Volume 3 Issue 3

Authors: F. Bilora; F. Pomerri; L. Sarolo; F. Manca; A. Zancan; M. Biasiolo

Abstract: Correlation between Primary Antiphospholipid Syndrome (PAPS) and cardiovascular events is well-known. For this reason it is important to evidence early atherosclerosis to prevent future events. Aim: to better evaluate Flow Mediated Dilation (FMD) in a group of subjects affected by PAPS paired with a control group, homogeneous for age, sex and without cardiovascular risk factors. Subjects and methods: 31 subjects affected by PAPS and 31 healthy controls underwent Echo- Doppler of brachial artery and evaluation of FMD. Results: PAPS cases perhaps revealed a reduced FMD respect controls. The correlation between age, sex, duration and severity of disease, arterious or venous thrombosis and severity of thrombocythaemia did not influence FMD. Coagulation parameters and presence of ß2 IgM and ß2 IgG antibodies correlated with FMD alterations. Conclusions: FMD is reduced in patients with PAPS and it correlates with coagulation parameters and presence of antibodies that can explain the rise of arterious imbalance. FMD evaluation is necessary in PAPS subjects to prevent fatal cardiovascular events.

Keywords: Primary Antiphospholipid Syndrome; Ultrasound; Flow Mediated Dilation (FMD); Intima-Media Thickness (IMT)


Authors: Carla Freire; Catarina Reis; Joaquin Fernandez; Josep Josep Monguet

Abstract: eTherapy can bring numerous advantages, however people have to adapt to a different discourse. It would be interesting to know patients’ expectations regarding to this type of therapy. A questionnaire was developed with the most studied factors proved to have an important role in technology acceptance. The results allowed highlighting some important factors that influence behavioral intention, and made it possible to verify that some of these factors may be linked or influence others among different dimensions.

Keywords: eTherapy; Expectations; Technology Acceptance; Behavioral Intention; Schizophrenic Patients


Authors: Wiebke Kelterer; Siegfried Steltenkamp; Marc André Dupré; Denis Nazaradeh; Claus Eckermann; Fridun Nazaradeh

Abstract: In previous publications we outlined the feasibility of a modular prosthesis of the larynx for patients suffering from laryngeal carcinoma. The larynx is located between the trachea and the pharynx with its main functions being phonation, protection and regulation of the air ways. Patients suffer severely from the diagnosis of a laryngeal carcinoma of the stages pT3 and pT4. In most cases this diagnosis will lead to a total laryngectomy, which usually leads to a dissatisfying postoperative rehabilitation. The postoperative consequences include the loss of the voice, the regular air ways via mouth and nose, the sense of smell, and the inability to build up an abdominal pressure. This paper deals with the basic research on the nervus laryngeus recurrens for the development of a modular prosthesis of the larynx which eventually will enable the laryngectomee to talk with his native voice, to breathe via the regular air ways, and to build up abdominal pressure. The voice reproduction will be performed by a vocoder. Vocoders are electronic devices which emulate the human vocal tract by using adequate filter settings on discrete filter units thus consisting of both variable and permanent filter settings. The signal pattern in the nervus laryngeus recurrens will affect the variable filter settings of the vocoder according to the current voice intonation whereas the vocal range of the patient's voice gives the limit of the permanent filter settings. In this work we put emphasis on the recording and analysis of the signal pattern in the nervus laryngeus recurrens. Therefore we tried to record the nerve potentials of this nerve first in a non-invasive approach by using skin electrodes along the anatomic course of the nerve. A sophisticated amplifier (Intan® Technologies RHA2000-Series Amplifier and RHA2116 Amplifier Board) was used to amplify the weak nerve potentials, but we had to cope with a poor SNR and strong signal distortions mostly due to muscle potentials from large muscles like the sternocleidomastoid muscle eventually delivering us only microphone potentials of the voiced parts of the speech generated by the muscle potentials of the laryngeal and pharyngeal muscles and not representing action potentials on the nerve thus rendering them useless for our needs. Further basic research in this field therefore is necessary, even taking an invasive approach into account.

