George Anogianakis

Visual function and visual perception in cerebral palsied children.

Purpose:  To investigate visual function and perception in cerebral palsied (CP) children.

Generation of TNF alpha, IFN gamma, IL-6, IL-4 and IL-10 in mouse serum from trichinellosis: effect of the anti-inflammatory compound 4-deoxypyridoxine (4-DPD)

Infections caused by the nematode Trichinella spiralis is characterized in the host by an inflammatory response with cytokine production. In these studies we have detected TNF alpha, IL-6, IFN gamma, IL-4 and IL-10 in the serum of 10 mice infected with T. spiralis. Moreover, we detected, for the first time, these cytokines in the serum of mice treated with 4-DPD, a potent antagonist of vitamin B6 coenzyme which has anti-inflammatory properties. 4-DPD was used at 100, 400, 800 micrograms/bolus for 20 days, starting one day before the infection. After 15 days of T. spiralis infection, TNF alpha reached a maximum level, while IL-6 was maximal after 7 days, IFN gamma at 20 days and IL-4 at 14 days. IL-10 was not affected by the T. spiralis infection. When the animals were treated with 4-DPD at the reported dosages and infected with T. spiralis the inhibition of TNF alpha and IL-6, were dose-dependent in the first 7 days while IL-4 was reduced only at 400-800 micrograms/bolus. 4-DPD-treated mice did not statistically (P > 0.05) affect the generation of IFN gamma. In healthy animals the production of cytokines were not measurable, just as it was in non-infected animals treated with 4-DPD. The increase of cytokines such as, TNF alpha and IL-6 may be related to the severity of the disease, boosting the hosts resistance to the pathogen and inhibiting parasite survival. In addition, the augmentation of IL-4 production enhances T and B cells and macrophage responses and may stimulate T-cell antibody-mediated response to the pathogen. 4-DPD, an inhibitor of IL-1 and inflammatory reactions, proved to be most effective on TNF alpha and IL-6, which are mainly produced by macrophages.

VISUAL FUNCTION AND EXECUTION OF MICROSACCADES RELATED TO READING SKILLS, IN CEREBRAL PALSIED CHILDREN

This article investigates the ability of cerebral palsied (CP) children to execute microsaccades. One-hundred and five congenitally CP school aged children (6 to 15 years old), without severe mental retardation, were classified into three groups: those with spastic quadriplegi, spastic diplegics, and spastic hemiplegics on the basis of: (1) patient anamnesis, (2) IQ estimation, (3) evaluation of the microsaccadic skills with the Developmental Eye Movement test (DEM). Their performance in these tests was compared with a control group from the general pediatric population. IQ of the CP children ranged between 70 and 100; the microsaccadic skills were severely affected: only 19% of the CP children had normal function, 20.9% of the CP children appeared with a pure oculomotor problem, 32.4% of the CP children had a visual-perceptual problem, and 27.7% of the CP children had a combined oculomotor and visual perceptual problem. CP children, in the absence of severe mental retardation, have disturbed visual skills and visual perception that usually leads to reading difficulties. It is also suggested that microsaccadic skills of CP children is an identifiable factor compounding the adverse effects of mental retardation on reading skills.

Arrhythmogenesis in patients with stable chronic obstructive pulmonary disease.

Objective Fatal arrhythmias are a common cause of death in chronic obstructive pulmonary disease (COPD). Two major hypotheses for arrhythmogenesis in COPD have been proposed: arrhythmias are a consequence of hypoxaemia, hypercapnia or (tissue localised) acid–base disturbances, or arrhythmias are the result of the autonomic neuropathy that characterises COPD. Our objective was to verify these two hypotheses. Methods A total of 29 consecutive COPD patients (seven men and 22 women, mean age 63.75 ± 10.50 years) were included in the study. Pulmonary function tests were performed and arterial blood gases were obtained simultaneously. Twelve-lead electrocardiograms were recorded from all patients. QT dispersion, which is a measure of myocardial repolarisation heterogeneity, and the coefficient of variation of the RR interval, which is a measure of heart rate variability, were calculated. Results Of the parameters measured, only the coefficient of variation of the RR interval appeared to be related to arrhythmias, since it correlated positively with arterial oxygen pressure (r = 0.418, statistical significance set at P < 0.05). Conclusions Our results rule out the electropathy hypothesis and underline the role of autonomic neuropathy as the most probable arrhythmogenic mechanism in hypoxaemic COPD patients. Our interpretation is based on the fact that hypoxaemia decreases heart rate variability and on the strong association between the reduction in heart rate variability and arrhythmogenesis.

