Constricción prematura del ductus arterioso: consecuencias del consumo excesivo de té negro y de hierbas / Premature ductus arteriosus constriction: consequences of excess maternal consumption of herbal and black tea

La constricción intrauterina del ductus arterioso es un evento raro, que a menudo resulta en una grave morbilidad fetal/neonatal y en mortalidad. La constricción del ductus fetal surge generalmente asociada a la exposición materna a los antiinflamatorios no esteroideos o a lesiones estructurales cardíacas. El pronóstico depende del grado y el intervalo de la obstrucción del flujo ductal. Para identificar la causa detrás de este diagnóstico se requiere generalmente la realización de una anamnesis detallada. En este artículo presentamos 2 casos de fetos con constricción del ductus arterioso diagnosticados por ecocardiografía rutinaria del tercer trimestre. El consumo excesivo de té negro y de hierbas fue identificado como la causa de la constricción del ductus arterioso. Alrededor de 2 semanas después de interrumpir el consumo de dichas sustancias, la constricción ductal se invirtió y los valores hemodinámicos han vuelto a la normalidad. Las mujeres embarazadas y los médicos deben ser sensibles a los efectos de los consumos en exceso de alimentos con altas concentraciones de polifenoles(AU)

Intrauterine constriction of ductus arteriosus is a rare event which often results in severe fetal/neonatal morbidity and mortality. Fetal ductus constriction is usually associated with maternal exposure to non-steroidal anti-inflammatory drugs or structural cardiac lesions. The prognosis depends on the degree and interval of ductal flow obstruction. Detailed history taking is generally required to identify the cause of this diagnosis. We report two cases of fetuses with ductus arterious constriction diagnosed by routine echocardiography in the third- trimester. The cause of the ductus arterious constriction was identified as excess consumption of black and herbal tea. Around 2 weeks after stopping consumption of these substances, ductal constriction was reversed and hemodynamic values returned to normal. Pregnant women and clinicians should be sensitized to the effects of excess consumptions of foods with high concentrations of polyphenol(AU)

[Vibrations of the human tympanic membrane measured with Laser Doppler Vibrometer]. / Drgania blony bebenkowej oceniane Dopplerowskim wibrometrem laserowym.

The knowledge of the physiology of the normal ear is important to understand the function of the ear. It is especially crucial in the reconstruction of the destroyed ear to apply the knowledge of the normal ear. We present results of tympanic membrane vibrations measurements using Laser Doppler Vibrometer in human temporal bone specimens. Six temporal bone specimens were harvested within 48 hours of death and stored cooled until preparation. The preparation included mastoidectomy with posterior tympanotomy and partial resection of the facial nerve to visualize the stapes with its footplate. We measured velocity and displacement of each quadrant of the tympanic membrane and the umbo with the laser Vibrometer equipped with velocity and displacement decoders. The sensor head OFV-534 produced and read the reflected laser beam directed at a measured point with a dedicated micromanipulator attached to an operating microscope. A retro-reflective tape was used to enhance the reflection of the laser beam. Vibrations were induced by a acoustic stimulation at the tympanic membrane. The results of the measurements were corrected to a sound pressure in the external ear canal. Laser Doppler Vibrometer system allows an undisturbed measurement of vibrations in the middle ear. Posterior quadrants of the tympanic membrane have greater velocity and displacement than anterior quadrants in lower frequencies up to 2 kHz.

Effects of potassium ions on dentine sensitivity in man.

OBJECTIVE: To determine the effect of applying 500 mmol/l KCl at a pressure of 150 mm Hg above atmospheric to exposed dentine on pain sensation evoked by probing and air blast stimuli in human subjects. DESIGN: The experiments were carried out on 14 pairs of premolars in 14 human subjects (aged 17-30 years). Dentine was exposed at the tip of the buccal cusp, etched with acid and covered with saline, then 500 mmol/l KCl in Ringer's was applied at a pressure of 150 mm Hg for 4 min. Mechanical probing and air-drying stimuli were performed before and 2, 10, 20, 30 min after applying the KCl solution. The subject indicated the intensity of any pain produced on a visual analogue scale (VAS). Pulpal blood flow was recorded with a laser Doppler flow meter. Exactly the same procedure was carried out on the contralateral tooth except that 500 mmol/l NaCl in Ringer's was used in place of the KCl solution. RESULTS: The pain responses to mechanical probing and air blast stimuli were significantly reduced during the first 10 min after applying the KCl but not the NaCl solution. Pulpal blood flow did not change significantly after either treatment. CONCLUSION: Potassium ions, when applied to exposed dentine at a pressure of 150 mm Hg above atmospheric, produced temporary block of impulse conduction in sensory nerve endings in the dentine or pulp.

