Assessment of ventricular diastolic function in AIDS patients from Congo: a Doppler echocardiographic study

The aim of this study was to evaluate the effect of transdermal clonidine on hemodynamic and metabolic parameters in patients who have elevated blood pressure and non-insulin-dependent diabetes mellitus (NIDDM). After a 2-week run in placebo period, 20 NIDDM patients who had diastolic blood pressure in the range of 90 to 105 mm Hg underwent a randomized, single blind, placebo controlled, cross-over study of 4 week treatment with clonidine (transdermal patch 2.5 mg/week) or placebo (inactive patch). Compared with placebo, clonidine significantly reduced systolic (153 +/- 6 v 163 +/- 8) and diastolic (88 +/- 2 v 98 +/- 3.5 mm Hg, P = .001) blood pressure, left ventricular mass (94 +/- 11 v 99 +/- 12 g/m2, P < .01) and fasting glucose levels. Total glucose disposal (glucose clamp) was 6.5 +/- 1.5 with placebo and 7.1 +/- 1.6 mg/kg/min with clonidine (P < .01). Oxidative glucose disposal (indirect calorimetry) was also greater after clonidine. Plasma glucose, insulin, and C-peptide responses following oral glucose (75 g) were significantly lower after clonidine, as well as urinary albumin excretion. Transdermal clonidine is effective in reducing blood pressure in hypertensive NIDDM patients and is well tolerated. It may be useful to reduce the cardiovascular impact of hypertension in diabetes mellitus.     

Posture,muscle activity and muscle fatigue in prolonged VDT work at different screen height settings

With the increasing use of video display terminals (VDTs), there is growing concern over the corresponding increase in the number of health problems reported. Although much research has focused on identifying the optimal screen height, there is to date no consensus. This study aimed to investigate the effect of prolonged (89 min) VDT work at four different screen heights on head-neck posture, muscle activity and the development of muscle fatigue. The results show that lowering screen height, starting from 15 cm above the baseline (i.e. top of the screen level with eye height while sitting), decreased the ear-eye angle, increased the viewing angle, increased the viewing angle relative to the ear-eye line, and increased the muscle activity of the neck extensor muscles. There were also some significant time effects on postural angles and muscle activity. In this study there were only rare occurrences of muscle fatigue, defined as a simultaneous increase in EMG amplitude and a shift of the EMG power spectrum to lower frequencies. Muscle activity increased significantly in some muscles and for certain screen heights.     

Survey of rheumatic heart disease in school children of Kinshasa town

Leukocyte adhesion under flow is preferentially mediated by the selectins. In this study we used intravital microscopy to investigate whether E-selectin may promote firm leukocyte adhesion in vivo. E-Selectin is expressed by endothelial cells activated with tumor necrosis factor-alpha (TNF-alpha) and causes slow leukocyte rolling. Microinjection of formyl-methionyl-leucyl-phenylalanine (fMLP) or macrophage inflammatory protein-2 (MIP-2) next to a venule of the TNF-alpha-treated mouse cremaster muscle significantly increased the number of adherent leukocytes. In gene-targeted mice homozygous for a null mutation in the E-selectin gene or in wild-type mice treated with an E-selectin monoclonal antibody (mAb), this response was significantly attenuated (by >80%). No such defect was seen in intercellular adhesion molecule-1 (ICAM-1)-deficient mice. E-Selectin-null mice showed more rapid leukocyte rolling than wild-type or ICAM-1-deficient mice, resulting in significantly shortened leukocyte transit times through venules. Topical application of fMLP onto the whole cremaster muscle generated the same number of adherent leukocytes in wild-type and E-selectin-deficient mice. We conclude that slow leukocyte rolling through E-selectin results in long transit times, which are essential for efficient leukocyte adhesion in response to a local chemotactic stimulus.     

Minimal shape and intensity cost path segmentation

A new generic model-based segmentation algorithm is presented, which can be trained from examples akin to the active shape model (ASM) approach in order to acquire knowledge about the shape to be segmented and about the gray-level appearance of the object in the image. Whereas ASM alternates between shape and intensity information during search, the proposed approach optimizes for shape and intensity characteristics simultaneously. Local gray-level appearance information at the landmark points extracted from feature images is used to automatically detect a number of plausible candidate locations for each landmark. The shape information is described by multiple landmark-specific statistical models that capture local dependencies between adjacent landmarks on the shape. The shape and intensity models are combined in a single cost function that is optimized noniteratively using dynamic programming, without the need for initialization. The algorithm was validated for segmentation of anatomical structures in chest and hand radiographs. In each experiment, the presented method had a significant higher performance when compared to the ASM schemes. As the method is highly effective, optimally suited for pathological cases and easy to implement, it is highly useful for many medical image segmentation tasks.