A training network for introducing telemedicine, telecare and hospital informatics in the Adriatic-Danube-Black Sea region

DIMNET is a training mechanism for a region of central Europe. The aim is to upgrade the information technology skills of local hospital personnel and preserve their employability following the introduction of medical informatics. DIMNET uses Internet-based virtual classrooms to provide a 200-hour training course in medical informatics. Training takes place in the cities of Drama, Kavala, Xanthi and Varna. So far, more than 600 people have benefited from the programme. Initial results are encouraging. DIMNET promotes a new vocational training culture in the Balkans and is supported by local governments that perceive health-care as a fulcrum for economic development.

N‐acetylcysteine exerts therapeutic action in a rat model of allergic rhinitis

The pathophysiologic mechanism of allergy is dependent on the action of many redox‐sensitive proinflammatory mediators. However, even though redox disturbances are believed to be a hallmark of inflammation, little is known of the effect of redox imbalance to the pathophysiology of allergic rhinitis. We thus opted to investigate the relation of oxidative stress and allergic rhinitis, through the utilization of a potent antioxidant substance (N‐acetylcysteine [NAC]) in a rat model of allergic rhinitis and the evaluation of its action on specific markers of inflammation.

A simple telemedicine system to provide second-opinion advice to the patients of an Albanian diagnostic centre

Since August 2003, the IKEDA Klinika diagnostic centre in Tirana, Albania, has offered patients telemedical help from Greece. The teleconsultation service is based on Internet technologies adapted to telemedical use, including the use of forms (e.g. for the patient history), multimedia file exchanges (e.g. for radiographs and electroencephalograms) and videoconferencing. The teleconsultants assist in treatment planning and, when necessary, in organizing the transfer of patients to Greece. The four cornerstones of the service are: the provision of second opinions by telemedicine; assistance in treatment planning; assistance to patients during transfer; and the continuity of medical care on their repatriation. Based on the first six months of operation, we estimate that, if bureaucratic visa restrictions to patient movement between Albania and Greece are removed, more than 2000 patients per year will benefit from the service and more than 400 patients will be transferred to Greek hospitals for treatment.

Attacking the Inverse Electromagnetic Problem of the Heart with Computationally Compatible Anatomical and Histological Knowledge

For over one hundred years the electrocardiogram (ECG) remains an extremely useful clinical tool and continues to play a major role in the evaluation and management of patients with known or suspected cardiac disease. Interpretation of the 12-lead ECG is a simplistic solution to the “inverse electromagnetic problem” for the electrical activity of the heart, which is to extract information about the instantaneous electrical state of the cardiac muscle from measurements of the body surface potentials that are generated from the electrical activity of the heart. Although adequate for patient management in most instances, there are conditions for which the sensitivity of the 12-lead ECG is suboptimal, as for example for the diagnosis of a posterior wall myocardial infarction. To enhance the diagnostic value of the ECG, one would need to address in depth and provide an actual solution to the inverse electromagnetic problem.

Long-term effects of the administration of the convulsive substance DL-methionine-DL-sulfoximine to the rabbit.

Methionine sulfoximine (MSO) is a centrally acting neurotoxin which inhibits the glutamate metabolism enzymes and has convulsive properties. Administration of a small dose of MSO to rabbits, either intravenously or intracerebroventricularly, except for the already known convulsive effects, may also be responsible for hind leg myopathy (rigid paralysis with histological findings resembling myositis) which sets in by the 4th day after MSO administration.

A semi-automated approach towards generating three-dimensional mesh of the heart using a hybrid MRI/histology database.

Both the forward and inverse problems of electrocardiography rely on the precise modelling of the anatomic and electrical properties of the thoracic tissues. This, in turn, requires good knowledge of the electrical anisotropy as well as conductivity inhomogeneity of the heart, lungs and the rest of the thorax. Cardiac electrical anisotropy is related to its microstructure (fibre length, density and orientation). We hereby present detailed three-dimensional (3D) meshes of the thorax and heart, using image data from contiguous 2D magnetic resonance (MR) imaging slices as well as a realistic 3D cardiac fibre orientation model that derives its data from high-resolution ex vivo human heart MR images and from histology specimens of heart tissue. Using specific software, we integrated the 3D thorax and heart meshes in one that addresses the related modelling requirements for the solution of the forward and inverse problems of electrocardiography.