[Effect of Kampo medicines on the peripheral blood flow rate of betamethason-induced Oketsu syndrome mice by laser Doppler flow meter].

Stagnation of peripheral blood flow is the cause of various diseases. Changes in peripheral blood flow after oral administration of Kampo medicines in mice with betamethasone-induced oketsu syndrome and normal mice were examined using a laser Doppler blood flow meter. The Kampo medicines used were: Toki-shakuyaku-san; Kami-shoyo-san; Keishi-bukuryo-gan; Daio-botanpi-to; Tokaku-joki-to; Goshuyu-to; and Hange-koboku-to. In the oketsu mice, blood flow was improved by single-dose administration of Toki-shakuyaku-san, Kami-shoyo-san, Keishi-bukuryo-gan, Daio-botanpi-to, Tokaku-joki-to, and Goshuyu-to, but only Toki-shakuyaku-san increased blood flow significantly in normal mice. In addition, blood flow decreased after single-dose administration of Keishi-bukuryo-gan, Daio-botanpi-to, and Tokaku-joki-to in normal mice.

Comparing a mechanical device with medicinal leeches for treating venous congestion.

OBJECTIVE: To compare mechanical device therapy to medicinal leech therapy for treating venous congestion. STUDY DESIGN: Fasciocutaneous flaps of 9 x 7-cm (porcine model, n = 11) were elevated and the associated veins clamped for 15 hours. Device-treated flaps (n = 6) were treated with up to 3 devices/flap. Leech-treated flaps (n = 5) were treated with 75 leeches/flap (5 leeches/hour). Treatment evaluation parameters included: blood volume removed, skin color, surface perfusion, tissue oxygen tension, and endpoint histology. RESULTS: No significant differences were seen in blood volume removed, surface perfusion, and oxygen tension. However, significant differences were seen in skin color change over time. Histological assessment showed mild congestion in 5/5 leech-treated flaps and 2/6 device-treated flaps. CONCLUSION: Device therapy was comparable to leech therapy for decongesting a 9 x 7-cm flap over a 15-hour period. However, digital images and significant differences in skin color change over time demonstrate that device therapy promotes more global decongestion versus leech therapy.

Cerebral and peripheral effects of laser needle-stimulation.

This study comprises scientific-theoretic fundamental investigations of laserneedle technology, a new and painless method of acupuncture stimulation. Laserneedles are not inserted in the skin, but are merely placed on the surface of the acupuncture point. The study documents the significant changes in peripheral microcirculation (p = 0.005) and surface temperature of the skin (p = 0.02) induced by laser, in 22 healthy volunteers (mean age 24.4 +/- 2.6 years). In addition, a randomised cross-over study to characterise the specific changes in cerebral blood flow velocity with laserneedle acupuncture (p < 0.001) is presented. These results provide important information for characterising the effects of laserneedle acupuncture.

Case studies of laser Doppler imaging system for clinical diagnosis applications and management.

The laser Doppler perfusion imager (LDPI) is a recent development in the field of laser Doppler flowmetry. It has great potential in many medical applications for the non-invasive diagnosis of problems based on microvascular perfusion. Established applications include assessment of breast skin blood flow, wound healing, skin burn, and systemic sclerosis. This paper aims to enhance the usability of LPDI for diagnostics testing through the examination of two major issues. The first issue deals with the performance of the LDPI technique. Two case studies are used not only to highlight the potential applications of LDPI, but also to illustrate the general procedure/precautions needed for ensuring the consistency and quality of the captured perfusion images. The first case study deals with the perfusion across the proximal interphalangeal joints of patients with osteoarthritis. The results showed that LDPI could provide an objective and specific assessment of hyperaemia over the interphalangeal joints in patients with rheumatoid arthritis. The second case study deals with the blood flow on the stomach region during acupuncture. The results indicated that LDPI could provide an objective and specific assessment of the stimulation level on acupuncture point. The issues discussed in these case studies would be useful for the evolution of other novel LDPI applications and the standardization of the proper clinical procedure for the capturing of the LDP images. The second issue deals with the intelligent management of the LDPI results to facilitate the prescription of treatment based on analysis of similar cases previously encountered. The framework of an intelligent diagnostics assistant is proposed to automate the search and retrieval of relevant past cases based on the LDPI diagnosis. The paper uses skin burn as an example to discuss the considerations and techniques for the implementation of the proposed intelligent diagnostics system. This work constitutes initial efforts to increase the productivity of the doctors in diagnostics testing using LDPI.

