the USB connector on the rear panel of the main unit. 4. Connect the power cord provided with the PC unit to the AC power socket on the rear panel of the PC unit.

3-prong AC outlets

2-1.16

5. Connect the other side of the cord to the 3-prong AC outlet on the rear panel of the isolation unit. Operator's Manual MEB-9400

2. INSTALLATION 6. Attach the earth block and protective earth cable to the serial connector of the PC unit and secure the earth block and protective earth cable with the provided screws (included in MEB-9400 standard accessories) 7. Connect the other side of the protective earth cable to the protective earth terminal of the main unit.

Serial connector

Connecting the Keyboard and Mouse

1. Connect the keyboard cable to the keyboard connector (Mini DIN 6 pins, lower) on the rear panel of the PC unit. 2. Connect the mouse cable to the mouse connector (Mini DIN 6 pins, upper) on the rear panel of the PC unit and place it near the operation panel.

Connecting the Foot Switch Main unit rear panel

Operator's Manual MEB-9400

Foot switch connector

Connect the foot switch cable to the foot switch connector on the rear panel of the main unit.

2-1.17

2. INSTALLATION

Setting the LCD Display Attaching the LCD Holder

The LCD holder and LCD cord holders are provided as standard accessories of the MEB-9400 EMG/EP Measuring System. 1. Remove the stand from the LCD display.

LCD holder

2. Attach the LCD holder to the LCD display and temporarily secure the LCD holder.

NOTE Make sure not to damage the LCD screen. Stand

Attaching the LCD Display to the Pillar CAUTION

Pillar Cable opening

Bushing M6×16 hexagon socket head cap screw

• Make sure that the stopper and free stopper are attached to the channel. Otherwise the support arm may fall off. • Secure the LCD display with the knobs on the LCD mounting bracket. Otherwise the LCD display may fall off the pivot block. Periodically check that the set screw on the pivot block is not loose. • Do not put your weight on the support arm. Otherwise the support arm may fall off.

1. Insert the pillar into the frame and secure it with the two M6×16 hexagon socket head cap screws, then attach the busing to the bolt hole.

Frame

2-1.18

Operator's Manual MEB-9400

2. INSTALLATION LCD mounting bracket Pivot block

2. Remove the M3 pan screw with spring washer from the stopper and remove the stopper. 3. Insert the pivot block into the channel on the pillar.

Support arm

Stopper

Channel

4. Attach the stopper to the channel and secure the stopper with the M3 pan screw with spring washer.

Free stopper M3 pan screw with spring washer

Use the 1/8” TENSION WRENCH to secure the pivot block.

1/8" TENSION WRENCH

5. Check that the set screw on the free stopper is not loose, otherwise the support arm may fall off

LCD holder

6. Hook the LCD display on the cutout of the LCD mounting bracket and secure the LCD holder with the two knobs on the bracket.

Cutout on the mounting bracket

Knob

7. Adjust the LCD display attaching position so that the LCD display is flush-mount and tighten the lower two M4×12 pan screws with washers.

Knob

M4×12 pan screw with washer

Operator's Manual MEB-9400

2-1.19

2. INSTALLATION

Adjusting the Tilt

The tilt of the LCD display can be adjusted. 1. Loosen the adjustment lever by turning it counterclockwise.

5/32" TENSION WRENCH

2. Hold the top and bottom of the LCD display and tilt it to the desired angle.

Adjustment lever

3. Tighten the adjustment lever. If the LCD display is excessively tilted, use the 5/32” TENSION WRENCH to adjust the overall tilt tension. If the adjustment lever cannot be turned, 1) Pull up the adjustment lever. 2) Turn the adjustment lever 180° in the opposite direction. 3) Attach the adjustment lever.

Example: Loosening the adjustment lever

Connecting the Cables

1. Loosen the two knobs which secure the LCD display to the LCD mounting bracket and remove the LCD display from the support arm. 2. Tighten the upper two M4×12 pan screws with washers which secures the LCD holder to the LCD display. 3. Remove the lower upper two M4×12 pan screws with washers. 4. Connect the LCD display cable to the LCD display. 5. Connect the power cord to the LCD display.

Power cord

LCD display cable

Swivel tension bolt

6. Adjust the swivel tension. The LCD display can swivel at the end of the arm. To rotate the LCD display, simply push its corner. To adjust the swivel tension, remove the cap which is located under the front end of the arm and use a 1/2” (13 mm) socket driver to tighten or loosen the swivel tension volt.

1/2" (13 mm) socket driver

2-1.20

Operator's Manual MEB-9400

2. INSTALLATION Cable cover

7. Put the LCD display cable and power cord in the cable cover.

LCD display cable Power cord

8. Connect the LCD display cable to the video connector (D-SUB 15 pins) on the rear panel of the PC unit and secure it with the two jackscrews. Run the cable through the opening for the cables of the top rack.

Isolation unit rear panel OUTPUT AC 110 - 127 V TOTAL 750 VA MAX.

9. Connect the other side of the power cord to the 3-prong AC outlet on the rear panel of the isolation unit. Run the power cord through the opening for the cables of the top rack.

WARNING

3-prong AC outlets

Operator's Manual MEB-9400

Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Do not connect the LCD display to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

2-1.21

2. INSTALLATION

Setting the Electrode Junction Box Example: JB-944BK

1. Attach the electrode junction box to the bracket of the electrode junction box arm and secure the electrode junction box with the two M4×8 pan screws with washer and spring washers.

2. Put the electrode junction box cable in the cable guide.

3. Insert the electrode junction box arm into the arm holder and secure the arm with the knob.

Main unit rear panel JUNCTION BOX connector

2-1.22

4. Connect the electrode junction box cable to the JUNCTION BOX connector on the rear panel of the main unit by pushing the two connector locks. The cable runs through the cable opening on the top rack and cutout of the rear cover.

Operator's Manual MEB-9400

2. INSTALLATION

Setting the Printer

CAUTION Be careful not to pinch your fingers between the printer and cart.

1. Turn the support arm so that the printer can be easily mounted.

Cutout

Printer table

2. Run the power cable and USB cable of the printer, and the power cable and LCD display cable of the LCD display through the cutout of the printer table. 3. Attach the printer table to the top rack and secure the printer table with the four M4 screws with spring washers and washers.

Cable opening

Velcro fastener (small)

Printer (bottom)

4. Stick together the small and large parts of the four pairs of velcro fasteners. Do not remove the backing paper from the velcro fasteners yet. 5. Clean the bottom of the printer and printer table with a cotton moistened with alcohol where the velcro fasteners will be attached. 6. Remove the backing papers from the small part of the velcro fasteners.

Velcro fastener (large)

Width of the printer table

7. Attach the velcro fasteners to the bottom of the printer so that the large part of the velcro fasteners can be attached to the printer table. 8. Put the printer on the printer table and check that the velcro fasteners are positioned so that the printer can be attached to the printer table. 9. Remove the printer from the printer table and remove the backing paper from the large part of the four velcro fasteners.

Operator's Manual MEB-9400

2-1.23

2. INSTALLATION 10. Set the printer on the printer table. 11. Push the printer down to securely attach it to the velcro fasteners. 12. Check that the printer is not easily removed from the printer table. Printer table

Connecting the Cables USB connector

Parallel port connector

1. Connect the USB cable provided with the printer to the USB connector of the printer. Refer to the operator’s manual of the printer. 2. Connect the other side of the USB cable to the USB connector on the rear of the PC unit. 3. Connect the power cord provided with the printer to the AC power socket on the rear of the printer.

AC power socket

4. Connect the other side of the power cord to the 3-prong AC outlet on the rear panel of the isolation unit. For the printer preparation, refer to the operator’s manual for the printer.

WARNING Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Do not connect the printer to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION

Belt

Use a USB cable which does not emit an unwanted radio frequency signal (EMC protected).

5. Attach the UL clamp to the printer table and bind the USB cable and power cord with the UL clamp. 6. Secure the printer with the belt. UL clamp

CAUTION Power cord

2-1.24

USB cable

When moving the cart, check the following: - Secure the printer to the cart with the belt. - Close the keyboard table by pushing it in all the way. Operator's Manual MEB-9400

2. INSTALLATION

Reattaching the Rear Cover Binding the Cables

1. Bind the electrode junction cable with the cable binder.

Cable binder

Cable holder

2. Bind the following cables with the cable holders • Mouse cable • keyboard cable • Power cord

NOTE Make sure that the mouse cable and keyboard cable do not catch on the keyboard table when it is pulled in or out.

Electrode junction box cable

Mouse cable

Power cord

3. Bind the other cables so that they do not drag when the cart is moved.

Keyboard cable

Attaching the Rear Cover

1. Check that all system components are correctly connected to each other. 2. Connect the AC power cord to the AC SOURCE socket on the isolation unit. When equipotential grounding is required, connect the ground lead to the equipotential ground terminal on the rear of the isolation unit.

Hook

3. Run the AC power cord and ground lead through the cable opening in the rear cover. 4. Hook the rear cover to the top rack. 5. Run the electrode junction box cable through the cutout of the rear cover. 6. Secure the rear cover with the five M4 pan screw with spring washer and washer.

Operator's Manual MEB-9400

2-1.25

2. INSTALLATION

Attaching the Tray and Basket

Hook the tray and basket on the adapters on the frame.

Tray

Basket

2-1.26

Operator's Manual MEB-9400

Section 2-2 Installation (for MEB9400 with a Laptop PC Unit) Introduction ..................................................................................................................... 2-2.1 MEB-9400 with a laptop PC System Composition (Example) .................... 2-2.1 Warnings and Cautions for Installation ........................................................................... 2-2.3 General ................................................................................................................. 2-2.3 Cable Connection ................................................................................................. 2-2.4 KD-019A Cart ....................................................................................................... 2-2.5 PC Unit ................................................................................................................. 2-2.5 Printer ................................................................................................................... 2-2.6 Electrode Junction Box ......................................................................................... 2-2.6 System Location ............................................................................................................. 2-2.7 Setting Flow .................................................................................................................... 2-2.8 Connection Diagram ....................................................................................................... 2-2.9 Assembling the Cart ..................................................................................................... 2-2.10 Attaching the Handle Assy and Connector Guard .............................................. 2-2.10 Attaching the Tray and Basket ............................................................................ 2-2.10 Setting the System Components on the Cart ................................................................ 2-2.11 Removing the Rear Cover .................................................................................. 2-2.11 Setting the Main Unit .......................................................................................... 2-2.11 Setting the PC Unit ............................................................................................. 2-2.12 Setting the Isolation Unit ..................................................................................... 2-2.13 Setting the Printer ............................................................................................... 2-2.14 Connecting the Cables .................................................................................................. 2-2.15 Connecting the Power Cords to the Isolation Unit .............................................. 2-2.15 Connecting the PC Unit, Main Unit and Isolation Unit ......................................... 2-2.15 Connecting the Printer ........................................................................................ 2-2.16 Connecting the Mouse ........................................................................................ 2-2.17 Connecting the Foot Switch ................................................................................ 2-2.17 Setting the Electrode Junction Box ............................................................................... 2-2.18 Reattaching the Rear Cover ......................................................................................... 2-2.19

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2-2C.1

2. INSTALLATION

Introduction This section explains how to set the components of the MEB-9400A/K EMG/EP Measuring System with a laptop PC (hereafter referred to as the system) on the KD-019A Cart and how to connect each component.

NOTE • Use only Nihon Kohden parts and accessories to assure maximum performance from your instrument. • Before installation, check that all ordered system components and cart components are present and not damaged. If there is any damage or missing component, contact your NK distributor or representative.

MEB-9400 with a laptop PC System Composition (Example) • DC-940BK Main Unit • CC-942BK PC Unit • SM-930AA/AJ/AK Isolation Unit • JB-942BK, JB-944BK Electrode Junction Box • Printer (locally purchased)

Electrode junction box Example: JB-944BK

PC unit

Main unit

Printer (Locally purchase)

Isolation unit

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2-2.1

2. INSTALLATION

The KD-019A Cart consists of:

Description Cart Basket Tray 3 Handle assy Hexagon socket head cap screw, M6 × 16 Velcro fastener, large, for printer Velcro fastener, small, for printer Connector guard Pan head screw with spring washer, M4 × 10

2-2.2

Q’ty 1 1 1 1 4 4 4 2 4

Operator's Manual MEB-9400

2. INSTALLATION

Warnings and Cautions for Installation General WARNING • Never install the system in the presence of any flammable anesthetic gas or high concentration oxygen atmosphere. Failure to follow this warning may cause explosion or fire. • Never install this system in an MRI examination room. The system may not operate properly due to high frequency magnetic noise from the MRI. • Never install the system in a high pressure oxygen medical care tank. Failure to follow this warning may cause explosion or fire. • When the system is connected to a network, electrically isolate the network components with an isolation transformer or use a wireless LAN system. Only use a hub which complies with IEC 950 Safety Information Technology Equipment.

CAUTION • Use the YS-004A9 tool set for cart assembly. • Do not install the system near equipment with a high power consumption, such as large X-ray equipment. • Do not install the system where it will be exposed to water or chemical solutions. Avoid direct sprinkling, spray or moist air from the nebulizer or humidifier. These cause malfunction and shorten the life of the system. • Do not install the system near a power line, dynamo or motor which has electromagnetic induction. • Select a room with no excessive noise, vibration, sunlight, high humidity or water splashes. • Make sure that there is no influence from a cellular phone. • Select a room with a 3-prong outlet with a ground third contact. • Avoid locations where the system may receive strong electromagnetic interference and high-frequency electric interference such as radio or TV stations, cellular phones or mobile two-way radios. Otherwise, the display may flicker or the displayed waveform trace may be thicker. • When the external noise is too large, install the system in a shielded room. • A sudden loss of power or extreme power surge can damage data and the computer. To assure an uninterrupted power supply, use an uninterruptable power supply (UPS). • Only install the specified software in the system. Otherwise the system may malfunction. • Be careful not to pinch your fingers between the PC unit, main unit, isolation unit, printer and cart. Operator's Manual MEB-9400

2-2.3

2. INSTALLATION Caution - continued • Do not carelessly touch connectors on the system components. The system may malfunction due to electrostatic energy. Everyone who uses this system must be trained in the prevention of electrostatic discharge (ESD). • Only use a cart which complies with IEC 60601-1 safety standard. Otherwise, the system components may fall off and cause injury, or the connection cable may be disconnected and cause electrical shock to the patient and operator.

Cable Connection WARNING • When connecting the cables, make sure that all equipment is turned off. • Only use the 3-prong power cord with the system. Failure to follow this warning may cause electrical shock to the patient and operator. • Do not connect any equipment except the main unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator. • Equipotential grounding is required for electrical safety. Consult with a qualified biomedical engineer. • When connecting external equipment to this system, ensure that the external equipment complies with the IEC60601-1 safety standard for medical equipment and CISPR11 Second Edition 1990-1999 Group 1 and Class B standard, or the equivalent. When the external equipment does not comply with the IEC60601-1 safety standard, use a locally available medical use isolation transformer unit between the external equipment and the AC outlet. • When connecting an external instrument to the connectors marked with of the system, the external instrument and system must be connected according to the IEC60601-1-1 “Medical electrical equipment - Part 1-1: General requirements for safety - Collateral standard: Safety requirements for medical electrical systems”. Failure to follow this warning may cause electrical shock to the patient and operator. • Periodically check that all cables are correctly connected to the specified connector. Failure to follow this warning may cause electrical shock to the patient and operator. • Connect only the specified equipment to the connector marked with by following the specified procedure. Otherwise, electrical leakage current may harm the patient and operator.

2-2.4

Operator's Manual MEB-9400

2. INSTALLATION

CAUTION Do not disconnect the USB cable between the main unit and PC unit when the system power is on. Data of the current measurement is lost.

KD-019A Cart CAUTION • Only use the KD-019A Cart for the MEB-9100A/J/K EP/EMG Measuring System and MEB-9400A/K EMG/EP Measuring System. • Do not sit or lean on the cart because it may tip over. • Do not apply over 8 kg of force on the mouse table of the KD-019A Cart. It may break and cause injury. • When moving the system, select a flat path and move the system carefully to prevent tipping over, components falling or impact. • When moving the cart, check the following: - Close the LCD display - Release the casters and move the cart by holding handle. • When storing the system, lock the casters. • Periodically check that the caster rotates smoothly and that no screw or knob bolt is loose.

PC Unit WARNING Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Do not connect the PC unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use DELL lattitudeD505 or compatible for a laptop PC. • The PC must comply with the IEC950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard or the equivalent. • Do not place anything on the PC unit or give impact to the PC unit.

Operator's Manual MEB-9400

2-2.5

2. INSTALLATION

Printer WARNING Only supply AC power from the isolation unit or medical-use isolation transformer. Do not connect the printer to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION • Only use a HP Deskjet 5850 or compatible printer. • The printer must comply with the IEC60950 standard and CISPR11 Second Edition 1990-09 Group 1 and Class B standard, or the equivalent. • Use a USB cable which does not emit an unwanted radio frequency signal (EMC protected).

Electrode Junction Box WARNING • Do not install the electrode junction box above the patient. Failure to follow this warning may cause the electrode junction box to fall off and cause serious injury to the patient. • Do not place the electrode junction box on the floor. Dirt or water may damage the electrode and it may cause electrical shock to the patient and operator.

CAUTION Hold the electrode junction box when tightening or loosening the knob or screw of the electrode junction box arm to prevent the electrode junction box falling off. When adjusting the arm, loosen the knob and screw.

2-2.6

Operator's Manual MEB-9400

2. INSTALLATION

System Location The system measures very small electrical potential changes like evoked potentials (0.5 to 10 µV). Ideally the system should be installed in a shielded room with constant environmental conditions. Select the examination location as follows and also refer to “GENERAL HANDLING PRECAUTIONS” and “Warnings and Cautions for Installation” in this section.

NOTE • Install the system where the screen can be seen clearly and does not reflect light. • Do not expose the system to direct sunlight. • Make sure that there is enough space between the system and the wall for adequate ventilation. Leave more than 5 cm of space between the wall and vent hole on the rear panel of the system. Otherwise the internal temperature of the system rises, which leads to inaccurate operation and shortens the system life. • Do not place blankets or cloth over the system. • Do not install the system in a dusty area. • Connect the power cable to an AC outlet which can supply enough AC current to the system. The system cannot function properly with low current. • Arrange the system and other equipment so that the radiation noise caused by other equipment with a CRT display is reduced as much as possible. • For warnings and cautions, installation, and operation of the PC unit and printer, refer to the operator’s manual of each device. For external instrument connection and local area network connection, refer to “General Requirements for Connecting Medical Electrical Systems” in this section.

Operator's Manual MEB-9400

2-2.7

2. INSTALLATION

Setting Flow 1. Assembling the cart 1) Attaching the handle assy 2) Attaching the connector guard 3) Attaching the tray and basket 2. Setting the system components on the cart 1) Removing the rear cover 2) Main unit 3) PC unit 4) Isolation unit 5) Printer 3. Connecting the Cables 1) Isolation unit 2) PC unit 3) Printer 4) Mouse 5) Foot switch 6) Electrode junction box 4. Reattaching the rear cover

2-2.8

Operator's Manual MEB-9400

2. INSTALLATION

Connection Diagram The shapes of the connection cable, connector, AC power cord differ according to the model.

PC unit - rear

Main unit To AC outlet

To equipotential ground terminal

Electrode junction box Example: JB-944BK

Printer (locally purchase) Foot switch

To equipotential ground terminal

Isolation unit

Operator's Manual MEB-9400

To AC outlet

2-2.9

2. INSTALLATION

Assembling the Cart Attaching the Handle Assy and Connector Guard

CAUTION Use the YS-004A9 tool set for cart assembly.

M6×16 hexagon socket head cap screws

1. Attach the handle assy to the top rack of the cart and secure it with four M6×16 hexagon socket head cap screws.

Handle assy

2. Insert the connector guard into the hole on the side of the top rack and secure the connector guard with the two M4×10 pan head screws with the washer.

Connector guard

Attaching the Tray and Basket Tray

Hook the tray and basket on the adapter on the cart. The water cup, electrodes, extension cables and headphone can be contained in the tray. The foot switch can be stored in the drawing tray under the cart. The tray and the basket can be attached to the rear cover.

Basket

Adapter

2-2.10

Operator's Manual MEB-9400

2. INSTALLATION

Setting the System Components on the Cart Remove the four screws and remove the rear cover from the cart.

Removing the Rear Cover

Rear cover

1. Place the main unit on the top rack of the cart and slide the main unit so that the hook is inserted into the adapter on the bottom of the main unit.

Setting the Main Unit Hook

Main unit

2. Pull out the mouse table. 3. Secure the main unit with the two knob bolts.

CAUTION Take care not to pinch your finger with the mouse table. Knob bolt

Mouse table

Operator's Manual MEB-9400

2-2.11

2. INSTALLATION

Setting the PC Unit

CAUTION Do not apply a lot of force when attaching the PC unit to the main unit.

A pair of velcro fasteners stick to each other with 3 kg force. PC unit

1. Clean the bottom of the PC unit with a cotton moistened with alcohol where the four velcro fasteners will be attached. One velcro fasteners for each

2. Attach the small and large parts of the four pairs of velcro fasteners provided with the MEB-9400. 3. Remove the backing papers from the large part of the velcro fasteners and attach the four pairs of velcro fasteners to the top panel of the main unit. 4. Remove the backing papers from the small part of the velcro fasteners.

Two velcro fasteners for each

5. Set the PC unit on the top panel of the main unit and push it down to securely attach it to the velcro fasteners. 6. Check that the PC unit is not easily removed from the main unit.

2-2.12

Operator's Manual MEB-9400

2. INSTALLATION

Setting the Isolation Unit CAUTION Be careful not to pinch your fingers between the isolation unit and base plate.

To set the Nihon Kohden isolation unit, the DI-941B bracket is required. The DI-941B bracket consists of a base plate, two end plates, two stoppers and two rubber sticks. 1. Attach the rubber sticks to the base plate.

2. Remove the two knob bolts from the middle rack of the cart and put the base plate of the DI-941B bracket on the base rack.

3. Insert the end plates between the base plate and the cart at the front and back. Secure them with four PS3 screws.

Operator's Manual MEB-9400

2-2.13

2. INSTALLATION 4. Put the isolation unit onto the base rack so that the four rubber feet fit into the holes.

Setting the Printer 1. Attach the four small velcro fasteners to each large velcro fastener. For the following steps, do not separate the two halves of the velcro fasteners.

Velcro fastener (large) Printer (bottom)

2. Clean the bottom of the printer and printer table with a cotton moistened with alcohol where the four small velcro fasteners will be attached.

Velcro fastener (small)

3. Remove the backing papers from the small velcro fasteners. 4. Attach the four small velcro fasteners to the bottom of the printer so that the four large velcro fasteners can be attached to the printer table. Width of the printer table

Printer (example)

5. Put the printer on the printer table and check that the positions of the four large velcro fasteners can be attached to the printer table. 6. Remove the printer from the printer table and remove the backing paper from the four large velcro fasteners. 7. Set the printer on the printer table and push it down to securely attach it.

CAUTION Printer table

Be careful not to pinch your fingers between the printer and cart.

8. Check that the printer is not easily removed from the printer table. 2-2.14

Operator's Manual MEB-9400

2. INSTALLATION

Connecting the Cables When connecting external equipment to the system, refer to the operator’s manual of the external equipment.

Connecting the Power Cords to the Isolation Unit

WARNING Do not connect any equipment except the main unit to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

Connecting the PC Unit, Main Unit and Isolation Unit

The connector positions and symbols of the PC unit differ according to the models. Refer to the operator’s manual of the PC unit.

WARNING Do not connect the PC unit to a wall AC outlet. Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Failure to follow this warning may cause electrical shock to the patient and operator.

USB cable

Ferrite core

CAUTION Do not disconnect the USB cable between the main unit and PC unit when the system power is on. Data of the current measurement is lost.

Main unit rear panel

USB connector

To PC unit

1. Connect the USB cable to the USB connector on the rear of the PC unit. 2. Connect the ferrite core to the USB cable. 3. Connect the other side of the USB cable to the USB connector on the rear panel of the main unit.

