Pulse wave reflection at the collapsed segment of an artery in Riva-Rocci's method

Summary The contours of pressure and flow of a pulse wave arriving at the entrance of a collapsed segment of an elastic tube can be described by application of the basic laws of reflection. The collapsed segment acts like a valve. It is opened by the pressure of the pulse wave when the pressure within the tube becomes higher than the collapse pressure, i.e. the pressure exerted on the segment from outside. This opening of the collapsed segment suddenly changes the sign of the pulse wave reflection from positive to negative; thus a typical contour change of the pulse proximal to the segment is observed. The most obvious effect is a reduction of the pulse pressure. The extent of this reduction is a function of the collapse pressure.A typical example of this phenomenon can be observed in an artery proximal to the segment which is collapsed due to the pressure exerted by an inflated Riva-Rocci cuff. The effect is explained by the assumption that the sign of reflection changes when the pressure of the pulse wave crosses the level of the cuff pressure. This explanation is supported by the results of model experiments.     

The Krotkoff sound

As the auscultatory method of blood pressure measurement relies fundamentally on the generation of the Korotkoff sound, identification of the responsible mechanisms has been of interest ever since the introduction of the method, around the turn of the century. In this article, a theory is proposed that identifies the cause of sound generation with the nonlinear properties of the pressure-flow relationship in, and of the volume compliance of the collapsible segment of brachial artery under the cuff. The rising portion of a normal incoming brachial pressure pulse is distorted due to these characteristics, and energy contained in the normal pulse is shifted to the audible range. The pressure transient produced is transmitted to the skin surface and stethoscope through deflection of the arterial wall. A mathematical model is formulated to represent the structures involved and to computer the Korotkoff sound. The model is able to predict quantitatively a range of features of the Korotkoff sound reported in the literature. Several earlier theories are summarized and evaluated.     

血脂与体外血栓形成的关系

应用国产ＤＪＨ－Ｉ型调速单型血栓形成仪，对４７４名４５岁以上成人体外血栓形成进行了检测，同时检查血脂水平。另外对部分隐性体外血栓阳性者及正常人的红细胞膜荧光偏振度（Ｐ）和微粘度（η）进行比较。结果表明：隐性体外血栓阳性者中血脂增高者为５７／１０９（５４．１２％），其中一级血栓３２／７５（４２．６％），二级血栓１１／１６（６８．７％），三级血栓１４／１８（７７．７％）。红细胞膜Ｐ和η在隐性体外血栓阳性者与正常人之间有显著差异（Ｐ＜０．０５）。提示：隐性体外血栓检测对临床心脑血管的血栓性疾病的早期预防、治疗有较大的参考价值     

Functional imaging of the brain using single photon emission computerized tomography (SPECT)

Summary The use of tracers is an important technique available for studying cerebral function. Changes in signal are large, but as a result of its photon limited nature, the measurement of this signal is limited: spatially, temporally and in terms of accuracy. The most commonly used single photon (SPECT) system (as apposed to positron) is that with a rotating gamma camera, although multi-headed devices and special purpose rings are now also commonly available. The problems of obtaining good functional information are however identical. Firstly the devices need to be optimised in terms of resolution and sensitivity. Secondly several sources of error, notably those associated with scatter, attenuation and limited spatial resolution, need to be corrected, with the aim of obtaining quantitative estimates of radioactivity concentration. Finally such quantitative estimates need to be converted into meaningful estimates of physiological variables by use of an appropriate model. The general aim of many SPECT measurements is to estimate blood flow for example using Tc-99m labelled HMPAO as a tracer. Good results have been obtained in many clinical conditions: stroke, dementia, tumour and epilepsy, for example. Many other tracers are also available, for example to measure density of receptor sites. The use of SPECT in conjunction with other techniques after image registration is suggested as being an essential tool in extracting maximal clinical information.     

Studies on subcutaneous fat necrosis of the newborn

Summary Biopsy specimens from the skin and subcutaneous fat tissue of four cases with neonatal subcutaneous fat necrosis were made and investigated by light and electron microscopy at 2, 4, and 6 weeks, and 5 months (Case 2) from the onset of the disease. Three stages of ultrastructural change of fat cells were observed. The evolution of crystal formation in the fat cells was seen and phagocytosis of crystals and fat droplets by macrophages and foreign-body giant cells was also noted. In the light microscope accumulation of calcium concretions in the spaces between and inside the fat cells was found. In the electron microscope we detected foci of highly electrondense granules, which were similar in distribution and structure to calcium salts stained with the von Kossa method. Changes in small and medium size blood vessels were observed.This work was written during a stay supported by Max-Planck-Gesellschaft from Dec. 1. 1973 to March 31. 1975 in the Max-Planck-Institut für Klinische und Physiologische Forschung (W.G. Kerckhoff-Institut), Bad Nauheim, West Germany (Director: Prof. Dr. Wolfgang Schaper)     

