[Mid-dermal elastolysis after insertion of a pacemaker]. / Élastolyse du derme moyen après pose d'un stimulateur cardiaque.

BACKGROUND: Mid-dermal elastolysis (MDE) is a rare acquired disease of elastic tissue histologically characterized by focal loss of elastic fibres within the mid-dermis. While the mechanisms leading to MDE remain unknown, increased degradation of elastic fibres may be involved. Many factors potentially triggering such degradation have been suggested. PATIENTS AND METHODS: A 58-year-old man consulted for an asymptomatic reticulated eruption that began in the area of a pacemaker implanted six weeks earlier. The eruption consisted of erythematous polycyclic and coalescing macules with a wrinkled centre. Histopathology with orcein staining revealed focal loss of elastic fibres in the superficial reticular dermis only. Hypersensitivity reaction to any components of the pacemaker was ruled out by means of allergy exploration. Laboratory investigations including autoimmunological and haematological factors were unremarkable. A diagnosis was made of a reticular variant of MDE following insertion of a pacemaker. DISCUSSION: We report the second case of MDE following the insertion of a pacemaker, which could have triggered an inflammatory response directed specifically towards the elastic fibres.

The role of EEG brain mapping in quantification of brain damage in hypertensive disease associated with pregnancy.

UNLABELLED: The existence of a high blood pressure during the pregnancy represents a real danger for the mother and child, responsible for damage of the kidney, brain, liver, and placenta, cardiovascular and hormonal system. Nervous system changes can include blurred vision, seeing spots, severe headaches, convulsions, brain hemorrhage, and even occasionally blindness. AIM: To evaluate the spatial distribution of electroneuro-pathological aspects of brain activity at pregnant women with hypertensive disease by BEAM (Brain Electrical Activity Mapping). MATERIAL AND METHODS: Twenty pregnant women (week 20 to 39) with hypertensive disease were recruited. Healthy pregnant women were also recruited control group. Maternal monitoring included spectral multichannel EEG analysis (brain mapping), repeated clinical examinations and laboratory investigations. RESULTS: The major EEG changes observed were focal slowing of the background activity (14 patients)--occipital lobes especially, and intermittent spike and sharp wave transients (5 patients). CONCLUSIONS: Our finding's indicate that EEG brain mapping are probably sensitive in detecting the extent of the pathology in the brain in women with in hypertensive disease associated with pregnancy.

Noninvasive hemodynamic study of the pulmonary circulation.

UNLABELLED: Cardiac catheterization is the reference method for the hemodynamic study of the pulmonary circulation. However, cardiac catheterization is an expensive and invasive method. Echocardiography is a reliable noninvasive alternative method. The purpose of our study was to determine the correlation between echocardiographic and haemodynamic data obtained by cardiac catheterization in patients with pulmonary hypertension. MATERIAL AND METHODS: We conducted a prospective study on 55 subjects diagnosed with pulmonary hypertension. They were examined by echocardiography and cardiac catheterization. The following parameters were measured: systolic, mean and diastolic pulmonary artery pressure and pulmonary vascular resistance. We determined the coefficient of linear correlation (Pearson) between the two methods. RESULTS: The mean pulmonary artery pressure obtained by cardiac catheterization was 48.82 +/- 18.4 mm Hg; the systolic pulmonary artery pressure at cardiac catheterization was 67.86 +/- 22.31 mm Hg; the diastolic pulmonary artery pressure was 32.85 +/- 15.49 mm Hg; the pulmonary resistance was 10.4 +/- 5.14 Wood units. We obtained very good correlation between the two methods for systolic pulmonary artery pressure (r 0.847, p < 0.0001), mean pulmonary artery pressure (r 0.7, p < 0.001), diastolic pulmonary artery pressure (r 0.54, p 0.01) and pulmonary vascular resistance (r 0.82, p < 0.001). CONCLUSIONS: Echocardiography is an excellent method for the hemodynamic study of the pulmonary circulation.

[Study of bioelectrical properties of acupuncture areas]. / Contributii la studiul proprietatilor bioelectrice a zonelor de acupunctura.

