Central circulation in rats with different tolerance to acute blood loss

Study of the dynamics of cardiac output in rats with different tolerance to acute massive blood loss showed that the pumping ability of the heart remains intact during the entire posthemorrhagic period in all high-resistant and in 65% low-resistant rats. In 35% rats that were low-resistant to blood loss, the cardiac output deficiency syndrome developed after cessation of bleeding against the background fall in arterial pressure and a decrease in the hepatic blood flow, which are the signs of rapid variant of the dysfunction produced by acute blood loss. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 126, No. 10, pp. 384–388, October, 1998     

Antigen Presentation By Class I Major Histocompatibility Complex Molecules: A Context for Thinking About HLA-G

PROBLEM: There is substantial data that support the efficacy of paternal leukocyte immunization (PLI) for the treatment of alloimmune mediated miscarriage; however, there is confusion regarding the laboratory test that should be performed to determine levels of maternal anti-paternal leukocyte antibodies (MAPLA). METHOD: Popular methodologies employed include: 1) microcytotoxicity (MCX), 2) mixed lymphocyte culture (MLC), and 3) cell flow cytometry crossmatch (FCXM). Cell flow cytometry crossmatch correlates well with the more difficult MLC assay although the former proves the more sensitive study. This work compares the MCX assays with FCXM. The study group consisted of ten women who had a history of three or more spontaneous abortions (SABs). All ten had very low levels (<10%) of MAPLA as measured by FCXM. Following PLI all subjects demonstrated elevated levels (>50%) of MAPLA by FCXM. At 12 weeks gestation, sera were simultaneously measured for MAPLA by MCX and FCXM. RESULTS: Although all ten patients had very high levels of MAPLA by FCXM during pregnancy, five of ten had antibodies to HLA Class I and two of ten had antibodies to HLA Class II paternal antigens by MCX. Furthermore, all patients who were positive by MCX to paternal Class I antigens were also positive to Class I antigens not seen in either parent. Both patients who were positive by MCX to paternal Class II antigens were also positive to maternal Class II antigens. Notable is that all ten women eventually delivered healthy infants. CONCLUSION: Based on this preliminary study, the MCX assay is neither sensitive or reliable enough to determine the need and/or to monitor the effectiveness of PLI. Flow cytometry should be the modality of choice when determining the need for alloimmunotherapy and to monitor the effectiveness of treatment.     

1例安置埋藏式自动复律除颤器病人的随访

埋藏式自动复律除颤器(AICD)能降低恶性快速室性心律失常患者的猝死发生率,已经得到基本肯定,但其猝死率的降低,在相当程度上取决于能否对置入AICD患者进行认真随访,不断完善其治疗。本文报告1例随访16个月经验,并就随访结果,结合文献,略予讨论。     

金丹肝泰1号对大鼠急性肝损伤防治作用的实验研究

用D-氨基半乳糖（D-GaIN）制备大鼠急性肝损伤模型。方法：检测血清丙氨酸氨基转氨酶（ALT）和血清天门冬氨酸氨基转氨酶（AST）的活性，观察光镜下肝组织的病理学改变，探讨对急性肝损伤的保护作用。结果：口服浸膏可显降低急性肝损伤大鼠血清ALT和AST水平，减轻肝细胞的变性坏死，其作用强度与肝炎宁相当，但弱于联苯双酯。     

~(99m)Tc-甲氧基异丁基异腈首次通过法心室显像评价左心室收缩功能

应用９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）对２９例受检者进行首次通过法心室显像，测定左室射血分数（ＬＶＥＦ），并与同期平衡法心室显像测得的ＬＶＥＦ进行相关分析。结果：首次通过法和平衡法心室显像测得的ＬＶＥＦ分别为（４６．５±１６．７）％、（４９．１±１６．１）％（Ｐ＞０．０５）。相关分析结果显示，二者有明显的相关（ｒ＝０．７８７，Ｐ＜０．０１）。结果表明：９９ｍＴｃ－ＭＩＢＩ为心肌显像剂，采用首次通过法心室显像，在观察心肌血流改变的同时，可准确可靠地评价左室收缩功能状态。     

Factors related to renal haemodynamics in young type-1 diabetes mellitus patients