Sympathoinhibition by rilmenidine in conscious rabbits: involvement of α2-adrenoceptors

Summary Cardiovascular and sympathetic nervous system effects of the mixed ₂-adrenoceptor and imidazoline receptor agonist rilmenidine were studied in conscious rabbits chronically instrumented for the recording of the firing rate of renal sympathetic fibers. Separate experiments were carried out on pithed rabbits with electrically stimulated (2 Hz) sympathetic outflow. Drugs were administered intravenously in a cumulative manner.In conscious rabbits, rilmenidine 0.1, 0.3 and 1.0 mg kg^–1 dose-dependently lowered blood pressure, renal sympathetic nerve activity, heart rate and the plasma concentration of noradrenaline and adrenaline. The effect on blood pressure and plasma catecholamines was maximal after 0.3 mg kg^–1 whereas heart rate and renal sympathetic nerve activity decreased further after rilmenidine 1.0 mg kg^–1. Yohimbine 0.1 and 0.5 mg kg^–1, when injected subsequently, attenuated and at the higher dose abolished all effects of rilmenidine. The effects of rilmenidine were also antagonized by the ₂-adrenoceptor antagonist 2-(2,3-dihydro-2-methoxy-1,4-benzodioxin-2-yl)-4,5-dihydro-1H-imidazole HCl (RX821002; 0.1 and 0.5 mg kg^–1). Yohimbine 0.1 and 0.5 mg kg^–1 did not attenuate or attenuated only slightly the decrease of heart rate and renal sympathetic nerve activity produced by infusion of vasopressin. In pithed rabbits with electrically-stimulated sympathetic outflow, yohimbine 0.1 submaximally and yohimbine 0.5 mg kg^–1 maximally increased the plasma noradrenaline concentration.The experiments show by direct measurement of sympathetic nerve firing and plasma catecholamines that rilmenidine causes sympathoinhibition in conscious rabbits, presumably through central sites of action. The antagonism by yohimbine, at doses which are selective for ₂-adrenoceptors (vs. imidazoline receptors), demonstrates the involvement of ₂-adrenoceptors in the sympatho-inhibition.Correspondence to: B. Szabo at the above address     

Does calcium balanced heparin affect blood gas and electrolyte analysis?

The effect of calcium-balanced heparin (471896, CIBA CORNING) on blood gas and electrolyte analysis was evaluated, by comparing with that of sodium heparin (Na heparin). One ml of whole blood was collected into a syringe, which contained calcium-balance heparin (Ca balanced heparin) or Na heparin. 122 pairs of blood samples obtained from 15 patients were analyzed for Na, K, ionized calcium (Ca(++)), total hemoglobin, pH, P(CO)(2), and P(O)(2) by an automatic blood gas and electrolyte analyzer, CIBA CORNING model 288. There was a significant difference ( P < 0.05) in pH, P(CO)(2), Na, and Ca(++) between the two different groups. Ca(++) concentration was significantly less in Na heparin group than in Ca balanced heparin group, probably due to more chelation of Ca(++) by Na heparin than Ca balanced heparin. The present study suggests that the Ca balanced heparin has minimal effect on the blood gas and electrolyte analysis, and is a suitable anticoagulant for the Ca(++) measurement.     

Change of Coagulation Factor Ⅷ and Antithrombin Ⅲ Activity in Bank-Stored Blood

Blood storage and blood transfusion have beenimportantclinical work.In recentyears,the demandfor the quality of blood transfusion is getting higher.Great progress has been made in blood storage tech-nique and more and more reports on change in bloodcomponents during storage have been published.However,reports on dynamic changes in blood com-ponentsin bank- stored blood are stillrare.The paperinvestigated the dynamic change of blood componentsF :c and AT- in blood stored in blood bank un-der…     

凝血酶烧伤膏治疗血液病鼻衄的临床观察

目的 为探讨血液病鼻衄的理想处理方法。方法 对２３例治疗组患者采用浸有凝血酶２０００Ｉｕ／ｍｌ的明胶海绵局部敷贴出血点,３～４日后用烧伤膏创面换药;３４例对照组采用凡士林纱条填塞止血。结果 治疗组有效率８６．９％,显效率６９．７％;对照组分别是５８．５％和３５．３％。两种方法有显著性差异（Ｐ〈０．０１）。结论 用凝血酶敷贴出血点及创面烧伤膏换药是治疗血液病鼻衄一种安全、有效的方法。     

血液血细胞比容血沉纤维蛋白原同血流变学相关指标检测的分析

本文通过临床常用的HCT、FIb、ESR与血流变中全血粘度、血浆粘度和红细胞聚集性之间相关性的实验对照观察、理论分析 ,认为血细胞比容 ,血沉和纤维蛋白原检测反映血液浓度、粘度、聚集、凝血状态是有一定相关价值。因此 ,再配合临床必要的生化实验 ,如血糖、血脂等检测采用微机对检测数据处理对心脑血管疾病的预测、疗效观察具有更实用的价值