脐静脉灌注提高分离人胎肝细胞纯度

应用脐静脉灌注冲洗人胎儿肝脏,胰蛋白酶消化后经光镜及扫描电镜观察,证实可获得纯度为90%以上的肝实质细胞,培养上清液可测出胎甲蛋白活性,证明胎肝细胞具有生物学活性,为应用人肝细胞培养进行生理生化及药理方面的实验研究,提供一种新的获取人肝细胞的方法.     

How Cluster Headache is Explained as an Intracavernous Inflammatory Process Lesioning Sympathetic Fibers

SYNOPSIS
A large body of evidence points to an inflammatory process in the cavernous sinus and tributary veins as being primarily responsible for cluster headaches. The inflammation obliterates the venous outflow from the cavernous sinus on one side and injures the through-running sympathetic fibers to the eye, upper eye lid, forehead skin, and the intracranial internal carotid artery and its branches. The active period ends when the inflammation is suppressed and the sympathetic fibers partially or fully recover. Evidence is presented that the symptoms suggestive of an enhanced parasympathetic activity during attacks may alternatively be explained as local pain fiber activation or a stasis in the outflow from the cavernous sinus. Vasodilator agents like nitroglycerin induce an attack by enhancing the venous load on the cavernous sinus. Constriction of the proximal intracranial internal carotid artery, spontaneously induced by tressful pain activation of the perivascular sympathetic nerves, or by exogenous administration of serotonin 1 D-like receptor agonists or oxygen, terminates the venous load and thus the pain and associated symptoms.     

USEFULNESS OF EUS IN PORTAL HYPERTENSION WITH ESOPHAGEAL VARICES

We investigated the relationship between esophageal varices and the collaterals by endoscopy and endoscopic ultrasound (20 MHz ultrasonic miniprobe; UMP). Moreover, we investigated the correlation between the collaterals around the esophagus and recurrence of esophageal varices in patients with portal hypertension who had undergone EIS. The collaterals were divided into two groups: peri‐esophageal collateral veins (peri‐ECVs) and para‐esophageal collateral veins (para‐ECVs). These were scored as mild or severe according to the stage of development. According to endoscopy, the varix form was significantly larger in severe the peri‐ECVs group than in mild the peri‐ECVs group. The prevalence of perforating veins increased according to the varix form. With regard to variceal recurrence, in patients with variceal recurrences, UMP findings included a significantly higher incidence of severe peri‐ECVs, a significantly larger diameter of perforating veins compared with patients without recurrence. In conclusion, the presence of severe peri‐ECVs and large perforating veins in the esophageal wall strongly correlates with occurrence and recurrence of esophageal varices in patients with portal hypertension. An understanding of these UMP abnormalities on the basis of hemodynamics around the esophagus is thought to be important for management of esophageal varices in patients with portal hypertension.     

门静脉高压经肾静脉自发性分流的多层CT诊断

目的：探讨肝硬化门静脉高压时经肾静脉自发分流的CT表现与诊断。方法：220例临床确诊为肝硬化门静脉高压的患者行多层螺旋CT检查，扫描参数：准直／有效层厚／重建间隔为5mm／6．5mm／2．0mm(180例)或2．5mm／3．2mm／1．6mm(40例)。双期增强扫描：动脉期延迟26～28s，门脉期延迟55～60s。对图像进行电影显示，对有异常血管的病例分别完成薄层块最大强度投影(TS-MIP)和容积显示(VR)三维血管成像。结果：经肾静脉分流26例(11．8％)，其中脾左肾静脉分流20例，胃左肾静脉分流16例(同时有此2种分流12例)，门脉右肾静脉分流2例。肾门周围静脉增多、增粗7例。结论：自发性门脉-肾静脉分流并不少见，多层螺旋CT增强扫描及血管造影可有效显示分流血管，有助于指导临床诊断和治疗。     

不同压力下人脐带静脉的形态变化

运用扫描电镜和光镜观察了人脐带静脉的形态结构及其在0～8.0kPa 压力下的变化.脐静脉结构类似中等动脉.内皮细胞和内弹力膜的形态随实验压力增大而改变.6.7～7.3kPa是脐静脉内膜的临界破坏压,5.3～6.7kPa 是制备脐静脉作为管道移植材料的最佳压力.     

