主动脉弓畸形及其临床意义

目的研究主有及其临床意义。方法：在历时１５年对３２０例主动脉弓的解剖中,发现４例主动脉弓畸形,并对此弓变形及其周围诸结构进行解剖和观察。结果：在４例主动脉弓畸形的病例,,２例为右食管后锁骨下动脉并存右非喉返神经,另２例为右主工存左食管后锁骨下一左背主动脉分离。食管后锁上动脉起始部形成憩中产生食管受压性咽下困难,左锁骨下动脉或左背主动脉经支汛管连接或发自左肺动脉,可形成先天性肺动脉一锁骨下动脉窃血症     

Identification of the three-element windkessel model incorporating a pressure-dependent compliance

A new one-step computational procedure is presented for estimating the parameters of the nonlinear three-element windkessel model of the arterial system incorporating a pressure-dependent compliance. The data required are pulsatile aortic pressure and flow. The basic assumptions are a steadystate periodic regime and a purely elastic compliant element. By stating two conditions, zero mean flow and zero mean power in the compliant element, peripheral and characteristic resistances are determined through simple closed form formulas as functions of mean values of the square of aortic pressure, the square of aortic flow, and the product of aortic pressure with aortic flow. The pressure across as well as the flow through the compliant element can be then obtained so allowing the calculation of volume variation and compliance as functions of pressure. The feasibility of this method is studied by applying it to both simulated and experimental data relative to different circulatory conditions and comparing the results with those obtained by an iterative parameter optimization algorithm and with the actual values when available. The conclusion is that the proposed method appears to be effective in identifying the three-element windkessel even in the case of nonlinear compliance.     

小径微孔聚氨酯人工血管的顺应性

由激光测微器、压力传感器、A／D卡、微电脑和循环回路等组成的装置测定了小径人工血管的径向顺应性，由微注射器、压力传感器等组成的装置测定了体积顺应性，轴向顺应性由体积顺应性和径向顺应性计算出。体积顺应性，径向顺应性和轴向顺应性都随血管材料弹性的增大、盐／胶比的增加（孔隙率）和浸渍层数（血管壁厚度）的减小而增大。PU血管的外周模量与径向模量分别由径向顺应性。轴向顺应性计算，外周模量与径向模量之比值接近1，即两模量大小与变形方向无关。外周模量与径向模量随血管材料弹性和盐／胶比增加而变小。但管壁厚度对其的影响不大。通过合理选择更具弹性的PU材料（Chro佳，PCU1500次之），最佳盐／胶比例（6：1）以及控制浸渍层数（4～6层），可以制备出顺应性接近天然血管的小径人工血管。     

Presynaptic depolarization in myelinated vagal afferent fibres terminating in the nucleus of the tractus solitarius in the cat

The presynaptic influences that act on terminals of slowly adapting lung stretch receptor afferents and aortic baroreceptor afferents within the nucleus of the solitary tract were assessed using intracellular recording and antidromic stimulation techniques.Central respiratory influences on the axcitability of lung stretch receptor terminals were observed in 29% (4 of 14) of measurements. These were confirmed in intracellular recordings where membrane depolarizations in synchrony with phrenic nerve discharge were seen in 17% (4 of 24) of fibres. In three cases membrane depolarization also occurred synchronously with artificial lung inflation.Neither tests of excitability nor intracellular recording revealed any evidence for equivalent presynaptic influences on 16 myelinated aortic baroreceptor terminals.Stimulation of the superior laryngeal nerve evoked depolarizations in 50% (7 of 14) of lung stretch receptor terminals. These took the form of complex waves of depolarization with both short (3–8 ms) and long latency (27–35 ms) components. The amplitude of the long latency response increased during the period of phrenic nerve discharge, i.e. during central inspiration.These effects are discussed in relation to the central respiratory influences on both respiratory and cardiovascular reflexes.     

A statistical analysis and comparison of soma diameter spectra for classical neurones from different regions of the cat retinal ganglion cell layer

Multimodal soma diameter spectra for neurones of the cat retinal ganglion cell layer have been represented by three subpopulations of independent, normal diameter distribution. Recurrent computation according to the technique of Vibert and Caille (1978) has extracted best fit populations for samples from various regions of central and peripheral retina. The model subpopulations from all these regions did not differ significantly in their relative proportions or variance. Significant progressive variation between subpopulations representing different regions of retina were observed only in the mean diameter of the and mode cells. The parameters of the mode population were statistically uniform across the retina. The cat retina thus appears to be more homogeneously organized than has been suggested elsewhere.     

Mechanical properties of dilated human ascending aorta

Dilation of the ascending aorta, associated with Marfan Syndrome, bicuspid aortic valve, or advanced age, may lead to aortic dissection and rupture. Mathematical models can be used to assess the relative importance of increased wall stresses and decreased strength in these mechanical failures. To obtain needed inputs for such models, mechanical properties of dilated human ascending aorta were measured in vitro. Specimens for opening angle, biaxial elastic, and uniaxial circumferential strength tests were cut from excised tissue obtained from 54 patients (age 18–81 years) undergoing elective aortic graft replacement surgery. Opening angle was significantly greater in patients older than 50 years (262°±76°, n=21) compared to younger patients (202°±70°, n=13 All biaxial elastic specimens n=40 exhibited nonlinear stress-strain behavior. Rapid increases in circumferential and axial stresses occurred at lower strains in the older patient group than in the younger. Mean strength was significantly lower in older patients (1.35±0.37 MPa, n=14) than younger (2.04 ± 0.46 MPa, n=11, age <50 years). These changes in mechanical properties suggest that age may influence the risk of aortic dissection or rupture of dilated ascending aorta. © 2002 Biomedical Engineering Society. PAC2002: 8719Rr, 8719Hh     

