Influence of opioids on the vascular tone of isolated porcine coronary artery segments

BACKGROUND: It was the aim of this study to elucidate the influence of opioids on coronary vascular tone using the model of isolated porcine coronary artery segments. METHODs: We studied the effects of fentanyl (0.01, 0.1, 1.0 microg ml(-1)), alfentanil (0.1, 1.0, 10 microg ml(-1)), and sufentanil (0.01, 0.1, 1.0 microg ml(-1)) on the contractile response to three vasoconstrictors, acetylcholine, histamine and serotonin. RESULTS: Fentanyl (0.1, 1.0 microg x ml(-1)) dose-dependently attenuated the contractile response to acetylcholine, but not to histamine and serotonin. There were no differences in fentanyl's vasorelaxing potency between rings with intact and denuded endothelium. Alfentanil and sufentanil did not exert any significant influence on any of the vasoconstrictors tested. CONCLUSION: It is concluded that, in isolated porcine coronary artery rings, fentanyl at high concentrations has an attenuating effect on acetylcholine-induced contractions, which is independent of endothelial function, whereas alfentanil and sufentanil do not influence coronary vascular tone.     

Does halothane or isoflurane affect hypoxic and post‐hypoxic vascular response in rabbit aorta?

BACKGROUND: Halothane and isoflurane affect differently endothelium-dependent and -independent vasorelaxation at 95% O2. In addition, hypoxic vascular response might involve endothelium-dependent and -independent mechanisms. Therefore, we investigated, in rabbit aortic rings, 1) the influence of halothane and isoflurane on vasodilation at 95% O2 and on hypoxic-induced vasorelaxation at 0% O2 and 2) the influence of halothane and isoflurane on endothelium-dependent and -independent post-hypoxic vascular response. METHODS: Endothelium-intact and endothelium-denuded rabbit aortic rings were used. Phenylephrine precontracted rings were exposed, at 95% O2, to acetylcholine (ACh, 10(-9) to 10(-4) M) or sodium nitroprusside (SNP, 10(-9) to 10(-4) M) in the presence or absence of anaesthetic at 1 or 2 MAC. Precontracted rings were also exposed to an acute reduction in O2 from 95% to 0% followed by an acute reoxygenation with 95% O2 in the absence or presence of anaesthetic at 1 or 2 MAC. RESULTS: At 95% O2, halothane decreased endothelium-dependent relaxation to ACh, while endothelium-independent relaxation to SNP was decreased only at 2 MAC. Isoflurane did not modify ACh- or SNP-induced relaxation. At 0% O2, neither halothane nor isoflurane altered the hypoxic vascular relaxation. Post-hypoxic response was not changed either. CONCLUSION: Our results indicate that halothane and isoflurane do not alter vascular hypoxic response in conductance arteries.     

Efficacy of targeted CT angiography in evaluation of intracranial internal carotid artery disease

RATIONALE AND OBJECTIVES: This study evaluated the efficacy of targeted computed tomographic (CT) angiography in the diagnosis of intracranial internal carotid artery (ICA) disease and compared the results of routine and targeted CT angiography. MATERIALS AND METHODS: Fifty-four patients (24 male and 30 female patients aged 2 months to 87 years) were examined with CT angiography. Digital subtraction angiography (DSA) was performed in 42. CT angiograms were reconstructed with the maximum-intensity projection (MIP) algorithm. Targeted CT angiography was performed by individually reconstructing a single ICA territory. Each ICA was divided into four segments, and findings of routine MIP CT angiography, routine MIP plus targeted CT angiography, and DSA were reviewed independently by two neuroradiologists for vascular lesions involving each segment. Routine and targeted CT angiograms were also evaluated to determine how well both ICAs were visualized. RESULTS: Routine CT angiography was rated good or excellent for ICA visualization in 64% of cases, compared with 81% for targeted CT angiography (P = .0005). The overall agreement between routine CT angiography and DSA and between routine plus targeted CT angiography and DSA was 92% and 94%, respectively. There was no statistically significant difference between the percentages of vascular lesions detected with routine CT angiography alone and with routine plus targeted CT angiography. Both methods tended to show false-positive findings of steno-occlusive disease, but targeted CT angiography showed details of aneurysms and stenotic lesions that were easily overlooked with routine CT angiography alone. CONCLUSION: Routine plus targeted CT angiography, while providing superior image quality, did not have much clinical effect; further assessment may be needed.     