The research has as a goal the investigation of the bioelectrical behaviour of the acupunctural areas in order to obtain a scientific substantiation of the correspondence between the extreme--eastern medical tradition and the academical medicine. It is obvious that the Chinese traditional medicine knows a certain mechanism of ensurance of homeostasis of the organisms, a mechanism represented, according to the Chinese medical tradition, by the net of acupuncture points and meridians. The experimental data presented in this paper lead to the discovery of the fact that this net works as the fourth system of integration, the electrical--regulator one. The maintenance of the internal homeostasis of the superior organisms and their adaptation to the environment is ensured by the neuro-endocrine and circulatory systems through a mechanism described by Selye under the name of the Uncertain General Syndrome of Adaptation represented by the hypothalamo-hypophyso-corticoadrenal axis. The evolution of these systems and of their mechanisms can be supervised on the basis of the cortisole concentration. The research emphasized the direct proportionality between the cortisone levels and the variation of the electrical values of the acupuncture points, a fact that demonstrates the involvement of the net of acupuncture points and meridians in the maintenance processes of the homeostasis, control, adjustment and adaptation of the living organisms. Additionally, the analysis of the bioelectrical behavior of the acupuncture areas led to the conclusion that the morpho-functional substrate of this net is the conjunctive tissue. The physical-chemical properties of the interstitial connective tissue assures its working as an electro-regulator system on one side and as a harmonization agent of the neuro-endocrine and circulatory systems on the other side, this aspect being to be developed in a future paper.

[Monitoring of the SaO2 and photoplethysmography in chronic disease]. / Monitorizarea saturatiei de oxigen si a pletismogramei in bolile cronice.

UNLABELLED: Non-invasive monitoring of some vital parameters can improve the management of chronic diseases resulting an important increasing of quality of life. Today the high number of the patients, suffering of chronically diseases, put a big pressure to the health system with their demand for homecare monitoring. MATERIAL AND METHOD: In this paper are presented the design of the wearable medical device for long term monitoring of pulse wave and SaO2 using a probe that includes two light emitting diodes (LEDs), one in the visible red spectrum (660 nm) and the other in the infrared spectrum (940 nm). The device stores all the data on SD memory card for post processing. RESULTS: The monitoring device is built using an ultra low power microcontroller that offers the advantage of high integration of some circuits. The custom made electronic boards used for signal acquisition are also included modules for storage device (SD/MMC card). The pulse wave was processed in MATLAB for calculate the second derivative of photoplethysmogram as an indicator of the hardness of the blood vessel. CONCLUSION: The work was focused on design and implementation of an ultra low power wearable device able to acquire the pulse wave, causing minimal discomfort and allowing high mobility.

[Visual evoked potentials (VEP) in the diagnosis and monitoring of ophthalmic diseases]. / Potentialul evocat vizual in diagnosticul si monitorizarea afectiunilor oftalmologice.

MATERIAL AND METHOD: 20 patients were examined (40 eyes) with different ophthalmic affections, age between 57 and 72 years old, 15 female and 5 male. RESULTS: Visual acuity was evaluated between 0.00 and 1.00 with correction. The laboratory exploration reveals changes of the lipidic profile--in 20% cases and the glucidic profile--in 12.50% cases. The inflammatory aspect also has been changed (the erytrocite sedimentation rate, the fibrinogen, reactive C protein)-- cases. The electrophysiological paraclinical exploration concentrated on recording the visual evoked potentials (VEP) of all patients. The record of visual evoked potential (VEP) pointed out in the majority of cases a increase of the P100 wave's latency, as well as modifications of the amplitude and form of the P100 waves, especially at patients examined and diagnosed with glaucoma, intraocular hypertension, ischemical nonarteritic anterior optical neuropaties or preatrophic globe. CONCLUSION: e consider that the record of the VEP - P100 wave, absolutely uninvasive exploration, may constitute an efficient way for the diagnosis and monitoring of patients with ophtalmic affections, even at early stages, orientating the physician in therapeuthical conduct.

[Monitoring system for cardiovascular parameters of drivers]. / Sistem de monitorizare a parametrilor cardiovasculari pentru conducatori auto.

UNLABELLED: In the world the road traffic accidents are in the 3rd place at WHO cause-of-death statistics. One of the main causes of these accidents is driving fatigue as results of stress. The aim of this study is to monitoring the heart rate variability for identifying the grade of stress of the drivers. MATERIAL AND METHOD: For this stage of the study we design and build an device that recording the ECG signal and the heart rate. We analysed of line the heart rate variability for determining one possible link between the grade of fatigue and heart rate variability. The device use only two electrodes placed on the steering wheel. RESULTS: We use three categories of subjects: beginner drivers, amateur drivers with more than 3 year experience, and expert drivers. The monitoring is made for 30 minutes in intensive traffic. CONCLUSION: The preliminary results are satisfactory which determine us to continuing the research in this direction.