AC adapter

Shelf

Operator's Manual MEB-9400

4. Connect the output plug of the AC adapter provided with the PC unit to the DC power connector on the rear of the PC unit. 5. Attach the AC adapter to the shelf and secure the AC adapter with two pairs of small velcro fasteners. 2-2.15

2. INSTALLATION Isolation unit rear panel OUTPUT AC 110 - 127 V TOTAL 750 VA MAX.

6. Connect the AC plug of the AC adapter to the 3-prong AC outlet on the rear panel of the isolation unit.

3-prong AC outlets

Serial connector

If the AC adapter of the PC has a 2-prong AC plug, do steps 7 and 8. 7. Attach the earthblock and protective earth cable to the serial connector of the PC unit and secure the earthblock and protective earth cable with the provided screws (MEB-9400 standard accessories). 8. Connect the other side of the protective earth cable to the protective earth terminal of the main unit.

Connecting the Printer WARNING Only supply AC power from a 3-prong AC outlet on the rear panel of the isolation unit. Do not connect the printer to a wall AC outlet. Failure to follow this warning may cause electrical shock to the patient and operator.

CAUTION Printer (example) USB connector

Parallel port connector

AC power socket

Use a USB cable which does not emit an unwanted radio frequency signal (EMC protected).

1. Connect the USB cable provided with the printer to the USB connector of the printer. Refer to the operator’s manual of the printer. 2. Connect the other side of the USB cable to the USB connector on the PC unit. 3. Connect the power cord provided with the printer to the AC power socket on the rear of the printer.

2-2.16

Operator's Manual MEB-9400

2. INSTALLATION Isolation unit rear panel OUTPUT AC 110 - 127 V TOTAL 750 VA MAX.

4. Connect the other side of the power cord to the 3-prong AC outlet on the rear panel of the isolation unit. For the printer preparation, refer to the operator’s manual for the printer.

3-prong AC outlets

Connecting the Mouse

Connect the mouse cable to the mouse connector (Mini DIN 6 pins) on the rear panel of the PC unit and place it near the operation panel.

Connecting the Foot Switch

Connect the foot switch cable to the foot switch connector on the rear panel of the main unit.

Foot switch connector

The foot switch can be stored in the drawing tray under the cart. Main unit rear panel

Operator's Manual MEB-9400

2-2.17

2. INSTALLATION

Setting the Electrode Junction Box Example: JB-944BK

1. Attach the electrode junction box to the bracket of the electrode junction box arm and secure the electrode junction box with the two M4×8 pan screws with washers and spring washer.

2. Put the electrode junction box cable in the cable guide.

3. Insert the electrode junction box arm into the arm holder and secure the arm with the knob.

Main unit rear panel

4. Connect the electrode junction box cable to the JUNCTION BOX connector on the rear panel of the main unit by pushing the two connector locks.

JUNCTION BOX connector

2-2.18

Operator's Manual MEB-9400

2. INSTALLATION

Reattaching the Rear Cover 1. Check that all system components are correctly connected to each other. 2. Bind the cables so that they do not drag when the cart is moved. 3. Connect the AC power cord to the AC SOURCE socket on the isolation unit. When equipotential grounding is required, connect the ground lead to the equipotential ground terminal on the rear of the isolation unit. 4. Run the AC power cord and ground lead through the cable opening in the rear cover. 5. Attach the rear cover to the cart and secure the rear cover with the four screws which were removed when removing the rear cover.

Rear cover

Operator's Manual MEB-9400

2-2.19

Section 2-3 Installation (for Both Models) Connecting the Power Cord ............................................................................................ 2-3.2 Equipotential Grounding ............................................................................. 2-3.2 Necessity of Equipotential Grounding ......................................................... 2-3.2 Connecting the Stimulators and Probe ........................................................................... 2-3.3 Connecting the Electric Stimulation Electrode ...................................................... 2-3.3 Connecting the Surface Stimulation Electrode (Option) ............................. 2-3.3 Connecting the Finger Electrode (Option) .................................................. 2-3.4 Connecting the Somato Control Box (Option) ............................................. 2-3.4 Connecting the Headphone or Earphone (Option) ............................................... 2-3.5 Connecting the LED Goggles (Option) ................................................................. 2-3.5 Connecting the CRT Monitor (Option) .................................................................. 2-3.6 Power On Procedure ....................................................................................................... 2-3.7 Power Off Procedure ....................................................................................................... 2-3.9 Installing the Software and USB Driver ......................................................................... 2-3.10 Before Starting Installation .................................................................................. 2-3.10 Entering the Serial Number ................................................................................ 2-3.10 Installing the Software ........................................................................................ 2-3.10 Installing the USB Driver ..................................................................................... 2-3.12 Registering the Examination Program ................................................................ 2-3.14 Obtaining the Optional Software Key Code ........................................................ 2-3.14 Entering the Software Key .................................................................................. 2-3.15 Changing the AC Interference Filter Setting .................................................................. 2-3.16 General Requirements for Connecting Medical Electrical System ................................ 2-3.17 KEY TO TABLE ......................................................................................... 2-3.18

Operator’s Manual MEB-9400

2-3C.1

2. INSTALLATION

This section explains installation procedure common to MEB-9400 EMG/EP Measuring System with a desktop PC unit and a laptop PC unit. Before starting the procedures in this section, finish the procedures in section 2-1 Installation (for MEB-9400 with a desktop PC unit) or section 2-2 Installation (for MEB-9400 with a laptop PC unit).

Operator's Manual MEB-9400

2-3.1

2. INSTALLATION

Connecting the Power Cord • Main unit Connect the power cord to the 3-prong AC outlet on the wall. • All components except the main unit Connect the power cord of each component to the 3-prong AC outlet on the rear panel of the isolation unit. Connect the connector of the provided 3-prong power cord to the AC SOURCE socket on the rear panel of the isolation unit and plug the cord into a 3-prong AC outlet.

WARNING Never use a water pipe or gas pipe as a ground because it is not properly grounded and there is a hazard of explosion.

When equipment that causes transitional change on power supply voltage such as an X-ray system is nearby or the equipment and the MEB-9400 are connected to the same power line, it may cause spike noise on the waveform. In this case, check the installation environment and power line and remove the cause. Equipotential Grounding Equipotential ground lead Power cord

WARNING Equipotential grounding is required for patient safety. Consult with a qualified biomedical engineer.

When equipotential grounding is required to ensure patient safety, connect the equipotential ground terminal on the isolation unit to the equipotential ground terminal on the wall with the ground lead.

Necessity of Equipotential Grounding When several ME instruments are used, avoid potential difference between instruments. Potential difference between instruments may cause current to flow to the patient connected to the instruments, resulting in electrical shock (micro shock). Never use any medical equipment in patient treatment without proper grounding. Perform equipotential grounding where equipotential grounding is required, such as in the operating room, ICU room, CCU room, cardiac catheterization room and x-ray room. 2-3.2

Operator's Manual MEB-9400

2. INSTALLATION

Connecting the Stimulators and Probe

WARNING Connect only the specified equipment to the connectors marked with by following the specified procedure. Otherwise, electrical leakage current may harm the patient and operator.

CAUTION When connecting or disconnecting a cable, make sure that the power of the system and connected equipment are turned off.

Connecting the Electric Stimulation Electrode

CAUTION After attaching the electric stimulation electrode (surface stimulation electrode, finger electrode or SOMATO control box) to the patient, start the stimulation intensity from 0 mA and increase gradually. Failure to follow this caution may apply maximum of 100 mA constant current to the patient.

Connecting the Surface Stimulation Electrode (Option) Connect the surface stimulation electrode connector to the SOMATO connector on the main unit with the YZ-0172 somato A→ →B connection cable (option). NM-420S Surface stimulation electrode

The stimulation intensity dial on the operation panel can control the output electrical stimulation intensity. Stimulation intensity dial

Operator's Manual MEB-9400

2-3.3

2. INSTALLATION Connecting the Finger Electrode (Option) Connect the finger electrode connector to the SOMATO connector on the main unit with the YZ-0172 somato A→ →B connection cable (option).

NM-450S Finger electrode

The stimulation intensity dial on the operation panel can control the output electrical stimulation intensity. Stimulation intensity dial

Connecting the Somato Control Box (Option) Connect the somato connector box cable to the SOMATO connector on the main unit.

RY-441B Somato control box

Both the stimulation intensity adjust button on the somato control box and the stimulation intensity dial on the operation panel can control the output electrical stimulation intensity. Stimulation intensity dial

Stimulation intensity adjust button

Stimulation ON/OFF button

2-3.4

Operator's Manual MEB-9400

2. INSTALLATION

Connecting the Headphone or Earphone (Option)

CAUTION Do not connect the headphone or earphone to the system when the system is turned on.

Connect the headphone or earphone connector to the AUDITORY connector on the right side panel of the main unit.

AUDITORY connector

DR-531B-14 Headphone

YE-103J Earphone (option)

Connecting the LED Goggles (Option)

Connect the LED Goggles connector to the GOGGLE connector on the right side panel of the main unit. This Product Contains Dry Natural Rubber.

GOGGLE connector

LS-102J LED Goggles

Operator's Manual MEB-9400

CAUTION The LED goggles contain dry natural rubber. Natural rubber may cause allergic reaction with symptoms such as itching, redness, urticaria, swelling, fever, dyspnea, symptoms similar to asthma, reduced blood pressure and shock. If the patient shows any of the above symptoms, immediately stop using the LED goggles and perform appropriate medical treatment.

2-3.5

2. INSTALLATION

Connecting the CRT Monitor (Option)

CAUTION Connect the CRT monitor to the system only when both the system and CRT monitor are turned off.

1. Connect the analog RGB cable to the D-SUB connector on the rear of the CRT monitor. 2. Connect the other side of the cable to the PATTERN connector on the right side panel of the main unit. D-SUB connector

CRT Monitor

PATTERN connector

2-3.6

Operator's Manual MEB-9400

2. INSTALLATION

Power On Procedure 1. Before turning the power on, check the following items. If there is any damage, contact your NK distributor or representative. Check Items before Turning the Power On Overview: • System is not dirty, damaged or in contact with liquid. • Power cord is not damaged. • No key on the keyboard is broken. • No electrode is dirty or damaged. • No electrode lead is frayed or damaged. Connection: • Power cords and ground lead are properly connected. • Electrode junction box, PC unit, foot switch, headphone LED goggles and/or CRT monitor are properly connected to the main unit. • Display, keyboard, mouse and printer are properly connected to the PC unit. • Recording paper is loaded in the printer. Accessories: • Enough electrodes. • Enough EEG paste. • Enough recording paper. 2. Press the POWER switch on the rear panel of the main unit. The power LED on the operation panel lights. 3. Press the POWER switch on the isolation unit to turn the power on. If this is the first time, press the power switch of the LCD display and PC unit.

Power LED

Operator's Manual MEB-9400

The Windows opening messages appear on the screen and the Main Menu window opens. For detailed information, refer to the Windows Operator’s manual and online help.

2-3.7

2. INSTALLATION 4. After turning the power on, check the following items. Check Items after Turning the Power On: • No fire, smoke or smell. • No electrical shock when touching the system. • System is not too hot. • System does not affect surrounding equipment. • All operation indicators light. • There is no error message on the screen or malfunction. • The screen display (such as brightness, contrast, color, no distortion) is correct. • The date and time on the screen is correct. • The mouse operates correctly. • All keys on the keyboard operate properly. • All keys and controls on the operation panel operate correctly. • All programs operate correctly. • All settings (such as montage and amplifier setting) are correct. • Calibration waveform is properly displayed and recorded: No noise on the calibration waveform. Amplitude of the calibration waveform is correct. • The measured waveform is properly displayed (not flat). • • • •

Auditory stimulators operate correctly. Visual stimulators operate correctly. Electrical stimulators operate correctly. Monitored waveform sound is correct.

• All storage devices (hard disk drive and CD-ROM drive operate correctly. • All storage media have enough space to save measured data files (hard disk drive and CD-ROM drive). • Printer operates correctly (paper feed, intensity, no jamming). • Optional equipment operates correctly. • External equipment operates correctly.

CAUTION Before examination, check and adjust the date and time of the system. The date and time on the screen and on the recording result are part of important information for the medical record.

To adjust the date and time, open the Date/Time Properties dialog box of Windows. This dialog box can be opened by clicking the time display on the Task bar on the desktop.

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2. INSTALLATION

Power Off Procedure

CAUTION Do not turn off the system while the program is running. If the system is turned off while the program is running, the system program and data files saved on the hard disk may be damaged. If the file is damaged, the saved data will be damaged and the program may not run.

To turn off the system, do the following shutdown procedure. 1. Close all examination programs and the Main Menu window. Check that the necessary measurement data is saved. The temporarily saved data is lost when the power is turned off. 2. After the hard disk access lamp goes off, click the Start button on the Task bar. The Start button menu opens. 3. Click Turn off computer. The Turn Off Computer Window dialog box opens. 4. Click the Turn off option button and wait for the shut down. 5. Press the POWER switch on the front panel of the isolation unit. This turns off the power of all connected units. 6. Press the POWER switch on the rear panel of the main unit. The power LED goes off.

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2-3.9

2. INSTALLATION

Installing the Software and USB Driver Install the system software, examination programs and USB driver in the PC unit by following procedure.

Before Starting Installation

1. Turn the system power on. Confirm that the Windows operating system is running. 2. Close all examination programs and Windows application programs. 3. Insert the software CD-ROM into the CD-ROM drive.

Entering the Serial Number

You need to enter the serial number the first time you install the MEB software. 1. From the Start Menu, select Run. The Run dialog box opens. 2. Type the following line and click the OK button. D:\makekey9400.exe (D: CD-ROM drive) The following dialog box opens.

Type the serial number of the main unit and click the OK button.

Installing the Software

1. From the Start menu, select Run. The Run dialog box opens. 2. Type the following line and click the OK button. The Welcome dialog box opens. D:\setup.exe (D: CD-ROM drive)

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Operator's Manual MEB-9400

2. INSTALLATION 3. Check that all examination programs and Windows applications are closed, and click the Next button. The Information dialog box opens.

4. Check that the software model which you want to install is displayed on the Information dialog box, and click the OK button. The Choose Destination Location dialog box opens.

5. Check that the line in the Destination Folder area is C:\Program Files\NPK, and click the Next button. The Setup program starts copying files from the CD-ROM.

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2-3.11

2. INSTALLATION If the following error message box appears, click the OK button and check that all examination programs and Windows applications are closed. Reinstall the software from step 1.

When all files are successfully copied, the Restarting Windows dialog box opens. 6. Remove the CD-ROM from the CD-ROM drive, then select the “Yes, I want to restart may computer now” option and click the OK button.

7. When Windows restarts and there is no error message, go to the “Registering the Examination Program” procedure. If the “Cannot open device driver” error message appears, install the USB driver. Refer to “Installing the USB Driver”. If the “Invalid Version ACQ Box Module” error message appears, shut down Windows and restart the PC unit.

Installing the USB Driver

1. Check that the USB cable is correctly connected to the USB connector on the MEB-9400 main unit. Turn on the main unit. .2. The following window appears. Select “Install from a list or specific location (Advanced)”.

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2. INSTALLATION

3. Select “Search for the best driver in these locations” and check “Include this location in the search:”. Type the following line exactly, including the space. C:\Program Files\NPK\driver Click Next.

4. Click “Continue Anyway”.

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2-3.13

2. INSTALLATION 5. Type the following line exactly, including the space. C:\Program Files\NPK\driver Click OK.

6. Click Finish.

Registering the Examination Program

Edit the Category Dialog box to display the examination program name that you installed in the Main Menu window. For the procedure, refer to Section 4.

Obtaining the Optional Software Key Code

The software key code is necessary to run the optional QP-946BK, QP-947BK or QP-948BK program. To obtain the software key code, send the “MEB-9400 Series OPTION SOFTWARE Registration Form” to your Nihon Kohden representative. We will send you back a software key code that consists of 6 or 7 alphanumeric characters.

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2. INSTALLATION

Entering the Software Key

For QP-946BK, QP-947BK and QP-948BK, you need to enter the software key code the first time you use the examination program. 1. On the Main Menu window, click the examination program which you registered. The following dialog box opens.

2. Type the software key code in the text box and click the OK button. When the software key code is entered correctly, the examination program starts. If the software key is not entered correctly, the error message box opens. Click the Retry button and type the software key code again.

To return to the Main Menu window, click the Cancel button.

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2. INSTALLATION

Changing the AC Interference Filter Setting 1. Click the Start button on the Task bar. The Start button menu opens. 2. Click Program. The Program submenu opens. 3. Click Npk. The Npk menu opens. 4. Click System Condition. The System Condition dialog box opens.

5. Select the AC Filter option according to the line frequency. 6. Click the OK button. The System Condition dialog box closes.

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2. INSTALLATION

General Requirements for Connecting Medical Electrical System When more than one electrical instrument is used, there may be electrical potential difference between the instruments. Potential difference between instruments may cause current to flow to the patient connected to the instruments, resulting in electrical shock (micro shock). Therefore, electrical instruments must be appropriately installed as specified in IEC 60601-1-1: 2000 Second edition. The following is an extract from IEC 60601-1-1 “Medical electrical equipment Part 1-1: General requirements for safety”. For details, refer to IEC 60601-1-1 and consult with a biomedical engineer. Examples of combinations of MEDICAL ELECTRICAL EQUIPMENT and non-medical electrical equipment Medically used room Situation No. 1 1a Items A and B in PATIENT ENVIRONMENT

1b Items A and B in PATIENT ENVIRONMENT

1c Item A powered from specified power supply in item B in PATIENT ENVIRONMENT 2 2a Item A in PATIENT ENVIRONMENT and item B in medically used room 2b Item A in PATIENT ENVIRONMENT and item B in medically used room 3 3a Item A in PATIENT ENVIRONMENT and item B in non-medically used room

Inside the PATIENT ENVIRONMENT A

B

IEC 60601

IEC 60601

A

B

IEC 60601

IEC XXXXX

Outside the PATIENT ENVIRONMENT

Non-medically used room

Feasible solution (See clause 19 in all situations)

For B: Additional protective earth or separating transformer

For B: Additional protective earth or separating transformer

A IEC 60601 B IEC XXXXX A

B

IEC 60601

IEC 60601

A

B

IEC 60601

IEC XXXXX

A

For B: See 19.201 and its rationale

B IEC 60601 or IEC XXXXX

IEC 60601

For B: See 19.201 and its rationale

common protective earth

3b Item A in PATIENT ENVIRONMENT and item B in non-medically used room

A

B IEC 60601 or IEC XXXXX

IEC 60601 protective earth

Operator's Manual MEB-9400

For B: Additional protective earth or SEPARATION DEVICE

protective earth with potential difference

2-3.17

2. INSTALLATION KEY TO TABLE • Additional protective earth: If necessary, provide additional protective earthing, which is permanently connected (see also 58.201). NOTE Equipment modification may be required. • Separating transformer: If necessary, limit the ENCLOSURE LEAKAGE CURRENT, by using an additional separating transformer according to annex EEE. NOTE 1 No equipment modification is required. NOTE 2 A separating transformer is a transformer with one or more input winding(s) separated from the output winding(s) by at least basic insulation [IEC 60989]. • SEPARATION DEVICE: If necessary, apply SEPARATION DEVICE. • IEC 60601: MEDICAL ELECTRICAL EQUIPMENT in compliance with IEC 60601. • IEC XXXXX: Non-medical equipment in compliance with relevant IEC safety standards.

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Section 3 Operating the MEB9400 Windows Basics ................................................................................................................. 3.1 Using the Mouse ...................................................................................................... 3.1 Windows Desktop .................................................................................................... 3.1 Basic Explanation of a Window ................................................................................ 3.3 Working with a Window ............................................................................................ 3.5 Using a Pull Down Menu .......................................................................................... 3.6 Using a Dialog Box .................................................................................................. 3.7 Explanation of Menu Command and Buttons on the Tool Bar .......................................... 3.10 Main Menu Window ............................................................................................... 3.10 Examination Window ............................................................................................. 3.12 MEB-9400 Basics ............................................................................................................ 3.18 Entering the Patient Information ............................................................................ 3.18 Selecting an Examination Program ........................................................................ 3.20 Entering the Examination Information .................................................................... 3.21 Checking and Changing the Measurement Settings .............................................. 3.23 Checking Skin-Electrode Contact Impedance ....................................................... 3.24 Operations during Examination ............................................................................. 3.25 Selecting the Function Button on the Bottom of the Screen ........................ 3.25 Displaying the Calibration Waveform ........................................................... 3.25 Returning the Waveform to the Baseline Position ........................................ 3.25 Turning the AC Interference Filter On/Off .................................................... 3.25 Displaying the Acquired Raw Waveform ...................................................... 3.25 Displaying the Evoked Waveform or Acquired Waveform which Exceeds the Trigger Threshold ......................................................................................... 3.25 Starting the Waveform Averaging ................................................................ 3.25 Stopping the Waveform Acquisition or Averaging ........................................ 3.26 Changing the Waveform Sensitivity ............................................................. 3.26 Changing the Waveform Sweep Time .......................................................... 3.26 Selecting Waveforms ................................................................................... 3.26 Changing the Waveform Display Position (Moving the Waveform) .............. 3.26 Displaying or Not Displaying the Waveform ................................................. 3.27 Measuring the Latency of the Waveform ..................................................... 3.27 Measuring the Amplitude of the Waveform .................................................. 3.27 Displaying the Latency and Amplitude of the Waveform .............................. 3.27 Operator’s Manual MEB-9400

3C.1

Changing the Stimulation Settings ............................................................... Calling Up Previous Waveforms ............................................................................. Saving Waveforms ................................................................................................. Deleting Waveforms from the Display .................................................................... Printing .................................................................................................................. Printing the Measurement (Monitor, Sweep or Average) Window (Hard Copy) ................................................................................................. Printing the Waveforms and Data on the Stop, Saved or Gather Window (Review Printing) ......................................................................................... Printing a Report ......................................................................................... Saving a File .......................................................................................................... Shortcut Keys ........................................................................................................ Using the Footswitch ........................................................................................................

3C.2

3.28 3.29 3.30 3.30 3.30 3.30 3.31 3.31 3.31 3.32 3.33

Operator’s Manual MEB-9400

3. OPERATING THE MEB-9400

Windows Basics This section briefly explains how to use Windows. For a detailed explanation, refer to the Windows operator’s manual or online help.

NOTE • When using the MEB system program, close all other programs. Otherwise, the MEB system program may not function properly. • Turn off any screen saver before opening the MEB system program.

Using the Mouse

With the mouse, you can do all operations to measure, review and print the waveforms. Right mouse button

Left mouse button

♦ Mouse pointer When you move the mouse on the desk, the mouse pointer (arrow-shaped cursor on the screen) follows the movement of the mouse. The mouse pointer indicates which area of the screen will be affected when you press the mouse button.

♦ Mouse button operations Click:

Quickly press and release the left mouse button. Use this operation to select an item or execute an operation button or function button on the screen. Double-click: Click the left mouse button twice in rapid succession. Use this operation to open a program or execute an operation. Drag: Press and hold down the left mouse button while you move the mouse. Use this operation to move or resize a window, or select consecutive items in the list (box). Point: Move the mouse until the mouse pointer on the screen rests on the desired item.

Windows Desktop

On the left side of the desktop there are three or more icons, depending on the options chosen during installation at the factory. You will use these icons to find and view the files and folders on your computer. At the bottom of the desktop is the Taskbar with its Start button and clock. The Taskbar is switcher. You can easily move between open documents and applications with the Taskbar. If a document or application is on the Taskbar, you need to click it only once to activate it.

