In vitro velocity measurements down strem from the lonescu-Shiley aortic bioprosthesis in steady and pulsatile flow

Velocity measurements were made in vitro using laser Doppler anemometry (LDA) downstream from an lonescu-Shiley (IS) bioprosthetic aortic heart valve. Velocity measurements were made in both steady and pulsatile flow. A systematic, flow mapping approach to the measurement methodology showed that the IS valve generated a large jetlike flow constriction. The acceleration ratio, defined as the maximum mean velocity for the IS valve divided by that for no valve obstructing the flow, was as high as 2·4 for steady flow and 2·6 for pulsatile flow. It was concluded that the IS valve generated a flow quite unlike that observed by other in vestigators for the natural human aortic valve, after which the leaflet design of the IS valve was modelled. In addition, a comparative analysis of steady and pulsatile results was undertaken. It was found that the pulsatile flow results for the systolic ejection interval could be divided into three phases, denoted early, mid, and late systole, as defined by the flow structure at the data plane location. Only during midsystole were the pulsatile flow results approximated by the steady flow results. Also, it was found that the magnitude of the flow disturbance measured in steady flow tended to be an upper bound on that measured for pulsatile flow.     

Morphological characteristics of cultured olfactory bulb cells

Cultured olfactory bulb cells from embryonic mice had ultrastructural characteristics similar to those of many cell types in the intact adult mouse olfactory bulb. Identified cultured cells included mitral/tufted cells, granule cells, short-axon cells, and fibrous and protoplasmic astrocytes. Cultured neurons were found as individual cells, clusters or aggregates. Clusters consisted of a loose array of neurons that appeared to be densely interconnected by neurites. However, few neurites or fascicles emanated from clusters to adjoining areas. Aggregates consisted of many small, usually rounded, neurons piled on top of one larger neuron, or on more than one, with typically many neurites and fascicles projecting to adjacent aggregates, clusters or individual neurons. Neurites of cultured olfactory bulb cells were well developed, and some were several millimeters long. Synapses were very prominent in these cultures, especially in aggregates, clusters, and fascicles. Electron-lucent, dense-core, and coated vesicles were present. Polarity, shape, and length of the long axis (size) of 815 cultured neurons, identified by positive anti-microtubule-associated protein 2 staining, were documented. Cultured neurons varied in size from 9 to 27 m, with an average size of 16 m. Elliptical bipolar (35%), triangular multipolar (21%), and round unipolar (15%) were the most common polarity/shape combinations found in culture. Multipolar, triangular, triangular multipolar, and elliptical bipolar cells increased in size with increasing age of culture. The relative proportions of triangular, multipolar, elliptical multipolar, and triangular multipolar cells decreased, whereas the relative proportions of round, unipolar, and round unipolar cells increased with increasing age of culture. These changes in population subtypes and cell size may indicate continued differentiation and maturation of cultured neurons.     

基于实时三维超声图像的二尖瓣环重建及运动分析

二尖瓣环的非平面特性对二尖瓣返流的超声诊断和二尖瓣环成形术的合理设计具有重要意义.基于心脏的实时三维超声图像,我们研究了一种对二尖瓣环三维重建及运动分析的方法.首先通过人机交互方式提取出二尖瓣环的特征点,并根据位置关系对特征点排序,然后利用非均匀有理B样条曲线建立二尖瓣环三维形态模型,并编程实现二尖瓣环的动态显示和运动分析.通过对20组病例分析,初步证明此方法所建模型较准确反映患者的二尖瓣环的运动,能满足二尖瓣环三维可视化和分析研究的需要.     

组织工程化心脏瓣膜的研究进展

心脏瓣膜置换术是外科治疗瓣膜性心脏病的主要方法，但目前临床应用的人工瓣膜的远期效果尚不满意。近年来，随着组织工程学技术的进展，利用培养的自身组织细胞种植于支架材料表面，体外重新构建理想的心脏瓣膜植物日益成为研究热点。本文简述了心脏瓣膜工程的定义，细胞支架材料的选择，种子细胞的培养、种植方法以及组织工程化心脏瓣膜的评估，并指出下一步研究中尚需解决的问题。     

