A new technique for simultaneous validation of two manual nonmercury auscultatory sphygmomanometers (A&D UM-101 and Accoson Greenlight 300) based on the International protocol.

INTRODUCTION: Auscultatory nonmercury manual devices seem good alternatives for the mercury sphygmomanometers in the clinic and for research settings, but individual internal validation of each device is time-consuming. The aim of this study was to validate a new technique capable of testing two devices simultaneously, based on the International protocol of the European Society of Hypertension. METHODS: The concept of the new technique is to measure blood pressure alternatively by two observers using a mercury sphygmomanometer and by two observers using the A&D UM-101 and Accoson Greenlight 300 devices, connected by Y-tube to obtain simultaneous readings with both nonmercury devices. Thirty-three participants were enrolled (mean age 47.2±14.0 years). Nine sequential blood pressure measurements were performed for each participant. RESULTS: Both devices passed phase 1 using 15 participants. In phase 2.1 (n=33), on a maximum of 99 measurements, the Accoson device produced 81/95/99 measurements within 5/10/15 mmHg for systolic blood pressure (SBP) and 87/98/99 for diastolic blood pressure (DBP). The A&D device produced 86/96/99 for SBP and 94/99/99 for DBP. In phase 2.2 (n=33), 30 participants had at least 2 out of 3 SBP obtained with Accoson device within 5 mmHg of the mercury device, as compared with 29 of 33 participants with the A&D device. For DBP, this was 33 of 33 participants for both devices. CONCLUSION: Both the nonmercury devices passed the International protocol. The new technique of simultaneous device testing using a Y-tube represents a time saving application of the International protocol.

Clinical results of autologous infrainguinal revascularization using grafts originating distal to the femoral bifurcation in patients with mild inflow disease.

AIM: Chronic critical limb ischemia (CLI) often requires venous bypass grafting to distal arterial segments. However, graft patency is influenced by the length and quality of the graft and occasionally patients may have limited suitable veins. We investigated short distal bypass grafting from the superficial femoral or popliteal artery to the infrapopliteal, ankle or foot arteries, despite angiographic alterations of inflow vessels, providing that invasive pressure measurement at the site of the planned proximal anastomosis revealed an inflow-brachial pressure difference of <or=10 mmHg. METHODS: Four hundred and twenty-three consecutive infrainguinal bypass grafts were performed for CLI between June, 1999 and November, 2002 at our institution. All patients underwent preoperative clinical examination, arteriography and assessment of the veins by duplex ultrasound. The study group are patients in whom the proximal and distal anastomoses of the bypass are below the femoral bifurcation and the popliteal artery, respectively. Invasive arterial pressure measurements were recorded at the level of the planned proximal anastomosis which was performed at that level if the difference of the inflow-brachial pressure was <or=10 mmHg, irrespective of angiographic alterations of the inflow vessels proximal to the planned anastomosis. All patients had a clinical follow-up included a duplex examination of their graft, at 1 week, 3, 9 and 12 months and, thereafter, annually. No patient was lost to follow-up. RESULTS: Sixty-seven patients underwent 71 short distal bypass grafts in 71 limbs with reversed saphenous vein grafts in 52, in situ saphenous veins in 11, reversed cephalic vein in 1 and composite veins in 7, respectively. Surgical or endovascular interventions to improve inflow were required in 4 limbs (5.6%). The mean follow-up time was 22.5 months and the two-year survival was 92.5%. Primary and secondary patency rates at 2 years were 73% and 93%, respectively, and the limb salvage rate was 98.5%. CONCLUSION: In appropriately selected patients, short distal venous bypass grafts can be performed with satisfactory patency and limb salvage rates even in the presence of morphologic alterations of the inflow vessels providing that these are not hemodynamically significant, or can be corrected intraoperatively.