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3. OPERATING THE MEB-9400

♦ Start Button The Start button appears at the left side of the Taskbar. To open the Start menu, click the Start button. The following Start menu appears. (The way the Start button is displayed on the screen can be changed. Refer to Windows Online Help.) Programs: Displays a list of the programs you can start. Documents: Displays a list of the most recently used documents you can reopen. Settings: Displays a list of the PC system configuration items (Control Panel or Printers, etc.). Find: Finds a document or program file by entering information about it. Help: Opens the Help window for Windows operation. Run: Opens a program, document or folder by entering the name of it. Shut down: Shuts down the computer, restarts the computer, restarts the computer in MS-DOS mode or closes all applications and logs on with another user ID.

♦ Taskbar:

All the applications that are running appear as buttons on the Taskbar. To reactivate an application, click its button in the Taskbar. To reduce an application to a button on the Taskbar, click the Minimize button. (The way the Taskbar is displayed on the screen can be changed. Refer to the Windows Online Help.)

♦ Icons: Icons are small pictures that represent applications or documents. To start an application, double click it with the mouse. To open the MEB system program, click the icon shown to the left.

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3. OPERATING THE MEB-9400

Basic Explanation of a Window

Control menu box Title bar Menu bar Menu

Tool bar

Function buttons

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3. OPERATING THE MEB-9400

♦ Control menu box To resize, move, maximize, minimize, or close a window, open the Control menu box by clicking it once. If you double-click the Control-menu box, the window closes or the icon is restored to a window. When you open the Control menu, a pull down menu with the following commands appears. (Some applications do not have all these commands.) Commands in the Control menu Restore: Restores the window to its previous size after you have enlarged it or reduced it to an icon. Move: Moves the window to another position with the keyboard. You can also move the window with the mouse. Size: Changes the size of the window with the keyboard. You can also change the size of the window with the mouse. Minimize: Reduces the window to a button on the Taskbar. (Same function as Minimize button.) Maximize: Enlarges the window to its maximum size. (Same function as Maximize button.) Close: Closes the window or dialog box. (From an application window, you can use this command to quit the application.) Switch To: Opens the Task List, which lets you to switch to another application or rearrange windows and icons on your desktop screen.

♦ Title bar Shows the name of the application or document. If more than two windows are opened, the characters of the title bar for the active window (the one which you are working) are white. The characters of the title bars for the other inactive windows are shaded out.

♦ Menu bar Lists the available menus. A menu contains a list of commands, or actions you can execute. Refer to Using a pull down menu.

♦ Tool bar Consists of a row of buttons below the Menu bar. By simply clicking the appropriate button in the Tool bar, you can instantly execute any of a wide variety of settings or operations.

♦ Close button Exits the program of the active application window.

♦ Maximize/Restore button Enlarges the active application window so that it fills the entire desktop. After you enlarge a window, the Maximize button is replaced by the Restore button. By clicking the Restore button, you can return the window to its previous size. Maximize/Restore

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3. OPERATING THE MEB-9400

♦ Minimize button Reduces the window to a button on the Taskbar. By clicking the button on the Taskbar, you can return the window to its previous size.

♦ Function buttons On the bottom of the screen above the Taskbar up to 8 function buttons appear when opening every examination window. Up to 16 buttons are provided so you can easily open the corresponding window or program. By clicking the right arrow, you can display the next 8 buttons.

Working with a Window

♦ Resizing a window You can change the size and shape of windows on your desktop, for example, to compare the contents of two documents. To change the size of a window with the mouse: 1. Move the mouse pointer to a border or corner of the window. The pointer changes to a two-head arrow. 2. Drag the corner or border until the window is the size you want. If you drag a border, the window size changes only on the side of the border you drag. If you drag a corner, the two adjoining sides that form the corner are moved at the same time. An outline shows the size and shape you are creating. 3. Release the mouse button. To cancel the resizing, press the ESC key before releasing the mouse button.

♦ Moving a window You can move any window to a different location on your desktop using the Control menu box or mouse. To move a window with the mouse: 1. Drag the title bar of the window to the new location. As you move the mouse pointer, the window moves with it. 2. Release the mouse button. To cancel the move, press the ESC key before you release the mouse button.

♦ Using scroll bars Some windows and dialog boxes have scroll bars you can use to view information that exists beyond the borders of the window. When you can view all the contents of a window or dialog box without scrolling, scroll bars may be absent or dimmed to indicate they cannot be used.

Operator's Manual MEB-9400

3.5

3. OPERATING THE MEB-9400 To scroll through the information displayed in a window or dialog box: • To scroll one line up or down, click the up or down scroll arrow. • To scroll one screen up or down or left or right, click the scroll bar above or below the scroll box on vertical scroll bar, or to the left or right of the scroll box on the horizontal scroll bar. • To continuously scroll, point one of the scroll arrows, and hold down the mouse button until the information you want comes in view. • To quickly scroll to any position, drag the scroll box in the scroll bar to the position you want. The selection of the document or list that moves into view depends on where you position the scroll box. For example, if you position the scroll box halfway down the vertical scroll, the text halfway through the document or list appears.

♦ Closing a window From the file menu, click Exit. Or click Close from the control menu. Or click the close button on the upper right of the window.

Using a Pull Down Menu

Lists commands or actions you can execute with Windows.

♦ Opening a menu With the mouse: Move the mouse pointer to the name of the menu on the menu bar, then click it. This opens a pull down menu or a dialog box. From the pull down menu or the dialog box you can execute a command. With the keyboard: 1. Press the ALT or F10 key to select (highlight) the menu bar. 2. Press the LEFT ARROW or RIGHT ARROW key to select the menu you want. 3. Press the ENTER key or DOWN ARROW key to open the selected menu. If a name in the menu bar has an underlined letter: Press the ALT key and the underlined letter in the item name to open the pull down menu.

♦ Executing a command in the menu With the mouse: From the selected menu, click the command. With the keyboard: Type the letter that is underlined in the command name. Or use the UP ARROW or DOWN ARROW keys until you reach the command that you want to execute, then press the ENTER key.

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Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 If a command in the pull down menu has an underlined letter: Press the ALT key and the underlined letter to execute the command.

♦ Closing a menu With the mouse: Click the menu name or anywhere outside the menu. With the keyboard: Press the ALT or F10 key to cancel the menu and move back to the application workspace. Or press the ESC key to close the menu but remain on the menu bar so that you can select another menu.

Using a Dialog Box A dialog box appears when you select certain menu items in the pull down menu. An ellipsis (...) after a menu command indicates that a dialog box will be displayed when you execute that command. The MEB system program displays a dialog box either to request information about an operation that you are now performing or to supply information that you might need.

♦ Dialog box options You can move through text (up or down) to see parts of the file or list. List boxes: A list box displays a list of choices. If there are more choices than can fit in the box, scroll bars are provided so you can quickly move through the list.

List box

Operator's Manual MEB-9400

3.7

3. OPERATING THE MEB-9400 Button: You can start an operation by clicking the button. To execute a button With the mouse: Click the command button. With the keyboard: 1. Press the TAB key to move to the switch you want. A dark border marks the selected switch. 2. Press the SPACE BAR or ENTER key. Option buttons: Option buttons represent mutually exclusive options. You can select only one option at a time. The selected option button contains a black dot. Unavailable options are dimmed. To select an option button With the mouse: Click the option button. With the keyboard: 1. Press the TAB key to move the cursor to the group of options you want. 2. Select the option button you want with the arrow keys. If the option button has an underlined letter: Type the underlined letter while pressing and holding down the ALT key. Drop-down list box: The current selection is displayed in the drop-down list box. When you click the arrow following the list box, a list of available choices appears. To open a drop down list box and select an item With the mouse: 1. Click the arrow following the list box. 2. Click the up or down scroll arrow. Or drag the scroll box to move the cursor to the item you want. 3. Click the item. With the keyboard:

NOTE Be sure the NUM LOCK key is turned off. 1. Press the TAB key to move the cursor to the selection list box. 2. Press the ALT key and DOWN ARROW key together to open the box. 3. Press the UP ARROW or DOWN ARROW key to move the selection cursor to the item you want. 4. Press the ALT key and UP ARROW key together or the ALT key and DOWN ARROW key together to select it. 3.8

Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 Check box: A check box next to an option means you can select or clear the option. You can select as many check box options as needed. When a check box is selected, it mark. Names of unavailable options are dimmed. contains a To select or clear a check box With the mouse: Click a blank check box to select it. Click a selected check box to clear it. With the keyboard: 1. Press the TAB key to move the cursor to the check box you want to select or clear. 2. Press the SPACE BAR to select the box. 3. Press the SPACE BAR again to clear the selected check box. If the option name has an underlined letter: Press and hold down the ALT key while typing the underlined letter to select or clear the check box. Text boxes: You can type information into a text box. When you click a text box, an insertion point (flashing vertical bar) appears. The text you type starts at the insertion point. If the box you want to type already contains text, you can replace it. To delete existing text, press the DEL or BACKSPACE key.

Operator's Manual MEB-9400

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3. OPERATING THE MEB-9400

Explanation of Menu Command and Buttons on the Tool Bar Main Menu Window

File menu Wave Open Opens the Open dialog box to select the patient file. Open Opens the Examination File Open dialog box. When the power is turned on, the Main Menu window opens with the latest settings. You can also open the Main Menu window with other settings which are saves as a different examination file. Use the Examination File Open dialog box to select a different examination file. Save Saves the changed Main Menu window settings on the existing examination program file (overwrite). Save As Opens the Examination File Save dialog box to save the changed Main Menu window settings as a new examination program file. Exit Closes the Main Menu window. Edit menu Opens the Select Category dialog box to change the category name, examination program name and add a comment to the examination program. Option menu Auto Minimize Select Category Select to automatically minimize the Main Menu window when the examination program is selected. Display1/Display2/Display3 Changes the Main Menu window display format. Refer to “Operating the Examination Program File - Changing the Main Menu Window Display Format” in Section 4.

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Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 Program Open menu Open Upper Lines: Opens all examination programs that are displayed in the upper rows in the selected category. Up to eight examination programs can be opened simultaneously. Open Lower Lines: Opens all examination programs that are displayed in the lower rows in the selected category. Up to eight examination programs can be opened simultaneously. Help menu Index Displays the online examination program Operator’s manual. Examination Guide Displays the online operator’s manual. About Opens the About dialog box. The About dialog box displays the installed optional program name, version, installed date and executive file name. Check box on the Main Menu window Menu Key Select next Menu check box: When this box is checked, the examination program automatically changes to the next examination program by pressing the MENU key on the operation panel. Show Patient Information at Menu Select check box: To automatically display the Patient Information dialog box when the examination program is changed, click this check box. Keep Patient Information from previous Menu check box: To use the patient information for all examination programs, click this check box.

Operator's Manual MEB-9400

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3. OPERATING THE MEB-9400

Examination Window

The function buttons change depending on examination program.

File menu Open Opens the Open dialog box to select the patient file. Save Saves the waveforms, measurement data and patient information in the currently opened patient file (overwrite). Save As Opens the Save dialog box to save the waveforms, measurement data and patient information as a new patient file. Print Hard Copy Prints the waveforms in the active measurement window (Monitor, Sweep or Average window) with the patient information and examination information. Report Prints a report in the Word format. Review Print Prints the waveforms from the Stop, Saved or Gather window with the patient information and condition information.

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Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 Condition menu Amplitude Opens the Amp page of the Set Conditions window to select the amplifier settings. Acquisition Opens the Acquisition page of the Set Conditions window to select the waveform acquisition settings. Trigger Opens the Trigger page of the Set Conditions window to select the trigger settings. Electric Opens the Electric page of the Set Conditions window to select the electric stimulation settings. Auditory stim. Opens the Auditory Stim page of the Set Condition window to select the auditory stimulation settings. Visual Opens the Visual page of the Set Conditions window to select the visual stimulation settings. Display Opens the Display page of the Set Conditions window to select the wave window display settings. Labeling Opens the Labeling page of the Set Conditions window to select marking settings of the waveform. Table Opens the Table page of the Set Conditions window to select the condition table settings. Misc. Opens the Misc. page of the Set Conditions window to select the settings on the Misc. page.

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3.13

3. OPERATING THE MEB-9400 Examination menu Impedance Check Starts the skin-electrode contact impedance check. The check result is displayed on the Impedance Check dialog box. Baseline Reset Returns the waveform to the baseline position. AC Filter Turns the AC interference filter on or off. Calibration Displays the calibration waveforms on a wave window. Monitor (Same function as the MONITOR key on the operation panel) Opens the Monitor window and start waveform acquisition. The acquired waveforms are displayed on the Monitor window. Stim./Sweep (Same function as the STIM/SWEEP key on the operation panel) Opens the Sweep window and start stimulation and waveform acquisition according to the examination. The acquired, triggered or evoked waveforms are displayed on the Sweep window. Analysis (Same function as the ANALYSIS key on the operation panel) Starts waveform averaging. The averaged waveforms are displayed on the Stop window. Stop (Same function as the STOP key on the operation panel) Stops waveform acquisition, stimulation and averaging. Display Gain Increase/Decrease Changes the waveform display sensitivity.

Time Scale Expand/Decrease Changes the waveform sweep time. Store Saves the waveforms and waveform processing result in memory. To select the types of waveforms and storage time, refer to “Store Raw Wave” on the Acquisition page of the Set Conditions window. Erase Deletes the selected waveform(s) on the Monitor, Sweep, Stop or Average window.

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3. OPERATING THE MEB-9400 Wave ON/OFF Displays or does not display the selected waveform. Measurement menu Cursor Latency Opens the Latency window. You can measure the waveform latency with the two vertical cursors. Amplitude Opens the Amplitude window. You can measure the waveform amplitude with the two horizontal cursors. Trigger Displays the trigger cursor(s) to select the waveform trigger threshold level on the Trigger Level Monitor window. This function is only available on the Trigger Level Monitor window. Marking Opens the Mark Label window, Latency window and Measurement Table window. The measurement results are displayed on the Measurement Table window. Display Table Patient Information Opens the Patient information dialog box to enter the patient information. Examination Information. Opens the Examination information dialog box to enter the examination information. Nerve List Opens the Nerve List box. Muscle List Opens the Muscle List box. Measurement Table Opens the Measurement Table window. Condition Table Opens the Condition Table window.

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3.15

3. OPERATING THE MEB-9400 Wave Position Superimpose Superimposes all waveforms in all stages. When the waveforms are not in a stage, the waveforms are superimposed in each channel. Separate by Ch Superimposed waveforms in each channel. Separate Individually displays the waveform. Cascade Display Individually displays the waveforms in every channel. Edit menu Undo [Stage Wave] Undoes the cut, copy or paste operation. Cut [Stage Wave] Cut the selected waveform. The waveform is saved in the clipboard. Copy [Stage Wave] Copies the selected waveform to the clipboard. Paste [Stage Wave] Pastes the waveform from the clipboard. Select All Selects all waveforms in one stage or site. Average Averages the waveforms saved in a site or stage. Subtract Subtracts a waveform from another waveform. Reverse Reverses the polarity of the waveform. Rectify Rectifies the waveform from a waveform trace. Expand Expands the waveform Digital Filter Reduces artifact from the waveform with the digital filter processing.

3.16

Reaverage Re-averages the waveforms by removing unnecessary waveforms. Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 Window menu Tile [Horizontal] Arranges all windows in the examination window side by side horizontally so that all of them are visible. Tile [Vertical] Arranges all windows in the examination window side by side vertically so that all of them are visible. Cascade Arranges all windows in the examination window so that the front window is the largest and the title bars of the other windows are visible. To bring a different window to the front, click its title bar. Initialize Position & Size Changes the position and size of all windows (including the examination window) to the default. Intensity Window Opens the Intensity window to display the stimulation intensity. Always on Top Always displays the examination window on top. Windows list Displays the names of the windows in the examination window.

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3. OPERATING THE MEB-9400

MEB-9400 Basics The examination is started by selecting the examination program you want. Any of following operations lets you perform examinations and operate the system. • • • •

Pressing the key on the operation panel Selecting a button on the Tool bar with a mouse Executing a command in a pull down menu Selecting a function button with the mouse or the function key on the keyboard

You can also operate the system with the keyboard. For more information, refer to the Windows online help. • To open a pull-down menu, press ALT and the letter underlined in the menu name on the Menu bar on the keyboard. • To execute a command in the pull-down menu, use the UP, DOWN, LEFT or RIGHT key to select the command, then press the ENTER key. Or press the underlined letter key.

Entering the Patient Information

1. When the power is turned on, the Main Menu window automatically opens. If the Main Menu window is minimized, open it. • Press the MENU key on the operation panel. • Or, click the Main Menu on the Task bar. • Or, press the Shift + F1 key.

2. Click the New Patient button on the Main Menu window. The Patient Information dialog box opens.

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Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 3. Enter the patient information with the keyboard. You can enter the preset patient information with the list box. Entry items: • ID No. (up to 20 characters) • Name (Patient name, up to 40 characters) • Sex (No entry, Female, Male) • Date of Birth (year: 4 numbers/month: 01 to 12/day: 01 to 31) • Age (up to 7 numbers, automatically calculated when the date of birth is entered) • Height (up to 10 characters) • Weight (up to 10 characters) • In/Out Patient (No entry, In, Out) • Referring Dept (Referring department, up to 20 characters) • Physician (up to 18 characters) • History (Patient history, up to 240 characters): You can enter the patient history using the History List dialog box. Refer to the next section. To delete all patient history in the History box, click the Clear History button. To search for patient information: (1) Type in the ID number. (2) Click the ID Search button. The number of patient files appears in the message window and the latest patient information appears in the Patient Information dialog box. 4. Enter the patient history 1) Click the Add Hist Item button. The History List dialog box opens. The patient histories which are set in the User Settings dialog box appear in the list. For the User Settings dialog box, refer to Section 9 “System Settings”.

2) Select the desired category from the Category list box. You can select from “Patient Status”, “Complaint/symptom”, “Parts”, “Medical History” or “Medication”. The selectable patient histories appear in the Items box. 3) Click the patient history. 4) Click the Add button. The selected patient history is added to the History box on the Patient Information dialog box. Operator's Manual MEB-9400

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3. OPERATING THE MEB-9400

5) Repeat steps 2) to 5) to enter another patient information. 6) Click the Close button. The History List dialog box closes. To clear the entered patient history, click the Clear History button. 5. Click the OK button. The Patient Information dialog box closes. • To clear the entered patient information, click the Clear All button. • To cancel entering, click the Cancel button.

Selecting an Examination Program

On the Main Menu window, you can select the examination program. Each program has its own measurement and stimulation settings.

1. Select the category. The selected category is displayed in the front. • Click the category tab. • Or, press the Tab key on the keyboard.

Category tab

Examination program button

2. Select the examination program. • Click the examination program. • Or, select the examination program with the ←, →, ↑ or ↓ key, then press the Enter key To close the examination program, • Click the close button on the menu bar. • Or, from the File menu, select Exit. When the currently displayed waveform is not saved, a dialog box opens to prompt you to save the waveform.

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3. OPERATING THE MEB-9400

Entering the Examination Information

1. Open the Examination information dialog box. Examination Information button on the Tool bar. • Click the • Or, click the Examination Information function button on the bottom of the window.

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

F9

• Or, select Examination Information from the Measurement menu. Measurement menu → Display Table → Examination Information • Or, press the corresponding function key.

2. Enter the examination information with the keyboard. You can enter the preset examination information with the list box. Entry items: • Date (Examination date, the date is automatically displayed as year: 4 numbers, month: 01 to 12, day: 01 to 31) • Examined by (up to 20 characters) • No. (Examination number, up to 10 characters) • Comments (up to 240 characters): You can enter comments in the Comment Items dialog box. Refer to the next step. To delete the comment in the Comments box, click the Clear Comment. 3. Enter the comment When the EMG examination program is selected: 1) Click the Add Comment button. The Comment Items dialog box opens. The comments which are set in the User Settings dialog box appear in the list. For the User Settings dialog box, refer to Section 9 “System Settings”. 2) Select the desired note with the Note list box. You can select the note from “Insert Activity”, “Spont. Activity”, “MUP”, “Maximum Activity”, “Effort” or “Others”. The selectable comments appear in Note List. 4) Click the comment. 5) Click the Add button. The selected comment is added to the Comments box on the Examination Information dialog box. 6) Repeat steps 2) to 5) to enter another comment. 7) Click the Close button. The Comment Items dialog box closes.

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3. OPERATING THE MEB-9400 When an examination program other than the EMG examination program is selected: 1) Click the Add Comment button. The Comment Items dialog box opens. The selectable comments which are set in the User Settings dialog box appear in the list box. 2) Click the comment. 3) Click the Add button. The selected comment is added to the Comments box on the Examination Information dialog box. 4) Repeat steps 2) to 3) to enter another comment. 5) Click the Close button. The Comment Items dialog box closes. 4. Click the OK button. The Examination Information dialog box closes. • To clear the entered examination information, click the Clear All button. • To cancel entering, click the Cancel button.

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3. OPERATING THE MEB-9400

Checking and Changing the Measurement Settings

Do one of the following to open the Set Conditions window and select the desired condition page. The selected page comes to the front. 1. Click the

Condition button on the Tool bar. The Set Conditions window

opens. 2. Click the condition tab to select the condition. Or, select the condition from the Condition menu on the examination window. Condition menu → required condition command Or, press the Shift + F2 key.

Refer to Section 5 “Selecting the Measurement Settings” for changing the measurement settings.

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3. OPERATING THE MEB-9400

Checking Skin-Electrode Contact Impedance

WARNING Do not check skin-electrode contact impedance when using an ERG contact lens electrode. Failure to follow this warning injures the patient’s eyes because impedance check current will be applied. When attaching the ERG contact lens electrode, refer to its operator’s manual.

CAUTION Never check the skin-electrode contact impedance while using a needle electrode. Failure to follow this caution causes electrical burn where electrodes are inserted.

Do one of following to start skin-electrode impedance check. • Select Impedance Check from the Examination menu. Examination menu → Impedance Check • Or, press the shift + F9 key The Impedance Check dialog box opens and skin-electrode impedance check is started.

• To change the impedance threshold, click the impedance button in the Impedance Threshold area. When skin-electrode contact impedance check is started, the electrode being checked is displayed in black in the Impedance Check dialog box. Skin-electrode contact impedance check indication: Impedance Electrode in the Impedance Check dialog box ≤ Threshold Displayed in green with the measured impedance. > Threshold Displayed in black on orange. Not used electrode Dimmed

3.24

• To close the Impedance Check dialog box, click the Close button on the menu bar. Operator's Manual MEB-9400

3. OPERATING THE MEB-9400

Operations during Examination

Selecting the Function Button on the Bottom of the Screen • Click the function button on the bottom of the window that you want. • Or, press the corresponding function key on the keyboard

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

F9

Displaying the Calibration Waveform • Click the

Calibration button on the Tool bar.

• Or, Select Calibration from the Examination menu. Examination menu → Calibration Returning the Waveform to the Baseline Position • Click the

Reset button on the Tool bar.

• Or, select Inst from the Examination menu. Examination menu → Baseline Reset Turning the AC Interference Filter On/Off • Click the

AC Filter button on the Tool bar.

• Or, select AC Filter from the Examination menu. Examination menu → AC Filter Displaying the Acquired Raw Waveform • Press the MONITOR key on the operation panel. • Or, select Monitor from the Examination menu. Examination menu → Monitor • Or, press the Shift + F3 key. The Monitor window opens. Displaying the Evoked Waveform or Acquired Waveform which Exceeds the Trigger Threshold • Press the STIM/SWEEP key on the operation panel. • Or, select Stim/Sweep from the Examination menu. Examination menu → Stim/Sweep • Or, press the Shift + F4 key. The Sweep window opens. Starting the Waveform Averaging • Press the ANALYSIS key on the operation panel. • Or, select Average from the Examination menu. Examination menu → Average • Or, press the Shift + F5 key. The Average window opens.

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3. OPERATING THE MEB-9400 Stopping the Waveform Acquisition or Averaging The stimulation automatically stops. • Press the STOP key on the operation panel. • Or, select Stop from the Examination menu. Examination menu → Stop • Or, press the Shift + F6 key. The Stop window opens. Changing the Waveform Sensitivity • Click the

Gain Increase or

Gain Decrease button on the Tool bar.

