Two cases of food-borne botulism in Finland caused by conserved olives, October 2011.

In October 2011 in Finland, two persons fell ill with symptoms compatible with botulism after having eaten conserved olives stuffed with almonds. One of these two died. Clostridium botulinum type B and its neurotoxin were detected in the implicated olives by PCR and mouse bioassay, respectively. The olives were traced back to an Italian manufacturer and withdrawn from the market. The public and other European countries were informed through media and Europe-wide notifications.

Wireless system for real-time recording of heart rate variability for home nursing.

Modern wireless communication technologies offer new possibilities for patient monitoring in hospitals, as well as at home or in outdoor environments. In this paper, we present a wireless system for ECG recordings and real-time analysis of heart rate variability (HRV). The system also makes it possible for distance consultation, for example with a specialist in cardiology, with the help of a WEB-solution.

A flexible measurement system for physiological signals in mobile health care.

In the nearest future a lot of post-operative treatment and health monitoring is going to be performed in people's homes instead of in hospital. The increasing number of elderly people in the developed countries and the need for more advanced medical treatment and equipment in conjunction with economical demands will force the development of more cost-effective solutions. The equipment used must be very rugged and safe for both the patient and the operator and easily configured for a number of different measurement parameters. In most cases storing data on a memory card in the equipment will be sufficient but sometimes a wireless real-time measurement system is needed. This paper presents an acquisition system flexible enough for a number of different applications, home care, mobile health care and other biomedical measurement situations. A prototype system has been tested with sufficient performance for several physiological signals.

Evaluation of a skin reference electrode used for intraoral pH measurements in combination with a microtouch electrode.

The aim of this in vivo study was to evaluate a skin reference electrode used with the microtouch method for measurements of intraoral pH. Registrations of plaque pH were made in ten healthy subjects before and up to 30 min after a mouth rinse with 10% sucrose. A microtouch electrode (Beetrode) was used in combination with two different half-cell reference electrodes: a skin silver-silver chloride plate or a glass capillary reference electrode. The skin electrode was placed on the subject's forearm in combination with a conductive gel. The glass capillary electrode, together with one of the test subject's fingers, was placed in a beaker with a 3 M KCl solution. High agreement between the two reference systems resulted in almost identical plaque-pH curves (r=0.97). The mean differences between the two systems at the different time points varied between -0.15 and +0.01 pH units, with an overall mean pH difference of 0.03 pH units. It can be concluded that the use of the skin reference electrode may very well replace the traditional reference electrode used in combination with a microtouch electrode for intraoral use.

Sustained cardiomyocyte apoptosis and left ventricular remodelling after myocardial infarction in experimental diabetes.

AIMS/HYPOTHESIS: Diabetes is known to reduce survival after myocardial infarction. Our aim was to examine whether diabetes is associated with enhanced cardiomyocyte apoptosis and thus interferes with the post-infarction remodelling process in myocardium in rat. METHODS: Four weeks after intravenous streptozotocin (diabetic groups) or citrate buffer (controls) injection, myocardial infarction was produced by ligation of left descending coronary artery. Level of cardiomyocyte apoptosis was quantified by TUNEL and caspase-3 methods. Collagen volume fraction and connective tissue growth factor were determined under microscope. Left ventricular dimensions were evaluated by echocardiography and planimetry. RESULTS: The number of apoptotic cardiomyocytes was equally high in diabetic and non-diabetic rats after 1 week from infarction. At 12 weeks after infarction the number of apoptotic cells was higher in the diabetic as compared to non-diabetic rats both in the border zone of infarction and in non-infarcted area. Correspondingly, left ventricular end diastolic diameter, relative cardiac weight, connective tissue growth factor-expression and fibrosis were increased in diabetic compared with non-diabetic rats with myocardial infarction. CONCLUSION/INTERPRETATION: Sustained cardiomyocyte apoptosis, left ventricular enlargement, increased cardiac fibrosis and enhanced profibrogenic connective tissue growth factor expression were detected after myocardial infarction in experimental diabetes. Apoptotic myocyte loss could be an important mechanism contributing to progressive dilatation of the heart and poor prognosis after myocardial infarction in diabetes.

Evaluation of applanation resonator sensors for intra-ocular pressure measurement: results from clinical and in vitro studies.

Glaucoma is an eye disease that, in its most common form, is characterised by high intra-ocular pressure (IOP), reduced visual field and optic nerve damage. For diagnostic purposes and for follow-up after treatment, it is important to have simple and reliable methods for measuring IOP. Recently, an applanation resonator sensor (ARS) for measuring IOP was introduced and evaluated using an in vitro pig-eye model. In the present study, the first clinical evaluation of the same probe has been carried out, with experiments in vivo on human eyes. There was a low but significant correlation between IOP(ARS) and the IOP measured with a Goldmann applanation tonometer (r = 0.40, p = 0.001, n = 72). However, off-centre positioning of the sensor against the cornea caused a non-negligible source of error. The sensor probe was redesigned to have a spherical, instead of flat, contact surface against the eye and was evaluated in the in vitro model. The new probe showed reduced sensitivity to off-centre positioning, with a decrease in relative deviation from 89% to 11% (1 mm radius). For normalised data, linear regression between IOP(ARS) and direct IOP measurement in the vitreous chamber showed a correlation of r = 0.97 (p < 0.001, n = 108) and a standard deviation for the residuals of SD < or = 2.18 mm Hg (n = 108). It was concluded that a spherical contact surface should be preferred and that further development towards a clinical instrument should focus on probe design and signal analysis.

