Relationship between venous return and right-atrial pressure

The dynamics and amplitude of changes in venous return and right atrial pressure (central venous pressure) in response to pressor stimuli were studied in acute experiments on cats. The increase in venous return was accompanied by either increase, or decrease in the central venous pressure. Thus, shifts in systemic venous return were not accompanied by simultaneous and co-directed changes in the central venous pressure. These findings suggest the absence of a direct relationship between these parameters.     

Effects of neonatal cortical lesions upon retinocollicular projections in the hamster

Autoradiography and anterograde horseradish peroxidase transport were used to examine retinocollicular projections in normal hamsters and in animals subjected to ablation of the ipsilateral, posterior neocortex at 1, 3, 6, 10 or 120 days of age. The crossed retinotectal projections of all groups were quite similar. There did, however, appear to be a slight increase in the density of the projection to the lower portion of the stratum griseum superficiale in the neonatally brain-damaged hamsters.The uncrossed pathway, on the other hand, was quite abnormal in the neonatally lesioned animals. In normals, the ipsilateral retinocollicular projection consisted almost entirely of a series of patches along the stratum yriseum superficiale-stratum opticum border in the rostral one-third of the colliculus. Only a few axons from the ipsilateral eye were observed in the caudal two-thirds of the tectum and these could only be visualized when horseradish peroxidase was used as the tracer. In all of the neonatally brain-damaged hamsters both autoradiography and horseradish peroxidase tracing demonstrated that the ipsilateral retina densely innervated the entire rostrocaudal extent of the colliculus.Retrograde tracing experiments demonstrated that the portion of the temporal retina which gave rise to the uncrossed retinocollicular projection in the normal hamsters was also the source of the expanded projection in the neonatally brain-damaged animals; and, further, that the numbers and areal distributions of ipsilaterally projecting retinal and retinocollicular ganglion cells were similar in the two groups.These findings suggest that, at least in the hamster, normal inputs from the two eyes may not be a sufficient condition for the development of the largely complementary pattern of collicular innervation by the two retinae.     

小脑梗死的临床研究现状

小脑动脉属椎、基底动脉的长旋支 ,供血范围主要包括小脑、脑干外侧部及被盖部。小脑梗死好发于 6 0～ 80岁男性 ,根据影像学改变可分为区域性和非区域性两大类。缺血机制不同 ,临床表现及预后差异较大。本文重点阐述小脑梗死的发病机制、各小脑动脉闭塞时的临床 -解剖相关性和预后。     

肝段下腔静脉阻塞症的外科治疗（附54例报告）

目的 探讨肝段下腔静脉阻塞症的有效治疗方法。方法 ５４例病人中,２０例下腔静脉隔膜破膜术,５例行下腔静脉切开根治性隔膜切除术,１６例行下腔静脉右心耳人造血管转流术,８例行肠系膜上静脉－右心耳人造血管转流术;４例作了下腔静脉－右心耳、肠系膜上静脉、下腔静脉人造血管联合转流术,１例行肺包脾手术。结果 本组５４例患者中,除３例分别于术后１２ｄ、４５ｄ、７个月因肝肾功能衰竭死亡死亡外,其余５１例术后症状明     

42例中心静脉置管术的临床应用

目的：探讨内科急危重患为进行静脉营养,休克救治及中心静脉压监测,肿瘤的系统化疗,建立静脉通路最人选择与术后护理。方法：４２例中选择锁骨下静脉置管术１１例,选择腋静脉末端置管术３１例。结果：术后经Ｘ检查,导管前端到达上腔静脉３９例,到位率为９２．８％,到达颈内静脉３例（占７．１４％）,无气胸、血胸、空气栓塞等并发症。结论：内科危重症患及肺心病、肺癌、脓胸、扩张型心肌病建立静脉通道可选用腋静脉末端     

B超对肺癌急症的诊断及疗效评估

目的评价Ｂ超对肺癌急症的快速鉴别诊断价值。方法应用Ｂ超诊断肺癌急症３５例,其中有中央型右上肺癌肿块压迫引起的上腔静脉综合征（ＳＶＣ）５例,探查取胸骨右缘第２、３肋间;中大量心包积液伴亚急性心包填塞症１０例,包括心肌与心包转移癌致急性出血性心包积液２例,探查取心前区及左腋前线第５、６肋间;恶性胸腔大量积液２０例,探查位于两侧背部膈上。介入性治疗,Ｂ超定位穿刺抽液并腔内注入中药榄香烯乳,配合临床化疗药物、输血等综合治疗。结果在４周内急症得到暂时缓解者占８２．８％,稳定占８．５％,无效占８．５％。结论简便、可重复性的超声诊断及时、可靠,并可提供疗效参考依据,证实榄香烯乳对控制急性心肌心包出血有特效,起乳剂微栓止血作用。对部分包裹性胸腔积液无效。Ｂ超对ＳＶＣ诊断有一定局限性。     

Inferior ST segment depression as a useful marker for identifying proximal left anterior descending artery occlusion during acute anterior myocardial infarction