• Or, press the VERTICAL RANGE ↑ ↓ key on the operation panel. • Or, select Gain Increase or Gain Decrease from the Examination menu. Examination menu → Display Gain → Increase or Decrease • Or, press the ↑ or ↓ key when a wave window is selected. Changing the Waveform Sweep Time • Click the

Time Scale Increase or

Time Scale Decrease button on the

Tool bar. • Or, press the TIME SCALE ← → key on the operation panel. • Or, select Time Scale Increase or Time Scale Decrease from the Examination menu. Examination menu → Time Scale → Increase or Decrease • Or, press the ↑ or ↓ key when a wave window is selected. Selecting Waveforms You can select: • all waveforms in one stage or site, or • all waveforms in one channel, or • one individual waveform. The selected waveform(s) is highlighted. 1. Press the ALL/INDV key on the operation panel. All, Channel or Individual button on the Tool bar. Or, click the Or, select All from the Edit menu to select the waveforms acquired from the same channel. Edit menu → Select All Or, press the Shift + F9 key, then press the F4 key. 2. Use the SELECT ↓ or ↑ key to select the stage/site, channel or individual waveform. Or, press the ↑ or ↓ key while pressing and holding the Ctrl key. Changing the Waveform Display Position (Moving the Waveform) After selecting the waveform(s), you can change the waveform display position. • Turn the WAVE dial on the operation panel. • Or, drag the waveform.

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Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 Displaying or Not Displaying the Waveform After selecting the waveforms: • To not display the waveform, click the

Wave ON/OFF button on the Tool

bar. Or, select Wave OFF from the Examination menu. • To display the waveform, click the

Wave ON/OFF button on the Tool bar.

Or select Wave ON from the Examination menu. Measuring the Latency of the Waveform 1. Select the latency cursors. The Latency window opens and the two vertical cursors are displayed on the window. • Press the LAT/AMP/TRIG key on the operation panel. • Or, click the

Latency button on the Tool bar.

• Or, select Latency from the Measurement menu Measurement menu → Cursor → Latency • Or, press the Shift + F9 key, then press the F5 key. 2. Select the cursor by pressing the A/B key on the operation panel.

3. Move the cursor by turning the CURSOR dial on the operation panel or with the mouse. The latency between the two cursors is displayed in the wave area. Measuring the Amplitude of the Waveform 1. Select the amplitude cursors. The Amplitude window opens and the two horizontal cursors are displayed on the window. • Press the LAT/AMP/TRIG key on the operation panel. • Or, click the

Amplitude button on the Tool bar.

• Or, select Amplitude from the measurement menu Measurement menu → Cursor → Amplitude • Or, press the Shift + F9 key, then press the F5 key. 2. Select the cursor by pressing the A/B key on the operation panel.

3. Move the cursor by turning the CURSOR dial or with the mouse. The amplitude between the two cursors is displayed in the wave area. Displaying the Latency and Amplitude of the Waveform The latency and amplitude of the waveform, etc. are displayed on the Measurement window. • Click the

Measurement Table button on the Tool bar.

• Or, select Measurement Table from the Measurement menu. Measurement menu → Display Table→ Measurement Table. • Or, press the F2 key. (Function key differs depending on the examination program.)

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3. OPERATING THE MEB-9400 Changing the Stimulation Settings 1. Press the L/R key on the operation panel to select the stimulation site. Or, press the Shift + Ctrl + F7 key. 2. Turn the STIMULATOR dial to select the electrical or auditory intensity. For pattern reversal stimulation, this selects the number of divisions in the pattern of the screen. Or, press the Shift + Ctrl + F1 (increment)/F2 (decrement) key. 3. Press the STIM RATE ↓ ↑ key on the operation panel to select the stimulation interval. Or, press the Shift + Ctrl + F3 (increment)/F4 (decrement) key. 4. When performing the electric stimulation, select the stimulation duration with the STIM DURATION ↓ ↑ key on the operation panel. Or, press the Shift + Ctrl + F5 key (increment)/Shift + Ctrl + F6 key (decrement). The intensity and duration of the electrical stimulation can be changed with the keyboard. 1) Press and hold the Alt key. The stimulation pulse setting area appears on the lower left of the examination window. 2) To change the intensity, press the ↑ (increment) or ↓ (decrement) key. To change the duration, press the → (increment) or ← (decrement) key. Stimulation pulse setting area

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3. OPERATING THE MEB-9400

Calling Up Previous Waveforms

Only waveforms on the Stop window can be processed, and only the most recently acquired or averaged waveform(s) can be displayed on the Stop window. To display and process earlier waveforms which are temporarily saved in memory, you can call them up on the Gather window and copy them to the Stop window. These displayed waveforms are saved as a stage. To temporarily save earlier waveforms in memory, set “Store Raw Wave” (Set Conditions window → Acquisition page) to “Gather”. 1. On the Stop window, click the Gather Waves function button. The Gather window opens. Second Sens

Gather Wave

F1

F2

F3

F4

F5

F6

F7

F8

F9

2. Select one or more waveforms with the mouse or with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel. Or, press the ↑ or ↓ key while pressing and holding the Ctrl key. 3. Select the Select Wave function button. The color of the selected waveforms changes. Select Wave

Copy to Stop Screen

F1

F2

F3

F4

Superimpose

Second Sens.

Patient Information

End

F5

F6

F7

F8

F9

4. Select the Copy to Stop Screen function button. The selected waveforms are copied to the Stop window and saved as a stage in memory.

In the following examinations, you can change the site number, test number or record number by pressing the Page Up or Page down key. Site number: Test number: Record number:

Operator's Manual MEB-9400

EMG, EOG, QEMG, SF EMG, Micro EMG, MICRO-N NCS F-wave, Rep. stim

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3. OPERATING THE MEB-9400

Saving Waveforms

You can temporarily save acquired waveforms and measurement result in memory. The Store Raw Wave setting on the Acquisition page of the Set Conditions window determines how many and which waveforms are saved when you save waveforms. • Press the STORE key on the operation panel. • Or, click the Store button on the Tool bar. • Or, select Store from the Examination menu. Examination menu → Store • Or, press the Shift + F7 key. When “Auto Store” (Set Conditions window → Misc page) is set to “On” (default setting), the waveforms are automatically saved by pressing the STOP key on the operation panel.

Deleting Waveforms from the Display

Before starting a new examination, delete previous waveform(s) from the Monitor, Sweep, Stop and Average windows. 1. Select the waveforms you want to delete. 2. Do one of following. • Press the ERASE key on the operation panel. • Or, click the

Erase button on the Tool bar.

• Or, select Erase from the Examination menu. Examination menu → Erase • Or, press the Shift + F8 key.

Printing

Printing the Measurement (Monitor, Sweep or Average) Window (Hard Copy) You can print the active measurement window (Monitor, Sweep or Average window) on the currently selected examination, including the waveforms and patient information and examination information. There are several ways to print: • Click the

Hard Copy button on the Tool bar.

• Or, select Hard Copy from the File menu. File menu → Print → Hard Copy • Or, press the Shift + F9 key, then press the F1 key. (When “Print Key” on the Misc. page of the Set Conditions window is set to “Hard Copy”)

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Operator's Manual MEB-9400

3. OPERATING THE MEB-9400 Printing the Waveforms and Data on the Stop, Saved or Gather Window (Review Printing) You can print waveforms on the Stop, Saved or Gather window together with patient information and condition information. You can select one of six waveform modes when you print. See Section 8 “Recording” for details. There are several ways to print: • Press the PRINT key on the operation panel. Or, press the Shift + F9 key, then press the F1 key. (When “Print Key” on the Misc. page of the Set Conditions window is set to “Hard Copy”) • To print one page of the Stop or Saved window, click the

Review Print

button on the Tool bar. • To print a different waveform mode, select Review Print from the File menu. File menu → Print → Review Print Printing a Report You can use Microsoft Word and Excel to print reports. The measurement data can be transferred to Word or Excel and converted to Word or Excel report format. • Click the

Report button on the Tool bar. • Or, select Report from the File menu. File menu → Print → Report

Saving a File

The waveforms and measurement data can be save in a patient file with a patient information by opening the Save dialog box. To open the Save dialog box, • Click the

Save As button on the Tool bar

• Or, select Save As from the File menu. File menu → Save As • Or, press the Shift + F9 key, then press the F2 key.

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3. OPERATING THE MEB-9400

Shortcut Keys

The function keys F1 to F9 on the keyboard correspond to the function buttons on the bottom of the screen. You can operate the system with the function keys.

When the Shift key is pressed: F1

F2

F3

F4

F5

F6

F7

F8

Menu

Settings

MONITOR

STIM/ SWEEP

ANALYIS

STOP

STORE

ERASE

F9

(next)

When the Shift + F9 key is pressed, the function button display changes as follow. F1

F2

F3

F4

F5

F6

F7

F8

F9

Print

Save

Imp-Check

Wave Sel.

Cursor Lat/Amp

Cursor A/B

Cursor ←

Cursor →

(next)

When the Ctrl key is pressed: F1

F2

F3

F4

F5

F6

F7

F8

CH1 JB/OFF

CH2 JB/OFF

CH3 JB/OFF

CH4 JB/OFF

CH5 OFF

CH6 OFF

CH7 OFF

CH8 OFF

When the Shift + Ctrl key is pressed, the function button display changes as follow. F1

F2

F3

F4

F5

F6

F7

F8

Intensity UP

Intensity DOWN

Stim Rate UP

Stim Rate DOWN

Stim Dur. UP

Stim Dur. DOWN

L/R

Reset

When a wave window is selected, the Page Up key corresponds to the SELECT ↑ key on the operation panel and the Page Down key corresponds to the SELECT ↓ key on the operation panel.

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3. OPERATING THE MEB-9400

Using the Footswitch The foot switch lets you do some operations, such as saving a waveform, by pressing a foot switch. There are two switches on the foot pedal, left and right. You can assign different functions to each switch on the Misc page of the Set Conditions window. On windows which allow foot switch operation, the function of each switch is displayed at the bottom right corner of the window.

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3. OPERATING THE MEB-9400

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Section 4 Working with the Main Menu Window General .............................................................................................................................. 4.1 Operating the Examination Program File ........................................................................... 4.2 Selecting the Examination Program ......................................................................... 4.2 Opening the Main Menu Window Saved in the Examination File ............................. 4.2 Opening the Examination Program in Preset Order ................................................ 4.3 Displaying the Patient Information When the Examination Program is Changed ..... 4.3 Using the Patient Information for All Examination Programs ................................... 4.3 Changing the Main Menu Window Display Format .................................................. 4.4 Minimizing the Main Menu Window .......................................................................... 4.5 Displaying the Online Operator’s Manual ................................................................. 4.5 Examination Program Operator’s Manual ...................................................... 4.5 Operator’s Manual ......................................................................................... 4.5 Displaying the Installed Optional Program Information ............................................ 4.5 Calling Up a Patient File ..................................................................................................... 4.6 Saving Changed Settings .................................................................................................. 4.7 Saving the Changed Settings as a New Examination Program File ........................ 4.7 Saving the Changed Settings in the Existing Examination Program File ................. 4.7 Editing the Main Menu Window .......................................................................................... 4.8 Opening the Select Category Dialog Box ................................................................ 4.8 Copying the Category Name ................................................................................... 4.8 Moving the Category Name ..................................................................................... 4.8 Closing the Select Category Dialog Box .................................................................. 4.8 Opening the Edit Category Dialog Box .................................................................... 4.9 Changing the Category Name ............................................................................... 4.10 Copying the Examination Program Name .............................................................. 4.10 Moving the Examination Program Name in the Edit Category Area ...................... 4.10 Deleting the Examination Program Name in the Edit Category Area ..................... 4.10 Checking the Examination Program Settings in the Set Conditions Window ......... 4.11 Changing the Examination Program Name and Comment .................................... 4.11 Closing the Edit Category Dialog Box .................................................................... 4.12

Operator’s Manual MEB-9400

4C.1

4. WORKING WITH THE MAIN MENU WINDOW

General You can select the examination program from the Main menu window. The settings of the Main Menu window can be changed according to your operation procedure. The changed settings can be saved as an examination program file. From the Main Menu window you can perform the following operations. • Opening the examination program. • Opening the saved examination program file on the Main Menu window. • Changing the category name, examination program name and comment for examination programs • Saving the changed settings on the Main Menu window as an examination program file. • Opening the patient file from the Main Menu window. • Displaying the patient information when the examination program is changed. • Automatically changing the examination program in preset order. • Using the patient information for all examination programs • Minimizing the Main Menu window when the examination program is performed. • Displaying the installed optional program information.

CAUTION • When using the system for brain death diagnosis, before examination, check and adjust the date and time of the system. The date and time on the screen and on the recording result are part of important information for the medical record. • During measurement, do not change the date and time. This makes the order of the saved event data and the time of the saved waveforms incorrect.

Operator's Manual MEB-9400

4.1

4. WORKING WITH THE MAIN MENU WINDOW

Operating the Examination Program File Selecting the Examination Program

When the power is turned on, the Main Menu window automatically opens with the latest settings. 1. Click the category tab. 2. Click the examination program button. Or, 1. Press the Tab key on the keyboard. 2. Select the examination program with the ←, →, ↑ or ↓ key on the keyboard, then press the Enter key. Or, 1. Press the MUSCLE/TEST ↑ ↓ key on the operation panel to select examination program. 2. Press the SIDE/SET key on the operation panel.

Opening the Main Menu Window Saved in the Examination File

You can open the Main Menu window with other settings which are saved as a different examination file. Use the Examination File Open dialog box to open a different examination file. 1. From the File menu, select Open. The Examination Program File Open dialog box opens. Create a new folder Up one level

List button

Detail button

File name box

Open button

Cancel button

If the file that you want to open is on a different folder or drive, select the folder or drive from the Look in box. 4.2

Operator's Manual MEB-9400

4. WORKING WITH THE MAIN MENU WINDOW Use the

Details button to display the detailed file information. When this

button is clicked the file name as well as size, type and date appear in the file list box. You can arrange the file display by name, size or date, etc. in ascending or descending order by clicking each title. To only display the file name, click the

List button.

You can also select the file by typing the file name in the File name text box. 2. Click the file you want to open. The selected file is highlighted and the category names, examination program names and the comments for the examination program that are saved in the selected file appear in the Category List and Examination List area. When the selected file is not program file, the “This file is not an examination program file.” message appears. Click the OK button and select the proper file. 3. Click the Open button. The Main Menu window opens with the selected examination file. You can also open the file by double-clicking its in the list box. The latest settings of the Main Menu window remain in memory after the power is turned off. To cancel it, click the Cancel button.

Opening the Examination Program in Preset Order

When the “Menu Key Selects next Menu” check box is checked, the examination program automatically changes to the next examination program by pressing the MENU key on the operation panel. To cancel it, click the check box again.

Displaying the Patient Information When the Examination Program is Changed

To automatically display the Patient Information dialog box when the examination program is changed, click the “Show Patient Information at Menu Select” check box on the Main Menu window. To cancel it, click the check box again.

Using the Patient Information for All Examination Programs

To use the patient information for all examination programs, click the “Keep Patient Information from previous Menu” check box on the Main Menu window. To cancel it, click the check box again.

Operator's Manual MEB-9400

4.3

4. WORKING WITH THE MAIN MENU WINDOW

Changing the Main Menu Window Display Format

From the Option menus, select Display1, Display2 or Display3 to change the Main Menu window display format. Display 1

Display 2

Display 3 (Neuropack Manager) When selecting Display 3, the examination program buttons in the leftmost category tab of the Display 1 are displayed on the Quick Menu area.

New Patient button: Quick Menu buttons: System Operation buttons Wave Open: File Utility: Menu Edit:

Operation Manuals: Examination Guide:

Opens the Patient Information dialog box to enter the patient information. Opens the examination window. Opens the Open dialog box to select the patient file. For the patient file, refer to Section 7 “Filing”. Opens the File Management dialog box. For the file management, refer to “File Management” in Section 7. Opens the Edit Category dialog box to edit the Main Menu Window. Refer to “Editing the Main Menu Window” in this section. Displays the online operator’s manual. Displays the online examination guide. To display the online manuals, install Adobe® Acrobat® Reader from the System CD-ROM.

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4. WORKING WITH THE MAIN MENU WINDOW

Minimizing the Main Menu Window

From the Option menu, select Auto Minimize. The Main Menu window is automatically minimized when the examination program is selected from the Main Menu or the MENU key on the operation panel is pressed. To restore the Main Menu window, click the Main Menu on the Taskbar. To cancel it, select Auto Minimize again.

Displaying the Online Operator’s Manual

Examination Program Operator’s Manual From the Help menu, select Examination Guide. The online examination program Operator’s manual can be displayed.

Operator’s Manual From the Help menu, select Index. The online operator’s manual can be displayed. To display the online manuals, install Adobe® Acrobat® Reader from the System CD-ROM.

Displaying the Installed Optional Program Information

From the Help menu, select About. The About dialog box opens. The installed optional examination program name, version, installed date and executive file name are listed in the About dialog box. To close the About dialog box, click the OK button.

Operator's Manual MEB-9400

4.5

4. WORKING WITH THE MAIN MENU WINDOW

Calling Up a Patient File Even when the examination program window is not opened, you can open a patient file from the Main Menu window. 1. From the File menu, select Wave Open. The Open dialog box opens.

2. Open the patient file that you want. Refer to “Opening the Patient File” in Section 7.

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4. WORKING WITH THE MAIN MENU WINDOW

Saving Changed Settings Saving the Changed Settings as a New Examination Program File

1. From the File menu, select Save as. The Examination Program File Save dialog box opens.

2. If you want to save the file in a different folder or drive, select the folder or drive from the Save in box. 3. Type an appropriate file name in the File name box. When a doctor name and/or examiner name is used as a file name, click the check box in the as File Name area. The Doctor and Examiner box contains the user-defined file names. You can also add an examination number (up to 999) to the file name to identify each file. To add an examination number, click the Add Suffix check box. When the examination number reaches 999 and the next file is saved with an examination number, the “Cannot assign file number because too many files are saved.” message appears and the file number is set to 999. 4. Click the Save button. The Examination Program File Save dialog box closes. To cancel saving, click the Cancel button. The Examination Program File Save dialog box closes.

Saving the Changed Settings in the Existing Examination Program File

Operator's Manual MEB-9400

From the File menu, select Save. The changed settings are saved in the existing examination program file.

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4. WORKING WITH THE MAIN MENU WINDOW

Editing the Main Menu Window The category name can be changed, copied or moved to another button.

NOTE The currently selected examination program cannot be edited.

Opening the Select Category Dialog Box

From the Edit menu, select Select Category. The Select Category dialog box opens.

Edit button: OK button:

Opens the Edit Category dialog box for the selected category. Saves the changed settings and closes the Select Category dialog box. Cancel button: Cancels the changes and closes the Select Category dialog box.

Copying the Category Name

Drag the category name to another button while pressing the Ctrl key. The selected category name is copied.

Moving the Category Name

Drag the category name to another button. The selected category name is moved.

Closing the Select Category Dialog Box

To save the changed settings and close the Select Category dialog box, click the OK button. The changed settings are saved and the Select Category dialog box closes. To cancel changes, click the Cancel button. The dialog box closes.

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4. WORKING WITH THE MAIN MENU WINDOW

Opening the Edit Category Dialog Box

1. Click Edit on the menu bar on the Main Menu window. The Select Category dialog box opens. 2. Click the category button you want to edit on the Select Category dialog box. 3. Click the Edit button. The Edit Category dialog box opens. For the selected category, you can change the category name and examination programs in the Edit Category area. Another category and its examination programs appear in the Use as Base Category area as a reference. 4. Select the reference category from the Name text box in the Use as Base Category area. The examination programs of the selected category are displayed on the Examination List area.

Edit Category area:

Displays the currently selected category name and its program names. To change the category name, type in the new name in the Name box Use as Base Category area: Displays the reference category name and its examination program name. To select the reference category, click the Name box arrow. Edit Examination button: Opens the Edit Examination dialog box to change the examination program name and its comment. Condition button: Displays the settings of the selected examination program. Move button: Moves the examination program name in the Edit Category area. Copy button: Copies the examination program name from the Use as Base Category area or Edit Category area to the Edit Category area. Delete button: Deletes the examination program name in the Edit Category area. Save one list button: Opens the Save As dialog box to save the currently selected category settings as a file (extension: .menu). Load one list button: Opens the Open dialog box to load the saved category settings. OK button: Saves the changed settings and closes the Edit Category dialog box. Cancel button: Cancels the changes and closes the Edit Category dialog box. Operator's Manual MEB-9400

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4. WORKING WITH THE MAIN MENU WINDOW

Changing the Category Name

1. Select the Name text box in the Edit Category area of the Edit Category dialog box. 2. Type in the new name with up to 20 characters.

Copying the Examination Program Name

1. Click the examination program name button that you want copy from in the Edit Category area or Use as Base Category area. The selected program name button is down 2. Click the Copy button. 3. Click the destination button in the Edit Category area. The selected examination program name is copied here. Or, drag the examination program name from the Use as Base Category area to the destination button in the Edit Category area.

Moving the Examination Program Name in the Edit Category Area

NOTE The examination program name cannot be moved from the Use as Base Category area to the Edit Category area. 1. Click the examination program name button that you want to move from in the Edit Category area. 2. Click the Move button. 3. Click the destination button in the Edit Category area. The selected examination program name is moved here. Or, drag the examination program name to the destination button.

Deleting the Examination Program Name in the Edit Category Area

NOTE The examination program name in the Use as Base Category area cannot be deleted. 1. Click the examination program name button that you want to delete in the Edit Category area. 2. Click the Delete button. The selected examination program name is deleted.

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4. WORKING WITH THE MAIN MENU WINDOW

Checking the Examination Program Settings in the Set Conditions Window

1. Click the examination program name button that you want to check the settings in the Edit Category area. 2. Click the Condition button. The Set Conditions window opens. 3. Check the settings on the Set Conditions window.

Changing the Examination Program Name and Comment

You can change the examination name and comment with the Edit Examination dialog box. 1. Open the Edit Examination dialog box 1) Open the Select Category dialog box 2) Click the examination program name in the Edit Category area. 3) Click the Edit Examination button. The Edit Examination dialog box opens. The preset names of the examination program appear in the Select Examination list box.

Select Examination: Main Name:

Displays the examination program names. Type in the new examination program name when program name change is required. Sub Name: Type in the comment for the examination program. Use Nerve as Sub Name: Select and click the nerve name when the nerve name is required as a comment. 2. Change the examination program name Click the examination program name that you want to change to in the Select Examination list box. The selected name is highlighted in the Select Examination list box and displayed in the Main Name text box. When the desired examination program name is not listed in the Select Examination list box, select any program name and type in an appropriate name in the Main Name text box with up to 20 characters.

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4.11

4. WORKING WITH THE MAIN MENU WINDOW 3. Enter the comment Select the appropriate comment in the Sub Name text box or type in appropriate comment with up to 20 characters. You can preset the comment with the User Settings dialog box. Refer to Section 9 “System Settings”. 4. Enter the nerve name as a comment. When the selected examination program is SEP, SSEP, ECG-SSEP, ESCP, Electric, MCS, SCS, Rep. STIM, F-wave, Hwave, H-reflex, Collision or Blink, a nerve name can be entered as a comment. 1) Click the Use Nerve as Sub Name button. The Nerve List box appears. 2) Click the nerve name that you want to enter. The selected nerve name appears in the Sub Name text box. You can preset the nerve name with the User Settings dialog box. Refer to Section 9 “System Settings”.

5. Click the OK button to save the changed settings and close the Edit Examination dialog box, To cancel changes, click the Cancel button. The dialog box closes.

Closing the Edit Category Dialog Box

Click the OK button on the Edit Category dialog box to save the changed settings and close the Edit Category dialog box. To cancel changes, click the Cancel button. The dialog box closes.