Intestinal pHi studied with continuous saline tonometry during ischaemia and reperfusion in the pig.

OBJECTIVE: To evaluate continuous saline tonometry for detection of progressive intestinal ischaemia and reperfusion in a porcine model. DESIGN: In eight anaesthetised pigs, small bowel mucosal pCO2 was recorded by means of two identical equipments for continuous saline tonometry and a standard tonometry balloon during ischaemia and reperfusion. RESULTS: Both systems of saline tonometry functioned stably during the four hour protocol ischaemia, although not significant until after 45 min for one of the tonometers. CONCLUSION: The equipment for continuous saline tonometry has a good reactivity, an accuracy comparable with standard tonometry.

Dual inhibition of angiotensin converting enzyme and neutral endopeptidase by omapatrilat in rat in vivo.

The pharmacological profile of a vasopeptidase inhibitor is dependent on the ratio of neutral endopeptidase (NEP)vs angiotensin converting enzyme (ACE) inhibition of the particular drug. We used in vitro autoradiography to determine the local renal and cardiac NEP and ACE inhibition after oral treatment with the dual NEP/ACE inhibitor omapatrilat in rat. Maximal inhibition of both renal NEP and ACE was achieved at the omapatrilat dose of 40 mg kg(-1)day(-1). Effective local ACE inhibition was detected also in the myocardium. The haemodynamic effects were similar to captopril, but omapatrilat treatment produced more favorable effect on natriuretic peptide levels. In conclusion, good tissue penetration of omapatrilat and balanced NEP/ACE inhibition may prove to be useful in the treatment of hypertension and heart failure.

Validation of a novel method for continuous saline tonometry in a porcine model.

Only intermittent and semi-continuous tonometric measurement of gastric and intestinal pHi is possible with the equipment available today. Earlier we developed a system for continuous saline tonometry and tested it in vitro. To assess the in vivo reliability of this method for continuous gastrointestinal saline tonometry, a standard tonometer for measurement of intestinal pCO2 and corresponding pHi was modified to allow continuous perfusion of physiological saline in a closed system and tested in a porcine model. In 11 anaesthetized and haemodynamically stable pigs, two continuous tonometry balloons were inserted into the distal small bowel, and a standard tonometry balloon was used as reference. To test long-term function of the continuous tonometers the research protocol lasted for eight hours. The two continuous saline tonometers performed well, and after an equilibration time of three hours the mean pHi values were stable between 7.35 and 7.43 and between 7.32 and 7.39 respectively. The standard tonometer measured stable pHi values. These preliminary studies indicate that continuous saline tonometry performs well over eight hours with a small bias and a good precision.

A resonator sensor for measurement of intraocular pressure--evaluation in an in vitro pig-eye model.

Intraocular pressure (IOP) measurement is performed routinely at every eye clinic. High IOP, which can be a sign of glaucoma, can lead to degeneration of the retina and can cause blindness. In this study we developed a resonator sensor for IOP measurement based on an oscillator consisting of a piezoelectric element made of lead zirconate titanate, a flat contact piece of nylon and a feedback circuit. The aim of this study was to evaluate the new sensor's ability to determine lOP in an in vitro pig-eye model. Six eyes from four pigs were removed and fixed in agar. They were then pressurized by a saline column (10-35 cm H2O) through a cannula inserted into the vitreous chamber. The IOP was measured with the resonator sensor applied to cornea. An Alcon applanation pneumatonometer and a standard Viggo-Spectramed pressure sensor connected to the saline column were used as references. The IOP as measured with the resonator sensor correlated well with the pressure elicited by the saline column for individual eyes (r = 0.96-0.99, n = 60) and for all eyes (r = 0.92, n = 360). The correlation between the resonance sensor and the pneumatonometer was r = 0.92 (n = 360). The pneumatonometer also showed a good correlation with the saline column (r = 0.98, n = 360). We conclude that our in vitro pig-eye model made it possible to induce reproducible variation in IOP, and measurement of that pressure with the newly developed resonator sensor gave very promising results for development of a clinically applicable IOP tonometer with unique properties.

A new method for continuous tonometric pCO2 measurement--in vitro studies.

The available methods for tonometric pCO2 measurement only provide the possibility of performing intermittent registrations. A new method allowing continuous tonometric pCO2 measurement has been developed and tested in an in vitro model. A standard tonometer for intestinal pCO2 measurement was modified to allow continuous perfusion of the balloon with physiological saline solution in a closed system. The pCO2 in the system was determined in a specially constructed measurement chamber with a TCM20 percutaneous pCO2 monitor. In this in vitro model the tonometer balloon was placed in a saline bath with a constant pCO2 concentration and the measurements from the closed circulating system were compared with those obtained from a standard tonometer placed in the same bath. In 8 and 24 h experiments the circulating system measured the pCO2 value as accurately and reliably as traditional tonometry. This study indicates that the new method makes continuous monitoring of pCO2 possible.

