Design principles, structure, and specific features of kardiovid computer diagnostic system

The design principles and hardware implementation of Kardiovid computer diagnostic system are considered. The system is intended for diagnosis of the state of cardiovascular system on the basis of the results of electrocardiographic and fluorographic examinations. It provides simulation and visualization of the state of cardiovascular system.     

Inflammatory bowel disease in a Swedish twin cohort: a long-term follow-up of concordance and clinical characteristics

BACKGROUND & AIMS: In 1988, we reported the first twin study in inflammatory bowel disease. The aim of the current study was to follow up these twins regarding new cases of inflammatory bowel disease and Crohn's disease characteristics using the Vienna classification. METHODS: The official Swedish population register and the cause of death register were used to search for the twins. All living patients were interviewed. RESULTS: Three monozygotic twins earlier classified as healthy had been diagnosed with inflammatory bowel disease (ulcerative colitis, n = 2; Crohn's disease, n = 1). Retrospectively, all 3 were symptomatic at the original survey. This changed the pair concordance in monozygotic twins from 6.3% to 18.8% in ulcerative colitis and from 44.4% to 50.0% in Crohn's disease. A high degree of concordance regarding age at diagnosis, disease location at diagnosis and during the course, and disease behavior was found in concordant monozygotic twin pairs with Crohn's disease. Seven of 9 pairs were identical in 3 or more of these disease characteristics compared with an expected number of 1.5 (P = 0.000076). CONCLUSIONS: This study confirms that the genetic influence is stronger in Crohn's disease than in ulcerative colitis. A remarkable phenotype similarity within concordant pairs with Crohn's disease was found using the Vienna classification.     

In vivo and in vitro studies exploring the pharmacokinetic interaction between bosentan, a dual endothelin receptor antagonist, and glyburide

BACKGROUND: In a clinical trial with patients with chronic heart failure, a higher incidence of elevated levels of liver transaminases was observed during concomitant treatment with bosentan, a dual endothelin receptor antagonist, and glyburide (INN, glibenclamide), a sulfonylurea-type antidiabetic drug, than with treatment with bosentan alone. This study was conducted to investigate a possible pharmacokinetic interaction between bosentan and glyburide. METHODS: In a randomized, 2-way crossover study, 12 healthy volunteers received treatments A and B. Treatment A consisted of 125 mg bosentan twice a day for 10 days plus concomitant 2.5 mg glyburide twice a day on days 6 to 10. Treatment B consisted of 2.5 mg glyburide twice a day for 10 days plus concomitant 125 mg bosentan twice a day on days 6 to 10. Plasma concentrations of bosentan and its metabolites and of glyburide were measured on days 5 and 10 of treatment A and treatment B, respectively. RESULTS: Bosentan reduced the area under the concentration-versus-time curve of glyburide approximately 40% (P <.05). Glyburide decreased the area under the concentration-versus-time curve of bosentan and its metabolites 20% to 30% (P <.05). Results of in vitro experiments showed that glyburide is metabolized by cytochrome P450 (CYP) 2C9, 2C19, and 3A4. No interaction was observed on the level of serum protein binding. CONCLUSIONS: The plasma levels of both bosentan and glyburide were reduced after concomitant administration. This finding is consistent with a CYP3A4-inducing potential of both drugs. The observed pharmacodynamic interaction between bosentan and glyburide in patients with chronic heart failure cannot be explained by a pharmacokinetic interaction.     

Frequency of extrasystoles in healthy male employees.

To determine reference values for ectopic activity 147 actively employed healthy men aged from 15 to 65 years were examined by 24 hour Holter monitoring during their ordinary daily activities. Age was the only risk factor significantly associated with supraventricular and ventricular extrasystoles. During a six year follow up only two men died. In both the frequency of ventricular extrasystoles had been high, but neither of them died from cardiovascular disease. Because the distribution of the frequency of extrasystoles in the study group was highly skewed a percentile distribution was used to determine normal values. This distribution showed that 95% of men aged 15-39 years had less than 2.9 ventricular extrasystoles per hour and the same proportion of men aged 40 years or older had less than 36 ventricular extrasystoles per hour. For field studies values above the 90th percentile (that is more than 10 ventricular extrasystoles per hour for men 40 years or older) may be a more appropriate cut off point.     

Cysts of the nasopalatine duct

Nasopalatine duct cysts in 70 patients were reexamined clinically and radiographically. 50 of them were also reexamined histopathologically. 20 specimens of normal duct tissue were likewise examined. More than half of the cysts showed clinical symptoms. The form on the radiograph was usually spherical or oval. Only 1 of 5 cysts was heart-shaped; 1 of 10 was unilateral. The mesiodistal width of the cysts ranged from 4-40 mm, with 75% from 6-12 mm. 3 of 4 showed pronounced radiolucency. Every 2nd cyst was completely surrounded by a thin radiopaque border. The histopathological investigation showed small cysts to be present in 1 of 4 clinically and radiographically normal nasopalatine ducts. More than 1 of 4 clinically and radiographically diagnosed cysts lacked histopathological characteristics of a cystic cavity. The type of epithelium in the cysts was independent of the vertical position in the duct.     

Specific features of electrocardiographic information analysis based on wavelet transform

Wavelet transform is a new tool for analysis of electrocardiographic information. In this work, we consider the procedure for selection of the mother wavelet on the basis of special criteria and substantiate an improved method for ECG analysis based on wavelet transform. An algorithm for selection of mother wavelet and synthesized wavelet providing optimal wavelet transform of ECG signal is developed. It is shown that 3D wavelet spectrograms should be constructed to increase the efficiency of assessment of the state of cardiovascular system.     

Three mixed venous saturation catheters in patients with circulatory shock and respiratory failure

Thirty-one critically ill patients with acute respiratory failure and circulatory shock were divided into three groups. Group 1 included 11 patients with an inserted mixed venous saturation (SvO2) catheter using three-reference wavelengths and characterized by one transmitting and one detecting fiberoptic filament (Oximetrix opticath catheter); group 2 included eight patients with an inserted SvO2 catheter using two-reference wavelengths and characterized by one transmitting and one detecting fiberoptic filament; (Edwards sat-one catheter); group 3 included 12 patients with an inserted SvO2 catheter using two-reference wavelengths and characterized by one transmitting and two detecting fiberoptic filaments. Once calibration procedures were performed, SvO2 measured by the catheter and by an hemoximeter OSM 3 (reference value) were compared following each therapeutic intervention. Over a period of 1.5 to 6 hours during which the hematocrit value remained unchanged, 119 measurements were obtained in group 1, 91 in group 2 and 181 in group 3. The dispersion of SvO2 values was much more pronounced with the two-reference wavelength systems using either one or two detecting fiber optic filaments, and the correlation coefficient was significantly higher with the three-reference wavelength system (r = 0.970 for the Oximetrix catheter vs r = 0.855 for the Edwards catheter and r = 0.826 for the Spectramed catheter, p less than 0.001). After 24 hours, the spontaneous drifts in the two-reference wavelength systems, using either one or two detecting fiber optic filaments (expressed as the SvO2 value measured by the catheter minus the reference SvO2 value) were significantly higher than the spontaneous drift in the three-reference wavelength system (9.3 +/- 7 percent for the Edwards catheter and +/- 6 +/- 4.1 percent for the Spectramed catheter vs 3.3 +/- 3.1 percent for the Oximetrix catheter, p less than 0.05). This study shows that a three-wavelength system is more accurate than a two-wavelength system for measuring acute changes in SvO2. The addition of a second detecting fiber optic filament does not seem to improve the accuracy of the system when SvO2 changes occur in conditions of stable hematocrit.