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Section 5 Selecting the Measurement Settings General .............................................................................................................................. 5.1 Condition Pages ....................................................................................................... 5.1 Opening the Set Conditions Window and Selecting a Condition Page ..................... 5.2 Changing Settings in a Table ................................................................................... 5.3 Changing a Setting for One Channel ............................................................. 5.3 Changing a Setting for Two or More Consecutive Channels .......................... 5.3 Changing a Setting for All Channels .............................................................. 5.3 Saving or Undoing Setting Changes ........................................................................ 5.3 Saving Settings .............................................................................................. 5.3 Undoing Setting Changes .............................................................................. 5.3 Closing the Set Conditions Window ......................................................................... 5.3 Amp Page .......................................................................................................................... 5.4 Acquisition Page ................................................................................................................ 5.7 Trigger Page ..................................................................................................................... 5.10 Electric Page .................................................................................................................... 5.15 Auditory Stim Page .......................................................................................................... 5.17 Visual Page ...................................................................................................................... 5.20 Display Page .................................................................................................................... 5.22 Labeling Page .................................................................................................................. 5.24 Table Page ....................................................................................................................... 5.27 Misc Page ........................................................................................................................ 5.28

Operator’s Manual MEB-9400

5C.1

5. SELECTING THE MEASUREMENT SETTINGS

General Measurement settings are preset at the factory. You can change and save measurement settings with the Set Conditions window.

Condition Pages

The Set Conditions window has ten pages of settings: Amplifier settings: Acquisition settings: Trigger settings Electric stimulation settings: Auditory stimulation settings: Visual stimulation settings: Display settings: Labeling settings: Table settings: Miscellaneous settings:

Operator's Manual MEB-9400

Amp page Acquisition page Trigger page Electric page Auditory Stim page Visual page: Display page Labeling page Table page Misc page

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5. SELECTING THE MEASUREMENT SETTINGS

Opening the Set Conditions Window and Selecting a Condition Page

To open the Set Conditions window and select a condition page: 1. Click the

Condition button on the Tool bar. The Set Conditions window

opens. 2. Click the condition tab to select a condition page. The selected page comes to the front. Condition tab

Or,

Select the condition from the Condition menu on the examination window. Condition menu → Required condition command The Set Conditions window opens with the selected condition page in front.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS

Changing Settings in a Table

Use the following procedures to change settings which are in a table. Changing a Setting for One Channel 1. Select the setting that you want to change. A Parameter List box opens next to the selected setting. 2. Select the new setting. The setting of the selected channel is changed.

Changing a Setting for Two or More Consecutive Channels 1. Drag over a setting for two or more consecutive channels. A Parameter List box opens next to the selected settings. 2. Select the new setting. The setting of the selected channels is changed.

Changing a Setting for All Channels 1. Click the button at the top of the column. The selected button is depressed. A Parameter List box opens next to the selected button. 2.

Saving or Undoing Setting Changes

Select the new setting. The setting of all channels is changed.

When you change a setting, the new setting is applied immediately. New settings remain until the power is turned off. You can save or undo new settings with the Backup or Initialize button. The Backup and Initialize buttons apply to all settings on all pages of the Set Conditions window.

Saving Settings Click the Backup button to save all current settings. Saved settings remain after the power is turned off.

Undoing Setting Changes 1. Click the Initialize button. A confirmation dialog box appears. 2. Click the Yes button to undo all setting changes. All settings return to the previously saved settings.

Closing the Set Conditions Window Operator's Manual MEB-9400

Click the Close button to close the Set Conditions window.

5.3

5. SELECTING THE MEASUREMENT SETTINGS

Amp Page

Example: JB-944BK Input channel table Input Select Selects the input source from either JB (Electrode junction box) or OFF (No input). You can change the input source to JB or OFF by pressing the Ctrl key + F1 to F4 key on the keyboard. The F1 to F4 keys correspond to channels 1 to 4. Electrode (-)/Electrode (+) Selects a pair of electrode names for each channel to acquire the waveforms from A1, A2, A+, Fz, Pz, C3, C4, Cz,, Oz, LO, RO, LT, RT, C5S, EP1, EP2, X1, X2, X3, X4, X5, X6, X7, X8 and DIN

NOTE When the location of the attached electrode and these settings are different, the correct waveform is not acquired. Sens. (/div) Selects the amplifier sensitivity. When “Additional Amplifier” is set to “Velocity”, this selects the amplitude of the velocity waveform. Hi cut Selects the high-cut filter frequency of the amplifier. Lo cut Selects the low-cut filter frequency of the amplifier.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Additional Amplifier Selects the processing when acquiring the waveforms. OFF: No processing is performed. Integral: Displays the integral of the acquired waveforms using the reset threshold which is selected in “Reset”. Mean: Displays the envelope of the acquired waveforms using the time constant which is selected in “Time Constant”. When a lower time constant is selected, higher resolution waveform envelope appears (with more slices per time). Velocity: Displays velocity waveform. Reset Selects the amplitude threshold at which the integrated waveform is reset when the “Additional Amplifier” is set to “Integral”. Time Constant Selects the time constant to obtain the envelope of the waveform when “Additional Amplifier” is selected to “Mean”. Rectify Selects the rectification mode. OFF: No rectification. HALF: Half-wave rectification FULL: Full-wave rectification

Speaker (ON/OFF) Selects “ON” to turn on the speaker on the operation panel. Dual Sens. Check this box to display the acquired waveforms with two different sensitivities by separating the waveform first period and second period. Smoothing Check this box to smooth the waveform in the second period by the moving average method when “Dual Sens.” is checked. Right Sens. Selects the sensitivity of the second period for the first period when “Dual Sens” is checked. Split Pos Selects the sensitivity separating position when “Dual Sens” is checked. Operator's Manual MEB-9400

5.5

5. SELECTING THE MEASUREMENT SETTINGS Smoothing Point Selects the number of the sampling points when “Smoothing” is checked. CAL Check this box to display the calibration waveform. CAL Level Selects the amplitude of the calibration waveform. Sound off at Saturation Check this box to turn off the speaker on the operation panel for 250 ms when the amplitude of the acquired waveform is +10 div or more. AC Filter Check this box to reduce 50 or 60 Hz AC interference. To select the AC filer frequency, refer to “Setting the System Condition” in Section 9. Auto Sens. Check this box to automatically reduce the amplifier sensitivity when the amplitude of the acquired waveform is ±5 div or more. The amplifier sensitivity is reduced in one step. Fast Recovery Check this box to immediately recover the baseline which is affected by stimulation artifact. The time constant is set to 15.9 seconds for 1 ms after stimulation.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS

Acquisition Page

Example: JB-944BK

Input channel table Sampling time Selects the sampling time. Monitor (/div) Selects the sweep time for the Monitor window for horizontal 1 div Analysis (/div) Selects the analysis time for horizontal length (scale/division) for trigger sweep and average. Setting range: 0.1 to 0.9 ms in 0.1 ms steps 1 to 9.5 ms in 0.5 ms steps 10 to 99 ms in 1.0 ms steps 100 to 1000 ms in 10 ms steps Delay Time Selects the delay time from the trigger point to the analysis start point from -10 to +10 div with 1 div as 1/10 analysis time. Setting range: 0 to 99.9 ms in 0.1 ms steps 100 to 500 ms in 1.0 ms steps Preset Count Selects the number of waveforms to acquire or average.

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5.7

5. SELECTING THE MEASUREMENT SETTINGS Reject Level Selects the amplitude threshold (div) to select the acquired waveforms for averaging. When the amplitude of the waveform exceeds the upper or lower threshold, it is not included in averaging. Store Raw Wave Selects which waveforms are saved when the STORE key is pressed. OFF: The latest evoked, averaged waveform on the Sweep window. Gather: All evoked waveforms including waveforms not currently displayed in the Sweep, Stop and Average windows. This setting saves the most waveforms. Up to 9,999 waveforms can be saved. Monitor: Continuous waveform (raw waveform). This item is only available in EMG, QEMG, EOG and MICRO-N. Store Time: Sets the total storage time for all continuously acquired EMG, QEMG, EOG or MICRO-N waveforms. Up to 600 seconds of waveforms can be temporarily saved. Analysis Key for Wave Acquisition Select the function of the ANALYSIS key on the operation panel. Gather: Acquires the waveforms. The number of waveforms is set in “Preset Count”. Average: Averages the acquired waveforms. The number of waveforms is set in “Preset Count”. Store: Acquires the waveforms for the length set in the Store Time setting in the Store Raw Wave area. This setting is only available for the EMG, EOG, Macro EMG, MICRO-N and QEMG examinations. Common Reject When a large noise interfered with a Sweep window waveform during averaging, the affected waveform can be removed from averaging. Common Reject selects the method to remove the waveform. The limit is set at Reject Level. The Reject Level can be set for each channel respectively. This item works only when channels use the same trigger source and have the same analysis time. ON: When noise interferes with a sweep waveform acquired from one channel and the waveform amplitude exceeds the Reject Level, the waveform and all other sweep waveforms which were simultaneously acquired from other channels are also removed. OFF: When noise interferes with a sweep waveform acquired from one channel and the waveform amplitude exceeds the Reject Level, only the sweep waveform is removed from averaging. Single Stim. Check this box to output one trigger signal for the trigger channel when “Trigger Mode” is set to “Recurrent” or Random” in the Set Conditions window - Trigger page when acquiring the waveforms in the Sweep window by pressing the STIM/ SWEEP key on the operation panel.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Alternate Average (Odd/Even) Check this box to alternately acquire the waveforms in two stages (first one stage, then the other stage). Signal Reject In the Sweep window and Averaging window, you can select the raw waveforms for averaging. The channel selected in “Signal Reject Channel” can be averaged. OFF: Averages all raw waveforms for the preset period. Level: Averages the preset period of the raw waveform when the waveform exceeds LEVEL (trigger level cursor). Window: Acquires the preset period of the waveform when the raw waveform exceeds LEVEL 1 (trigger level cursor A) but does not exceed LEVEL 2 (trigger level cursor 2). Window

Level LEVEL 2

LEVEL

LEVEL 1 Trigger point End of the screen

Start of waveform acquisition End of the screen

Signal Reject Channel. Select the channel for “Signal Reject”. Acquisition Length Selects the duration from 10 or 20 div of the acquired waveform. Display Length Selects the horizontal scale of the Monitor window from 10 div or 20 div when acquiring EMG, EOG, QEMG, MICRO-N, SF EMG, Macro EMG, ECG (R-R interval measurement) waveforms.

Operator's Manual MEB-9400

5.9

5. SELECTING THE MEASUREMENT SETTINGS

Trigger Page

Trigger table Trigger Mode Selects the trigger mode. OFF: No trigger signal is used. Recurrent: Generates a trigger signal at the stimulation rate which is set in “Stim Rate”. Random: Generates a trigger signal at a random rate within 50% of the stimulation rate which is set in “Stim Rate”. Signal: Generates a trigger signal when trigger source waveform amplitude exceeds the preset threshold. The amplitude threshold is set to the amplitude of the waveform acquired in the channel which is set in “Signal Trigger Channel”. Foot SW: Generates a trigger signal when the right foot switch is pressed. EXT 1: Generates a trigger signal synchronized with an external trigger signal which is input to the TRIGGER IN/OUT connector of the main unit. Stim Rate Selects the stimulation frequency. You can type in the frequency with the keyboard. Setting range with the keyboard: 0.1 to 100.0 Hz in 0.1 Hz steps

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Wave Mode Selects the stimulation signal output method. Single: One stimulation signal is output to a trigger signal.

Double: Two stimulation signals are output to a trigger signal

The stimulation interval is set in “Stim Interval”. TRAIN: Three or more stimulation signals are output to a trigger signal.

The stimulation interval is set in “Stim Interval” and the train stimulation output way is set in “Train”. Stim. Interval Selects the stimulation interval. You can type in the interval with the keyboard. Setting range with the keyboard: 0 to 60 ms in 0.01 ms steps 60 to 99 ms in 1 ms steps 100 to 990 in 10 ms steps 1,000 to 10,000 ms in 100 ms steps Train Mode Selects the train stimulation output method. This item is only available when “Wave Mode” is set to “Train”. Number: Outputs the stimulation signals to a trigger signal. The number of the stimulation signals is set in “Train Number”. Time: Outputs the stimulation signal to a trigger. The duration of the stimulation signal is set in “Train Time”.

Operator's Manual MEB-9400

5.11

5. SELECTING THE MEASUREMENT SETTINGS Train Number Selects the number of stimulation signals for the train stimulation (i.e. when “Train Mode” is set to “Number”). You can type in the number with the keyboard. Setting range with the keyboard: 2 to 99 in one step. Train Time Selects the interval between the stimulation signals for the train stimulation (i.e. when “Train Mode” is set to “Number”). You can type in the number with the keyboard. Setting range with the keyboard: 1 to 120 s in 1 s steps. Stimulator Selects the stimulation source. Somato: Electrical stimulator Auditory: Auditory stimulator Goggle: Flash stimulation for both eyes with the optional LS-102J LED Goggles Goggle-L: Flash stimulation for a left eye with the optional LS-102J LED Goggles Goggle-R: Flash stimulation for a right eye with the optional LS-102J LED Goggles Pattern: Pattern reversal stimulation with the optional CRT Monitor EXT: External instrument Signal Trigger Channel Selects the channel for the trigger signal. The amplitude threshold is set to the amplitude of the waveform acquired in the selected channel. Trigger Slope Selects which part is used as the trigger point of the trigger source waveform. This item is only available when “Trigger Mode” is set to “Signal”. Rising: Upward slope of the trigger source waveform. Falling: Downward slope of the trigger source waveform.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Inhibit Time “Reject Level” in the Set Conditions window - Acquisition page selects the amplitude threshold the acquired waveforms for averaging. When the amplitude of the waveform exceeds the upper or lower threshold, it is not included in averaging. You can include the waveform that exceeds the upper or lower threshold by setting “Inhibit Time”. Reject Level

Reject Level

Baseline

Baseline

Reject Level

Reject Level

Inhibit Time Trigger point

Inhibit Time Trigger point

Waveform is not included.

Both waveform is included in averaging.

Signal Trigger Mode Selects the trigger level and trigger point. OFF: Acquires the preset period of the raw waveform as a sweep wave when the raw waveform exceeds a trigger level cursor.

LEVEL

TRIGGER OUTPUTsignal

Waveforms 1 and 2 are acquired.

Window:

Acquires the preset period of the raw waveform when the raw waveform exceeds the LEVEL 1 cursor but does not exceed the LEVEL 2.

LEVEL 2 LEVEL 1

TRIGGER OUTPUT signal

Only waveform 1 is acquired.

Rise Time: Acquires the raw waveform when the raw waveform exceeds a trigger level and the Rise Time (the time interval between 10 and 90% (peak to peak) of the raw waveform) is less than “Rise Time Threshold”. Operator's Manual MEB-9400

5.13

5. SELECTING THE MEASUREMENT SETTINGS

Rise Time 1

Rise Time 2

LEVEL

TRIGGER OUTPUT signal

When “Rise Time 1” < “Rise Time Threshold” < “Rise Time 2”, only waveform 1 is acquired.

Rise Time Threshold Selects the time interval when “Signal Trigger Mode” is set to “Rise Time”. Increment Mode Increases the stimulation delay time interval from the main trigger signal or previous stimulation. The delay time is set in “Increment Step”. OFF: Does not increase the stimulation time interval Delay N: Increase the stimulation delay time interval from the main trigger signal. Interval N: Increase the stimulation delay time interval from the previous stimulation. Increment Step Selects the stimulation delay time interval from the main trigger signal. You can type in the delay time with the keyboard. Setting range: 10 to 500 µs in 10 µs steps. Continuous Stim. When this box is checked, stimulation is not stopped when averaging is complete and the Stop window opens. To manually stop stimulation when this box is checked, press the STOP key on the operation panel. Soft Start Check this box to start stimulation with no stimulation intensity. The stimulation intensity is automatically increased and the averaging starts when the stimulation intensity reaches the selected intensity.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS

Electric Page

Somato table Intensity Selects the intensity of the electrical stimulation signal. You can type in the intensity with the keyboard. Setting range: 0.0 to 100.0 mA in 0.1 mA steps Duration Selects the duration of the electrical stimulation signal. You can type in the width with the keyboard. Setting range with the keyboard: 0.01 to 1.00 ms in 0.01 ms steps Output Select “ON” to output the electric stimulation signal. Output Limit Selects the maximum current for each electrical stimulator. Output Step Select the step “0.1 mA”, “0.2 mA” or “1 mA” for the stimulation intensity adjust button of the RY-441B Somato control box and stimulation intensity dial on the operation panel. The intensity can be increased and decreased with the selected step by pressing the stimulation intensity adjust button or with the selected intensity by turning the stimulation intensity dial.

Operator's Manual MEB-9400

5.15

5. SELECTING THE MEASUREMENT SETTINGS Safety Mode

CAUTION Always check the Safety Mode box for patient safety.

“Safety Mode” is checked for patient safety when the power is turned on. When “Safety Mode” is checked, the range of the electric stimulation intensity, duration and rate is limited for patient safety. For research or advanced study which requires no limitation, uncheck this box.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS

Auditory Stim Page

Auditory table Waveform Selects the shape of the auditory stimulation signal. Click: Rectangular shape wave. The duration is set in “Click Duration”. Burst: Tone burst (modified sine wave). The duration is set in “Plateau Time”, the rising and falling period is set in “Rise/Fall Time” and the frequency is set in “Tone Freq.”. Output Phase Selects the phase of the auditory stimulation signal. Cond: Positive phase Rare: Negative phase Alter: Alternating phase

Click Duration Selects the duration of the click wave for auditory stimulation. This item is only available when “Waveform” is set to “Click”. You can type in the duration with the keyboard. Setting range with the keyboard: 0.1 to 1.0 ms in 0.1 ms steps

Operator's Manual MEB-9400

5.17

5. SELECTING THE MEASUREMENT SETTINGS Tone Freq. Selects the frequency of the tone burst (modified sine wave) auditory stimulation signal. This item is only available when “Waveform” is set to “Burst”. You can type in the frequency with the keyboard. Setting range with the keyboard: 50 to 125 Hz in 25 Hz steps 150 to 450 Hz in 50 Hz steps 500 to 2,900 Hz in 100 Hz steps 3,000 to 10, 000 Hz in 500 Hz steps. Plateau Time Selects the plateau time (duration) of the tone burst (modified sine wave) auditory stimulation signal. This item is only available when “Waveform” is set to “Burst”. You can type in the plateau time with the keyboard. Setting range with the keyboard: 0 to 1,000 ms in 1 ms steps

Rise/Fall Time Selects the rising and falling period of the tone burst (modified sine wave) auditory stimulation signal. This item is only available when “Waveform” is set to “Burst”. You can type in the rising and falling period with the keyboard. Setting range with the keyboard: 0.1 to 9.9 ms in 0.1 ms steps 10 to 3,000 ms in 1 ms steps Intensity Left Selects the intensity of the left auditory stimulation signal. You can type in the intensity with the keyboard. Setting range with the keyboard: 0 to 135 dB SPL in 5 or 1 dB steps Intensity Right Selects the intensity of the right auditory stimulation signal. You can type in the intensity with the keyboard. Setting range with the keyboard: 0 to 135 dB SPL in 5 or 1 dB steps Stim. Site Left Selects the auditory stimulation site. OFF: No stimulation ON: Left ear Mask: The white noise for masking is applied to the left ear. The white noise intensity is the intensity set in “Intensity Right” + the intensity set in “Mask Level”.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Stim. Site Right Selects the auditory stimulation site. OFF: No stimulation ON: Right ear Mask: The white noise for masking is applied to the right ear. The white noise intensity is the intensity set in “Intensity Left” + the intensity set in “Mask Level”. Mask Level Selects the intensity of the signal output as white noise. The white noise is applied to the ear which is not examined to mask it from the stimulation. Distance Selects the distance between the patient and external speaker for auditory stimulation. The delay time (0.03 ms/cm) for the distance is compensated when the latency of the auditory evoked potential is measured. You can type in the distance with the keyboard. Setting range the keyboard: 0 to 100 cm in 1 cm steps 0 dB nHL Ref. Selects the reference sound pressure for nHL (Normal Hearing Level). First set 0 dB nHL Ref to 0 and perform the personal hearing threshold test, then set in “0dB HL Ref” to the threshold value. You can type in the reference pressure (threshold value) with the keyboard. To indicate the stimulation intensity in SPL (Sound Pressure Level), set “0dB HL Ref” to 0. Setting range with the keyboard: 0 to 50 in one step Output Step Select “5 dB” or “1 dB” steps for the auditory stimulation intensity of the stimulation intensity dial on the operation panel. The intensity can be increased and decreased in the selected steps by turning the stimulation intensity dial on the operation panel.

Operator's Manual MEB-9400

5.19

5. SELECTING THE MEASUREMENT SETTINGS

Visual Page

Pattern Location Selects the location where the pattern is displayed on the optional CRT monitor for pattern reversal stimulation. Pattern Size Selects the size of the pattern displayed on the CRT monitor for pattern reversal stimulation. Display Pattern Selects the pattern for pattern reversal stimulation. Check: Displays the checked pattern on the CRT monitor. H-Bar: Displays the horizontal bars (stripes) on the CRT monitor. V-Bar: Displays the vertical bars (stripes) on the CRT monitor. Display Mode Selects the pattern for the visual stimulation on the CRT monitor. Reverse: Displays the reversing pattern on the CRT monitor (Pattern reversal visual stimulation). Flash: Displays the flashing pattern on the CRT monitor (Flash pattern visual stimulation). The duration of each flashing pattern is set in “Pattern Display Time”.

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Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Pattern Display Time Selects the duration of each flash pattern for the visual stimulation. You can type in the duration with the keyboard. Setting range with the keyboard: 20 to 1,000 ms in 10 ms steps Target Display:

Check this box to display an indicator on the CRT monitor in the pattern reversal visual stimulation. V position: Selects the vertical position of the indicator. H position: Selects the horizontal position of the indicator. Trigger V-sync. Check this box to display the Monitor window synchronized with the pattern reversal stimulation signal. Goggles Side Left /Goggle Side Right (area) Check the box to select the visual stimulation sight from left, right or both.

Operator's Manual MEB-9400

5.21

5. SELECTING THE MEASUREMENT SETTINGS

Display Page

Graticle Display Selects scale displayed on the Waveform window Frame: Displays the vertical scale at the left side of the screen and horizontal scale at the bottom of the screen. Dot: Frame with a dot grid. Vertical: Frame with vertical dotted lines. Grid: Frame with horizontal and vertical dotted lines. Split Screen Selects the display format on the Waveform window. The Waveform window can be separated to up to 4 areas. Show Vertical Scale Check this box to display the sensitivity for each waveform on the Waveform window. Show Analysis Time Check this box to display the analysis time for each waveform on the Waveform window. Cascade Display in (Monitor/Sweep Mode , Stop Mode) Check the box to display cascaded waveforms on the Monitor/Sweep windows and/or Stop window. Traces per Field Selects the number of waveforms displayed on one screen. 5.22

Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Field Assign Selects the area to display the waveform. Use Auto Positioning Check this box to automatically move the waveform to the best position on the screen when the stage, stimulation site (right or left) and/or stimulation intensity changes. The following options are available. You can select up to three options simultaneously. Stage: Auto positioning is done when the stage changes. Stim Site: Auto positioning is done when the stimulation site changes. Stim Intensity: Auto positioning is done when the stimulation intensity changes. • Example 1 When Stage and Stim. Site is checked in the Position Key 1 Auto positioning is done only when both the Stage and Stimulation Site change. • Example 2 When Stage is checked in the Position Key 1 and Stim. Site is checked in the Position Key 2 Auto positioning is done when either the stage changes or the stimulation site changes.

Operator's Manual MEB-9400

5.23

5. SELECTING THE MEASUREMENT SETTINGS

Labeling Page

Mark table Label Selects the label for marking the waveform. Mark Type Selects the mark type. The following marks are available.

Mark Position Selects the amplitude mark position on the response waveform when the Auto Mark check box is checked. Take Off: Sets the mark on the rising point (onset position). Peak: Sets the mark on the peak point. Bottom: Sets the mark on the bottom point. Cross: Sets the mark on the first baseline crossing point. End: Sets the mark on the second baseline crossing point.