[Wireless device for monitoring the patients with chronic disease]. / Dispozitiv wireless pentru monitorizarea pacientilor cu afectiuni cronice.

UNLABELLED: Remote monitoring of chronic diseases can improve health outcomes and potentially lower health care costs. The high number of the patients, suffering of chronically diseases, who wish to stay at home rather then in a hospital increasing the need of homecare monitoring and have lead to a high demand of wearable medical devices. Also, extended patient monitoring during normal activity has become a very important target. MATERIAL AND METHOD: In this paper are presented the design of the wireless monitoring devices based on ultra low power circuits, high storage memory flash, bluetooth communication and the firmware for the management of the monitoring device. RESULTS: The monitoring device is built using an ultra low power microcontroller (MSP430 from Texas Instruments) that offers the advantage of high integration of some circuits. The custom made electronic boards used for biosignal acquisition are also included modules for storage device (SD/MMC card) with FAT32 file system and Bluetooth device for short-range communication used for data transmission between monitoring device and PC or PDA. CONCLUSION: The work was focused on design and implementation of an ultra low power wearable device able to acquire patient vital parameters, causing minimal discomfort and allowing high mobility. The proposed wireless device could be used as a warning system for monitoring during normal activity.

[Biofeedback in young singer vocal training]. / Biofeedback-ul in antrenamentul vocal al tinerilor cântareti.

UNLABELLED: Biofeedback therapy is a learning process that is based on "operant conditioning" techniques. AIM: To estimate the significance of biofeedback to an accurate and faster control of singing voice emission. RESULTS: Significantly, it was discovered that professional singers active in performing of both classical and music theatre repertoire with regard to the visual-kinesthetic effect of melodic contour in musical notation as it affect vocal timbre. The results of the study also indicate that the development of new technology for youth singer vocal training, may be useful to these singers.

[Ionic calcium and magnesium from pharmaceutical product BEROCCA effects on neuromuscular excitability]. / Efectul ionilor de calciu si magneziu din produsul farmaceutic BEROCCA asupra excitabilitatii neuro-motorii.

The important physiological role of calcium and magnesium ions is all over recognised, about a lot of enzymatic reactions. Magnesium deficit produce neuromuscular hyper-reactivity, psychic reactions, functional hypoparathyroidism, increase of K+ channels membranes permeability, while hypermagnesemia decrease Ach release from neuromuscular synapsis, with post-synaptic excitability decreasing. Using BEROCCA (Hoffman la Roche) 1 cp/day, 30 days at the teenagers with behaviour troubles and at a goup of pregnant women (trimester I-III) with paresthesia, irritability, sleeplessness, we observed an improve of clinical signs, increasing plasma Ca2+ and Mg2+. EEG and EMG prove the beneficial effects of pharmaceutical product BEROCCA.

[Significance of auditory and kinesthetic feedback in vocal training of young professional singers (students)]. / Importanta feedback-ului auditiv si a celui kinestezic în antrenamentul vocal al tinerilor artisti lirici.

The study was to estimate the significance of auditory and kinesthetic feedback to an accurate control of fundamental frequency (F0) in 18 students beginning a professional singing education. The students sing an ascending and descending triad pattern covering their entire pitch range with and without making noise in legato and staccato and in a slow and fast tempo. F0 was measured by a computer program. The interval sizes between adjacent tones were determined and their departures from equally tempered tuning were calculated, the deviation from this tuning were used as a measure of the accuracy of intonation. Intonation accuracy was reduced by masking noise, by staccato as opposed to legato singing, and by fast as opposed to slow performance. The contribution of the auditory feedback to pitch control was not significantly improved after education, whereas the kinesthetic feedback circuit was improved in slow legato and slow staccato tasks. The results support the assumption that the kinesthetic feedback contributes substantially to intonation accuracy.

[An update on the polysomnographic assessment of sleep-related respiratory disorders]. / Actualitati în evaluarea polifiziografica a tulburarilor respiratorii asociate somnului.

The paper presents a review of recent findings in the instrumental assessment of sleep-related breathing disorders. Basic concepts of definition, classification and especially medical instrumentation used for polysomnography (PSG) are introduced. The authors present standard protocols of polygraphic investigation and solutions to some practical problems, as they appear in literature.