Proliferation, Vascular Endothelial Growth Factor Expression and Cavernous Sinus Invasion in Growth Hormone Secreting Pituitary Adenomas

Summary  Surgical cure of growth hormone producing pituitary adenomas (GHomas) becomes difficult when they invade the cavernous sinus (CS). Tumour proliferative activity and angiogenesis are thought to be required for tumour growth and invasion, and vascular endothelial growth factor (VEGF) activates neovascularization around tumours. In this study, the mechanism and clinical significance of CS invasion is analysed. In 25 surgically treated GHomas, the extent of CS invasion was classified as high (Knosp's grade 3 and 4), and low (grade 0, 1 and 2) MR grades, and the MR grades were compared with tumour proliferative potential (Ki-67 expression), angiogenetic demand (VEGF expression), volume of adenomas and serum hormone levels.  The Ki-67 index of high MR grade adenomas (1.17±0.62%) was significantly higher than that of low MR grade adenomas (0.55±0.42%, p=0.027), whereas VEGF expression showed no significant correlation with MR grades (p>0.999). Tumour volume also showed a significant correlation with MR grade (p=0.002). VEGF expression was not correlated with serum hormone level and volume, but was correlated with tumour proliferative potential. Proliferative potential and tumour volume were two independent factors related to CS invasion. Although VEGF expression was not a direct factor related to CS invasion, it may indirectly play a role in activation of tumour aggressiveness, which is required in CS invasion.  Our results show that high MR grade adenomas have higher proliferative ability. In order to improve the surgical outcome, pre-operative medical debulking is indicated, particularly, in such adenomas.     

Multifocal Cerebral Hemangio-Endothelioma. Case Report and Review of the Literature

BACKGROUND: Intracranial hemangio-endotheliomas (HE) are rare vascular tumours that present histological features and biological behaviour of an intermediate malignancy. We report the first case of primary HE presenting as multiple intracranial masses. CASE DESCRIPTION: The patient is a 20-year-old female who presented with paresis of the left arm. Magnetic Resonance imaging (MRI) showed multiple lesions in both frontal lobes. Total surgical excision of the tumours was obtained; a histological diagnosis of hemangio-endothelioma was made. Five months later, MRI scan showed new intradiploic skull lesions whereas a scintigraphic study revealed multicentric extracranial bone involvement. Treatment based on interferon-alpha (IFN-alpha) administration was undertaken; this produced partial regression of the lesions. Approximately three years after the first operation, the patient is in good clinical condition. CONCLUSIONS: Surgery continues to play the leading role in the treatment of intracranial HE. However, adjuvant therapy with IFN represents a new and well-tolerated therapeutic method for residual intracranial lesions as well as multicentric extracranial disease.     

长沙地区部分小学生皮肤病调查

目的　了解长沙地区小学生皮肤病的发病情况。　方法　由皮肤科医生对长沙市雨花区 3 7所小学 ,共175 42名小学生进行皮肤体格检查。　结果　发现皮肤病共 3 7种 ,患皮肤病者 2 70 3人 ,皮肤病总患病率为 15 .41% ,时点患病率以单纯糠疹 ( 8.43 % )最高 ,其次为雀斑 ( 2 .64 % )、丘疹性荨麻疹 ( 1.44 % )、痤疮 ( 0 .87% )、湿疹皮炎 ( 0 .47% )、扁平疣 ( 0 .3 2 % )、毛周角化症 ( 0 .3 0 % )、血管瘤 ( 0 .19% )。男生高于女生的皮肤病有单纯糠疹、丘疹性荨麻疹、毛周角化症、扁平疣、体癣 (P <0 .0 1) ,而女生高于男生的有痤疮 (P <0 .0 1)。在小学阶段 ,随年龄的增长皮肤病的患病人数有增加趋势的有单纯糠疹、雀斑。　结论　在长沙地区小学生中 ,皮肤病发病率较高的是单纯糠疹、雀斑、丘疹性荨麻疹、痤疮、湿疹皮炎、扁平疣、毛周角化症、血管瘤。随年龄的增长而发病率增加的皮肤病有单纯糠疹、雀斑。     