Puunkäsittelykoneen simulointi ja mekaaniset häviöt

Diplomityö on osa Savonia-amk:n koneosaston TOVI-projektia, jossa metsä-konevalmistaja Ponsse Oyj on mukana. Työssä tutkittiin Ponsse Oyj:n metsäkoneen harvesteripäätä. Tavoitteena oli harvesteripään puun syöttöliikkeessä syntyvien mekaanisten häviöiden selvittäminen. Mekaanisilla häviöillä tarkoitamme karsintaterien kitkavoimia ja syöttörullien vierintävastusta.Edellisten lisäksi tavoitteena oli tutkia puun syöttöliikkeen simuloitavuutta monikappaledynamiikkaan perustuvalla simu-lointiohjelmistolla. Työ toteutettiin mittaamalla harvesteripään hydraulisten toimilaitteiden paineita, puun syötön aikana. Mittasimme myös puun ja harvesteripään välistä liikematkaa, nopeutta, kiihtyvyyttä, sekä puun paksuutta. Mittausten lisäksi harvesteripäästä rakennettiin simulointimalli. Mitattujen paineiden avulla laskettiin vastaavien toimilaitteiden synnyttämät voimat ja momentit. Simulointimallilla toistettiin mittaustapahtumat, käyttäen mittausten avulla laskettuja voimia ja momentteja. Mallin kitkakertoimien ja vierintävastusten avulla simuloidut ja mitatut liikematkat haettiin yhteneviksi. Toisin sanoen, simulointimalli verifioitiin todellisuutta vastaavaksi, jolloin simulointimallista voitiin lukea syntyneet häviöt.

La vitesse de l'onde de pouls et la pression artérielle centrale devraient-elles être mesurées chez les patients hypertendus [Not Available].

Diagnosis and treatment of arterial hypertension are essential in order to reduce the mortality and the morbidity associated with this condition. The decision to treat hypertension is often based on serial office blood pressure measurements, but new non-invasive measurements such as pulse wave velocity or central blood pressure measurement using pulse wave analysis can be useful to assess the cardiovascular risk with more precision. Indeed, pulse vawe velocity, which is a marker of arterial stiffness, is an independent risk factor for future cardiovascular events. Non-pharmacological and pharmacological therapies can affect both pulse wave velocity and central pressure. However, more studies are needed in order to determine if these measurements can be use as surrogate marker of cardiovascular disease.

Diagnostiikkamenetelmät höyrykattilan leijukerroksen tilan ja käytettävyysongelmien tunnistamiseksi

Diplomityön tavoitteena oli tutkia höyrykattiloiden leijukerrosten käytettävyysongelmia ja kirjallisuudesta löytyvien diagnostiikkamenetelmien toimivuutta leijukerroksen tilan ja käytettävyysongelmien tunnistamiseksi. Diagnostiikkamenetelmien toimivuutta testattiin VTT:n kiertoleijukoelaitteen prosessimittauksiin perustuen. Analysoinnissa käytettiin prosessimittauksia, jotka ovat yleisesti käytössä energiantuotannon leijukerroskattiloissa. Analysoitavina koeajotapauksina olivat kylmäkokeet partikkelikokojakaumaltaan vaihtelevalle leijutusmateriaalille, tuhkapartikkelien aiheuttama petimateriaalin karkeneminen ja agglomeroituminen, sekä vaihtelevien ajoarvojen vaikutus leijukerroksen hydrodynaamiseen käyttäytymiseen. Kokeellisesta osiosta saaduista tuloksista selvisi leijutusilman tilavuusvirran, petimassan ja partikkelikoon vaikutus analysoitavaan prosessimittaukseen. Tuloksista oli havaittavissa myös kiertävän petimateriaalin ja pohjapedin osuuksien vaikutus mitattuun painesignaaliin. Petipartikkelien agglomeroitumisen ja karkenemisen todettiin lisäävän kiertoleijukoelaitteistossa nousuputken pohjapedin määrää suhteessa kiertävään petimateriaaliin, mikä voitiin havaita painemittauksista.

