Relative significance of the nitric oxide (NO)/cGMP pathway and K+ channel activation in endothelium‐dependent vasodilation in the femoral artery of developing piglets

Mechanisms mediating endothelium‐dependent vasodilation were investigated in femoral artery rings from <2‐day‐old (newborn) and 2‐week‐old piglets. Based on previous results we hypothesized an age difference in the relative contribution of nitric oxide(NO)‐cyclic 3′,5′‐guanosine monophosphate (cGMP) and K⁺ channel‐activation to acetylcholine (ACh)‐induced vasodilation. Changes in vascular tone were studied in organ baths in the absence or presence of NO synthase(NOS) inhibition or K⁺ channel blockade and the intra‐arterial accumulation of cGMP in response to ACh was measured with radioimmunoassay (RIA). In control experiments, relaxant responses to ACh were equal in the two age groups. In the presence of the NOS‐inhibitors N ^G‐monomethyl‐L ‐arginine acetate (L ‐NMMA; 100 μM ) or N^G‐nitro‐L ‐arginine (L ‐NOARG; 1–100 μM ), however, relaxation was significantly more reduced in femoral artery rings from 2‐week‐old than from newborn, with lower pD₂ values in the older age group. Inhibition of large (BK_Ca) conductance calcium‐sensitive K⁺ channels with tetraethylammonium chloride (TEA; 1 mM ), gave a significant rightward shift in the concentration‐response curves to ACh which was of the same magnitude in both age groups. The ACh‐induced vasodilation was abolished in both age groups by high K⁺ (20 mM ) in combination with L ‐NOARG (100 μM ). The relative increase in cGMP levels after addition of ACh (10 nM ) was significantly larger in rings from newborn compared with 2‐week‐old piglets (12‐ vs. four‐fold). In summary, sensitivity to NOS inhibition increased with age while the effect of K⁺ channel blockade with TEA was the same in femoral artery rings from newborn to 2‐week‐old piglets. Lower sensitivity to NOS inhibition and a larger increase in cGMP in response to ACh could indicate a higher efficacy of the NO/cGMP pathway in this vessel in the newborn piglet.     

Dominantly inherited tubular aggregate myopathy.

We report an unusual familial myopathy characterized morphologically by the presence of large tubular aggregates in all fibre types. Two patients, a father and daughter, presented with slowly progressive proximal weakness, limitation of eye movement, and Achilles tendon contractures. Serum creatine kinase was 5-10 times normal. Light microscopy revealed type I fibre predominance. Basophilic accumulations, which stained intensely with the NADH-TR reaction, were present in both fibre types. Electron microscopy revealed that these consisted of tightly packed parallel tubular arrays. These varied somewhat in their ultrastructural appearance and were classified accordingly as type I, II, and III tubular structures. The tubular aggregates appear to be derived from the sarcoplasmic reticulum. This report further supports the evidence of a distinct clinico-pathological entity of genetic origin.     

Structural evidence for counter-current flow in proximal tubules versus pertitubular capillaries in the rat kidney. Evaluation of the counter-current mechanism between the proximal convoluted tubules and the peritubular capillaries in the rat nephron

BACKGROUND: In spite of the very high exchange of water and solutes between the proximal tubules and the peritubular capillaries, very little is known about flow directions in these two interrelated structures. We therefore developed a morphological technique suitable for the quantitative evaluation of a counter-current system between the proximal convoluted tubules and the peritubular capillaries in rat renal cortex. METHODS: In male pentothal-anesthetized Wistar rats (body weight 200-250 g), India ink was injected into the aorta above the renal arteries, followed by instant freezing of the right kidney in isopentane at -165 degrees C, and subsequent freeze-substitution in alcohol. In microscopic slides from kidneys in which only 20-55% of the cortical peritubular capillary loops was filled with ink--representing the arterial end of the capillaries--and in which the proximal tubular segmentation could be identified in PAS-stained sections, the segments of the convoluted proximal tubules were quantitatively compared with regard to the presence of ink-stained and unstained peritubular capillaries in nephrons from the whole renal cortex. RESULTS: In the microscopic specimens of the five animals used both the loops from the first segment (P1) of the proximal convoluted tubule and those of the second segment (P2) were systematically packed closely together, the transitional segment (P1-2) being interposed between the groups. Around the loops of P1, 8%+/-2% of the capillaries was stained with India ink. In contrast, surrounding the P2 loops 67%+/-5% of the capillaries contained ink, significantly exceeding that for P1 (p<0.01). CONCLUSION: Throughout the rat renal cortex, the most proximal fraction of the peritubular capillaries surrounds the second segments of the proximal convoluted tubules, while the first tubular segments are surrounded by the more distal fraction of the peritubular capillaries. Consequently, the flows in the peritubular capillaries and in the proximal convoluted tubules in the rat renal cortex are systematically arranged as a counter-current system. This feature was previously identified only in superficial nephrons.     