雌激素调节免疫系统的研究进展

雌激素不仅对生殖系统有不可缺少的作用 ,且对包括免疫系统在内的其它方面也有重要作用。研究表明雌激素可以调节体液免疫和细胞免疫 ;雌激素含量和功能的失调可以导致一些自身免疫性疾病。深入研究雌激素与免疫系统的调节、作用机制以及与自身免疫性疾病的关系 ,可以更好地了解某些雌激素相关性疾病的发病机理 ,并开创新的治疗方法和思路     

常见几种疾病的血液流变学指标的观察与分析

[目的 ]　探讨血液流变学指标在临床常见疾病中的应用价值。　 [方法 ]　对 2 91例 5种疾病患者血液进行血液流变学指标测定 ,并与 10 0名体检健康者血液作比较分析。　 [结果 ]　临床常见的脑梗死 ,冠状动脉粥样硬化 ,急、慢性支气管炎 ,糖尿病等疾病的血液流变学指标都存在异常变化。　 [结论 ]　临床上可通过血液流变学指标的检查来帮助预防、诊断和治疗这些病     

1997～2002年湖南省献血者血液检测结果分析

目的 研究湖南省献血者与输血有关主要感染性疾病的情况。方法 ALT采用赖氏法，HBsAg、抗-HCV、抗-HIV1／2检测采用联免疫吸附试验(ELISA)，梅毒血清学检查采用快速血浆反应素环状卡片法(RPR)或甲苯胺红法(TRUST)。结果 共测定2342897人次，其中不合格血为99689人次，占4．25％；6年来献血者与血液传染疾病有关标志物总检出率以1997年为最高，差异存在非常显著性，各项目检出率从高到低依次为ALT(1．59％)、HBsAg(1．54％)、抗-HCV(0．88％)、(0．13％)和抗-HIV1／2(0．11％)，其中，ALT、HBsAg、抗-HCV与总检出率相同，以1997年为最高，但抗-HIV1／2、TRUST或RPR则分别呈现先增加后稳定、先增加后下降的情况。结论 实行无偿献血是使输血感染性疾病总检出率下降的原因，抗-HIV1／2、TRUST或RPR检出的增加与疾病流行状况相关。     

中耳胆固醇肉芽肿

目的 探讨中耳胆固醇肉芽肿的病因、发病机制以及治疗方法。方法 回顾性总结分析我院1988年3月～2003年3月经手术和病理证实的70例(耳)中耳胆固醇肉芽肿病人的临床资料。70例(耳)中，术前诊断为胆脂瘤型中耳炎37例，骨疡型中耳炎13例，此二者之中考虑胆固醇肉芽肿者13例；中耳乳突术后感染5例，分泌性中耳炎7例，特发性血鼓室8例，其中考虑可能为胆固醇肉芽肿者2例。所有病人均有不同程度听力下降、耳闭塞感或伴耳鸣，亦可有耳溢液、头痛、头昏及其他症状。70例(耳)均接受手术治疗，依照术前检查，根据病变程度不同而选择不同术式。结果 65例(耳)干耳，随访1年以上无复发。3例(耳)行改良乳突根治加鼓室成形术，术后半年流脓，后改行乳突根治术，术后均干耳；2例(耳)行鼓室探查加鼓窦开放术，术后半年及1年又流脓伴听力下降，后改行改良乳突根治加鼓室成形术，术后干耳。结论 中耳胆固醇肉芽肿的病因主要有：含气腔通气受阻、引流障碍及含气腔出血。中耳胆固醇肉芽肿与特发性血鼓室、分泌性中耳炎及胆脂瘤关系密切。术式的选择应根据病变范围和程度来决定，其原则是彻底清除病变，保持通畅引流。