An unusual content of the inguinal canal: The external pudendal vein

Summary In a 43-year-old male cadaver the external pudendal vein ran an abnormal course in both inguinal regions. On each side the vein passed through the superficial inguinal ring, and after a short course in the canal pierced the inguinal ligament and drained into the femoral vein. The significance of this rare relation between the external pudendal vein and the inguinal canal is discussed from the embryological, surgical and diagnostic point of view.     

Experimental selective segmental ablation of rat liver by transportal ethanol injection

For use in the treatment of malignant hepatic tumors, we undertook selective segmental ablation of the liver by transportal ethanol injection, first studying its efficacy and safety in rats. We forced a 4: 1 mixture of ethanol and contrast medium from a syringe into hepatic tissues via a branch of the portal vein in 80 Wistar rats. The amount of ethanol injected was from 0.05 to 0.60 ml. Soon after the injection, the hepatic segment treated with ethanol was yellowish-white with a distinct outline. Two to three weeks after the injection, the segment was completely necrotic. The findings when a mixture of ethanol and India ink was injected suggested that the necrosis was a direct result of the ethanol. The portal branch into which the injection was made was completely obstructed immediately after the injection. The maximum ethanol concentration in the peripheral blood was 0.4 mg/ml. No histological changes were found in any other organ. Liver and kidney function was almost unaffected. This technique might be useful clinically for the treatment of malignant hepatic tumors. Correspondence to: T. Kaminou     

Clinical significance of removal of tumor thrombi in the main portal vein in patients with hepatocellular carcinoma

Twenty-two patients with portal vein tumor thrombi secondary to hepatocellular carcinoma were studied to evaluate the effectiveness of diagnostic and treatment procedures. B-mode ultrasonography is a simple and accurate means for the detection of tumor thrombus in the portal vein. All of the 22 patients were correctly diagnosed by this method, which should be used as the initial screening procedure in such patients. Fourteen of the 22 patients underwent surgical procedures, including embolectomy from the portal trunk; removal of the tumor thrombi combined with hepatectomy or through the rechanneled umbilical vein; and operative transcatheter arterial chemotherapy. The other 8 patients were treated by transcatheter arterial embolization or were not treated. The surgical treatment effectively prevented acute variceal bleeding in the patients who underwent the procedures successfully. The mean value of the portal venous pressure was reduced from 46 cmH₂O to 32 cmH₂O after the surgery. As a result of the effective portal decompression, the patients in the surgical group had a better prognosis and longer mean survival than the others. Our study suggests that portal vein tumor thrombus is not an absolute contraindication for surgery, and that accurate detection and prompt treatment are the keys to the achievement of better clinical results.     

Retrograde pulmonary vein wedge angiography: A new technique

A new technique of pulmonary vein wedge angiography to delineate pulmonary artery anatomy is described. Conventional pulmonary vein wedge angiography requires an interatrial communication—natural or created by a transseptal puncture. In retrograde pulmonary vein wedge angiography, the left atrium and pulmonary veins are entered from arterial route using a specially designed catheter. This technique can be specially utilized for patients in whom there is no interatrial communication.     

大鼠肝硬变门脉高压性瘀证舌脉诊变化的实验研究

用复制的肝硬变门脉高压性瘀证大鼠模型,以探索舌脉变化与合深静脉压、门脉压、门脉血流量之间的关系.结果实验组大鼠形成坏死后肝硬变,以假小叶Ⅲ期病变为主;舌深静脉压力升高,与门脉压升高呈正相关;门脉血流量明显减少,与对照组比较P<0.01.认为肝硬变门脉高压性瘀证的舌脉粗张与细络瘀血主要是因门脉血经门—腔侧支循环回流入上腔静脉,引起上腔静脉阻力增大,压力增高,导致舌的静脉系统回流受阻,舌深静脉压力升高所致.     

Portal imaging by intravneous three-dimensional computed tomography after pancreaticoduodenectomy: A report of four cases

By employing three-dimensional computed tomography (CT) for portography, we analyzed the portal vein changes during the initial stage after a pancreaticoduodenectomy (PD), which seemed to affect postoperative complications. Four patients underwent PD without portal vein reconstruction with a standard radical lymph node dissection for cancer of the pancreaticoduodenal area. A total of 140 ml of contrast medium was intravenously injected at 2.5 ml/s, and imaging was started after 65 s with a Hitachi W-2000 CT scanner. Three-dimensional portal vein images were then reconstructed by the Voxel Transmission method. Three-dimensional CT showed portal stenosis in our all patients from the first to the third week after PD. In three of the patients, stenosis disappeared by week 7,8, or 15, respectively, without the formation of a bypass. In three patients, portal vein stenosis was severe while in one patient, it was mild. Severe complications such as gastrointestinal hemorrhaging and hepatic abscess occurred in two patients with severe portal stenosis. The onset of portal stenosis might therefore affect postoperative complications after PD.     

Superior accuracy of anatomic positioning with echocardiographic- over fluoroscopic-guided endomyocardial biopsy

To assess the superior anatomic positioning of echocardiographic-guided endomyocardial biopsy compared to traditional fluoroscopic-guided technique, these two modalities were compared in a blinded fashion during femoral sheath endomyocardial biopsy in 21 patients, 19 being evaluated after orthotopic cardiac transplantation. The simultaneous fluoroscopic and echocardiographic imaging indicated that traditional fluoroscopic positioning of the bioptome against the septum is inaccurate in over half of patients undergoing biopsy. This finding should be considered in cardiomyopathy patients or those at high risk for biopsy-related complications. © 1993 Wiley-Liss, Inc.     

内皮细胞生长因子的分离纯化及生物活性的研究

介绍了内皮细胞生长因子(ECGF)一种分离纯化的方法,经硫酸铵分级盐析和肝素亲和层析可得到高纯度的ECGF。经SDS—PAGE电泳分析其分子量为17000,等电点为4.8。肝素与ECGF的生物活性密切相关,并可使已失活的(ECGF)恢复70%～80%的生物活性。     

The role of the spleen in endotoxin-induced liver injury

In these experiments, the role of the spleen in endotoxin-induced liver injury was evaluated, using rats which underwent splenectomy or splenic vein ligation with antecedent spleno-systemic shunt. Male Wistar rats were divided into three groups: a sham-operated group, a splenectomy group, and a splenic vein ligation group. In each animal, 48 h after surgery, 5 mg/kg lipopolysaccharide (LPS) were injected intravenously. Six rats from each group were sacrificed 6 or 12 h after LPS administration. Bronchoalveolar lavage fluid (BALF) and arterial blood were also collected. Splenectomy reduced the liver injury as indicated by the serum lactate dehydrogenase level. A decrease in liver tissue adenosine triphosphate and increase in lipid peroxide were induced by LPS administration and inhibited by splenectomy. Splenectomy also reduced alveolar protein release as indicated by the protein level in BALF. Splenic vein ligation provided similar protective effects on the liver, but did not affect lung injury. From these results, it appears that the spleen plays a significant role in endotoxin-induced liver injury, and a mediator derived from the spleen is likely associated with development of liver injury. This mediator may be cleared or inactivated by not only splenectomy but also splenic vein ligation.     

A case report of venous aneurysm of the neck vein

We treated a 37 year old woman with venous aneurysm along left side of the neck. In the beginning, she was asymptomatic and with increase in size of the venous aneurysm she experienced severe pain. Pathohistological examinations revealed a destructive change of the venous wall and thrombosis. Therefore, in cases of venous aneurysm along the neck, such aneurysm should probably be treated surgically to prevent the occurrence of pulmonary embolism.