The influence of metabolic control (HbA_1c), noradrenaline (NA) and insulin-like growth factors (IGF-I and IGF-II) on renal function and size was investigated in 11 insulin-dependent diabetes mellitus patients aged 11–17 years. Renal function was evaluated in terms of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal size was determined as renal parenchymal volume (RPV) by ultrasonography. The patients' HbA_1c values ranged from 8.2% to 12.9% (normal range 5.5–8.5%) and their GFR and ERPF were higher than normal. Their IGF-II values were higher, and NA and IGF-I levels were lower than those of healthy controls. Inverse correlations between NA and GFR (r=–0.66) and NA and ERPF (r=–0.63) were found. No correlation was found between serum IGF-I and renal functional parameters. The IGF-II values correlated with GFR and HbA_1c (r=0.63,r=0.70 respectively). There were linear correlations between RPV and GFR, RPV and ERPF, HbA_1c and GFR, and ERPF and RPV. Decreased NA concentrations and increased IGF-II values appear to be factors contributing to renal hyperfunction in these patients.     

Pregnancy and uncomplicated vaginal delivery only 13 months after cardiac transplantation (case report)

Summary Background Pregnancy is prossible in female patients who underwent cardiac transplantation but is associated with unpredictable risks. Methods A 23-year old female patient underwent cardiac transplantation because of dilatative cardiomyopathy. Results Against our advice, she became pregnant 4 months after transplantation. Following an uneventful pregnancy, spontaneous vaginal delivery occurred 13 months after transplantation. The patient gave birth to a healthy new-born in good physical condition. Thereafter, the patient refused to attend any further routine follow-up control. 9 months after delivery, the patient was admitted to hospital in severe cardiac shock. Biopsy showed a serious, acute rejection which was treated with a course of methylprednisolone. Clinically, the patient recovered within 1 week, but died from acute myocardial infarction 1 day after discharge from hospital. Conclusions Only women without a history of rejection episodes, with good kidney function, good graft function, and high compliance should be counselled to become pregnant.      

Left Ventricular Transvenous Electrode Dislodgement After Mustard Repair for Transposition of the Great Arteries

An 11-year-old girl who underwent Mustard's operation for complete transposition of the great arteries in infancy, developed Mobitz type II second-degree AV block 81/2 years later. A transvenous, active fixation left ventricular lead was inserted and connected to a rate responsive pacemaker. Two years later the lead dislodged due to the child's growth. A new active fixation electrode was positioned in the left ventricle below the pulmonary valve, leaving an electrode loop in the ventricle. Such an approach may prevent lead dislodgement due to growth after intraatrial repair for transposition of the great arteries, but regular radiological or echocardiographic follow-up of lead position is recommended in these patients.     

Validation of impedance cardiography measurements of cardiac output during limited exercise in heart transplant recipients

Abstract. Twenty-one patients were studied at rest and during exercise after heart transplantation to compare cardiac output measured by thermodilution and impedance cardiography. Exercise was performed on a bicycle ergometer over a limited range of work load (25 and 50 watt) whilst metabolic gas exchange was recorded. One patient was studied at rest whilst his circulation was maintained by a Jarvik-7 artificial heart. The values of cardiac output measured by impedance cardiography corresponded closely with the flow rate from the artificial heart. There was also close agreement between the impedance and thermodilution measurements of cardiac output at rest and during exercise. Both measurements followed the changes in heart rate and oxygen consumption. Both thermodilution and impedance cardiography methods elicited good reproducibility of cardiac output measurements at rest and during exercise. These observations suggest that the noninvasive and continuous record of cardiac output obtained by impedance cardiography can be used for the postoperative monitoring of heart transplant recipients.     

兔心肌挫伤心功能障碍与心肌细胞内Ca2+和线粒体ATP酶的变化

目的：探讨心肌细胞内游离钙([Ca^2 ]i)和心肌ATP酶变化在心肌挫伤（MC）后心功能障碍发生机制中的意义。方法：随机选取兔36只，分为6组：正常对照、伤后2、4、8、12、24h，每组6只。经右颈总动脉插管至左心室测左室压力。采用BIM-II型生物撞击机致成MC模型。在上述时相点测定左室压力，并测定心肌细胞内[Ca^2 ]i和心肌匀浆组织及线粒体ATP酶活力。结果：心脏收缩/舒张功能受到损害，心肌细胞内[Ca^2 ]i升高，心肌匀浆组织及线粒体ATP酶下降，相关分析表明心功能障碍与心肌细胞内[Ca^2 ]i含量升高呈明显负相关，与ATP酶活性降低呈明显正相关。结论：MC后心脏功能下降，心肌细胞内[Ca^2 ]i含量升高和ATP酶活性下降可能是其原因之一。