5.24

Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Label Disp. Select “ON” to display the label which is set to the waveform. Mark Disp. Select “ON” to display the mark on the waveform. Auto Marking Check this box to automatically set the mark on the waveform. The marked position is set in “Mark Position”. Auto Baseline Check this box to automatically change the baseline position of each waveform trace according to the examination item and delay time. When this box is not checked, the baseline position of each waveform trace is fixed at the electrical zero point at the internal A/D converter. Measurement Table Type Selects the Measure Table window type to display the durations, amplitudes and analysis results. Type I: The durations, amplitudes and analysis results are displayed in the several windows. Type II: The durations, amplitudes and analysis results are displayed in one window. Show Annotation Selects the annotation position on the waveform. OFF: Does not annotate the waveform Left: Aligns the beginning of the annotation and the beginning of the waveform. Right: Aligns the end of the annotation and the end of the waveform. Use Electrode as Annotation Check this box to display the electrode name ((−) electrode name – (+) electrode name) as an annotation. Display Intensity Check this box to display stimulation intensity with annotations on the waveform. Show on Measurement Table Annotation: Check this box to display the annotation on a Measurement Table window. Intensity: Check this box to display the stimulation intensity on a Measurement Table window.

Operator's Manual MEB-9400

5.25

5. SELECTING THE MEASUREMENT SETTINGS Area Calculation Mode Selects the area calculation mode Base: Calculate the area bounded by the waveform, the baseline and the vertical lines from the two marks (L1 and L2) to the baseline. Mark: Calculates the area bounded by the waveform and the line between the two marks (L1 and L2). Base

Mark

Enable Inhibit Period Check this box to inhibit marking for a certain period after start of measurement when the Auto Mark check box is checked. Period Enter a period in milliseconds, which is used to calculate the inhibit marking period. Inhibit marking period (div) = Period (ms) / Analysis time (ms)

5.26

Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS

Table Page

Condition Table These items are displayed on the Condition Table window. Condition List Lists items which can be added to the Condition Table. Condition Selects the type of items in the Condition Table and Condition List. > button Moves the selected item in the Condition Table to the Condition List. Add All button Adds all items listed in the Condition List to the Condition Table. Remove All button Moves all items in the Condition Table to the Condition List. Up/Down button Moves the selection up or down in the Condition Table. Default button Sets all items in the Condition List and the Condition Table to the factory default settings.

Operator's Manual MEB-9400

5.27

5. SELECTING THE MEASUREMENT SETTINGS

Misc Page

Show Intensity Window Check this box to display the window which displays the stimulation intensity. On the Intensity window, you can set the stimulation output on or off. Show Measurement Window Check this box to display the Measurement window for each examination program when the examination program opens. Show Nerve/Muscle Table Check this box to display the table to enter nerve name or muscle name when the examination program opens. Show Manual MUP Window (EMG examination program only) Check this box to display the Manual MUP window when the EMG examination window opens. Show Operation Window Check this box to display the operation panel window when the examination program opens. Auto Store Check this box to automatically save the acquired waveform in temporary memory when the STOP key on the operation panel is pressed. Auto V-gain Check this box to automatically enlarge the averaged waveform on the screen in the ratio determined by the averaging count. 5.28

Operator's Manual MEB-9400

5. SELECTING THE MEASUREMENT SETTINGS Print Key Selects the print operation when the RECORD key on the operation panel is pressed. Hard Copy: Prints the selected measurement window (Monitor, Sweep, Average or Stop window) , including the waveforms and patient and examination information. One Frame: Prints one page of waveforms on a Stop or Saved window. Screen Wave: Prints the waveforms on a Stop or Saved window. Threshold Test + I-L Curve: In the ABR examination, prints the Stop or Saved window waveforms acquired in the auditory threshold test and the I-L curve. Threshold Test: In the ABR examination, prints the Stop or Saved window waveforms acquired in the auditory threshold test. Refer to Section 8 “Printing”. Electrode Label Changes the electrode name assigned on the electrode junction box. When the Use Electrode as Annotation check box on the Labeling page is checked, the electrode names displayed on the Waveform window change to the names on this page. Foot Switches Left, Right Selects the function for the left and right foot switches. Setting list: Monitor, Stim/Sweep, Analysis, Record, Store, Erase, Pause, Single, Speaker off. Monitor Before waveform acquisition: Opens the Monitor window and starts waveform acquisition [MONITOR key]. During waveform acquisition: Opens the Stop window and stops waveform acquisition, stimulation and averaging [STOP key]. Stim/Sweep Before waveform acquisition: Opens the Sweep window. Depending on the examination, starts stimulation and/or acquisition of triggered waveforms [STIM/SWEEP key]. During waveform acquisition: Opens the Stop window and stops waveform acquisition, stimulation and averaging [STOP key]. Analysis Before waveform acquisition: Opens the Average window and starts waveform averaging or analysis [ANALYSIS key]. During waveform acquisition: Opens the Stop window and stops waveform acquisition, stimulation and averaging [STOP key]. Record Prints the screen image (hard copy) [PRINT key]. Store Operator's Manual MEB-9400

5.29

5. SELECTING THE MEASUREMENT SETTINGS Temporarily saves acquired waveforms in memory while the foot switch is pressed and held. In the EMG, EOG, Macro EMG, MICRO-N and SF EMG examination, the waveforms from 2 seconds before the foot switch is pressed until the foot switch is released are saved. The saved waveform length (time) is displayed on the waveform window. Erase Deletes the selected waveform [ERASE key]. Pause During averaging: When averaging is stopped:

Stops averaging. The stimulation continues. Restarts the averaging.

Single When the switch is pressed:

Opens the Sweep window and single stimulation is performed. After stimulation, the Stop window opens. When the switch is pressed and held more than one second: Opens the Sweep window and stimulation is started. The stimulation continues while the switch is held. After stimulation, the Stop window opens. Speaker off The monitor or external speaker turned off while the switch is held.

5.30

Operator's Manual MEB-9400

Section 6 Processing the Waveform General .............................................................................................................................. 6.1 Using the Edit Window ....................................................................................................... 6.2 Averaging the Waveforms .................................................................................................. 6.4 Moving a Waveform Display Position ....................................................................... 6.5 Superimposing All the Waveforms ........................................................................... 6.5 Canceling Averaging ................................................................................................ 6.6 Saving the Averaged Waveform ............................................................................... 6.6 Closing the Processing [Average] Window .............................................................. 6.6 Subtracting One Waveform from Another .......................................................................... 6.7 Moving a Waveform Display Position ....................................................................... 6.8 Superimposing All Waveforms ................................................................................. 6.8 Canceling Subtraction .............................................................................................. 6.9 Saving the Subtracted Waveform ............................................................................. 6.9 Closing the Processing [Subtract] Window .............................................................. 6.9 Reversing the Polarity of the Waveform ........................................................................... 6.10 Moving a Waveform Display Position ..................................................................... 6.11 Superimposing All Waveforms ............................................................................... 6.11 Canceling Reversing .............................................................................................. 6.11 Saving the Waveform Which Polarity is Reversed .................................................. 6.12 Closing the Processing [Reverse] Window ............................................................ 6.12 Rectifying the Waveform from a Waveform Trace ............................................................. 6.13 Superimposing All Waveforms ............................................................................... 6.15 Canceling Rectification .......................................................................................... 6.15 Saving the Rectified Waveform .............................................................................. 6.15 Closing the Processing [Rectify] Window .............................................................. 6.15 Expanding a Waveform .................................................................................................... 6.16 Superimposing All Waveforms ............................................................................... 6.18 Canceling Expanding ............................................................................................. 6.18 Saving the Expanded Waveform ............................................................................ 6.18 Closing the Processing [Expand] Window ............................................................. 6.18 Digital Filter Processing ................................................................................................... 6.19 Superimposing All Waveforms ............................................................................... 6.22 Canceling Filtering ................................................................................................. 6.22 Saving the Filtered Waveform ................................................................................ 6.23 Operator’s Manual MEB-9400

6C.1

Closing the Processing [Digital Filtering] Window .................................................. Reaveraging the Waveforms ............................................................................................ Canceling Reaveraging .......................................................................................... Saving the Reaveraged Waveform ......................................................................... Closing the Processing [Reaverage] Window ........................................................

6C.2

6.23 6.24 6.25 6.26 6.26

Operator’s Manual MEB-9400

6. PROCESSING THE WAVEFORM

General The acquired waveforms can be processed in the following ways. • • • • • • •

Averaging two or more waveforms Subtracting one waveform from another Reversing the polarity of the waveform Rectifying the waveform from a waveform trace Expanding a waveform with a specified ratio to the full time scale Digital filter processing Reaveraging the waveforms

You can use the Edit window to process the waveforms easily. When selecting the waveform, you can use the mouse. To select two or more consecutive waveforms: 1. Click the first waveform you want to select. 2. Press and hold down the Shift key while you click the last waveforms on the window. To select two or more non-consecutive waveforms: Press and hold down the Ctrl key while you click each waveform.

Operator's Manual MEB-9400

6.1

6. PROCESSING THE WAVEFORM

Using the Edit Window You can use the Edit window to easily process the waveforms. For detailed waveform processing, use an individual processing window. The following processing is available.

About the Edit window

NOTE Averaging and subtracting can only be done when the selected waveforms have the same analysis time. Average page Average: Averages two or more waveforms by the weighted moving averaging. Mean: Averages two or more waveforms. Add: Adds two or more waveforms. Subtract page (for P300 examination program only): Subtracts a waveform from another waveform. [Target] - [Non target]: Subtracts a waveform from the waveforms in all channels. Rectify page Rectifies the waveform from a waveforms trace. Half: All parts below the measurement baseline are cut off. Full: All parts below the measurement baseline are inverted. Smoothing page Reduces high frequency component with a high-cut filter based on the movingaveraging method. Smoothing Point: Select number of smoothing points. Weighted: Select when using the moving-averaging method.

6.2

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM Procedure 1. Click the Processing function button on the Stop window. The function keys change as follows and the Edit window opens.

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Select the waveforms for averaging on the Stop window with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms have a different color. You can also select the waveform(s) by clicking the All, Channel or Individual button on the Tool bar. ALL/INDV key:

Individual button

All button

Selects one or more waveforms. The All, Channel or Individual button on the Tool bar indicates the selected waveform(s). The All button is down: All waveforms in one stage or site are selected. The Channel button is down: All waveforms in one channel are selected. The Individual button is down: One individual waveform is selected. SELECT ↓ ↑ key:

Channel button

Selects the stage if the ALL button is selected; selects the channel if the Channel button is selected.

3. Select the processing mode by clicking the page tab. 4. Select the processed waveform output method. Append: Appends the processed waveform in the new stage. Replace: Replaces the target waveform with the processed waveform. Non target waveforms are not replaced. 5. Click the OK button.

Operator's Manual MEB-9400

6.3

6. PROCESSING THE WAVEFORM

Averaging the Waveforms You can average waveforms and save the averaged waveform in a stage.

NOTE Averaging can only be done when the selected waveforms have the same analysis time. 1. Click the Processing function button on the Stop window.

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Click the Average function button. The Processing [Average] window opens. 3. Select the waveforms for averaging on the Stop window with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms have a different color. You can also select the waveform(s) by clicking the All, Channel or Individual button on the Tool bar.

NOTE Individual button

All button

When the Transfer button on the Processing [Average] window is depressed, the waveform can not be selected. If the Transfer button is depressed, click it before selecting the waveform. ALL/INDV key:

Channel button

Selects one or more waveforms. The All, Channel or Individual button on the Tool bar indicates the selected waveform(s). The All button is down: All waveforms in one stage or site are selected. The Channel button is down: All waveforms in one channel are selected. The Individual button is down: One individual waveform is selected. SELECT ↓ ↑ key:

Selects the stage if the ALL button is selected; selects the channel if the Channel button is selected.

4. Select the averaging mode and double click the selected waveforms, or click the Select button on the Processing [Average] window.

6.4

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM Raw Waves: Ground averaging Example: (A1 × Number of A1 averaging) + (A2 × Number of A2 averaging) (Number of A2 averaging + Number of A2 averaging) Analyzed Waves: Normal averaging Example: (A1 + A2)/2 The selected waveforms and averaged waveform appear in the window. The number of selected waveforms appears in the Waves box. Waves box example: A1+B4+D2: Averages the A1, B4 and D2 waveforms in a different stage. A+B: Averages all waveforms in stage A and B. Selected waveforms Averaged waveform

To remove a waveform from the averaged result, double-click it or click it, then press the Delete key on the keyboard. The averaged result is automatically updated.

Moving a Waveform Display Position

You can move a waveform horizontally or vertically. When a waveform on the window is moved horizontally, the averaged result is automatically updated. 1. Click the Vertical or Horizontal button in the Dial/Drag area.

2. Move the waveform position by turning the WAVE dial on the operation panel.

Superimposing All the Waveforms

Operator's Manual MEB-9400

Click the Superimpose check box. All waveforms on the window are superimposed. To return all waveforms to their original position, click it again.

6.5

6. PROCESSING THE WAVEFORM

Canceling Averaging

Click the Cancel button on the Processing [Average] window, or click the Cancel function button. The Processing [Average] window closes.

Saving the Averaged Waveform

You can save the averaged waveform in an unused stage or in the current stage by overwriting the current waveform or stage. To save the average waveform in an unused stage: 1. Click the Transfer button. 2. Click the Append button in the Transfer area. 3. Click the OK button in the Transfer area. The averaged waveform is transferred to the Waveform window and saved. 4. Click the Transfer button again for the next averaging. Or drag the averaged waveform to the Waveform window. To save the averaged waveform in the current stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Replace button in the Transfer area. 3. Select the waveform or stage from the Wave(s) box in the Transfer area. 4. Click the OK button in the Transfer area. 5. When the confirmation message window appears, click the OK button. The averaged waveform is transferred to the Waveform window and saved. 6. Click the Transfer button again for the next averaging.

Closing the Processing [Average] Window

6.6

Click the close button on the title bar.

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM

Subtracting One Waveform from Another You can subtract a waveform from another waveform and save it in a stage.

NOTE Subtracting can only be done when the selected waveforms have the same analysis time. 1. Click the Processing function button on the Stop window..

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Click the Subtract function button. The Processing [Subtract] window opens. 3. Select the waveforms for subtraction on the Stop window with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms have a different color. You can also select the waveform(s) by clicking the All, Channel or Individual button on the Tool bar.

NOTE Individual button

All button

When the Transfer button on the Processing [Subtract] window is depressed, the waveform can not be selected. If the Transfer button is depressed, click it before selecting the waveform. ALL/INDV key:

Channel button

Selects one or more waveforms. The All, Channel or Individual button on the Tool bar indicates the selected waveform(s). The All button is down: All waveforms in one stage or site are selected. The Channel button is down: All waveforms in one channel are selected. The Individual button is down: One individual waveform is selected. SELECT ↓ ↑ key:

Selects the stage if the ALL button is selected; selects the channel if the Channel button is selected.

4. Double click the selected waveforms or click the Select button on the Processing [Subtract] window. The selected waveforms and subtracted waveform appear in the window. The number of selected waveforms appears in the Waves box. Operator's Manual MEB-9400

6.7

6. PROCESSING THE WAVEFORM Waves box example: A1-B4: Subtracts the B4 waveform in stage B from the A1 waveform in stage A. A-B: Subtracts all waveforms in stage B from all waveforms in stage A. Selected waveforms Subtracted waveform

To remove a waveform from the subtract result, double-click it or click it, then press the Delete key on the keyboard. The subtraction result is automatically updated.

Moving a Waveform Display Position

You can move a waveform horizontally or vertically. When a waveform on the window is moved horizontally, the subtraction result is automatically updated. 1. Click the Vertical or Horizontal button in the Dial/Drag area.

2. Move the waveform position by turning the WAVE dial on the operation panel.

Superimposing All Waveforms

Click the Superimpose check box. All waveforms on the window are superimposed. To return all waveforms to their original position, click it again.

6.8

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM

Canceling Subtraction

Click the Cancel button on the Processing [Subtract] window or click the Cancel function button. The Processing [Subtract] window closes.

Saving the Subtracted Waveform

You can save the subtracted waveform in an unused stage or in the current stage by overwriting the current waveform or stage. To save the subtracted waveform in an unused stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Append button in the Transfer area. 3. Click the OK button in the Transfer area. The subtracted waveform is transferred to the Waveform window and saved. 4. Click the Transfer button again for the next subtracting. Or drag the subtracted waveform to the Waveform window. To save the subtracted waveform in the current stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Replace button in the Transfer area. 3. Select the waveform or stage from the Wave(s) box in the Transfer area. 4. Click the OK button in the Transfer area. 5. When the confirmation message window appears, click the OK button. The subtracted waveform is transferred to the Waveform window and saved. 6. Click the Transfer button again for the next subtracting.

Closing the Processing [Subtract] Window

Operator's Manual MEB-9400

Click the close button on the title bar.

6.9

6. PROCESSING THE WAVEFORM

Reversing the Polarity of the Waveform You can reverse the polarity of the waveform and save it in a stage. Electrode positive and negative polarity are exchanged with each other in the Status table. 1. Click the Processing function button on the Stop window.

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Click the Reverse function button. The Processing [Reverse] window opens. 3. Select the waveforms for averaging on the Stop window with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms have a different color. You can also select the waveform(s) by clicking the All, Channel or Individual button on the Tool bar.

NOTE Individual button

All button

When the Transfer button on the Processing [Reverse] window is depressed, the waveform can not be selected. If the Transfer button is depressed, click it before selecting the waveform. ALL/INDV key:

Channel button

Selects one or more waveforms. The All, Channel or Individual button on the Tool bar indicates the selected waveform(s). The All button is down: All waveforms in one stage or site are selected. The Channel button is down: All waveforms in one channel are selected. The Individual button is down: One individual waveform is selected. SELECT ↓ ↑ key:

Selects the stage if the ALL button is selected; selects the channel if the Channel button is selected.

4. Double click the selected waveform or click the Select button on the Processing [Reverse] window. The waveform which polarity is reversed appears in the window. The number of selected waveforms appears in the Waves box.

6.10

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM Waves box example: A1, B4, D2: Reverses the polarity of the A1, B4 and D2 waveform in a different stage. A, B: Reverses the polarity of all waveforms in stage A and B

Reversed waveform

To remove a waveform from the window, double-click it or click it, then press the Delete key on the keyboard.

Moving a Waveform Display Position 1. Click the Vertical or Horizontal button in the Dial/Drag area.

2. Move the waveform position by turning the WAVE dial on the operation panel.

Superimposing All Waveforms

Click the Superimpose check box. All waveforms on the window are superimposed. To return all waveforms to their original position, click it again.

Canceling Reversing

Operator's Manual MEB-9400

Click the Cancel button on the Processing [Reverse] window or click the Cancel function button. The Processing [Reverse] window closes.

6.11

6. PROCESSING THE WAVEFORM

Saving the Waveform Which Polarity is Reversed

You can save the reversed waveform in an unused stage or in the current stage by overwriting the current waveform or stage. To save the reversed waveform in an unused stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Append button in the Transfer area. 3. Click the OK button in the Transfer area. The reversed waveform is transferred to the Waveform window and saved. 4. Click the Transfer button again for the next reversing. Or drag the reversed waveform to the Waveform window. To save the reversed waveform in the current stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Replace button in the Transfer area. 3. Select the waveform or stage from the Wave(s) box in the Transfer area. 4. Click the OK button in the Transfer area. 5. When the confirmation message window appears, click the OK button. The reversed waveform is transferred to the Waveform window and saved. 6. Click the Transfer button again for the next reversing.

Closing the Processing [Reverse] Window

6.12

Click the close button on the title bar.

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM

Rectifying the Waveform from a Waveform Trace You can rectify the waveform from a waveform trace. The reference is the measurement baseline. The rectified waveform can be saved in a stage. There are two rectifying methods. Half-wave rectification: All parts below the measurement baseline are cut off. Full-wave rectification: All parts below the measurement baseline are inverted. 1. Click the Processing function button on the Stop window.

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Click the Rectify function button. The Processing [Rectify] window opens. 3. Select the waveforms for averaging on the Stop window with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms have a different color. You can also select the waveform(s) by clicking the All, Channel or Individual button on the Tool bar

NOTE Individual button

All button

When the Transfer button on the Processing [Rectify] window is depressed, the waveform can not be selected. If the Transfer button is depressed, click it before selecting the waveform. ALL/INDV key:

Channel button

Selects one or more waveforms. The All, Channel or Individual button on the Tool bar indicates the selected waveform(s). The All button is down: All waveforms in one stage or site are selected. The Channel button is down: All waveforms in one channel are selected. The Individual button is down: One individual waveform is selected. SELECT ↓ ↑ key:

Selects the stage if the ALL button is selected; selects the channel if the Channel button is selected.

4. Double click the selected waveforms or click the Select button on the Processing [Subtract] window. The selected waveform appears in the window. The number of selected waveforms appears in the Waves box. Operator's Manual MEB-9400

6.13

6. PROCESSING THE WAVEFORM Waves box example: A1, B4, D2: Rectifies the A1, B4 and D2 waveform in a different stage. A, B: Rectifies of all waveforms in stage A and B.

Selected waveforms

To remove a waveform from the window, double-click it or click it, then press the Delete key on the keyboard.

5. Move the waveform display position or its baseline, if necessary 1) Click the Vertical, Horizontal or Baseline button in the Dial/Drag area.

2) Move the waveform position by turning the WAVE dial on the operation panel. To return the baseline to the original position, click the Reset Baseline button. 6. Click the Half or Full button in the Rectify area to select the rectifying method. Half: All parts below the measurement baseline are cut off. Full: All parts below the measurement baseline are inverted. 7. Select the waveform for rectification by clicking it. 8. Click the Rectify button. The selected waveform is rectified.

Rectified - Full 6.14

Rectified - Half Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM

Superimposing All Waveforms

Click the Superimpose check box. All waveforms on the window are superimposed. To return all waveforms to their original position, click it again.

Canceling Rectification

Click the Cancel button on the Processing [Rectify] window or click the Cancel function button. The Processing [Rectify] window closes.

Saving the Rectified Waveform

You can save the rectified waveform in an unused stage or in the current stage by overwriting the current waveform or stage. To save the rectified waveform in an unused stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Append button in the Transfer area. 3. Click the OK button in the Transfer area. The rectified waveform is transferred to the Waveform window and saved. 4. Click the Transfer button again for the next rectifying. Or drag the rectified waveform to the Waveform window. To save the rectified waveform in the current stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Replace button in the Transfer area. 3. Select the waveform or stage from the Wave(s) box in the Transfer area. 4. Click the OK button in the Transfer area. 5. When the confirmation message window appears, click the OK button. The rectified waveform is transferred to the Waveform window and saved. 6. Click the Transfer button again for the next rectifying.

Closing the Processing [Rectify] Window

Operator's Manual MEB-9400

Click the close button on the title bar.

6.15

6. PROCESSING THE WAVEFORM

Expanding a Waveform You can expand the waveforms 2, 3, 4, 5 or 8 times and save the expanded waveforms in a stage. The analysis time in the Condition Table window is marked with “*”. 1. Click the Processing function button on the Stop window.

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Click the Expand function button. The Processing [Expand] window opens. 3. Select the waveforms for averaging on the Stop window with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms have a different color. You can also select the waveform(s) by clicking the All, Channel or Individual button on the Tool bar.

NOTE Individual button

All button

When the Transfer button on the Processing [Expand] window is depressed, the waveform can not be selected. If the Transfer button is depressed, click it before selecting the waveform. ALL/INDV key:

Channel button

Selects one or more waveforms. The All, Channel or Individual button on the Tool bar indicates the selected waveform(s). The All button is down: All waveforms in one stage or site are selected. The Channel button is down: All waveforms in one channel are selected. The Individual button is down: One individual waveform is selected. SELECT ↓ ↑ key:

Selects the stage if the ALL button is selected; selects the channel if the Channel button is selected.