To determine whether or not ST segment deviation on admissionelectrocardiograms can identify patients with anterior acutgemyocardial infarction due to proximal left anterior descendingartery occlusion, the magnitude and location of ST segment elevationor depression were compared between patients with proximal leftanterior descending artery occlusion (group A, n=47) and thosewith distal left anterior descending artery occlusion (groupB, n =59). ST segment depression in each of the inferior leadswas significantly greater in group A than in group B. The incidenceof ST segment depression 1 mm in each of the inferior leads(II; 81% vs 27%, III; 85% vs 54%, aVF; 87% vs 47%, P<0·01)was significantly higher in group A than in group B. In addition,the incidence of ST segment depression 1 mm in all of the inferiorleads was significantly greater in group A than in group B (77%vs 22%, P<0·01). In group A, maximal ST segment elevationwas more frequent in lead V alone (43% vs 14%, P<0·01).Group A had greater ST segment elevation in lead a VL than groupB, and the incidence of ST segment elevation 1 mm in lead aVL was significantly higher in group A than in group B (66%vs 47%, P<0·05). ST segment depression 1 mm in allof the inferior leads was most valuable for identifying groupA patients (77% sensitivity and 78% specificity). In contrast,the maximal ST segment elevation in lead V₂ alone or ST segmentelevation 1 mm in lead a VL had a low diagnostic value (43%sensitivity and 86% specificity, 66% sensitivity and 53% specificity,respectively). In conclusion, this study indicates that analysisof ST segment deviation in the inferior leads is useful foridentifying patients with acute anterior myocardial infarctiondue to proximal left anterior descending occlusion.     

Colour Doppler ultrasound assessment of the inferior vena cava in patients with Wilms' tumour

OBJECTIVE: To assess the diagnostic accuracy of colour flow Doppler ultrasound in diagnosing inferior vena caval (IVC) extension of tumour thrombus in patients with Wilms' tumour. MATERIALS AND METHODS: Over a 3-year period from June 1994 to June 1997, 74 patients with Wilms' tumour were referred to our institution. In this retrospective study we reviewed the preoperative colour flow Doppler ultrasound reports of 64 of these patients and compared the reports with the intra-operative findings in 51 patients who underwent surgery. RESULTS: Vena caval extension of tumour thrombus was present in 12 patients (18.7%) and in six of these patients (9.4%) there was also atrial extension of the tumour. Colour flow Doppler ultrasound correctly diagnosed IVC extension of tumour thrombus in nine patients and correctly predicted the cranial extent of the tumour thrombus in eight patients. CONCLUSION: Colour flow Doppler ultrasound has an overall positive predictive value of 73.4% in assessing IVC patency and correctly diagnosing IVC extension of tumour thrombus, in patients with Wilms' tumour. However, non-diagnostic ultrasound examinations can occur in over 20% of patients.     

Categorization of complex visual images by rhesus monkeys. Part 2: single-cell study

In order to investigate the neural coding of ordinate-level visual categories, single-cell recordings were made in the anterior temporal cortex of two rhesus monkeys performing a categorization of colour images of trees versus images of other objects. Neurons showed a high average degree of selectivity for these complex colour images. Although most neurons responded to trees and non-trees, about a quarter responded in a category-specific manner, e.g. to trees but not non-trees, and about one-tenth responded almost exclusively to exemplars of the trained category. The responses of these neurons were largely invariant for stimulus transformations, e. g. changes in position or size, and decreased with the degree of image scrambling, mimicking the behavioural results. However, the responses of single neurons were insufficiently stimulus invariant to accommodate the entire range of variability present in the features of exemplars within the same category. This strong within-category selectivity challenges the idea that a prototype is represented at the single neuron level, but suggests that ordinate-level categorization is based on a population of neurons, each selective for a limited set of exemplars.     

Strabismus and diplopia as complications after cataract surgery with IOL implantation

Summary In our Department of Orthoptics we have seen an increasing number of patients suffering from diplopia after cataract surgery with IOL implantation. Between 1993 and 1997 the total number of patients with this problem was 24 (2.7 % of all patients, mean age 71 years, age range 38–88). We addressed the question of whether there is a common pattern of motility dysfunction. Methods: After evaluation of the clinical history and the basic ophthalmological findings the following parameters were examined: binocular function (Bagolini test), squint angles (Maddox cross), ocular motility. Results: The 24 patients could be divided up into three groups. Group 1 consisted of 9 patients (mean age 82 years, range 64–88) who complained about diplopia because of strabismus incomitans with vertical deviation and restricted motility on the first day after surgery. In 8 of the 9 patients strabismus surgery was done. Group II consisted of 10 patients (mean age 66 years, range 38–77) who noticed diplopia and strabismus within 7 days after surgery. We found various kinds of heterotropia. Seven of these patients were operated on and two had a prism correction. Group III consisted of 5 patients (mean age 67 years, range 61–78). Their already known strabismus paralyticus or concomitans deteriorated, leading to diplopia in some cases. All patients in this group were operated on. Discussion: For group I we believe that retro-, para- or peribulbar anesthesia caused the motility dysfunction. In groups II and III it is unlikely that local anesthesia had a causative role. The prolonged disruption of binocular vision and the abrupt change in the sensory situation after the cataract operation with lens implantation may be the leading causes for strabismus or deterioration of a preexisting strabism, respectively. Conclusions: These patients need a subtil meticulous diagnostic work-up and follow-up because of the possibility of early surgical therapy, which has a good prognosis. Evaluation of binocular vision and eye movements prior to cataract surgery appears to be helpful for later strabismic surgery.