Suljetun jäähdytysvesiverkon mallinnus

Työssä selvitettiin Neste Oil Porvoon jalostamon tuotantolinja 2 jäähdytysvesiverkon tilaa. Jäähdytysvesiverkon hydraulinen malli päivitettiin ja verifioitiin painemittauksin. Mallia tarkennettiin säätöventtiilien mallinnuksen sekä virhelähteiden tarkastelun perusteella havaituin muutoksin. Mallin verifioinnissa havaittiin huomattavia eroja mallin ja mitattujen paineiden välillä. Tämä johti mallin tarkempaan tarkasteluun, sekä virhelähteiden ja niiden vaikutusten selvittämiseen. Putkivarusteiden mallinnusmenetelmiä, sekä mallinnusperiaatteita vertailtiin keskenään. Koska jäähdytysveden kokonaiskierto oli riittämätön, tarkasteltiin kolmea vaihtoehtoa riittävän kiertovesimäärän aikaansaamiseksi. Nykyisten kiertovesipumppujen rinnanoperointi, sekä riittävän suureksi skaalatun pumpun käyttö simuloitiin. Kolmantena tapauksena arvioitiin lämmönvaihdinkohtaisen kuristussuunnitelman vaikutus putkiston painehäviöön, sekä putkistolle sopiva kiertovesipumppu. Vaihtoehdoille laskettiin suuntaa-antavat investointi- ja käyttökustannukset. Tarkastelun perusteella riittävän suureksi skaalattu pumppu todettiin kannattavimmaksi pienen hintaeron, sekä luotettavamman jäähdytysvesikierron käyttövarmuuden vuoksi. Työssä onnistuttiin tuottamaan yleispätevää tietoa suljetun jäähdytysvesiverkon hydrauliseen mallinnukseen vaikuttavista tekijöistä, sekä niiden vaikutuksesta mallin tarkkuuteen. Selvityksen perusteella tarkasteltua mallia saatiin tarkemmaksi.

Lung tissue mechanics in the early stages of induced paracoccidioidomycosis in rats

Pulmonary dysfunction represents the most important cause of death in patients with paracoccidioidomycosis (PBM). In order to investigate the functional changes of the lungs in the early stages of PBM, a model of benign disease was developed by intratracheal challenge of 12-week old isogenic Wistar rats with 1 x 106 yeast forms of Paracoccidioides brasiliensis. Animals were studied 30 and 60 days after infection, when fully developed granulomas were demonstrable in the lungs. Measurements of airway resistance, lung elastance and tissue hysteresis were made during sinusoidal deformations (100 breaths/min, tidal volume = 2 ml) with direct measurement of alveolar pressure using the alveolar capsule technique. Infection caused a significant increase in hysteresis (infected: 1.69, N = 13; control: 1.13, N = 12, P = 0.024, ANOVA), with no alterations in airway resistance or lung elastance. Histopathological analysis revealed the presence of fully developed granulomas located in the axial compartment of the lung interstitial space. These results suggest that alterations of tissue mechanics represent an early event in experimental PBM