4. Double click the selected waveforms or click the Select button on the Processing [Expand] window. The selected waveform appears in the window. The number of selected waveforms appears in the Waves box. The two vertical lines to select a part of the waveform for expansion.

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Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM Waves box example: A1, B4, D2: Expands the A1, B4 and D2 waveforms in a different stage. A, B: Expands all waveforms in stage A and B.

Selected waveforms

To remove the waveform from the window, double-click it or click it, then press the Delete key on the keyboard.

5. Select the expand ratio from the Expand Ratio list box.

6. Select the part of the waveform for expansion. To select the cursor, press the A/B key on the operation panel. To move the cursor, turn the CURSOR dial on the operation panel 7. Click the Expand button.

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6. PROCESSING THE WAVEFORM

Superimposing All Waveforms

Click the Superimpose check box. All waveforms on the window are superimposed. To return all waveforms to their original position, click it again.

Canceling Expanding

Click the Cancel button on the Processing [Expand] window or click the Cancel function button. The Processing [Expand] window closes.

Saving the Expanded Waveform

You can save the expanded waveform in an unused stage or in the current stage by overwriting the current waveform or stage. To save the expanded waveform in an unused stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Append button in the Transfer area. 3. Click the OK button in the Transfer area. The expanded waveform is transferred to the Waveform window and saved. 4. Click the Transfer button again for the next expanding. Or drag the expanded waveform to the Waveform window. To save the expanded waveform in the current stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Replace button in the Transfer area. 3. Select the waveform or stage from the Wave(s) box in the Transfer area. 4. Click the OK button in the Transfer area. 5. When the confirmation message window appears, click the OK button. The expanded waveform is transferred to the Waveform window and saved. 6. Click the Transfer button again for the next expanding.

Closing the Processing [Expand] Window

6.18

Click the close button on the title bar.

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM

Digital Filter Processing You can reduce artifact from the selected waveform with the digital filter processing and save the processed waveform in a stage. Smoothing: Reduces high frequency component with a high-cut filter based on moving-averaging method. The high-cut filter in the status table is marked with “*”. IFFT: Reduces high frequency component with a high-cut filter by IFFT (Inverse Fast Fourier Transformation). The low-cut filter in the status table is marked with “*”. 1. Click the Processing function button on the Stop window.

Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Click the Digital Filter function button. The Processing [Digital filter] window opens. 3. Select the waveforms for averaging on the Stop window with the ALL/INDV key and SELECT ↓ ↑ key on the operation panel or mouse. The selected waveforms have a different color. You can also select the waveform(s) by clicking the All, Channel or Individual button on the Tool bar.

NOTE Individual button

All button

When the Transfer button on the Processing [Digital Filtering] window is depressed, the waveform can not be selected. If the Transfer button is depressed, click it before selecting the waveform. ALL/INDV key:

Channel button

Selects one or more waveforms. The All, Channel or Individual button on the Tool bar indicates the selected waveform(s). The All button is down: All waveforms in one stage or site are selected. The Channel button is down: All waveforms in one channel are selected. The Individual button is down: One individual waveform is selected. SELECT ↓ ↑ key:

Operator's Manual MEB-9400

Selects the stage if the ALL button is selected; selects the channel if the Channel button is selected.

6.19

6. PROCESSING THE WAVEFORM 4. Double click the selected waveforms or click the Select button on the Processing [Expand] window. The selected waveform appears in the window. The number of selected waveforms appears in the Waves box. Waves box example: A1, B4, D2: Filters the A1, B4 and D2 waveforms in a different stage. A, B: Filters all waveforms in stage A and B.

Processing [Digital Filter] window

Selected waveform

Stop window

To remove the waveform from the window, double-click it or click it, then press the Delete key on the keyboard. 5. Filter the selected waveform. Smoothing: 1) Click the Smooth tab.

1 2

3

2) Select the number of smoothing points from the Smoothing Point list box. To perform weighted moving averaging, click the Weighted check box.

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Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM 3) Click the Smoothing button. The filtered waveform appears in the window.

IFFT: 1) Click the IFFT tab.

1

3 2

4

2) Click the Rectangular, Hanning or Hamming button in the Window area to select the analysis window. 3) Click the Linear or Log button in the Scale area to select the vertical scale. 4) Click the FFT button. The FFT result (spectrum waveform) and two vertical cursors appear in upper of the waveform area.

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6. PROCESSING THE WAVEFORM

5

5) Click the Pass or Cut button in the Band area to select the filter characteristic. PASS: Cuts all frequencies except the frequencies between the two cursors. CUT: Cuts the frequencies between the two cursors.

6

6) Click the IFFT button. The IFFT result appears in the lower of the waveform area. The Spectrum dialog box also appears to indicate the frequency and spectrum power of the cursor position. To move the cursor, use the A/B key and CURSOR dial on the operation panel.

Superimposing All Waveforms

Click the Superimpose check box. All waveforms on the window are superimposed. To return all waveforms to their original position, click it again.

Canceling Filtering

6.22

Click the Cancel button on the Processing [Digital Filtering] window or click the Cancel function button. The Processing [Digital Filtering] window closes.

Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM

Saving the Filtered Waveform

You can save the filtered waveform in an unused stage or in the current stage by overwriting the current waveform or stage. To save the filtered waveform in an unused stage: 1. Click the Transfer button. The transfer button is depressed. 2.

Click the Append button in the Transfer area.

3.

Click the OK button in the Transfer area. The filtered waveform is transferred to the Waveform window and saved.

4.

Click the Transfer button again for the next filtering.

Or drag the filtered waveform to the Waveform window. To save the filtered waveform in the current stage: 1. Click the Transfer button. The transfer button is depressed.

Closing the Processing [Digital Filtering] Window

Operator's Manual MEB-9400

2.

Click the Replace button in the Transfer area.

3.

Select the waveform or stage from the Wave(s) box in the Transfer area.

4.

Click the OK button in the Transfer area.

5.

When the confirmation message window appears, click the OK button. The filtered waveform is transferred to the Waveform window and saved.

6.

Click the Transfer button again for the next filtering.

Click the close button on the title bar.

6.23

6. PROCESSING THE WAVEFORM

Reaveraging the Waveforms You can reaverage the waveforms after removing waveforms affected by artifact. The averaged waveform can be saved in a stage. 1. Click the Processing function button on the Stop window. Marking

Measurment Table

Condition Table

Processing

Superimpose

Examination Information

Patient Information

End Saved Waves

F1

F2

F3

F4

F5

F6

F7

F8

Average

Subtract

Reverse

Rectify

Expand

Digital Filter

Reaverage

Cancel

F1

F2

F3

F4

F5

F6

F7

F8

F9

F9

2. Click the Reaverage function button. The Processing [Reaverage] window opens. 3. Press the ALL/INDV key until the

All button is down.

4. Press the SELECT ↓ ↑ key to select the stage. The selected stage has a different color.

NOTE When the Transfer button on the Processing [Reaverage] window is depressed, the waveform can not be selected. If the Transfer button is depressed, click it before selecting the waveform. 5. Double click the selected waveforms or click the Select button on the Processing [Reaverage] window. The averaged waveform and first sweep waveform of the selected stage appear in the window. The number of selected stage appears in the Waves box. To move the waveform display position.

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Operator's Manual MEB-9400

6. PROCESSING THE WAVEFORM To move the waveform display position. 1) Click the Vertical or Horizontal button in the Dial/Drag area.

2) Move the waveform position by turning the WAVE dial on the operation panel.

To display all sweep waveforms used for averaging, click the S-imp. button in the Display Wave area. The default setting is “Individual”.

6. Click the Ch check box to select the channel for re-averaging. All sweep waveforms in the selected channel can be reaveraged. 7. Select the sweep waveforms for re-averaging. To display the sweep waveform one by one by, click the Sweep No. box arrow. To remove the sweep waveform for re-averaging, click the Reject button. When the Reject button is clicked, the removed sweep waveform has a different color and the reaveraged result is updated. To cancel removing, select the waveform with the Sweep No. box arrow, then click the Accept button. When the Accept button is clicked, and the selected waveform has the default color and the reaveraged result is updated.

Canceling Reaveraging

Operator's Manual MEB-9400

Click the Cancel button on the Processing [Reaverage] window or click the Cancel function button. The Processing [Reaverage] window closes.

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6. PROCESSING THE WAVEFORM

Saving the Reaveraged Waveform

You can save the reaveraged waveform in an unused stage or in the current stage by overwriting the current waveform or stage. To save the reaveraged waveform in an unused stage: 1. Click the Transfer button. The transfer button is depressed. 2. Click the Append button in the Transfer area. 3. Click the OK button in the Transfer area. The reaveraged waveform is transferred to the Waveform window and saved. 4. Click the Transfer button again for the next re-averaging. Or drag the reaveraged waveform to the Waveform window. To save the reaveraged waveform in the current stage: 1. Click the Transfer button. The transfer button is depressed.

Closing the Processing [Reaverage] Window

6.26

2.

Click the Replace button in the Transfer area.

3.

Select the waveform or stage from the Wave(s) box in the Transfer area.

4.

Click the OK button in the Transfer area.

5.

When the confirmation message window appears, click the OK button. The reaveraged waveform is transferred to the Waveform window and saved.

6.

Click the Transfer button again for the next re-averaging.

Click the close button on the title bar.

Operator's Manual MEB-9400

Section 7 Filing

General .............................................................................................................................. 7.1 Opening a Patient File ........................................................................................................ 7.2 Opening the Open Dialog Box ................................................................................. 7.2 Selecting a File Type ................................................................................................ 7.2 Searching for a File .................................................................................................. 7.3 Changing the File Information Layout in the File List ............................................... 7.6 Saving the Measurement Result and Patient Information .................................................. 7.7 Saving Data in a New File ........................................................................................ 7.7 Saving Data in an Existing File ................................................................................ 7.9 File Management ............................................................................................................. 7.10 General .................................................................................................................. 7.10 Copying, Moving and Deleting Patient Files ........................................................... 7.11

Operator’s Manual MEB-9400

7C.1

7. FILING

General The measurement result and patient information can be saved as a patient file in the hard disk or removable media (CD-ROM disk, magneto-optical disk, etc.). You can select a file type from an MEB-2000/9000 file or MEB-2000/9000 text file. The back-up file is automatically created when the Store button on the Tool bar is clicked or the STORE key on the operation panel is pressed. You can recover the measurement result from the back-up file even when power down occurs. MEB-9400 EMG/EP Measuring System can also read the data which is saved in a floppy disk or magneto-optical disk from Nihon Kohden Evoked potential measuring system MEB/MEM-4200 series (version 4.8 or later), MEB-5500 series (version 3.0 or later) , MEB-2200 series, MEB-9100 series, MEB-9200/9300 EP/ EMG Measuring System. To open and save the examination program file refer to “Working with The Main Menu Window” in Section 4.

Operator's Manual MEB-9400

7.1

7. FILING

Opening a Patient File Opening the Open Dialog Box

Do one of the following: • Click the

Open button on the tool bar on the Stop window.

• From the File menu, select Open on the Stop window. • From the File menu, select Wave Open on the Main Menu window.

Patient list

The measurement date of the selected file The latest edited date of the selected file The files for the patient

Selecting a File Type

1. Click the Type of Files box arrow to select the file type. The list box opens. 2. Click the file type. The instrument can use the following files: MEB-2000/9000: Patient file saved by an MEB-2200, MEB-9100 MEB-9200, MEB-9300 and MEB-9400 instrument Text (MEB-2000/9000): Patient file saved by an MEB-2200, MEB-9100, MEB-9200, MEB-9300 and MEB-9400 instrument as a text file MEB-4200/MEB-5500: Patient file saved by an MEB-4200 or MEB-5500 instrument Backup: Backup file

7.2

3. If the file that you want to open is on a different folder or drive, select the folder or drive from the Look in box. The file name and its examination program name appear in the file list box. Operator's Manual MEB-9400

7. FILING Use the

Details button to display the detailed file information. When this

button is clicked, the file information which is selected in the Arrange List window appears in the file list box. You can arrange the file display by file name, examination program name, or date, etc. in ascending or descending order by clicking each title. To display only the file name and examination program name, click the

List button.

4. Click a patient name. The patient ID No. is highlighted and files for the patient are displayed. 5. Click the file you want to open. The selected file is highlighted and the measurement date and latest edited date of the selected file are displayed. You can also open the MEB-2000/9000 text file by typing the file name in the File Name text box. • To open two or more files, type “;” between the file name. • To search for a file, refer to “Searching for a file” in this section. • To select file information, click the Arrange List button. Refer to “Changing the file information layout in the file list“ in this section. • To view the patient information in the selected file, click the Patient information button. • To select the waveform type, click the Screen, Gather, Monitor, Summary or Analysis button in the Wave type area. This button is only available when the selected file is MEB-2000/9000 file or MEB-2000/9000 text file. 6. Click the Open button. The Stop window opens and the measurement result is displayed on the window.

Searching for a File

You can search for a file by entering keyword. For a keyword, refer to “Entry item for File Search dialog box”. 1. Click the All or Current button in the Select area on the Open dialog box. All: Searches for a file in the patient database master index file. Current: Searches for a file in the patient database media index file in the selected drive or removable media. For the patient database master and media index file, refer to “File Management” in this section. 2. Click the Search button. The File Search dialog box opens.

Operator's Manual MEB-9400

7.3

7. FILING

3. Type in or select the keywords. You can search for a file by one or more of the keywords in the search dialog box. If you enter more than one keyword, the instrument searches for files which satisfy all of entered keywords from the selected Bookmark. • To clear all keywords, click the Clear All button. • To cancel searching, click the Cancel button. The File Search dialog box closes. 4. Click the OK button. The matched files appear in the file list box on the Open dialog box.

Entry item for File Search dialog box * The item has a list box to enter the keyword. Patient area • ID No. (From – to, up to 20 characters) • Name (Patient name, up to 40 characters) • Sex * (No entry, Female, Male) • Date of Birth (From – to, up to 19 characters) Set the format in Windows. • Age (From – to, up to 4 numeric characters, month: 01 to 12, day: 01 to 31) • Height (From – to, up to 10 characters) • Weight (From – to, up to 10 characters) • In/Out Patient * (No entry, In, Out) • Referring Dept *. (Referring department, up to 20 characters) • Physician * (Up to 18 characters) • History * (Patient history, up to 240 characters) The patient history can be copied from the History List dialog box. To open it, click the History List button. To delete all entered patient history in the History text box, click the Clear History button. 7.4

Operator's Manual MEB-9400

7. FILING Examination area • Program * (Examination program name, up to 12 characters) • Date (Examination date, from – to) Set the date format in Windows. • No. (Examination number, from – to, up to 10 characters) • Examined by * (up to 20 characters) • Comment (up to 240 characters) The comment can be copied from the Note Lost dialog box. To open it, click the Note List button. To delete all entered comments in the comment text box, click the Clear Comment button. Nerve & Muscle/Site area • Side (Examination site) To select the examination site, check the Left or Right check box. • Bookmark To select the A/B search criteria, click the A or B check box. If you are not sure, leave the both boxes unchecked. Refer to the Bookmark check box on the Save dialog box (“Saving Data in a New File” in Section 7). • Nerve (Nerve name, up to 20 characters) The nerve name can be copied from the Nerve list box (20 characters). To open it, click the Nerve List button. • Muscle/Site (Muscle name, up to 20 characters) The muscle name can be copied from the Muscle list box (20 characters). To open it, click the Muscle List button.

Operator's Manual MEB-9400

7.5

7. FILING

Changing the File Information Layout in the File List

The file information layout can only be changed for MEB-2000/9000 files. The file information of other files is fixed as follows: MEB-2000/9000 text file: File name, Size, Modified (Modified date) MEB-4200/MEB-5500 file: File name, Program (Examination program name), Data Time (The date and time when the file was created) Backup file: Program, Modified 1. Click the Arrange Headings button on the Open dialog box.

The Arrange Headings dialog box opens. The currently selected file information is listed in the File List list box and the selectable file information is listed in the Patient Information list box. To select a file information type in the Patient Information list box: 1) Click a file information type in the Patient Information List. In the figure, “Sex” is added between “Program” and “Date”. To change its displayed position, click the Up or Down button. 2) Click the > button. 2. Click the OK button. To cancel changing, click the Cancel button. The Arrange Headings dialog box closes. To restore the default file information display, click the Initialize button.

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Operator's Manual MEB-9400

7. FILING

Saving the Measurement Result and Patient Information Saving Data in a New File CAUTION Do not remove the magneto optical disk until the disk drive access lamp is off. Otherwise, the disk or disk drive may be damaged.

1. Open the Save dialog box • Click the Save as button on the tool bar on the Stop window. • Or, from the File menu, select Save as on the Stop window. 2. Click the File Format box arrow to select the file type. MEB-2000/9000: Saved as a MEB-2000/9000 file Text (MEB-2000/9000) Saved as a MEB-2000/9000 text file. 3. Click the options in the Contents area to select the data to save. Site:

Operator's Manual MEB-9400

This setting is only available when the examination is EMG, QEMG, EOG, MICRO-N, Rep-stim, F-Wave, SF EMG or Macro EMG and the Screen Wave check box in the Contents area is not checked. All: All sites in the examination window are saved. Current: The currently selected site in the examination window is saved.

7.7

7. FILING Type of waveform:

Patient information:

Condition Table:

Measurement Table:

Summary:

Analysis:

Screen Wave: The waveform displayed on the Stop window. Gather Wave: The waveform used for averaging Monitor Wave: The raw waveform The patient information is selected as the default setting. To not save the patient information when saving a file as an MEB-2000/9000 text file, click the Patient Information check box to uncheck. The Condition Table is selected as the default setting. To not save the patient information when saving a file as an MEB-2000/9000 text file, click the Condition Table check box to uncheck. The Measurement Table is selected as the default setting. To not save the measurement result when saving a file as an MEB-2000/9000 text file, click the Measurement Table check box to uncheck. This setting is only available when the examination is EMG, QEMG, EOG, MICRO-N, Rep-Stim, F-wave, SF EMG or Macro EMG. The summary is selected as the default setting. To not save the summary when saving a file as an MEB-2000/9000 text file, click the Summary check box to uncheck. This setting is only available in QEMG, SF EMG and ST SFEMG examination programs. Analysis is selected as the default setting. To not to save QEMG measurement results, click the Analysis check box to uncheck.

4. You can also check any of the A and B boxes. A and B have no set meaning. You can use them for your own search criteria. For example, if you want to create a group of patients with a certain condition, you could check “A” for those patients’ files and easily search for them later. This setting is only available when a file is saved as an MEB-2000/9000 file. 5. Select the folder, drive or removable media from the Look In box. Only files of the selected file type appear in the list box. 6. Save data Saving data as an MEB-2000/9000 file: 1) Click the new file at the top of the file list. The new file is highlighted. 2) Click the Save button. The patient name is used as the file name. To cancel saving, click the Cancel button. If a patient name is not included in a patient information, a confirmation dialog box prompts you whether or not to save the file. Click the Yes button, to save the file without a patient name. Click the No button to cancel saving.

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Operator's Manual MEB-9400

7. FILING The file is saved and registered in the patient data master index file and patient database media index file in the selected drive or removable media. The index files are updated. When a file is first saved, the dialog box appears with a new volume number for creating a new patient database media index file in the selected drive or removable media. Click the OK button in the dialog box. Saving a new file as an MEB-2000/9000 text file:

NOTE When the file name is not entered in the File Name text box, the Save button cannot be used. 1) Click the new file at the top of the file list. The new file is highlighted. When saving a file as an MEB-2000/9000 text file, the patient name, examined by, ID number and examination number can automatically be used for the file name. Click the Patient Name, Examination Name, ID No. or Add Suffix check box to select. The file name appears in the File Name text box. File name = patient name + examiner + ID number + examination number To cancel saving, click the Cancel button. 2) Click the Save button.

Saving Data in an Existing File

1. Open the Save dialog box. 2. Select the file to save data in. All previous data in that file will be deleted. To select a file refer to “Opening a Patient File”.

3. View the detailed file information by clicking the

Details button.

4. Check the patient information by clicking the Patient Information button. 5. Click the Save button. The confirmation dialog box opens. To cancel saving, click the Cancel button. 6. Click the Yes button to overwrite the data in the existing file. The patient database master and media index file are updated.

Operator's Manual MEB-9400

7.9

7. FILING

File Management General

On the File Management dialog box, you can perform the following operations between the two or more MEB-2200, MEB-9100, MEB-9200, MEB-9300 series EP/EMG Measuring System (MEB instrument) and MEB-9400 EMG/EP Measuring System with a local area network. • Registering a patient file in another MEB instrument A patient in another MEB-2000/9000 file can be registered to the patient database master index file in this instrument. After registering it, you can search for a patient file in another MEB instrument. The wave file is not copied from the other MEB instruments. • Copying a patient file from/to another MEB instrument A patient file can be copied from or to the selected drive or removable media in another MEB instrument. The copied file is registered in the patient database master index file and media index file in the selected drive or removable media. • Moving a patient file from/to another MEB instrument A patient file can be moved from or to the selected drive or removable media in another MEB instrument. The moved file is registered in the patient database master index file and media index file in the selected drive or removable media. • Deleting a patient file Unnecessary patient files can be deleted and removed from the main patient database and media index file in an individual drive.

• Patient database master and media index files Patient database master index file: The master index file keeps track of the location of all files saved by the instrument–whether on the hard disk or on removable media. The master index file can contain information for up to 100,000,000 files and is automatically updated when a file is saved, copied, moved or deleted. A file saved in another MEB instrument can be registered in the patient database master index file using the File Management dialog box. Patient database media index file: The media index file keeps track of the location of all files on a single drive or removable media. The media index file is automatically saved in the individual drive or removable disk when a new file is created and is automatically updated when a file is saved, copied, moved or deleted. The media index file can contain information for up to 20,000 files.

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Operator's Manual MEB-9400

7. FILING • Information maintained by the patient database master index file and patient database media index file Examination program name (default setting), examination program name (which you specified), comment for the examination program name, ID No., patient name, sex, date of birth, age, height, weight, in/out patient, referring department, doctor, history, examination date, examination number, examiner, site, nerve name, muscle name, comment, screen wave, gather wave, monitor wave, analysis, summary, volume number, file name

Copying, Moving and Deleting Patient Files

NOTE • When a source or destination file is saved in a removable media, prepare a media before copying, moving and deleting patient files. • When the source drive and the destination drive is the same, files cannot be copied or moved. • When the destination file is smaller than the source file to be copied or moved, the file cannot be copied or moved. 1. From the Start button menu, click Program. The program sub-menu appears. 2. Click Npk. The Npk sub-menu appears. 3. Click File utility. The File Management dialog box opens.

The measurement date of the selected file The latest edited date of the selected file

Operator's Manual MEB-9400

7.11

7. FILING 4. Select and click the Registration, Copy, Move or Delete from the Files for list box. 5. If the file that you want is on a different drive or removable media, select the drive or removable media from Drive box in the Source Disk area. The file name and its file information appear in the file list. The check mark in the top of the file information shows that the file is registered in the patient data master index file and saved in a drive in the instrument. 6. Select the file that you want. The check box of the selected file has a different color. The measurement date and latest edited date of the selected file are displayed on the File Management dialog box. To select two or more consecutive files: 1) Click the check box of the first file that you want to select. 2) Press and hold down the SHIFT key while you click the check box of the last file. • To select two or more non-consecutive files, press and hold down the CTRL key while you click the check box of each file. • To arrange the file display by file name, examination program name, or date, etc. in ascending or descending order, click each title. • To change the file information displayed in the file list, click the Arrange Headings button. Refer to “Changing the file information layout in the file list” in this section. • To check the patient information of the selected file, click the Patient Information button. 7. When copying or moving the file, select the destination drive from the Drive box in the Destination area. The selectable drive or removable media appears in the list box. To cancel operation, click the Cancel button. 8. Click the OK button. When the confirmation dialog box opens, click the Yes button to execute the selected operation.