Mechanism of blood pressure elevation during angiotensin infusion

The mechanism of increased preload and its contribution to the rise in blood pressure during intravenous angiotensin infusion were studied in anesthetized dogs. In open-chest dogs angiotensin increased mean aortic blood pressure by 58±12 mmHg. Left ventricular end-diastolic dimension, measured as myocardial chord length (MCL) by ultrasonic technique, increased by 7±1 %. By inflating a balloon in the inferior vena cava, end-diastolic MCL was reduced to control value and the rise in mean aortic blood pressure was almost halved to 32±10 mmHg above control value. A similar preload effect was recorded in closed-chest dogs using end-diastolic left ventricular pressure as an estimate of left ventricular volume. During angiotensin infusion to the upper body only, end-diastolic MCL did not increase. When redistribution of the splanchnic blood volume was prevented, the effect of angiotensin on end-diastolic MCL was reduced to 1/3. Angiotensin reduced liver but not splenic dimension measured by ultrasonic technique. We conclude that about half of the rise in blood pressure during angiotensin infusion is due to increased end-diastolic volume caused by blood redistribution. About 2/3 of this increase in preload is due to redistribution from the splanchnic bed, mainly from the liver.     

Determinants of pulmonary blood volume. Effects of acute changes in pulmonary vascular pressures and flow

To examine the effects of pulmonary vascular pressures and flow on pulmonary blood volume (PBV), experiments were performed at constant heart rate and zone 3 conditions (mean left atrial pressure (LAP) above airway pressure) in six anesthetized, open-chest dogs. PBV was calculated as the product of electromagnetic aortic flow and pulmonary mean transit time for ascorbate, obtained without blood withdrawal by polarographic recording of aortic ascorbate changes. In three series of experiments LAP was raised similarly in three steps, from 4.5 to 14.8 mmHg: by mitral constriction which reduced pulmonary blood flow, by blood volume expansion which more than doubled pulmonary blood flow, or by a combination of the two procedures which kept pulmonary blood flow constant. In all three series, LAP and mean pulmonary arterial pressure (PAP) rose in proportion, but PBV was better correlated to PAP (r=0.87±0.02) than to LAP (r=0.66±0.09). These experiments suggest that PAP is the most important factor in determining PBV under zone 3 conditions, whether PAP is raised by increasing pulmonary blood flow or by mitral constriction.     

Morphometric study of the ductus arteriosus during human development

During prenatal life, the ductus arteriosus connects the left pulmonary artery and the descending aorta. Morphometric features (length, external diameter, volume) of the ductus arteriosus in 131 human fetuses (65 males, 66 females) were studied by means of anatomical, digital and statistical methods. Regression analysis was used to investigate the growth of the ductus arteriosus during gestation. The values of the length of the ductus arteriosus ranged from 3.95 mm for the 15 week gestational group to 12.20 mm for the 34th week of gestation. The length of the ductus arteriosus related to fetal age (x) increased according to the linear function y = -3.0726 + 0.4381x. The mean values of the diameter of the ductus arteriosus ranged from 1.34 to 3.49mm for the 15 and 34 week gestational groups, respectively. The growth of the ductus arteriosus diameter followed in accordance with the linear function y = 0.2072 + 0.0935x. The mean values of the ductus arteriosus volume ranged from 5.08 mm3 for the 15 week group to 117.30 mm3 of the 34 week gestation group. The volume growth increased according to the function y = 0.0007x3.3782. Positive correlation coefficients between arterial parameters and fetal age were statistically significant (P < or = 0.01) and reached the following values: r1 = 0.98 for Length, r2 = 0.90 for diameter and r3 = 0.94 for volume. Despite the increase in absolute diameter, the relative diameter of the ductus arteriosus (ductus arteriosus-to-aortic bulb diameter ratio) decreased from 0.80 to 0.48.     

Positive correlation between aortic valve pressure gradient and mitochondrial respiratory chain capacity in hypertrophied human left ventricle

Summary The effect of chronic left ventricular pressure overload on the activities of mitochondrial respiratory chain enzymes was investigated in myocardial biopsies from the left ventricular apex of 13 patients undergoing aortic valve replacement for aortic valve stenosis. Transvalvular pressure gradients measured by left-sided heart catheterization ranged from 52 to 100 mmHg. The specific activity of mitochondrial respiratory chain enzyme complexes I + III (antimycin A sensitive NADH cytochrome c oxidoreductase) and the myocardial concentrations of coenzyme Q₁₀ (CoQ₁₀) increased significantly (P < 0.05) with increasing aortic valve pressure gradient. In contrast, the specific activities of complex IV (cytochrome c oxidase), succinate dehydrogenase, and citrate synthase, a mitochondrial matrix enzyme, showed no significant correlation with the pressure gradient. Since (CoQ₁₀) is the rate-limiting compound of the activity of complexes 1+111 but not of cytochrome c oxidase, succinate dehydrogenase, or citrate synthase, these data suggest that the increase in the activity of complexes I+III is due to the increase in (CoQ₁₀) content.Abbreviations CoQ coenzyme Q - CoQ₉ coenzyme Q₉ - CoQ₁₀ coenzyme Q₁₀ - SDH succinate dehydrogenase - NCP noncollagen protein