The hepatic veins: Anatomy and classification on single slice spiral CT in North Indian population

AimsTo find out the normal pattern of hepatic veins in the North Indian population and to categorize them.MethodsThe present study was conducted on 100 patients whose spiral CT abdomen was performed for various medical conditions in the department of radiodiagnosis.ResultsFour categories were recognized. Category-1, when right hepatic vein drains independently into the inferior vena cava whereas middle and left hepatic veins join together to form a common trunk before draining into the inferior vena cava. It was observed in 74% patients. Category-2 was observed in 2% patients, where right & middle hepatic veins join to form a common trunk and left hepatic vein drain independently into the inferior vena cava. Category-3 was observed in 21% patients, where all the three major hepatic veins drain independently into the inferior vena cava. Category-4 was observed in 3% patients, where all the three major hepatic veins join together to form a common trunk before draining into the inferior vena cava.ConclusionsCategory-1 is the most common pattern of major hepatic vein drainage found in the North Indian population. The present study also concluded that single right, middle and left hepatic vein is the most common pattern of hepatic veins present in the North Indian population. Caudate lobe is drained by more than one vein in majority of North Indians. Also superomedial vein, right accessory vein and inferior right hepatic vein are the most common accessory veins present in the North Indian population.     

Study of atrial activities for abnormality detection by phase rectified signal averaging technique

Abstract

Non-invasive detection of Atrial Fibrillation (AF) and Atrial Flutter (AFL) from ECG at the time of their onset can prevent forthcoming dangers for patients. In most of the previous detection algorithms, one of the steps includes filtering of the signal to remove noise and artefacts present in the signal. In this paper, a method of AF and AFL detection is proposed from ECG without the conventional filtering stage. Here Phase Rectified Signal Average (PRSA) technique is used with a novel optimized windowing method to achieve an averaged signal without quasi-periodicities. Both time domain and statistical features are extracted from a novel SQ concatenated section of the signal for non-linear Support Vector Machine (SVM) based classification. The performance of the proposed algorithm is tested with the MIT-BIH Arrhythmia database and good performance parameters are obtained, as indicated in the result section.     

心房颤动数据元标准化研究

目的 编制标准化的心房颤动病例数据元、数据集,使心房颤动的数据资源能够被其他各类卫生信息系统共享.方法 通过研究分析心房颤动临床与科研业务需求,结合专家研讨,制定心房颤动病例报告表和构建信息模型,并从信息模型中提取数据元.遵循卫生信息标准,规范数据元及其属性.结果 制定出心房颤动病例报告表3个、标准化数据元647个、标准数据集39个.结论 心房颤动疾病标准化数据元从根本解决了数据名称、类型、值域不统一的问题,为不同信息系统提供了一个共同遵守的数据交换规范.     

左向右分流型先天性心脏病患儿血清MMP-2和MMP-9变化

目的探讨左向右分流先天性心脏病（CHD）患儿血清基质金属蛋白酶（MMPs）-2、9水平的变化及意义。方法采用ELISA方法检测并比较40例CHD患儿（其中无肺动脉高压组22例、肺动脉高压组18例）和20例健康患儿的血清MMP-2、MMP～9。结果CHD无肺动脉高压组及肺动脉高压组患儿MMP-2（分别为206．14±20．62及258．83±31．44,pg／ml）、MMP-9（分别为207．68±20．77及240．00±31．10pg／m1）与正常对照组相比均有显著性（P均小于0．05）;而肺动脉高压组MMP-2及MMP-9水平明显高于无肺动脉高压组,差异有显著性（P均小于0．01）。CHD患儿血清MMP-2、MMP-9与LVEF、LVFs均无明显相关性（P〉0．05）;CHD患儿血清MMP-2及MMP-9浓度与肺动脉收缩压呈正相关（r分别为0．783及0．635,n=40,P〈0．05）。结论CHD肺动脉高压患儿血清MMP-2、MMP-9浓度升高并与肺动脉收缩压成正相关,提示MMP-2、MMP-9与肺动脉高压的病理生理有关。     

A case of a persistent left vena cava superior with atresia of the right atrial ostium of the coronary sinus

A persistent left vena cava superior with an atretic ostium of the coronary sinus was found during the routine dissecting course in the embalmed cadaver of an 83-year-old woman who had died from cardiac infarction. The left vena cava superior was very narrow in diameter (4 mm), originated at the lateral part of the left vena brachiocephalica and ran down between the venae pulmonales sinistrae and the auricula sinistra. The vena cava opened into the sinus coronarius of the heart, which terminated as a blind sac due to an atretic ostium. The vena coronaria sinistra as well as the vena interventricularis posterior drained into the sinus coronarius. Congenital atresia of the coronary opening is a rare malformation and is usually associated with other anomalies. The congenital ostial atresia could be the cause of a persistent left vena cava superior, which then takes over the drainage of the cardiac veins.     