[The role of paraclinical studies in the diagnosis of hypomagnesemia spasmophilia]. / Rolul explorarilor paraclinice în diagnosticarea spasmofiliei hipomagneziemice.

Assuming that Ca+2 and Mg+2 play an important role in the cell (especially the neuronal and muscular ones) membrane excitability, this paper presents the place that the paraclinical specific investigations have in the proper diagnose of normal calcium serum level hypo-magnesium spasmophilia. A number of 52 patients presenting significant clinical spasmophilia, of age between 21 and 55 years old, from different professions and social classes, were selected for this study. Paraclinical investigations (spectrophotometry) showed a normal serum calcium level (an average of 9.22 mg%); also, a decrease of Mg+2 serum level (an average of 1.41 mg%) and normal levels for Na+ (3.04 g/l) and K+ (0.21 g/l). The electrophysiological investigations (EMG, EEG, VCN m, EKG) performed showed, on the EMG recordings, in 85% of the cases the presence of the typical spasmophilic repetitive discharges, increased when using compression ischemia and 3 minutes hyperventilation, while on the EEG recordings, most patients demonstrated the presence of diffuse or mainly frontal lobe cortical bioelectrical activity alteration, either in spontaneous conditions or after specific stimulation (3 minutes hyperventilation or SLI). The muscle bioelectrical activity was analyzed by mean of EMG recordings--a decrease of VCN m was detected on the SPE nerve (34.4 m/s) and also on the SPI nerve (34.2 m/s) The EKG recordings performed showed in 5% of the cases the presence of the ventricular repolarization disturbances (flat T waves). After receiving a proper treatment which included oral administration of calcium and magnesium gluconolactate, magnesium gluconolactate with B6 vitamin or Trimagant, there were important changes of all the studied parameters and so, as a specific therapy, we recommend the use of Mg+2 compounds, because it demonstrates a significant improvement of the clinical symptoms in spasmophilia and has no danger to precipitate in the body as Ca+2 exceeding does.

Cardiovascular effects of L-arginine as physiological precursor of nitric oxide.

In this study the cardiovascular effects of L-arginine were investigated. Perfusion with sorbitol L-arginine 5% solution induced a significant decrease of the systolic blood pressure in the human arterial hypertension. The hypotensive effects of L-arginine are accompanied by an increase of the ventricular ejection fraction. In vitro, L-arginine as physiologic precursor of nitric oxide induced a smooth muscle relaxation more evident in the coronary vessels than in the thoracic aorta rings. Selective inhibition of NO-synthetise with L-NAME reduced the L-arginine vasodilation and intensified the vasoconstrictor effect of phenylephrine.

[Microcirculation study by video-monitored intravital microscopy]. / Studiul microcirculatiei prin microscopie intravitala monitorizata video.

As a result of a interdisciplinary team's work, the in vivo study of microcirculation by video monitoring systems, adapted to the optic microscopy, opens new perspectives for the fundamental as such for the clinical and pharmacological research. The multiple possibilities of image acquisition on video tapes, as well as on colour films, offers a variety of post processing of the images through dedicated computer based programs, in order to obtain a precise measurement of the changes occurring in the living tissues. Furthermore, this technical devices along with a proper directed health program, may be used as a modern diagnostic tool in populational screening.

[The effect of captopril on the coronary circulation in a clinical and experimental study]. / Influenta captoprilului asupra circulatiei coronariene. Studiu clinico-experimental.

Taking into account the well-known angiotensin II-induced coronary constriction, in a first series of experiments the effects of captopril were studied upon the rabbit, guinea pig and rat coronary circulation during perfusion with oxygenated Krebs-Henseleit solution at 37 degrees C under constant pressure and variable flow according to the Langendorf technique. The inhibition of angiotensin I to angiotensin II conversion enzyme with captopril (5-500 microgr./ml) resulted in a coronary dose dependent dilation as a consequence of a reduction in the basal coronary tonus. Testing the coronary distensibility by using pressure and flow variations revealed a significantly increased distensibility when the conversion enzyme was specifically blocked with captopril. The anginal threshold of the atrial electrostimulation was increased after captopril (25-50 mg i.v.) in 15 out of 18 patients with coronary insufficiency by a mean value of 17%, white the systolic dynamics was significantly better. The obtained results bring new arguments in favour of the intrinsic renin-angiotensin system participation in maintaining the basal vascular tonus and of the increased coronary distensibility in the presence of captopril as an inhibitor of the local synthesis of the vasoconstrictor angiotensin II.