Monitoring of renal pelvic pressure in patients with hydronephrosis.

A diagnostic method for the determination of obstructions in the pelvoureteral junction in patients with suspected idiopathic hydronephrosis is described and discussed. Two microtransducer catheters (MTCs) with infusion lumens are inserted under fluoroscopic control, one into the renal pelvis and the other in the perirenal space as a reference. The pressure values obtained are stored on a portable microcomputer system, carried by the ambulatory patients. Renal pelvic pressure, intra-abdominal pressure and differential pressure are calculated and displayed as time-pressure diagrams on a plotter. The pressures can be measured for long periods (3-24 h). Furthermore, steady state conditions can be evaluated during pelvic infusion of saline. The results from the pressure measurements are compared with clinical and radiological evaluations. Our results show that this method of long-term monitoring of intrapelvic pressure together with intra-abdominal pressure contributes to the evaluation of patients with suspected pelvoureteral obstructions and complements other methods in the preoperative investigation. However, this study reveals difficulties with measurements of intra-abdominal pressure. Carrying the equipment was not inconvenient for the patients.

Knee extension torque and intramuscular pressure of the vastus lateralis muscle during eccentric and concentric activities.

The objectives of this study were to determine whether the occurrence of delayed onset muscle soreness (DOMS) for the vastus lateralis muscle was associated with elevated intramuscular pressure (IMP); and to assess, whether high eccentric forces occurred at an increased muscle length (as determined by joint angle). Therefore, peak knee extension torque, peak IMP of the vastus lateralis muscle, and the joint angle at which peak torque (JAPT) occurred were determined in eight male subjects during repetitive eccentric and concentric activities until fatigue occurred. Peak torque was significantly higher for eccentric compared to concentric activity (P < 0.01) and declined significantly for both activities (P < 0.01) throughout the protocols. When comparing the start (prior to fatigue) to the end (fatigue state), mean torque for eccentric activity declined from 191 to 147 (N.m) and for concentric activity declined from 166 to 104 (N.m). In contrast, peak IMP was not significantly different between the types of activity and did not change significantly with time. At the start and the end, the mean IMP remained constant for eccentric activity at 54 mmHg (7.2 kPa) but for concentric activity was 78 mmHg (10.4 kPa) and 96 mmHg (12.8 kPa), respectively. All the subjects, however, experienced DOMS of the vastus lateralis muscle exclusively for the eccentric activity leg. The JAPT was not different between activity types and did not change significantly with time; however, a significant interaction between activity type and time was observed (P = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

An electromechanical breathing device for minimal particle loss while inhaling aerosols.

The design of an electromechanical breathing mask that minimizes particle loss during inhalation of aerosols from a provocation box is described. The device measures air flow by means of an anemometer. A provocation example is depicted and the possibility of measuring the provocation dose is discussed. The breathing device here described has been shown to be easy to use and to give reliable results.

Platelet autoantibodies detected by immunoblotting in systemic lupus erythematosus: association with the lupus anticoagulant, and with history of thrombosis and thrombocytopenia.

71 patients with systemic lupus erythematosus (SLE) were studied for the occurrence of platelet antibodies by immunoblotting. Binding of IgG antibodies to platelet protein antigens was observed in 39 of the 71 patients. The most frequently detected and exceptionally strongly reacting antibodies were directed against platelet protein antigens with an approximate molecular weight of 65 kDa under nonreducing conditions. These antibodies were autoreactive and, when followed, they usually persisted. Interestingly, in this group of well-defined SLE patients, platelet antibodies against the most common targets (65 kDa) were significantly associated with the lupus anticoagulant, a history of thrombocytopenia and thrombosis, particularly with arterial occlusions. The lupus anticoagulant, on the other hand, correlated significantly only with venous thrombosis. In addition to the lupus anticoagulant, platelet antibodies against this unknown platelet protein may thus be a marker of a higher risk of thrombosis in SLE patients.

An improved optical eye movement detector for visual half-field studies of cerebral hemisphere memory.

An instrument for the evaluation of cerebral hemisphere memory using the visual half-field (VHF) technique is described. The object was to improve the existing VHF-techniques by means of an infra-red eye movement detector to control visual fixation, and to automatically control the presentation of visual stimuli. The instrument consists of four functional parts; visual presentation; optical eye movement control; electronic programming; and reaction time measuring. The instrument has been used on normal controls and in neuropsychological pre- and post-operative investigations on patients with drug resistant partial epilepsy. It has proved easy to use and reveals valuable information about hemisphere memory function. The use of an optical eye movement detector together with electronic logic has improved the accuracy and reliability of the VHF-test. A schematic outline of the instrument and a brief description of electronic circuitry are given.