Transcatheter treatment of life-threatening lower gastrointestinal bleeding due to advanced pelvic malignancy

We present two patients with life-threatening, massive, lower gastrointestinal (GI) bleeding and locally advanced cervical carcinoma. Selective pelvic arteriography demonstrated that the site of bleeding originated from a pseudoaneurysm of the right internal iliac artery with fistulous communication to the sigmoid colon in one patient and from the left internal iliac artery into the rectum in the second patient. Transcatheter embolotherapy was then performed using balloon occlusion in one patient and coil embolization in the second patient. The iliac arteries should also be evaluated in patients with pelvic cancer who present with lower GI bleeding.     

活络育阴方治疗糖尿病模型大鼠的实验观察

目的　探讨活络育阴方治疗消渴病 (糖尿病 )的药理学机制。方法　用四氧嘧啶制备糖尿病模型大鼠 ,观察活络育阴方和中汇糖脉康对糖尿病模型大鼠血糖、总胆固醇、甘油三酯、血液流变学的影响。结果　观察组总有效率 80 0 0 % ,对照组总有效率 6 8 75 % ,两组疗效有显著性差异 (P <0 0 1)。结论　二药物对糖尿病均有疗效 ,但活络育阴汤对降低化验指标方面优于中汇糖脉康。     

MR angiography of the supra-aortic arteries using a dedicated head and neck coil: image quality and assessment of stenoses

Our purpose was to evaluate a dedicated head and neck coil for demonstration of supra-aortic arteries with optimised magnetic resonance angiography techniques. We performed 47 examinations with a 1.5-T system. We used coronal 3D fast imaging with steady precession (FISP), axial 3D tilted optimised nonsaturating excitation (TONE) and 2D fast low-angle shot (FLASH) for the carotid bifurcation, axial 3D TONE with or without magnetisation transfer (MT) for intracranial arteries, and axial 3D FISP or TONE for the aortic arch. Evaluation included visual assessment of image quality and grading of stenoses near the carotid bifurcation; digital subtraction angiography was used as the reference method. Axial 3D TONE gave superior image quality at the carotid bifurcation, MT-TONE intracranially, and 3D FISP for the aortic arch vessels. Nevertheless, sensitivity and specificity for detection of significant stenoses were similar with coronal 3D FISP (96.3 %, 94.0 %), axial 3D TONE (92.6 %, 92.5 %) and axial 2D FLASH (96.3 %, 86.6 %). Image quality at the aortic arch needs further improvement. Received: 29 November 1996 Accepted: 7 February 1997     

Internal mammary artery embolization for hepatic tumors

Purpose To prospectively identify patients with collateral internal mammary artery (IMA) supply to hepatic tumors, and to embolize the IMA as part of palliative hepatic artery embolization (HAE). Methods Over a 4-year period, 222 patients were enrolled in an HAE protocol for inoperable liver tumors. All underwent abdominal computed tomography (CT) prior to preembolization diagnostic hepatic arteriography. When anterior subcapsular hepatic tumor was seen on the CT scan, patients underwent IMA arteriography as well. All arteries supplying tumor were embolized. Results Six patients had anterior subcapsular lesions identified on CT. IMA catheterization revealed that these lesions drew blood supply directly or indirectly from one or both IMAs in all six patients. All IMAs were embolized. Conclusion When an hepatic tumor is identified in an anterior subcapsular location prior to HAE, the IMA should be examined and, if significant tumor supply is demonstrated, these branches should be embolized.     

山莨菪碱对大鼠颈总动脉吻合术后血流动力学的影响

目的研究山莨菪碱对血管吻合后血流动力学的影响。方法取ＳＤ大鼠９６只，切断左侧颈总动脉作端端吻合后，随机分成术后６、１２、２４、４８、７２和１２０小时共６个时间组。各时间组再分成实验组和对照组，每组８只大鼠。实验组用２％氢溴酸山莨菪碱（３０ｍｇ／ｋｇ）作腹腔注射，对照组则注射等体积生理盐水，给药１０分钟后用彩色多普勒血流仪检测颈总动脉吻合口前、吻合口、吻合口后动脉收缩期平均最高血流速度，并计算吻合口横截面积。结果术后１２、２４、４８、７２和１２０小时组，颈总动脉吻合口前的血流速度比对照组明显增加（Ｐ＜０．０５），平均增加３１．５％。术后６和２４小时组，实验组吻合口狭窄程度比对照组明显减轻（Ｐ＜０．０１，０．０５）。术后１２０小时组，山莨菪碱能够明显增加吻合口后的血流速度，实验组和对照组相比有显著性差异（Ｐ＜０．０５）。结论山莨菪碱能够提高大鼠颈总动脉吻合后，血管吻合口前及吻合口的血流速度，术后２４小时内用药能够减少吻合口的狭窄程度。     

Percutaneous transluminal aortic angioplasty: Early and late results

Percutaneous transluminal angioplasty of the infrarenal abdominal aorta (13 patients) and its bifurcation (15 patients) was performed in 28 patients with a total of 32 dilatation procedures. The group consisted of 16 female and 12 male patients and initial successful dilatation was achieved in all Recurrence within 1 month requiring bypass surgery occurred in 1 patient. Three patients were lost to follow-up. Long-term follow-up in the remaining 24 patients ranged from 1 to 9 years with a mean of 4.5 years. During the follow-up period, repeat angioplasty of the original stenosis was performed in 3 patients and another patient underwent dilatation of a new lesion which developed in the aorta. According to clinical and noninvasive studies, these 4 patients, as well as the other 20, have maintained patency of the treated lesions and are symptom free. No immediate complications requiring surgery occurred. We conclude that angioplasty is the initial treatment of choice in focal lesions of the distal abdominal aorta and its bifurcation.     

冠心病、高血压中小动脉脉搏波传播速度的研究

采用无创方法测定右肱动脉末端至右食指尖端部的脉搏波传播速度(PWV)。结果:冠心病、高血压病病人的该段动脉PWV均较对照组显著减慢(P<0.001),Ⅱ期高血压又显著慢于Ⅰ期高血压(P<0.01)。不同年龄和不同性别的高血压、冠心病病人的PWV差异无显著性。     

Percutaneous dilatation and recanalization of iliac and femoral arteries

Five-year follow-up studies in patients with superficial femoral arterial occlusions and iliac artery stenoses have demonstrated a high success rate with percutaneous transluminal angioplasty performed by the Dotter technique. The special balloon catheters developed by Grüntzig, a standardized accessory pharmaceutical regimen, and more exact indications have further increased the rate of long-term success; the patency rates now approach 70% after three years. Clinical follow-up studies by Doppler ultrasound are useful for assessing the hemodynamic effects of the procedure.