Shielding assessment of high field (QED) experiments at the ELI-NP 10 PW laser system.

High field quantum electrodynamics experiments will be conducted in the E6 experimental area of the Extreme Light Infrastructure-Nuclear Physics building. Here electrons and protons will be accelerated up to relativistic energies by multi-petawatt laser beam-target interactions. In this respect, the requirements for radiological safety measures are similar to those associated with the operation of conventional high energy accelerators. The paper presents a FLUKA simulation approach to the shielding assessment of the individual experiments. Updated source terms were used in order to compute ambient dose equivalent rates throughout E6 and neighbouring areas and check the compliance of the results with legal dose constraints. We investigated the effectiveness of an 'all-purpose' beam dump at E6 and the practicality of local muon shielding.

Central and peripheral components of chronic heart failure: determinants of exercise tolerance.

This study sought to determine the relationship between myocardial dysfunction and peripheral haemodynamic disorders to exercise intolerance in patients with chronic heart failure (CHF). Seventeen patients with mild to moderate CHF (peak oxygen consumption (VO2) >16 ml/min/kg) and 13 with severe CHF (peak VO2 <16 ml/min/kg) underwent invasive (Swan-Ganz) cardiopulmonary exercise testing and forearm venous occlusion plethysmography at rest and during maximal dilatation in reactive hyperaemia. There was a shift from central to peripheral haemodynamic factors limiting exercise, suggesting an increasing importance of peripheral factors in parallel to the progression of CHF. In mild to moderate CHF peak VO2 was closely related to central haemodynamics (r = 0.57 for cardiac index at rest; r = 0.76 for cardiac index at maximal workload; r = -0.54 for right arterial pressure at maximal workload; all p<0.05) and poorly correlated with peripheral haemodynamics (blood flow, vascular resistance and venous tone). In contrast, in severe CHF peak VO2 was closely related to peripheral haemodynamic factors (r = 0.79 for forearm blood flow; r = -0.82 for vascular resistance; r = -0.77 for venous tone; all p<0.05) and less to central ones. Thus, exercise tolerance of patients with mild to moderate CHF is predominantly determined by central haemodynamic factors, notably by the cardiac index. In severe CHF peripheral factors assume ever greater importance in the determining of exercise capacity.

A comparative study of processing simulated and experimental data in elastic laser light scattering.

The intensity of the laser light scattered by a suspension of biological particles undergoing Brownian motion contains information about their size distribution function and optical properties. We used several methods (implemented in MathCAD programs), including a new one, to invert the Fredholm integral equation of the first kind, which represents the angular dependence of the elastic scattering of light. The algorithms were first tested on different sets of simulated data. Experimental data were obtained using biological samples and an experimental arrangement which are briefly described. We study the stability of the inversion procedures relative to the noise levels, and compute the first two moments of the retrieved size distribution function. A comparison of the results corresponding to simulated and experimental data is done, to select the best processing algorithm.

[The clinico-statistical aspects in allergic conjunctivitis]. / Aspecte clinico-statistice în conjunctivitele alergice.

Ocular allergy represents the hypersensitivity reaction of the ocular surfaces in contact with the external environment. Allergic conjunctivitis are one of the frequent disorders of the clinical practice. In this paper we present statistically the cases attended in our service for one year, a few pathogenetical factors; the positive diagnose and the therapeutic strategy.

[Recurrent unilateral inflammatory exophthalmos]. / Exoftalmie unilaterala inflamatorie recurenta.

The issue discusses the diagnosis difficulties concerning the case of 58-years-old woman who was watched for a recurrent exophthalmos after a mild conjunctival trauma. The debut was orbital cellulite appearance, complicated by a nonaxial exophthalmos due to a dacryoadenitis. The exophthalmos is axial in the other two recurrences. All exophthalmic episodes progressed with inflammatory features associated with optic neuritis and oculomotor nerves implication without any neurological signs. The paraclinical tests (ECHO, orbital radiography, CAT) find inflammation of orbital elements: extrinsic muscles and lacrimal gland. Biochemical tests showed minimal inflammatory changes without be able to provide the positive diagnosis. Initial combined therapy (antibiotics and steroids), then steroid monotherapy had favorable response.

Immunogenetic risk factors of dilated cardiomyopathy.

This work deals with the investigation of the HLA system antigen, classes A, B, CW and DR, in 100 patients with dilated cardiomyopathy and 200 healthy donors. It was shown that the HLA system antigen is involved in the hereditary predisposition to dilated cardiomyopathy and in its clinical polymorphism determination. The HLA system antigen distribution in patients with dilated cardiomyopathy clearly differs from the same index in the general population following this medical examination. The direct connection between the dilated cardiomyopathy and the HLA DQA1 gene confirms the hypothesis on the genetic determinism of this disease.

Noncardiac pulmonary edema, newer environmental aspects. An update.

Accidental spread of potentially toxic gases, fumes, and particulate chemicals has been reported recently in various cities throughout the country and appears to be on the increase throughout the world in the past few years. Moreover, cerebral trauma, septic shock (ARDS), and environmental pulmonary edema from drug intoxication have been commonly encountered. Newer modalities of treatment include selective [corrected] fiber optic bronchoscopy, constant positive airway pressure mask, administration of surfactant, pentoxifylline, and use of newer experimental agents such as nitrous oxide, antitumor necrosis factor (ATNF), and extracorporeal carbon dioxide with low-frequency positive pressure (ECCO2R-LFPPV). The future holds promise for probable reductions in both morbidity and mortality rates of this ubiquitous occupational and environmental health problem, which is of global importance.