Prosessiautomaatio pinnankorkeusmittauksen koelaitteistoissa

Pinnankorkeuden tunteminen kiehutusvesireaktorin painesäiliössä on erittäin tärkeää sen turvallisuusvaikutusten takia. Pinnankorkeutta mitataan vesipatsaiden korkeutta havaitsevien paine-eromittausten avulla. Säteilyturvakeskuksen YVL-ohjeiden mukaan turvallisuuteen vaikuttavien mittausten täytyy noudattaa moninkertaistus- ja erilaisuusperiaatteita. Yleensä erilaisuusperiaatetta on toteutettu käyttämällä erityyppisiä paine-eromittareita, mutta erilaisella fysikaalisella toimintaperiaatteella oleva mittaus olisi parempi ja toteuttaisi paremmin erilaisuusperiaatetta. Uimurikytkin olisi tällainen fysikaalisesti eri periaatteeseen perustuva pinnankorkeuden mittauslaite. Ydinvoimalaan tarkoitettu teknologia tulee kelpoistaa riippumattoman tahon toimesta ennen käyttöönottoa. Kelpoistamiskokeita varten Lappeenrannan teknillisen yliopiston Ydinturvallisuuden tutkimusyksikköön rakennettiin vuosina 2011–2013 kaksi koelaitteistoa. Näillä koelaitteistoilla tutkittiin uimurikytkimien toimintaa ja ominaisuuksia erilaisissa kiehutusvesireaktorin käyttötilanteissa. Koelaitteistot tarvitsivat toimiakseen automaatiojärjestelmät, jotka suunniteltiin pääosin noudattamalla suunnittelun elinkaarimallia sekä automaatiosuunnittelun sisältökokonaisuuksia. Automaatiojärjestelmien suunnittelu aloitettiin määrittelemällä koejärjestelyjen asettamat vaatimukset, jonka jälkeen tehtiin teknologiavalinnat. Seuraavaksi suunniteltiin automaatiojärjestelmien logiikkaohjelmistot, joiden kuvaukseen tämä työ pääasiassa keskittyy. Logiikkaohjelmistot toteutettiin graafisella National Instruments LabView -ohjelmointikielellä. Logiikkaohjelmistojen tuli hoitaa tiedonkeruuta, käyttöautomaatiota, turvallisuustehtäviä sekä kokeisiin liittyviä erikoistehtäviä. Ohjelmistot saatiin esikokeiden aikana toimimaan halutusti, ja varsinaiset kokeet voitiin suorittaa ilman merkittäviä ongelmia.

Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes

Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001). Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001), insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001) and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011) were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001) was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002) remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.

Health in early adulthood: the contribution of the 1978/79 Ribeirão Preto birth cohort

The increase in non-communicable chronic diseases of adults is due to demographic changes and changes in the risk factors related to physical activity, smoking habits and nutrition. We describe the methodology for the evaluation of persons at 23/25 years of age of a cohort of individuals born in Ribeirão Preto in 1978/79. We present their socioeconomic characteristics and the profile of some risk factors for chronic diseases. A total of 2063 participants were evaluated by means of blood collection, standardized questionnaires, anthropometric and blood pressure measurements, and methacholine bronchoprovocation tests. The sexes were compared by the chi-square test, with alpha = 0.05. Obesity was similar among men and women (12.8 and 11.1%); overweight was almost double in men (30.3 vs 17.7%). Weight deficit was higher among women than among men (8.6 and 2.6%). Women were more sedentary and consumed less alcohol and tobacco. Dietary fat consumption was similar between sexes, with 63% consuming large amounts (30 to 39.9 g/day). Metabolic syndrome was twice more frequent among men than women (10.7 vs 4.8%), hypertension was six times more frequent (40.9 vs 6.4%); altered triglyceride (16.1 vs 9.8%) and LDL proportions (5.4 vs 2.7%) were also higher in men, while women had a higher percentage of low HDL (44.7 vs 39.5%). Asthma and bronchial hyper-responsiveness were 1.7 and 1.5 times more frequent, respectively, among women. The high prevalence of some risk factors for chronic diseases among young adults supports the need for investments in their prevention.

The association of ACE gene D/I polymorphism with cardiovascular risk factors in a population from Rio de Janeiro