Laser Doppler measurement of cochlear blood flow changes during conditioning noise exposure.

Using laser Doppler flowmetry, cochlear blood flow was assessed in Mongolian gerbils exposed to noise. Anesthetized animals were surgically implanted with permanent electrodes and then exposed for 10 consecutive days (6 h on/18 h off) to an octave band noise centered at 4 kHz (85 dB SPL). The auditory brainstem responses and the blood flow in the basal turn of the cochlea were compared with those of gerbils not exposed to noise. The exposed animals developed an initial threshold shift, followed by a progressive reduction in threshold shift up to complete recovery at the end of the test. In the exposed animals, a reduction in the cochlear blood flow during the first 4 days of exposure was observed, which was then followed by a progressive increase up to the end of the test. The results of this study exclude a possible role of the microvasculature of the lateral cochlear wall in determining the resistance to 4 kHz frequency noise exposure.

[Laser Doppler imaging and cryoglobulinemia]. / Laser Doppler Imaging und Kryoglobulinämie.

Continuous microcirculation monitoring of the right foot was carried out for the first time in a 62-year-old patient with cryoglobulinaemia prior to, during and after manual needle insertion at Jie Xi(St.41) acupuncture point using a new method of laser Doppler perfusion imaging (PIMII, Lisca AB, Linköping, Sweden). In addition to visual inspection, changes in mean perfusion were also used as evaluation parameters. Our results suggest that the new biomedical technique of laser Doppler imaging is a useful method for monitoring the effects of acupuncture on the peripheral microcirculation.

Progressive calibrated pressure device to measure cutaneous blood flow changes to external pressure strain.

The present methodological paper describes a simple and useful device for local, external pressure application. The mechanical devices, the difficulties, the time required, the possibilities and limitations of the technique to apply a progressive calibrated pressure and to measure cutaneous blood flow with a laser Doppler probe at the same site are discussed. This technique was used to study the effects of local pressure on the cutaneous blood flow with laser Doppler technique. Use of this protocol has provided evidence for a transient cutaneous vasodilation in the human hand during progressive externally applied pressure strain. Results from our laboratory thus far suggest that this vasodilator response is mediated by small sensory nerve fibres in the skin.

[Laser Doppler data analysis during interstitial laser thermotherapy with magnetic resonance control within the scope of an animal experiment study]. / Laser-Doppler-Datenanalyse während interstitieller Laserthermotherapie unter Magnetresonanz-Kontrolle im Rahmen einer tierexperimentellen Studie.

The aim of the present study was to investigate, using laser Doppler (LD) flowmetry, the phases immediately prior to and following experimental, neurosurgical laser therapy in animals. Two statistical models obtained on the basis of discriminant analysis are described. These models should enable the user to classify the sets of parameters calculated from the LD signals. With both models which contain 3 and 5 parameters, respectively. 100% discrimination of the two phases was attained. The usefulness of the models could be validated by results obtained with other models.

Continuous multiparametric monitoring of brain activities following fluid-percussion injury in rats: preliminary results.

Severe head injury can result in a high mortality rate or irreversible brain damage. One technique used to induce traumatic brain injury (TBI) is exposure of the brain to fluid percussion pressure while monitoring the increase in intracranial pressure (ICP). Since brain injury is a multifactorial, pathological, time-dependent state, the multiparametric monitoring approach was adopted for studying fluid percussion effects on the rat brain. A multiprobe assembly (MPA) connected to the brain in vivo (right hemisphere) enabled the simultaneous monitoring of CBF, NADH redox state, extracellular K+, Ca2+, H+ levels as well as DC potential, ECoG and ICP. The animal was connected to the monitoring system and exposed to TBI after a recuperation period of at least 3 hours after the end of the operation. Two typical responses to TBI were recorded in our preliminary experiments. When severe injury was induced, ischemic depolarization (ID) developed, whereas mild or moderate injury led to repetitive spreading depression (SD) cycles. The relationship between the ID and SD observed under TBI is important to the understanding of the mechanism of brain injury. ICP before injury was between 2-6 mm Hg and increased to 20-22 mm Hg 2-3 minutes after the ID. After severe head injury, ICP remained high and in some cases increased to critical values causing death of these animals. Some animals developed seizures at various stages after the TBI. Hyperbaric oxygenation was used as a therapeutic tool to treat severely injured animals. These preliminary results suggest that it is feasible and practical to use the MPA approach for monitoring the brain after TBI.