The genetic basis of Turner syndrome aortopathy

Our goal is to identify the genetic underpinnings of bicuspid aortic valve and aortopathy in Turner syndrome. We performed whole exome sequencing on 188 Turner syndrome study subjects from the GenTAC registry. A gene‐based burden test, SKAT‐O, was used to evaluate the data using bicuspid aortic valve (BAV) and aortic dimension z‐scores as covariates. This revealed that TIMP3 was associated with BAV and increased aortic dimensions at exome‐wide significance. It had been previously shown that genes on chromosome Xp contribute to aortopathy when hemizygous. Our analysis of Xp genes revealed that hemizygosity for TIMP1, a functionally redundant paralogue of TIMP3, increased the odds of having BAV aortopathy compared to individuals with more than one TIMP1 copy. The combinatorial effect of a single copy of TIMP1 and TIMP3 risk alleles synergistically increased the risk for BAV aortopathy to nearly 13‐fold. TIMP1 and TIMP3 are tissue inhibitors of matrix metalloproteinases (TIMPs) which are involved in development of the aortic valve and protection from thoracic aneurysms. We propose that the combination of TIMP1 haploinsufficiency and deleterious variants in TIMP3 significantly increases the risk of BAV aortopathy in Turner syndrome, and suggest that TIMP1 hemizygosity may play a role in euploid male aortic disease.     

牦牛主动脉瓣叶的流变学性质

作者研究了牦牛主动脉瓣叶的单向拉伸和应力松弛行为。发现在生理应变范围内,试件的应力应变曲线斜率在纤维方向比其垂直方向约大20倍,瓣叶对应变速率不很敏感。在分析瓣叶的松弛行为时应用了冯元桢[9](1972)提出的松弛模型,根据实验结果,得到了牦牛主动脉瓣叶的归一化松弛函数。     

BMP4 is required in the anterior heart field and its derivatives for endocardial cushion remodeling, outflow tract septation, and semilunar valve development

The endocardial cushions play a critical role in septation of the four-chambered mammalian heart and in the formation of the valve leaflets that control blood flow through the heart. Within the outflow tract (OFT), both cardiac neural crest and endocardial-derived mesenchymal cells contribute to the endocardial cushions. Bone morphogenetic protein 4 (BMP4) is required for endocardial cushion development and for normal septation of the OFT. In the present study, we show that anterior heart field (AHF)-derived myocardium is an essential source of BMP4 required for normal endocardial cushion expansion and remodeling. Loss of BMP4 from the AHF in mice results in an insufficient number of cells in the developing OFT endocardial cushions, defective cushion remodeling, ventricular septal defects, persistent truncus arteriosus, and abnormal semilunar valve formation.     

Adult T cell leukemia/lymphoma with massive involvement of cardiac muscle and valves

An autopsy case of a 58-year-old woman with massive cardiac Involvement of adult T cell leukemia/lymphoma (ATLL) is reported. She developed cardiac failure due to aortic and mitral regurgitation with cardiac infiltration of ATLL cells, and underwent replacement of both aortic and mitral valves. Studies of the cut-surfaces revealed diffuse thickening of the subendocardial wall of the left chamber with widespread whitish-brown tumor infiltrates. In the regions surrounding the replaced aortic and mitral valves there was also massive tumor cell infiltration. The tumor cells infiltrating the cardiac muscle wall were T cell in origin and exhibited Leu-3a (CD4)-positive immunoreaction. Ultrastructurally, tumor cells contained markedly indented nuclei and some were attached directly to the muscle cells. These findings suggest that this was an unusual form of ATLL with widespread involvement of the heart.     

心脏瓣膜置换术48例围手术期的处理

目的：总结瓣膜置换术围手术期处理所临床经验。方法：回顾性分析48例瓣膜置换术病人术前、术中、术后处理的临床资料。结果：发生围手术期并发症共14例,其中低心排4例,心律失常4例最多。长期存活47例,死于多器官功能衰竭1例。结论：术前注意纠正心功能不足与合并症的治疗,术中注意心肌保护与三尖瓣关闭不全的矫治,术后强调补足血容量和血清钾后强心利尿。     

股浅静脉戴戒术治疗原发性下肢深静脉瓣膜功能不全

目的 用股浅静脉戴戒术治疗原发性下肢深静脉瓣膜功能不全。方法 本文应用股浅静脉戴戒术治疗原发性下肢深静脉瓣膜功能不全34例,并应用无创性光电容积描记（PPG）结合临床症状改善状况对手术疗效进行评估。结果 手术前后静脉返流时间（VRT）有显著差异（P＜0．01）,临床症状改善。结论 股浅静脉戴戒术是治疗下肢深静静脉瓣膜功能轻度不全的有效方法,PPG检查结合临床改善程度是判断手术疗效更有效的方法。