Our aim was to determine the frequencies of the angiotensin-converting enzyme (ACE) gene alleles D and I and any associations to cardiovascular risk factors in a population sample from Rio de Janeiro, Brazil. Eighty-four adults were selected consecutively during a 6-month period from a cohort subgroup of a previous large cross-sectional survey in Rio de Janeiro. Anthropometric data and blood pressure measurements, echocardiogram, albuminuria, glycemia, lipid profile, and ACE genotype and serum enzyme activity were determined. The frequency of the ACE*D and I alleles in the population under study, determined by PCR, was 0.59 and 0.41, respectively, and the frequencies of the DD, DI, and II genotypes were 0.33, 0.51, and 0.16, respectively. No association between hypertension and genotype was detected using the Kruskal-Wallis method. Mean plasma ACE activity (U/mL) in the DD (N = 28), DI (N = 45) and II (N = 13) groups was 43 (in males) and 52 (in females), 37 and 39, and 22 and 27, respectively; mean microalbuminuria (mg/dL) was 1.41 and 1.6, 0.85 and 0.9, and 0.6 and 0.63, respectively; mean HDL cholesterol (mg/dL) was 40 and 43, 37 and 45, and 41 and 49, respectively, and mean glucose (mg/dL) was 93 and 108, 107 and 98, and 85 and 124, respectively. A high level of ACE activity and albuminuria, and a low level of HDL cholesterol and glucose, were found to be associated with the DD genotype. Finally, the II genotype was found to be associated with variables related to glucose intolerance.

Human umbilical cord blood cells in infarcted rats

Therapy with bone marrow-derived cells has been used in ischemic patients with reported success. The aim of this study was to determine the therapeutic efficacy of fresh and frozen human umbilical cord blood cells (hUCB) in Wistar rats submitted to permanent occlusion of the left coronary artery. Three hours after myocardial infarction, 2 x 10(7) hUCB cells or vehicle were administered by intramyocardial injection. The animals were divided into five groups: control (N = 10), sham operated (N = 10), infarcted that received vehicle (N = 9), infarcted treated with cryopreserved hUCB (N = 7), and infarcted treated with fresh hUCB (N = 5). Cardiac function was evaluated by electrocardiogram (ECG) and echocardiogram (ECHO) before cell therapy, and by ECG, ECHO, cardiopulmonary test, and left ventricular pressure measurements 3 weeks later. After 3 weeks, both groups treated with hUCB still had Q wave present in L1, âQRS >90° and reduced shortening fraction (less than 50%). In addition, cardiac indexes of left ventricular contractility and relaxation were 5484 ± 875 and -4032 ± 643 mmHg (cryopreserved hUCB) and 4585 ± 955 and -2862 ± 590 mmHg (fresh hUCB), respectively. These values were not statistically different from those of saline-treated animals. Cardiopulmonary exercise test profile was typical of infarcted hearts; exercise time was about 14 min and maximal VO2 was 24.77 ± 5.00 mL·kg-1·min-1. These data show that hUCB therapy did not improve the cardiac function of infarcted animals or prevent cardiac remodeling.

Acute lead-induced vasoconstriction in the vascular beds of isolated perfused rat tails is endothelium-dependent

Chronic lead exposure induces hypertension in humans and animals, affecting endothelial function. However, studies concerning acute cardiovascular effects are lacking. We investigated the effects of acute administration of a high concentration of lead acetate (100 µΜ) on the pressor response to phenylephrine (PHE) in the tail vascular bed of male Wistar rats. Animals were anesthetized with sodium pentobarbital and heparinized. The tail artery was dissected and cannulated for drug infusion and mean perfusion pressure measurements. Endothelium and vascular smooth muscle relaxation were tested with acetylcholine (5 µg/100 µL) and sodium nitroprusside (0.1 µg/100 µL), respectively, in arteries precontracted with 0.1 µM PHE. Concentration-response curves to PHE (0.001-300 µg/100 µL) were constructed before and after perfusion for 1 h with 100 µΜ lead acetate. In the presence of endothelium (E+), lead acetate increased maximal response (Emax) (control: 364.4 ± 36, Pb2+: 480.0 ± 27 mmHg; P < 0.05) and the sensitivity (pD2; control: 1.98 ± 0.07, 2.38 ± 0.14 log mM) to PHE. In the absence of endothelium (E-) lead had no effect but increased baseline perfusion pressure (E+: 79.5 ± 2.4, E-: 118 ± 2.2 mmHg; P < 0.05). To investigate the underlying mechanisms, this protocol was repeated after treatment with 100 µM L-NAME, 10 µM indomethacin and 1 µM tempol in the presence of lead. Lead actions on Emax and pD2 were abolished in the presence of indomethacin, and partially abolished with L-NAME and tempol. Results suggest that acute lead administration affects the endothelium, releasing cyclooxygenase-derived vasoconstrictors and involving reactive oxygen species.