带蒂股后皮神经营养血管皮瓣的解剖与临床应用

目的：报道股后皮神经营养血管带蒂皮瓣的解剖特点与临床应用疗效。方法：在10侧经动脉灌注红色乳胶成人新鲜下肢标本上，解剖观测股后皮神经血供及其筋膜皮支的分布范围，设计股后皮神经营养血管岛状皮瓣转移修复腘窝、髋关节周围软组织缺损6例。结果：股后皮神经营养血管主要来源臀下动脉、穿动脉和腘动脉后侧穿支的升皮支，并在股后区形成网状吻合营养股后侧皮肤。皮瓣5例全部成活，1例皮瓣远端少量坏死，换药后愈合。经12～44个月随访，皮瓣无破溃，膝、髋关节功能活动良好。结论：股后皮神经营养血管岛状皮瓣转位是一种修复腘窝、髋关节周围软组织缺损良好的方法。     

股骨远端骨折锁定钢板断裂原因分析及处理

目的探讨股骨远端骨折锁定钢板内固定失效的原因及防治措施。方法对2007年5月~2012年6月共14例应用锁定钢板固定失败的股骨远端骨折患者的临床资料进行分析,其中男9例,女5例,年龄27~68岁,平均39.2岁,骨折内固定术后1~8月(平均5.6个月)锁定钢板断裂。钢板断裂者均采用钢板螺钉取出术,5例予交锁髓内钉内固定,9例再次锁定钢板固定,均同时取自体髂骨移植植骨治疗。结果二次术后14例均获得随访,术后随访9~24月,平均14月,13例获得骨性愈合,1例二次锁定钢板固定患者于二次术后8月再次发生钢板断裂,予行钢板螺丝钉取出、交锁髓内钉固定治疗,再次手术后6月获骨性愈合。膝关节功能按Kolment评分标准:优4例,良9例,差1例。断裂原因具有多样性,5例钢板选择过短,9例存在螺钉置入密度过大,8例内侧皮质粉碎、缺失,4例因过早负重,2例因锻炼时摔伤而导致内固定失败。结论锁定钢板内固定失效的原因通常与对锁定钢板的适应证掌握不全,骨折端过度剥离、复位不良或内侧皮质存在缺损及术后功能锻炼不当有关。因此,选择合适的内固定物,注重植骨,加强术后康复指导、避免过早负重可有效预防及治疗股骨远端骨折钢板内固定失败。     

尺骨头进针固定尺骨的解剖及临床应用研究

目的 :报道尺骨头进针固定尺骨骨折的解剖基础及其临床应用效果。方法 :观察 7具 1 4侧成人上肢标本 ,测量尺骨茎突的长度。以尺侧腕伸肌腱沟内缘 2mm尺骨茎突远端以上 1 5mm处为进针点 ,测量该点到尺神经手背支的距离、该点在前后两侧到尺骨头环状关节面的距离。以该点进针模拟手术并试用于临床。结果 :①尺骨茎突长为 (6 .0± 1 .2 )mm ;②进针点与尺神经手背支距离为 (1 4 .1± 3 .8)mm ;③进针点在前后两侧到尺骨头环状关节面的距离分别为 (1 6 .7± 0 .7)mm、(1 6 .6± 1 .1 )mm ,配对t检验比较两者差异 (P >0 .0 5) ;④术后随访未见严重并发症。结论 :自尺骨头背侧进针能避免传统的从尺骨鹰嘴进针的并发症 ,且钢针尾部不影响前臂的旋转运动和腕关节活动     