[The reconstruction of the losses of substance in the floor of the mouth with split lingual flaps]. / Reconstructia pierderilor de substanta ale planseului bucal cu lambouri de limba despicata.

The loses of substance, as a result of malignant tumor removement of floor of the mouth, with or without metastasis in the afferent ganglions, have such multiple and difficult morphological complications, that need immediate and complete reconstruction. From the multiple sources with reconstructive potential of the loco-regional or distant prevention suggested in literature, authors have used lingual musculo-mucosal flap. The use of the lingual flap avoided the inconveniences and the risks of tissue transfer from another origin, offering the advantages of one and only surgery and at the same time the superior morphological and functional results.

Melodic intonation therapy in the verbal decoding of aphasics.

Melodic Intonation Therapy is a well-known method exploring the verbal encoding of aphasics but within this study, it was used to investigate the verbal decoding (the auditory comprehension). Two separate groups, 240 cases each, were investigated, the former with MIT and the latter with other therapy methods. Each group included three subgroups according to the three frequent types of aphasia (Wernicke, Broca and Anomia). The method of semantic fields was associated to treat the second group since it is usually used in the treatment of aphasics with auditory decoding disturbances. All patients were tested twice, before and after therapy.

Statistical study of lethal stroke.

Deceased cases with cerebral infarction and hemorrhage constituted the subjects of the present study. They were divided into two groups: 127 cases in group 1 (1954-1959) and 427 cases in group 2 (1977-1982). The purpose of the study was to compare clinical data to evidence any statistical difference between groups. No statistically significant difference was noticed, except the increase of age mean in both diagnoses due to the overall increase of age mean of the population (2.5-10 yrs).

Melodic intonation in the rehabilitation of Romanian aphasics with bucco-lingual apraxia.

The main objective of the present study was to assess the efficiency of the melodic intonation therapy (MIT) in the rehabilitation of Romanian aphasics. Eighty predominantly Broca aphasics used the melodic intonation therapy when no other therapy methods were very efficient. The speech therapist intonated the respective word, then together with the patient and finally let him continue alone. The control group counted 80 aphasics and it applied other therapy methods. Each patient, regardless of the group, was tested twice, before and after therapy. Since most of the patients displayed severe language disorders, and other therapy methods failed in rehabilitating them, MIT was considered an efficient method in the early stages of Broca aphasia with bucco-lingual apraxia.

Type and frequency of phonetic errors in aphasics: therapeutic aspects.

Fifty aphasics were studied in three separate groups: nonfluent Broca, fluent Wernicke and fluent anomics in order to form a therapeutic guide of their phonetic errors (omission substitution, addition, repeated phonemes, perseveration of phonemes belonging to the preceding word, reversed order, phonematic targetting and misplacing. Frequency of phonetic error was also assessed.

Type and frequency of phonemic errors in aphasics.

The research, performed on 80 Romanian-speaking aphasics showed that the frequency of various types of phonetic errors is quite different in various languages, as presented in aphasiologic references. In our study the main phonemic errors were in the order of their frequency as follows: omissions, substitutions and additions of phonemes. The other types of errors appeared rather infrequently, in decreasing order: targeting (tir à la cible phonématique), order reversing, misplacing, repeated phonemes, preservation of phonemes of previous words. It must be underlined that for English-speaking aphasics some authors observed that substitutions are the most frequent phonemic errors but some others considered that additions are more frequent than other types of phonemic errors.

Biomechanical interpretations of some bony structures in the skull.

For the causal understanding of some evolutive morphological particularities at the level of the lateral wall of orbits (in mammals and in man), the authors have resorted to biomechanical interpretations of bony structures at the cranium level. To this effect some stress factors as well as the modeling effect on the local bone morphogenesis have been analysed.

[Volvulus of the gallbladder]. / Volvulusul de vezicula biliara.

An observation is presented concerning a volvulus of the gallbladder, a rare cause of acute abdomen. This affection is mostly encountered in aged people or in those with various background diseases, and its development is favoured by the presence of congenital malformations, visceral ptoses, or by exaggerated intestinal peristaltism. The preoperative diagnosis is only exceptional and indications for surgical intervention are made on the basis of signs suggesting peritoneal irritation, or the presence of a "tumor" in the right flank. Cholecystectomy, facial in most of the cases is followed by full recovery in all the cases when the intervention is performed at an early stage.

[Early postoperative (10th day) thrombosis of a Starr mitral prosthesis. Successful fibrinolytic treatment]. / Thrombose postopératoire précoce (10e jour) d'une prothèse de Starr mitrale. Succès du traitement fibrinolytique.

The authors report a case of early postoperative thrombosis of a Starr-Edwards mitral valve prosthesis in a 36 year old female who had undergone closed heart surgery nine years previously for tight mitral stenosis. Severe restenosis led to mitral valve replacement in 1980, and the insertion of a Starr-Edwards prosthesis. On the 8th postoperative day thrombosis of the prosthesis presented with pulmonary oedema and a change in the prosthetic valve sounds which regressed with therapy. The diagnosis was confirmed on the 9th postoperative day by left heart catheterisation and angiography. Fibrinolytic treatment was instituted on the 10th postoperative day with 4500 u/Kg of Urokinase for 24 hours. Pulmonary oedema regressed at the 6th hour of treatment and the prosthetic valve sounds reverted to normal. No significant complication was observed. The good result has been maintained up to the 6th postoperative month. This case demonstrates the possibility of using fibrinolytic therapy in the early postoperative period after valve replacement: this should be weighed in the balance against the mortality of reoperation in such cases of early thrombosis of prosthetic heart valves.