各种辅助泵对心室功能恢复的影响

应用自制隔膜泵、非捕动流叶轮泵和捕动流叶轮泵,以及临床应用的美国Ｓａｒｎｓ转子泵分别在迷你猪和小公牛身上做左心室或双心室辅助试验。结果显示搏动流泵在自然心脏衰竭时能维持动物主动脉压的搏动特性,从而降低周身而增加血流循环流量,而叶轮泵及转子泵因没有瓣膜返流能提高动物主动脉舒张压,增加自 脏冠状动脉灌注,因此搏动流叶轮泵对于衰竭心脏功能的恢复,最为有利。     

Diagnosis of atrial fibrillation in heart failure patients with implantable cardioverter defibrillator or cardiac resynchronisation therapy

IntroductionImplantable cardioverter defibrillators register various types of arrhythmias. Thus they can be exploited to better identify patients with atrial fibrillation episodes and increase the proportion of patients who may benefit from implementation of pharmacological prophylaxis of thromboembolic events, most of which are asymptomatic. The aim of the study was to assess of the frequency, symptoms and predisposing factors for the occurrence of atrial fibrillation episodes in patients with an implanted implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy with defibrillator (CRT-D) based on the analysis of intracardiac electrocardiograms (EGM/IEGM) records.Material and methodsThe study included 174 consecutive outpatients with heart failure, sinus rhythm and an implanted cardioverter defibrillator and cardiac resynchronisation therapy with defibrillator. Follow-up visits with analysis of IEGM records occurred every 3 months. During a mean follow-up of 20 months, 901 visits were carried out. One hundred forty-seven patients had at least 1 year of follow-up.ResultsAtrial fibrillation episodes in the study group occurred in 54 (31.0%) patients and 71.4% were asymptomatic. Predisposing factors were: history of paroxysmal atrial fibrillation (37.0% vs. 13.3%, p < 0.001), atrioventricular conduction abnormalities (42.6% vs. 20.0%, p = 0.002), intraventricular conduction abnormalities (59.3% vs. 40.8%, p = 0.02) and more severe mitral regurgitation (7.4% vs. 0.8%, p = 0.04). Chronic renal disease was a risk factor for death in the study group. No stroke occurred during the study.ConclusionsEpisodes of paroxysmal atrial fibrillation in patients with systolic heart failure and implanted cardioverter-defibrillator systems are quite common. The majority of the episodes recorded in the study were asymptomatic.     

左侧肋间后动脉用于冠状动脉搭桥术的应用解剖

目的：为左侧肋间后动脉冠状动脉搭桥术提供解剖学基础。方法：在３０具成人尸体标本上,对左侧肋间后动脉及心脏冠状动脉的后降支和左缘支进行了观察。结果：左侧第８、９、１０肋间动脉到后降支（房窒交点下方１ｃｍ处＿平均外径分别为２．５、２．６、２．８ｍｍ,与冠状动脉后降支此点处外径（２．５ｍｍ）较为接近;到左缘支点处的平均外径为２．７、２．８、２．６ｍｍ,与左缘地此点处外径（２．１ｍｍ）较为接近;到后降支中     

Atrial automaticity and atrioventricular conduction in athletes: contribution of autonomic regulation

Little is known about the sinoatrial automatism and atrioventricular conduction of trained individuals who present a normal resting electrocardiogram. We used transesophageal atrial stimulation, a minimally invasive technique, to evaluate aerobically trained athletes (n=10) and sedentary individuals (n=10) with normal resting electrocardiograms, to test the hypothesis that parasympathetic tone, as detected by heart rate variability, could be associated with changes in sinoatrial automatism and atrioventricular conduction. Corrected sinus node recovery time tended to be longer in athletes than in sedentary individuals, but this difference did not reach statistical significance. The Wenckebach point occurred at a lower rate in athletes than in the controls. Over a 24-h period of measurement, the mean RR interval was longer in the athletes than in the sedentary individuals. The mean square root of successive differences (rMSSD) tended to be higher in athletes than in controls, but this difference did not reach statistical significance. There was a moderate correlation (r=0.48, P < 0.05) between the index of atrioventricular conduction, the rate at the Wenckebach point, and the logarithmically transformed rMSSD. Thus, as a corollary to its effects on the sinus node, where increased parasympathetic tone, decreased sympathetic tone, and non-autonomic components may contribute to sinus bradycardia, it is possible that athletic training may also induce intrinsic adaptations in the conduction system, which could contribute to the higher prevalence of atrioventricular conduction abnormalities observed in athletes. Accepted: 2 January 2000     

农村留守儿童友谊质量与孤独感、抑郁的关系研究

目的:探讨农村留守儿童友谊质量状况及其与孤独感、抑郁的关系。方法:采用友谊质量量表(FQI)、儿童孤独量表(CLS)和儿童抑郁量表(CDI)对河南省250名中小学留守儿童和212名非留守儿童进行了测试。结果:①单亲外出留守儿童友伴冲突和抑郁得分显著低于其他儿童。②友谊质量显著预测单亲外出留守儿童的孤独感和抑郁,显著预测双亲外出留守儿童的孤独感。③友谊质量对留守时间在1年以下儿童孤独感的预测作用大于2-4年;对留守时间在1年以下儿童的抑郁有显著预测作用。④友谊质量对初中留守儿童孤独感和抑郁的预测作用均显著大于小学留守儿童。结论:友谊质量在一定条件下能缓冲留守压力对儿童的影响,是留守儿童心理健康的一个保护因素。