Liver transplant recipients: portable duplex US with correlative angiography

Twenty patients, aged 4 months to 58 years, were evaluated for liver transplantation by duplex sonography, and 15 transplantations were completed; 42 postoperative examinations were performed. Sonographic findings were correlated with seven preoperative and five postoperative angiographic evaluations. Preoperative duplex US findings included tumors, portal vein occlusion, varices, biliary obstruction, and variant vascular anatomy. Postoperative findings included hepatic artery occlusion, portal vein occlusions (one with cavernous transformation), portal vein stenosis, biliary obstruction, intrahepatic and extrahepatic fluid collections, and air in the portal vein due to ischemic bowel. Use of angiography allowed confirmation of the vascular abnormalities and demonstrated evidence of rejection in patients with normal Doppler waveforms. Duplex sonography is a valuable portable technique for evaluating these patients and can be used in triage of patients requiring angiography.     

2-[对-(二甲氨基)苯乙烯]氯化甲基吡啶对大鼠心电图、豚鼠左心房收缩及乳头肌动作电位的影响

2-[对-(二甲氨基)苯乙烯]氯化甲基吡啶(DSPM-Cl),是由氯取代2-[对-(二甲氨基)苯乙烯]碘化甲基吡啶(DSPM)上的碘而得。本文应用心电图、机械收缩描记方法及细胞内标准微电极技术,研究DSPM-Cl对大鼠心电图(ECG)、豚鼠心房肌量效曲线及对豚鼠乳头肌快反应动作电位(AP)、高钾除极慢反应动作电位(SAP)的影响。结果显示,DSPM-Cl(2mg·kg^-1)对大鼠有明显的负性频率、负性传导作用,分别使PP间期、PR间期延长达66.2%(P<0.01),17.0%(P<0.01),50μmol·L^-1能明显抑制左心房收缩力,非竟争性拮抗Iso及CaCl₂对豚鼠左心房的正性肌力作用,PD^2'分别为4.6,4.34,100μmol·L^-1DSPM-Cl延长动作电位时程APD₉₀,有效不应期(ERP),降低高钾除极豚鼠乳头肌0期最大上升速率Vmax,其作用与Ver相似,提示DSPM-Cl可能为钙拮抗剂。     

Focal liver masses: differential diagnosis with pulsed Doppler US

Duplex Doppler ultrasound (US) was used in 68 consecutive patients with focal liver lesions, including 12 hepatocellular carcinomas, one cholangiocarcinoma, 37 metastases, 15 hemangiomas, one hemangioendothelioma, and two focal nodular hyperplasias. Of the hepatocellular carcinomas, six were diffusely hyperechoic, two were hypoechoic, two were single hyperechoic lesions, and two were multifocal and hyperechoic. All ten tumors with Doppler shifts of 5 kHz or above proved to be hepatocellular carcinomas. The other two hepatocellular carcinomas showed Doppler shifts of 3 kHz. In contrast, no hemangioma showed shifts above 0.7 kHz, and ten of the 15 gave no detectable signal. Of the metastases, 20 gave no signal and 17 had signals of up to 4 kHz. Three-kilohertz signals were also obtained from a cholangiocarcinoma, a hemangioendothelioma, and focal nodular hyperplasia. Correlation with angiographic findings suggested that the high-velocity Doppler signals were associated with large pressure gradients due to arteriovenous shunting. Duplex Doppler US can therefore aid in the differential diagnosis of diffuse and focal liver lesions.