Keywords: Prosthesis; Larynx; Vocoder; Nervus Laryngeus Recurrens; Action/Nerve Potential; Laryngectomy; Nervus Vagus


Authors: Simona-Delia Talu

Abstract: Minimally Invasive Vitrectomy System is a concept that was developed during the past years with the goal to make pars plana vitrectomy a safer and a less traumatizing procedure. The development of small gauge vitrectomy systems has led to the decrease of tissue damage and the shortening of the operating time. Although MIVS is increasingly popular, its use varies substantially according to the personal experience of each vitreo-retinal surgeon. The transition from the 20 gauge to the small gauge vitrectomy (23G, 25G) is directly related to the global approach to vitrectomy regarding incision making, intraoperative fluidics, cutting technology, illumination and accessory instruments. The development of new instruments capable to overcome the size and lumen handicaps became necessary. The use of small gauge instruments has various consequences on the vitrectomy itself: the modification of fluidics during surgery, the decrease of illumination, the need of fewer accessory and multi-function instruments. For the past 12 months, we used 25+ vitrectomy system sustained by the Constellation platform, in 296 cases that required vitreo-retinal surgery. The clinical conditions were the following ones: rhegmatogenous retinal detachments (120 cases - 40.54%), vitreous haemorrhages (100 cases - 33.78%), tractional retinal detachments (35 cases - 11.82%), epimacular membranes (15 cases - 5.06%), nucleus/lens luxated into the vitreous cavity (11 cases - 3.71%), intraocular foreign bodies (6 cases - 2.02%), macular holes (5 cases - 1.68%), endophthalmitis (4 cases - 1.35%). In this paper, the personal experience of using MIVS in variate cases that required vitreo-retinal surgery is illustrated.

Keywords: Pars Plana Vitrectomy; Minimally Invasive Vitrectomy System (MIVS)


Authors: Tomohiro Fukui; Koji Morinishi

Abstract: Transposition of the great arteries (TGA) is one of the most severe congenital heart diseases. The arterial switch operation (ASO) is the procedure of preference for treatment of TGA. After ASO, some patients suffer from circulatory system problems such as neo-aortic root dilatation and neo-aortic valve regurgitation, and supravalvar pulmonary stenosis. The neo-aortic root dilatation is often explained by the structural vascular difference between normal great arteries and the neo-aorta after ASO. Since the aortic and pulmonary roots generally remain in situ after ASO, i.e., the original pulmonary artery is connected to the left ventricle (LV), whereas the original aorta is connected to the right ventricle, the neo-aorta has no sinus of Valsalva after ASO. The influence of these morphological changes on the blood flow field at the aortic root should be investigated in detail as well as the structural vascular difference to consider the circular system problems. In this study, we apply the virtual flux method (VFM), which is a tool to describe stationary or moving body shapes in a Cartesian grid, to the 2D aortic valves and reproduce the blood flow fields around the aortic valves and the sinus of Valsalva by regularized lattice Boltzmann method (RLBM), and consider the influence of longitudinal length of sinus of Valsalva on blood flow fields around the aortic valves. As a result, we found that the longitudinal length of the sinus affects development of vortices around the aortic valves strongly. We also assessed the wall shear stress (WSS) distribution on the aortic valves and sinus wall and showed the effect of vortices in the sinus of Valsalva on local WSS distribution.

Keywords: Aortic Valves; Sinus of Valsalva; Vorticity; Wall Shear Stress; Virtual Flux Method; Regularized Lattice Boltzmann Method


Authors: Alsafi A. Abdulla; Omer A. Mahmoud; Mustafa Z. Mahmoud

Abstract: This study was carried out to evaluate whether Transverse Cerebellar Diameter (TCD) in singleton gestations can serve as a reliable predictor of gestational age (GA) in fetuses in the second and third trimester of pregnancy. A prospective study was carried out with 50 pregnant ladies, GA ranging from 15to37 weeks (estimation of mean GA was 26.8 ± 6.8 weeks), with a single fetus.TCD measurement by ultrasound was used for each fetus. Correlations between fetal TCD and GA were determined for the whole sample. Mean TCD was 28.6 ± 7.5 mm in 15-37 weeks of gestation. Regression analysis indicates a significant relationship between TCD and GA; correlation coefficient (r) = 0.94 and p< 0.001. Fetal TCD by ultrasound could be a predictive biometric parameter of GA in the last two trimesters of a pregnancy.

Keywords: Fetal Transverse Cerebellar Diameter (TCD); Gestational age (GA); Ultrasound