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Operator's Manual MEB-9400

Section 8 Printing

General .............................................................................................................................. 8.1 Printing the Measurement (Monitor, Sweep, Average or Stop) Window (Hard Copy) ........ 8.2 Printing the Stop, Saved or Gather Window Waveforms and Data ..................................... 8.3 Printing One Page of Waveforms from the Stop or Saved Window .......................... 8.4 Printing All Waveforms on the Stop or Saved Window ............................................. 8.6 Printing ABR Threshold Test Waveforms ................................................................. 8.8 Printing Waveforms on the Gather Window ........................................................... 8.11 Printing Raw Waveforms on the Stop Window ....................................................... 8.14 Printing Waveforms for All Sites on the Stop Window ............................................ 8.19 Printing a Report ............................................................................................................. 8.21 General .................................................................................................................. 8.21 Outline of the Report Printing ................................................................................ 8.21 Composition of the Report ..................................................................................... 8.22 Report Printing Procedure (Microsoft Word) .......................................................... 8.22 Changing Word Security Setting .................................................................. 8.22 Printing ........................................................................................................ 8.23 Report Printing Procedure (Microsoft Excel) ......................................................... 8.27 Selecting the Excel Installation Folder ......................................................... 8.27 Changing Excel Security Setting ................................................................. 8.28 Printing ........................................................................................................ 8.29 Editing the Title of Each Item on the Report ................................................ 8.30

Operator’s Manual MEB-9400

8C.1

8. PRINTING

General The following three printing methods are available. • Printing the measurement (Monitor, Sweep, Average or Stop) window (Hard copy) You can print the active measurement window (Monitor, Sweep, Average or Stop window) on the currently selected examination, including the waveforms and patient and examination information. • Printing the waveform in the preset format (Review Printing) You can print waveforms from the Stop, Saved or Gather window together with patient and condition information. You can select one of six waveform modes when you print. • Printing a report You can use Microsoft Word and Excel (not supplied with the system) to print reports. The measurement data can be transferred to Word or Excel and converted to the Word or Excel report format. The report printing is available for the following examination programs: SEP, SSEP, ECG-SSEP, Electric, ABR, MLR, SVR, Ecoch G, Auditory, PatternVEP, Goggle-VEP, Flash-VEP, ERG, Visual, MCS, SCS, Resp. Stim, H-reflex, Blink, QEMG, Micro-N, SSR, EMG, NCS (Excel only), EMG Manual MUP (Excel only) EMG, QEMG, Macro EMG, EOG, Micro-N: When the waveforms are saved by “Saved Waves”, the report printing is available.

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8. PRINTING

Printing the Measurement (Monitor, Sweep, Average or Stop) Window (Hard Copy)

You can print the active measurement window (Monitor, Sweep, Average or Stop window) on the currently selected examination, including the waveforms and patient and examination information. There are several ways to print: • Click the

Hard copy print button on the Tool bar.

• Or, select Hard Copy from the File menu. File menu → Print → Hard Copy You can print the registered user name on the header or footer. Refer to “Changing the Settings in the User Define Dialog Box” in Section 9.

8.2

When the Cancel button in the message box is clicked during printing, the printing is canceled. However the data which has been sent to the printer is printed.

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8. PRINTING

Printing the Stop, Saved or Gather Window Waveforms and Data You can print waveforms from the Stop, Saved or Gather window together with the patient and condition information. Waveforms can be printed in one of the following six modes. You can select the mode when you print. Not all waveform modes are available in all examinations. • Stop/Saved Window - One Page Waveforms (One Frame) Prints one page of waveforms from the Stop or Saved window. The number of waveforms that can be printed depends on the examination program. Waveforms cannot be printed if more than the maximum number of printable waveforms is saved. F-wave, H-reflex: maximum 20 waveforms on the Stop window Rep-stim: maximum 10 waveforms on the Stop window EMG, QEMG, EOG, MICRO-N, Macro EMG: maximum 8 waveforms on the Saved Waves window Other examination programs: maximum 8 waveforms on the Stop window • Stop/Saved Window - All Waveforms (Screen Wave) Prints the following waveforms. In EMG, QEMG, EOG, MICRO-N and Macro EMG examination programs: Waveforms on the Saved Waves window. In other examination programs: Waveforms on the Stop window. • ABR Threshold Test Waveforms (Threshold Test) In the ABR examination, prints the Stop or Saved window waveforms acquired in the auditory threshold test and the I-L curve. Printing is not possible if more than 16 waveforms are saved on the Stop window. This mode is only available for ABR examinations. • Gather Window - Selected Waveforms (Gather/Site (T) wave) Prints the following waveforms. • Waveforms on the Stop window in Rep-stim and F-wave examination programs. • Triggered acquired waveforms in EOG, EMG, QEMG, MICRO-N, SF EMG and Macro EMG examination programs. • Waveforms on the Gather window in other examination programs.

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8. PRINTING • Stop Window - Raw Waveform (Monitor/Site (M) wave) Prints the raw waveform on the Stop window. This mode is only available for EOG, EMG, QEMG, MICRO-N, SF EMG or Macro EMG examinations. • Stop Window - All Site Waveforms (All Sites) Prints the waveforms for all sites on the Stop window. This mode is only available for EOG, EMG, QEMG, MICRO-N, SF EMG or Macro EMG examinations.

Printing One Page of Waveforms from the Stop or Saved Window

There are three ways. • Press the PRINT key on the operation panel. • Or, Click the

Review Print button on the Tool bar. The one frame printing

starts. • Or, 1. Select Review Print from the File menu. The Review Print dialog box opens. File menu → Print → Review Print

2

2. Click the One Frame button in the Wave select area. 3. Click the Print button. The Screen Wave Print dialog box opens.

3

4. Select the printing options in the Sequence area. Patient: Patient information Condition: Measurement settings Measurement: Measurement values Waveform: Measured waveforms To change the printing order, select an item and move it with the Up or Down button. 5. Select the printing size with the X box and Y box in the Wave Scale area. X: Horizontal length from 100 to 180 mm in 5 mm steps Y: Vertical length from 100 to 250 mm in 5 mm steps 6. Select the number of copies with the Number of Copy box. 7. Click the Print button. • To cancel printing, click the Cancel button. • To save the settings on the Screen Wave Print dialog box without printing, click the OK button. 8.4

Operator's Manual MEB-9400

8. PRINTING Printing Example The printing order and the page size for waveform printing are fixed.

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8. PRINTING

Printing All Waveforms on the Stop or Saved Window 1. Select Review Print from the File menu. The Review Print dialog box opens. File menu → Print → Review Print 2. Click the Screen Wave button in the Wave select area.

2

3. Click the Print button. The Screen Wave Print dialog box opens.

3

To cancel printing, click the Cancel button.

4. Select the printing options in the Sequence area. Patient: Patient information Condition: Measurement settings Measurement: Measurement values Waveform: Measured waveforms To change the printing order, select an item and move it with the Up or Down button. 5. Select the printing size with the X box and Y box in the Wave Scale area. X: Horizontal length from 100 to 180 mm in 5 mm steps Y: Vertical length from 100 to 250 mm in 5 mm steps 6. Select the number of copies with the Number of Copy box. 7. Click the Print button. • To cancel printing, click the Cancel button. • To save the settings on the Screen Wave Print dialog box without printing, click the OK button.

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8. PRINTING

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8. PRINTING

Printing ABR Threshold Test Waveforms

1. Select Review Print from the File menu. The Review Print dialog box opens. File menu → Print → Review Print

2 3

2. Click the Threshold Test button in the Wave select area. 3. Click the Print button. The Review Print dialog box closes and printing starts. To cancel the Threshold Test printing, click the Cancel button on the Review Print dialog box.

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8. PRINTING Threshold Test printing example The printing order and the frame size for waveform printing are fixed. The I-L curve graph is printed on the second page.

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8. PRINTING

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8. PRINTING

Printing Waveforms on the Gather Window

1. Select Review Print from the File menu. The Review Print dialog box opens. File menu → Print → Review Print

2

3

2. Click the Gather/Site (T) wave button in the Wave select area. 3. Click the Print button. The Gather/Site (T) Wave Print dialog box opens.

To cancel printing, click the Cancel button. 4. Select the printing options. Site No.: This is only available when the EMG, QEMG, MICRO-N, EOG, F-wave or Rep-stim examination program is selected. The selected site appears in the box. Number of Copy: Selects the number of copies. Raster Pitch (mm): Selects the printing distance between the waveforms from 1 to 100 mm in 1 mm steps. Grid Size (mm): Selects the grid size. Sweep No.: Selects the waveforms to be printed with the waveform number. Site Info.: Check this box to print the patient and examination information. 5. Click the Print button. • To cancel printing, click the Cancel button. • To save the settings on the Gather/Site (T) Wave Print dialog box without printing, click the OK button. Operator's Manual MEB-9400

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8. PRINTING Review print - Gather wave example-1

When the Site Info. check box is not checked, this page is not printed. Only the waveform is printed.

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8. PRINTING Review print - Gather wave example-2

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8. PRINTING

Printing Raw Waveforms on the Stop Window

1. Select Review Print from the File menu. The Review Print dialog box opens. File menu → Print → Review Print

2

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2. Click the Monitor/Site (M) wave button in the Wave select area. 3. Click the Print button. The Monitor/Site (M) Wave Print dialog box opens.

To cancel printing, click the Cancel button. 4. Select the printing options. Site No.: The selected site appears in the box. Number of Copy: Selects the number of copies. Time Scale (/div): Selects the time scale corresponding to 1 div from 5, 10, 20, 30, 50 ms, 0.1, 0.2, 0.5, 1 s. The default setting is “Monitor Time” selected in the Waveform window. Raster Pitch (mm): Selects the printing distance between the waveforms from 1 mm to 100 mm in 1 mm steps. This option is only available when the Raster button is checked in the Monitor Waveform area. Grid Size (mm): Selects the grid size. Monitor Wave Form: Continuous: Prints the page in portrait orientation. Raster: Prints the page in landscape orientation. Print Period (sec): Selects the portion of the waveform. Enter the beginning and ending of the waveform in the From and To box in 5 s steps. Site Info.: Check this box to print the patient information. 8.14

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8. PRINTING 5. Click the Print button. To cancel printing, click the Cancel button. To save the settings on the Monitor/Site (M) Wave Print dialog box without printing, click the OK button.

Review print – Monitor/Site (M) wave, continuous printing example-1

When the Site Info. check box is not checked, this page is not printed. Only the waveform is printed.

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8. PRINTING Review print – Monitor/Site (M) wave, continuous printing example-2

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8. PRINTING Review print – Monitor/Site (M) wave, raster printing example-1

When the Site Info. check box is not checked, this page is not printed. Only the waveform is printed.

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8. PRINTING Review print – Monitor/Site (M) wave, raster printing example-2

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8. PRINTING

Printing Waveforms for All Sites on the Stop Window

1. To open the Review Print dialog box, select Review Print from the File menu. File menu → Print → Review Print

3 2

2. Click the All Sites button in the Wave select area. 3. Click the Print button. The Review Print dialog box closes and printing starts. To cancel the All Sites printing, click the Cancel button on the Review Print dialog box.

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8. PRINTING All Sites printing example The waveform is printed in the Site No. order with the oldest site at the top. All Sites can be printed in either continuous printing format or raster printing format. Select either format on the Monitor/Site (M) Wave Print dialog box.

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8. PRINTING

Printing a Report General

You can use Microsoft Word and Excel to print reports. The measurement data can be transferred to Word or Excel and converted to the Word or Excel report format. Report printing is available for the following examination programs. SEP, SSEP, ECG-SSEP, Electric, ABR, MLR, SVR, Ecoch G, Auditory, Pattern-VEP, Goggle-VEP, Flash-VEP, ERG, Visual, MCS, SCS, Rep-Stim, Fwave, H-reflex, Collision, Blink, EMG, QEMG, P300, CNV, MRCP, MICRON, SSR

NOTE When two or more examination windows are opened, no wave data can be transferred to Word or Excel. The followings report settings are set in System Setting: Word • Making a new report format • Changing the report format name • Changing the Word document template file • Selecting the printing order of the selected measurement data when two or more files are transferred. • Presetting the title name • Selecting the measurement data for printing • Selecting the frame for waveform printing • Selecting whether or not to use Word for entering the data. • Selecting the Measurement Table window Type I or II. Excel • Editing the title of each item

Outline of the Report Printing System Program

Microsoft Word, Excel

Measurement data Transfers the measurement data selected in the report format Full report, Brief report (Word only) and Summary report

file is template program d te c le m The se by the syste p Word/Excel template file called u riefj.dot) llj.dot, B u (F te mpla Word te mplate l te e c x or E

Enter title, summary. etc

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8. PRINTING

Composition of the Report

The report consists of • Patient information • Examination information • Condition table (measurement settings) • Measurement table (measurement results) • Waveform data

Report Printing Procedure (Microsoft Word)

Changing Word Security Setting 1. From the Start menu, select Word to open Word. Start button menu → Program → Word 2. From the Tools menu, select Security to open the Security sheet. Tools menu → Macro → Security

2 3. Click the Medium button and click the OK button. The Security sheet closes.

3

4. Close Word. 8.22

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8. PRINTING Printing 1. Open the Report Result dialog box. • Click the

Report button on the Tool bar.

• Or, select Report from the File menu. File menu → Print → Report 2. Select the number of copies with the No. of Copies box. 3. Check the Word option button in the Output to area.

4. Select the report format. For details, refer to “Setting the Report Format” in Section 9. The following default formats are provided: Full report: The measurement data (patient information, examination information, condition table, measurement table, and waveform data) is transferred to Word and the title, examination summary and conclusion can be entered. Brief report: The measurement data (patient information, examination information, condition table, measurement table, and waveform data) is transferred to Word. Summary report: Patient information, examination information and measurement table are transferred to Word and the title, examination summary and conclusion can be entered. 5. Select the measurement data for report printing by clicking the check box beside the file name. To select all measurement data, click the Check All results check box. You can select the printing order by sorting the measurement data. To sort the measurement data, click the information tab. The data is displayed in ascending order. 6. Click the OK button. The selected file is transferred to Word and the Warning window (Macros) opens. 7. Click the Enable Macros button to use Macros. The transferred file is opened in Word. To cancel transferring the file, click the Cancel button on the Report Result dialog box. 8. Enter the title, examination summary and examination conclusion when “Full” report is selected. 9. From Word, print the report.

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8. PRINTING The report format can be selected from the Word document template file. Fullj.dot format is • Printing size: A4, 210 × 297 mm • Font: Times New Roman • Orientation: Portrait

1. Header: Date and time aligned right. 2. Title: Entered title using Word 3. Here, you can enter the desired characters. 4. Patient information field: Up to 240 characters are available and 80 characters in one line. 5. Examination information field Up to 240 characters are available and 80 characters in one line. 6. Status information field: Status information 7. MCS Measure information field: The measurement data displayed on the measurement table window of the MCS, SCS , H-reflex and Collision examination program. Or, Measure field 1: The measurement data displayed on the measurement table window (Latency) of the basic evoked potential examination program 8. Footer: Page number 9. MCS Measure information field 2: The measurement data displayed on the NCS measurement table window of the MCS and SCS examination program. Or, Measure field 2: The measurement data displayed on the measurement table window (Mark pair) of the basic evoked potential examination program 10. Waveform field: Waveform displayed on the Waveform window. 11. EMG Summary field 1: Remarks on the EMG Findings Summary Table window of the EMG, QEMG and Macro EMG examination program. 12. EMG Summary field 2: Findings on the EMG Findings Summary Table window of the EMG, QEMG and Macro EMG examination program. 13. Summary field: Entered summary using Word 14. Conclusion field: Entered conclusion using Word

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8. PRINTING 1

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8. PRINTING

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8. PRINTING

Report Printing Procedure (Microsoft Excel)

1. From the Start menu, select Edit Report Setting to open the Edit Report Setting dialog box. Start button menu → Program → Npk → Edit Report Setting 2. Click the Browse button on the Related Application area. The Open dialog box opens.

3. Select the C:\Program Files\NPK\ExceReport\MEBReport_Excel.exe file and click the Open button.

Selecting the Excel Installation Folder Select the folder according to the installed excel program in the Folder section of the Report,ini file (Default setting: Excel 2000). Refer to ”Editing the Title of Each Item on the Report”.

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8. PRINTING Changing Excel Security Setting 1. From the Start button menu, select Excel to open Excel. Start button menu → Program → Excel 2. From the Tools menu, select Security to open the Security sheet. Tools menu → Macro → Security

2

3. Click the Medium button and click the OK button. The Security sheet closes.

3

4. Close Excel.

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8. PRINTING Printing 1. Open the Report Result dialog box. • Click the

Report button on the Tool bar.

• Or, select Report from the File menu. File menu → Print → Report 2. Select the number of copies with the No. of Copies box. 3. Check the RIF File option button in the Output to area.

4. Select the measurement data for report printing by clicking the check box beside the file name. To select all measurement data, click the Check All results check box. You can select the printing order by sorting the measurement data. To sort the measurement data, click the information tab. The data is displayed in ascending order. 5. Click the OK button. The Neuropack Report dialog box opens. 6. Select the report format Full report: The measurement data (patient information, examination information, condition table, measurement table, and waveform data) is transferred to Excel and the title, examination summary and conclusion can be entered. Summary report: Patient information, examination information and measurement table are transferred to Excel, and the title, examination summary and conclusion can be entered The selected file is transferred to Excel and the Warning window (Macros) opens. 7. Click the Enable Macros button to use Macros. The transferred file is opened in Excel. To cancel transferring the file, click the Cancel button on the Neuropack Report box. 8. Enter the title, examination summary and examination conclusion. 9. From Excel, print the report.

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8. PRINTING Editing the Title of Each Item on the Report The title of each item on the report can be edited. 1. Check the folder where Excel is installed. If Excel is not installed in the following folder, change the setting in the Report.ini file. Excel 2000: C:\Program Files\Microsoft Office\Office Excel XP: C:\Program Files\Microsoft Office\Office10\Excel.exe 1) Right-click the My Computer icon on the desktop. The pop-up menu opens. 2) Select Explore. The My Computer window opens. 3) Double-click the C:\Program Files\NPK\ExeclReport\Report.ini file. The Report.ini file opens in Notepad. 4) Change the “Appname” setting in the Folder section to the folder where Excel is installed. Folder (default setting): For Excel 97/98 Appname=””C:\Program Files\Microsoft Office\Office\Excel.exe”” For Excel 2000: Appname=””C:\Program Files\Microsoft Office\Office\Excel.exe”” For Excel XP: Appname=””C:\Program Files\Microsoft Office\Office10\Excel.exe””

NOTE Do not delete the four double quotation marks before and after the folder name. 5) From the File menu, select Save and close Notepad. The new settings overwrite the current settings. 2. Edit the title and settings 1) From the Start button menu, select Excel Report Setting. Start button menu→ Program → Npk → Excel Report Setting The Excel Report setting dialog box opens. 2) Edit the title and select the settings 3) When setting is complete, click the OK button. To cancel setting, click the Cancel button

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8. PRINTING Excel Report Setting dialog box

Title1, 2: Type the title 1 and/or 2 OS area: Select the operating system. Print size area: Select the paper size. Doctor Name area: Type the doctor name displayed in the Signature list box on the Excel spreadsheet. Patient Information area: Edit the title for each patient information item. Report Format area Select the Report format for each examination program. MCS/SCS area Amplitude Norm Data ON/OFF: Select whether or not to display the Amplitude Normative Data column. MCS Amp Unit/MCS Area Unit: Select the MCS amplitude unit and MCS area unit. F-wave measurement mode [NCS-F] area Cursor/Mark: Select either the cursor display or mark display. Cursor mode: A brief table is printed. Mark mode: A detailed table is printed.

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8. PRINTING Cursor on Waveform: When the cursor mode is selected, select whether or not to display the cursor on the waveform. Second Sens.: Select the amplitude for “Second Sens”. ABR area Routine Table [Type I]/Threshold Table [Type II]: Select the type of the ABR Measurement Table window. Output on Table: Select whether or not to display the Amp column on the measurement table window. Blink area: Select the type of the Blink Measurement Table window. EMG Stored Wave area: Select the acquisition length of the EMG waveforms. SSEP area: Select the type of the SSEP Measurement Table window. Table area: Select whether or not to print the measurement table window when no mark is set on the waveform. This setting is only available for evoked potential measurement such as ABR, SEP, or VEP. When the measurement table window is not printed, you can set a comment. WaveName. Mark Label area Show Wave Name: Select whether or not to display the waveform name. Show Label Name: Select whether or not to display the mark label on the waveform. These settings are only available for evoked potential measurement such as ABR, SEP, or VEP. Impression area Select the Impression column position. You can change the title of the Impression and Signature columns.

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8. PRINTING

This page is intentionally left blank.

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Section 9 System Settings

General .............................................................................................................................. 9.1 Changing the Settings in the User Define Dialog Box ........................................................ 9.2 Opening the User Settings Dialog Box .................................................................... 9.2 Registering a User Name ........................................................................................ 9.2 Changing the Muscle Name Displayed in the Muscle List Box on the EMG Findings Window and File Search Dialog Box ........................................................................ 9.3 Changing the Nerve Name Displayed in the Nerve List Box on the Nerve Input Window and File Search Dialog Box ........................................................................ 9.4 Changing the EMG Findings in the EMG Findings Table Dialog Box ....................... 9.6 Adding the Names and Comments for Entering a Patient Information and Examination Information .......................................................................................... 9.7 Default Settings of the Names and Comments .............................................. 9.9 Selecting the Tool Buttons Displayed on the Examination Window ........................ 9.12 Customizing the Window .................................................................................................. 9.13 Setting the Report Format ............................................................................................... 9.15 Setting the System Condition ........................................................................................... 9.18

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9. SYSTEM SETTINGS

General This section explains how to set the following items: • Registering a user name (User Settings dialog box). • Changing and adding muscle names, nerve names, EMG finding list and characters (User Settings dialog box). • Customizing the window (Properties window). • Setting the report formats (Edit Report Setting dialog box). • Setting the AC filter line frequency, input/output sensitivity and whether or not to create backup file (System Condition dialog box).

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9. SYSTEM SETTINGS

Changing the Settings in the User Define Dialog Box Opening the User Settings Dialog Box

From the Start button menu, select User Settings. Start button menu → Program → Npk → User Settings

To close the User Define dialog box, click the OK button. The changed settings are saved after the power is turned off. To cancel changing, click the Cancel button.

Registering a User Name

9.2

Type in a user name with up to 40 characters in the Name on Printout text box and click the Header or Footer button to select the user name print position.

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9. SYSTEM SETTINGS

Changing the Muscle Name Displayed in the Muscle List Box on the EMG Findings Window and File Search Dialog Box

You can change the muscle name displayed in the Muscle list box on the EMG Findings window and File Search dialog box when the Muscle box arrow or Muscle List button is clicked. You can select the frequently used muscle names in the Quick list box.

Muscle box arrow is clicked: The muscle name selected in the left list box on the Edit Muscle Table dialog box appears in the Muscle list box on the EMG Findings window and File Search dialog box. Muscle List button is clicked: The muscle name selected in the Quick list on the Edit Muscle Table dialog box appears in the Muscle list box on the EMG Finding window and File Search dialog box. 1. Click the Muscle Table button on the User Settings dialog box. The Edit Muscle Table dialog box opens.

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9.3

9. SYSTEM SETTINGS 2. Change the muscle name list in the left list box. 1) Click the Upper Extremity, Lower Extremity or Head & Trunk button in the Muscle Table area. The selectable muscle names appear in the left list box. 2) Click the muscle name in the left list box. The selected muscle name is highlighted and appears in the Muscle name text box. 3) Type in the new muscle name in the Muscle Name text box. 4) Press the Enter key. The old muscle name is replaced with the new muscle name and new muscle name appears in the left list box. 3. Change the muscle name list in the Quick list box. To add the muscle name from the left list box to the Quick list box: 1) Click the muscle name in the left list box. The selected muscle name is highlighted. 2) Click the Add >> button. The selected muscle name is copied to the Quick list. To remove the muscle name in the Quick list box: 1) Click the muscle name in the Quick list box. The selected muscle name is highlighted. 2) Click the