Excitation-contraction coupling in femoral arterial smooth muscle in response to noradrenalin

Bulletin of Experimental Biology and Medicine -     

Proximal tubular function in adult rats treated neonatally with enalapril

Neonatal treatment with angiotensin-converting enzyme (ACE) inhibitors or the angiotensin II type-1 receptor antagonist losartan in rats induces irreversible renal histological abnormalities, mainly papillary atrophy, in association with an impairment in urinary concentrating ability. The aim of the present study was to assess proximal tubular function in adult rats treated neonatally with enalapril. Male Wistar rats received daily, intraperitoneal injections of either enalapril (10 mg kg^?1) or isotonic saline vehicle from 3 to 24 days of age. In 15-week-old, hydropenic rats we analysed: (i) proximal tubular iso-osmotic fluid reabsorption using the method of lithium clearance; and (ii) maximal tubular D -glucose reabsorption (Tm_G), under pentobarbital anaesthesia. The main findings were that neonatally enalapril-treated rats showed: (i) reductions in absolute (APRH₂O) and fractional (FPRH₂O) iso-osmotic fluid reabsorption in the proximal tubules (APRH₂O: 0.50 ± 0.02 vs. 0.64 ± 0.03 mL min^?1 g KW^?1, P < 0.05; FPRH₂O: 58 ± 3 vs. 68 ± 2%, P < 0.05); and (ii) a normal Tm_G. In addition, during baseline clearance measurements neonatally enalapril-treated rats showed increases in urine volume and fractional excretion rates of sodium and potassium, a reduction in urine osmolality, whereas glomerular filtration rate and effective renal plasma flow were unaltered. These results suggest that neonatal ACE inhibition produces an irreversible, but differentiated, abnormality in proximal tubular function. Thus, the development of a normal proximal tubular function in the rat seems to be dependent on an intact renin-angiotensin system, (RAS) neonatally.     

经股动脉至冠状动脉插管的应用解剖观测

目的:为动脉造影术以及对病变脏器进行化学治疗时的导管插入提供解剖学依据。方法:用不锈钢尺测量从股动脉起始处至冠状动脉起始处全程中主动脉各主要分支的距离;用游标卡尺测得各动脉起始部的外径。结果:从左、右股动脉起始处,经髂外动脉、髂总动脉最终到左冠状动脉起始处之间的长度分别为(68.9±4.2)cm和(69.0±3.9)cm;到右冠状动脉起始处之间的长度分别为(68.3±4.0)cm和(68.5±3.6)cm。左、右冠状动脉起始处的外径分别为(6.2±1.3)mm和(5.0±0.8)mm。结论:本文的测量数据可供经股动脉至冠状动脉起始处全程中主动脉的各主要分支施行心导管诊断治疗和对内脏器官的疾病进行化学治疗以及局部脏器动脉造影术参考。     

旋股外侧动脉升支阔筋膜张肌支髂骨瓣的解剖学研究及临床意义

目的 :探讨带旋股外侧动脉升支阔筋膜张肌支髂骨瓣的解剖及应用要点。方法 :在 2 5侧经动脉灌注红色乳胶的成人下肢标本上 ,重点观测旋股外侧动脉升支阔筋膜张肌支的走行、分支、发出点和外径等。结果 :旋股外侧动脉升支的阔筋膜张肌支上行支发出点距髂前上棘平面 7.1± 2 .3cm ,外径 1.2± 0 .8mm ,该支又分出 2～ 3支外径在 0 .3mm～ 0 .5mm的小分支从阔筋膜张肌后份进入肌质 ,上行至肌起始处达髂骨 ;其下行支发出点距髂前上棘平面 7.9± 1.8cm ,外径 1.3± 0 .8mm。结论 :旋股外侧动脉升支阔筋膜张肌支髂骨瓣具有手术可行性和实际应用价值