Presión arterial en preescolares de la localidad de Usaquén en Bogotá

Introducción: La hipertensión arterial es un problema de salud pública tanto en países industrializados como en vía de desarrollo. Su prevalencia en la infancia viene en aumento por lo que es relevante determinarla en niños preescolares a nivel local. Objetivo: Determinar la prevalencia de hipertensión arterial en niños de tres a cinco años de una cohorte de 14 hogares infantiles del ICBF de la localidad de Usaquén en Bogotá. Materiales y métodos: Se realizó un estudio de corte transversal analítico, utilizando la base de datos de un ensayo aleatorizado y controlado del año 200913, y se evaluaron las cifras de tensión arterial de acuerdo a sexo, edad, talla y su correlación con el IMC con un nivel de confianza del 95% y precisión del 1%. Se calcularon las medias, desviaciones estándar, percentiles y prevalencia. Resultados: Se obtuvo una muestra de 1035 casos, encontrándose una prevalencia de 4,5% de HTA sistólica, 10,4% de diastólica, ambas en estadio I; teniendo en cuenta tanto sistólica como diastólica, fue de 11,6% en estadio I. Se determinaron los valores de presión arterial sistólica y diastólica en cuartiles de acuerdo a edad, sexo y talla. El coeficiente de correlación entre el IMC y los niveles de presión arterial sistólica y diastólica fueron de 0.0992 y 0.0362 respectivamente. Conclusión: La prevalencia de HTA general fue de 11,6%, predominando la diastólica en estadio I en niños preescolares. No se encontró correlación entre el IMC y las cifras de tensión arterial sistólica y diastólica.

Puroindoline-b mutations control the lipid binding interactions in mixed puroindoline-a: puroindoline-b systems

The interactions have been investigated of puroindoline-a (Pin-a) and mixed protein systems of Pin-a and wild-type puroindoline-b (Pin-b+) or puroindoline-b mutants (G46S mutation (Pin bH) or W44R mutation (Pin-bS)) with condensed phase monolayers of an anionic phospholipid (L-α-dipalmitoylphosphatidyl-dl-glycerol (DPPG)) at the air/water interface. The interactions of the mixed systems were studied at three different concentration ratios of Pin-a:Pin-b, namely 3:1, 1:1 and 1:3 in order to establish any synergism in relation to lipid binding properties. Surface pressure measurements revealed that Pin-a interaction with DPPG monolayers led to an equilibrium surface pressure increase of 8.7 ± 0.6 mN m-1. This was less than was measured for Pin-a:Pin-b+ (9.6 to 13.4 mN m-1), but was significantly more than was measured for Pin-a:Pin-bH (4.0 to 6.2 mN m-1) or Pin-a:Pin-bS (3.8 to 6.3 mN m-1) over the complete range of concentration ratio. Consequently, surface pressure increases were shown to correlate to endosperm hardness phenotype, with puroindolines present in hard-textured wheat varieties yielding lower equilibrium surface pressure changes. Integrated amide I peak areas from corresponding external reflectance Fourier-transform infrared (ER-FTIR) spectra, used to indicate levels of protein adsorption to the lipid monolayers, showed that differences in adsorbed amount were less significant. The data therefore suggest that Pin-b mutants having single residue substitutions within their tryptophan-rich loop that are expressed in some hard-textured wheat varieties influence the degree of penetration of Pin-a and Pin-b into anionic phospholipid films. These findings highlight the key role of the tryptophan-rich loop in puroindoline-lipid interactions.