B超引导下脐静脉穿刺术临床应用

目的分析B超引导下脐静脉穿刺术的临床应用价值。方法对1200例临床怀疑异常的孕妇进行B超引导下脐静脉穿刺术,检测、分析所抽取的脐静脉血。结果成功率99.7%,发现异常胎儿349例。结论B超引导下脐静脉穿刺术成功率高,应用广泛,是一项安全的产前诊断方法。     

Renal vein renin analysis: Limitations of its use in predicting benefit from percutaneous angioplasty

Two hundred forty-four consecutive patients (mean age 61 years), including 123 who had technically valid renal vein renin (RVR) analysis and 121 without RVR data, underwent technically successful percutaneous renal artery angioplasty (PTRA). They were retrospectively examined to evaluate the utility of RVR analysis in identifying renal hypertension (RVH), predicting benefit from PTRA, and determining if the lack of knowledge of renin levels significantly affected clinical outcome after PTRA. Abnormal RVR values were associated with clinical benefit after PTRA in 62 of 93 patients (67% sensitivity, 20% specificity, 72% positive predictive value). Clinical improvement following PTRA occurred in 31 of 37 patients with normal pre-PTRA RVR values (16% negative predictive value). RVR analysis correctly identified 86 of 117 patients with renovascular hypertension (74% sensitivity, 16% negative predictive value). Improved blood pressure (BP) control occurred in 72% with abnormal RVR analysis and 66% of the 121 patients without RVR data (p>0.1). We conclude that the very low negative predictive value significantly limited the use of RVR analysis in this elderly (mean age 60 years) patient population with a high incidence of mild renal functional impairment (mean serum creatinine 1.4 mg/dl) and bilateral renal artery stenosis (38%). The lack of pre-PTRA renin data did not significantly affect clinical outcome. If RVR data were relied upon as the exclusive selection criterion in patients of this type, many would be prevented from having the benefit of cure or improvement by PTRA.     

Tentorial sinus

Summary The authors report a case of tentorial sinus draining the telencephalic and diencephalic tributaries of the basal vein. Dorsally the sinus joined the straight sinus and later the confluence of the sinuses. Attention should be paid to this normal variation whenever a transtentorial surgical approach is considered.

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Sinus de la tenteAspect radiologique et anatomique, à propos d'un cas

Résumé Les auteurs rapportent un cas de sinus de la tente du cervelet drainant les affluents télencéphaliques et diencéphaliques de la veine basale. En arrière, le sinus rejoint le sinus droit puis le torcular. Une attention particulière pré-opératoire devrait être accordée à la mise en évidence de cette variété lorsqu'une approche transtentorielle est discutée.

     

Ultrasound study of the cranial venous system in the human new-born infant and the adult

A pulsed doppler ultrasound technique has been used to measure changes in blood velocities in the superior sagittal sinus, the jugular veins and intracranial and extracranial arteries in 13 neonates, and in the jugular veins and an extracranial artery in 13 adults, during unilateral and bilateral jugular venous compressions. The results have enabled us to determine how the subject under examination functionally uses his cranial venous drainage system in the resting state, and whether or not he can shunt obstructed venous flow through other cranial venous channels. We have found great variability between the subjects. In the resting situation the range of possibilities from total dependence on one jugular vein alone to usage of both jugular veins and the vertebral veins exists. Shunting of blood on jugular compression from either or both jugular veins to the vertebral veins may occur, and contralateral shunting between the jugular veins may be possible in both directions, in one direction or not at all.