Non-invasive estimation of the diastolic elastic and viscoelastic properties of the left ventricle

The present study applies a non-invasive method to the quantitative evaluation of left ventricular stiffness in normal subjects and in patients with ischaemic heart disease (IHD). We have studied 20 patients with IHD and 25 healthy subjects. The third heart sound (S3) was detectable in all patients. We have correlated the energy spectrum of S3, divided into 15 Hz bands, with a series of echocardiographic parameters. The existence of a significant correlation between the spectrum energy and the diameter and thickness of the left ventricle at the moment of S3 allowed us to explore the possibility of interpreting the origin of S3 based on a mathematical model. Our hypothesis has been that, once the left ventricle starts vibrating, it behaves as a simple physical model composed of a mass and an elastic element. To this purely elastic model one can add a factor accounting for viscosity, with a damping effect, to obtain a more complex viscoelastic model. The stiffness coefficient 'k' was computed in both models from the peak frequency of S3 and the left ventricular mass at the moment of S3. Furthermore, in the viscoelastic model, the damping element 'c' was also computed. Both parameters--k and c--were significantly increased in the group with IHD compared with the control group. Although a simplification of the vibrating system, these models make it possible to obtain non-invasively information on the characteristics of the left ventricle through the combined use of echocardiography and spectral analysis of S3.     

左心室造影功能成像的临床应用

为探讨左心室造影功能成像的价值与限度，我们选择冠脉及左心室造影者38例行左室功能成像，观察左室壁运动情况并与节段法室壁运动定量分析比较。结果示左室收缩正常18例，其各节段EF值平均39％，节段性收缩减弱7例，无收缩3例，矛盾收缩4例，普遍性收缩减弱6例，病变节段的EF值平均5～19％，明显低于正常者（P＜0．01）。结论：左室功能成像效果直观且客观，可作为室壁运动定量分析的一个重要补充。     

雌激素对左心室舒张功能影响的多谱勒超声心动图研究

目的:研究雌激素对左心室舒张功能的影响。材料和方法:利用多谱勒超声心动图记录了25例健康绝经后妇女二尖瓣口血流频谱,其中15例为雌激素替代治疗组,10例为对照组。所测参数有:舒张早期峰值速度(E),舒张晚期峰值速度(A),E加速度及减速度,并计算E/A比值及心房舒张晚期充盈分数(AFF)。结果:二组间左心室舒张期充盈明显不同,尤其是替代治疗组E/A比值高,AFF低,替代治疗组舒张早期充盈量大于对照组。结论:本研究表明长期雌激素替代治疗可以影响左心室舒张功能。     

急性左半结肠癌梗阻一期切除吻合治疗39例

目的：探讨左半结肠癌致急性肠梗阻的手术处理方法。方法：回顾分析1995－2001年间39例左半结肠癌致肠梗阻一期切除吻合术的外科临床效果。结果：全组39例病人均采用梗阻近端肠管减压灌洗，并留置盲肠造瘘管术后接负压吸引，术后均一期愈合，未出现吻合口漏。随访2例中，1例存活率58％，3年存活率16％，5年存活率8％。结论：严格掌握手术适应症和基本操作，在病情允许时，对左半结肠癌急性肠梗阻行一期切除吻合手术是可行的。     

缬沙坦对急性心肌梗死患者左室结构和功能的影响

目的　观察缬沙坦对急性心肌梗死 (AMI)患者左室结构和功能的影响。方法　将 72例AMI患者随机分为两组 ,常规治疗组 36例 ,口服消心痛 10mg,3次 d;缬沙坦组 36例 ,口服消心痛 10mg ,3次 d ,缬沙坦80mg ,1次 d,并于治疗后 2周、 2 4周分别进行超声心动图和平衡法核素心室造影 ,测定左室心肌重量、左室收缩和舒张功能 ,了解缬沙坦对AMI后左室重塑的阻抑作用。结果　AMI治疗 2 4周时两组患者的室间隔厚度 (IVST)、左室后壁厚度 (LVPWT)、左室舒张末内径 (LVDd)和左室心肌重量指数 (LVMI)、左室射血分数 (LVEF)、左室峰射血率时间 (LPER)、左室高峰充盈率 (LPFR)和左室高峰充盈率时间 (LTPFR)的各均值间差别均有显著性意义 (P<0 0 5 )。结论　缬沙坦能明显减轻心肌梗死后心肌肥厚和左室重塑 ,改善左室功能。     

脉冲多普勒超声心动图评定正常人的左室舒张功能

本文用脉冲多普勒超声心动图(PDE)对103例不同年龄的正常人进行左室舒张功能的评定,表明年龄是影响正常人左室舒张功能的主要因素,并推荐一个40岁以上人群舒张功能正常与否的参考标准。     

The Mini Rhytidectomy

A technique is described in which superficial musculoaponeurotic system (SMAS) is plicated from the deep temporal fascia above the zygoma to the level of the earlobe. This procedure requires only an extended preauricular incision. The neck is dealt with by liposuction. This technique is ideally suited to the younger patient requesting facelift and is based on a sound understanding of the anatomy of SMAS. The outcome of 35 patients who underwent this procedure during a 3.5-year period are described. There were no cases of facial nerve paresis or hair loss. There were no cases of skin necrosis but two patients developed small hematomas and one patient complained of a stretched preauricular scar. The mini facelift leads to a satisfactory result in the younger patient requesting rhytidectomy. The technique is simple and safe and can easily be performed on an ambulatory basis. Complications are uncommon and of a minor nature.     

Osteogenic Sarcoma of the Left Atrium

A primary cardiac osteogenic sarcoma is described in a patient presenting with a left atrial obstructive lesion. Wide surgical excision was possible with left atrial reconstruction and mitral valve replacement. The patient survived the operation and was symptom free for 1 year, finally dying at 18 months of cerebral metastases.