Intrapulmonary bronchial blood flow of rats as studied by the microsphere method

Summary The intrapulmonary bronchial blood flow of the left lung (systemic arterial blood flow to the left lung via the bronchial artery) was determined in 45 anesthetized and artificially ventilated male Wistar rats, weighting 263±5 g (mean ± SEM). The microsphere method was employed and designed so that recirculating microspheres across the peripheral arteriovenous anastomoses were prevented from lodging in the left lung, and disturbances of the isovolemic state of the animals became minimal. Under normal conditions with a mean arteiral pressure of 115±2 mmHg (n=40), the bronchial blood flow of the left lung was found to be 0.307±0.033 ml/min on average, and amounted to 0.52±0.06% of the cardiac output. The flow (ml/min) normalized per kg body weight, 100 g wet lung, or 100 g dry lung was 1.14±0.12, 76±8, or 368±39, respectively. The total intrapulmonary bronchial blood flow of the left and right lungs could be estimated by multiplying the intrapulmonary bronchial flow of the left lung by the weight ratio (total: left) of 2.9. The variability of the flow data was small, as confirmed in a study with simultaneous injection of two differently radiolabeled microspheres. The reproducibility of duplicate measurements was excellent.     

Impact of chemotherapy on collagen metabolism: a study of serum PIIINP (aminoterminal propeptide of type III procollagen) in advanced sarcomas

We have previously shown that the serum aminoterminal propeptide of type III procollagen (PIIINP) is a prognostic factor for survival in localised soft-tissue sarcomas, and that elevated values are frequent in metastatic discase. In the present study PIIINP is analysed during chemotherapy in 26 patients with advanced sarcomas. Non-responders had a significantly higher pretreatment level of PIIINP than responders (P=0.05), when only patients with no recent therapeutic interventions were studied. However, during chemotherapy PIIINP followed the clinical course of the malignant disease in only a minority of patients. Patients with recent surgery or recently completed chemotherapy had an increased pretreatment PIIINP value (P=0.03). In these patients PIIINP declined during chemotherapy irrespective of tumour response. A pretreatment PIIINP level within the reference range tended to increase with time irrespective of response. Moreover, the values taken during a chemotherapy infusion were significantly higher than those immediately preceding the corresponding cycle (P=0.001). Our results suggest that pretreatment PIIINP is of value as a prognostic factor for chemotherapy response in patients with advanced sarcomas. During chemotherapy PIINP is of minor importance in monitoring response because of the influence of chemotherapy and other therapeutic interventions on the level of PIIINP.This study was supported in part by grants from the Finnish Cancer Foundations, the Medical Research Council of the Academy of Finland and Finska Läkaresällskapet (Finnish Medical Society)     

不同剂量瑞舒伐他汀钙治疗冠状动脉慢血流的临床效果研究

目的评价瑞舒伐他汀钙对冠状动脉慢血流(coronary slow flow,CSF)的治疗效果及其与剂量的关系。方法选取2010年1月—2013年1月我院经冠状动脉造影确诊为CSF患者90例,随机分为高剂量瑞舒伐他汀钙组(高剂量组)、低剂量瑞舒伐他汀钙组(低剂量组)及对照组各30例,前两组在常规治疗基础上分别给予瑞舒伐他汀钙20 mg/d、10 mg/d,对照组仅予基础治疗。治疗4周后,采用心肌梗死溶栓血流帧数平均值(M-TFC)比较治疗前后各组冠状动脉血流速度;根据心绞痛发作次数改善情况,评价各组心绞痛治疗总有效率。结果治疗4周后,3组M-TFC较治疗前均明显下降,且治疗后高剂量组、低剂量组M-TFC均低于对照组,高剂量组M-TFC低于低剂量组,差异均有统计学意义(P0.01);高剂量组、低剂量组心绞痛改善总有效率均明显高于对照组(χ2=6.2388,P=0.0125;χ2=4.8000,P=0.0285),而高剂量组与低剂量组心绞痛改善总有效率比较差异无统计学意义(χ2=0.0113,P=0.7386)。结论在常规扩血管药物治疗基础上联用瑞舒伐他汀钙,可有效改善CSF患者冠状动脉血流速度,明显提高心绞痛治疗有效率,且瑞舒伐他汀钙20 mg/d强化治疗更有效。     

Anemia in patients on chronic hemodialysis in Cameroon: prevalence,characteristics and management in low resources setting

BackgroundAnemia is a common complication of chronic kidney disease. We investigated the prevalence, characteristics and management of anemia in patients on chronic hemodialysis and assessed the response to blood-transfusion based management in Cameroon.MethodsThis was a cohort study of five months'' duration (August–December 2008) conducted at the Yaoundé General Hospital''s hemodialysis center, involving 95 patients (67 men, 70.5%) on chronic hemodialysis by a native arteriovenous fistula. A monthly evaluation included full blood counts, number of pints of red cell concentrates transfused, and vital status.ResultsAt baseline, 75 (79%) patients had anemia which was microcytic and hypochromic in 32 (43%). Anemia was corrected in 67 (70.5%) patients using blood transfusion only, while 28 (29.5%) patients were receiving erythropoietin (11 regularly, 39%). Only 77.2% of 342 pints (median 3.0, range 0–17 per patients) of red cell concentrates prescribed were effectively received during the follow-up at an unacceptably high cost to patients and families. Mean hemoglobin and mean corpuscular hemoglobin levels remained stable during follow-up, while mean corpuscular volume increased. Erythropoietin treatment was the main determinant of favorable trajectories of hematological markers.ConclusionsPatients on chronic hemodialysis have predominantly microcytic hypochromic anemia, with limited capacity for correction using blood transfusion.     

Blood flow velocity in monocular retinoblastoma assessed by color doppler

OBJECTIVE:

To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging.

METHODS:

A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables.

RESULTS:

Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p<0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p=0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p=0.675 and p=0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p=0.027). The pulse index in the central retinal vein was lower in male patients (p=0.017) and in eyes with optic nerve invasion (p=0.0088).

CONCLUSIONS:

TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion.     

Hemodynamic responses during and after multiple sets of stretching exercises performed with and without the Valsalva maneuver

OBJECTIVE:

This study investigated the acute hemodynamic responses to multiple sets of passive stretching exercises performed with and without the Valsalva maneuver.

METHODS:

Fifteen healthy men aged 21 to 29 years with poor flexibility performed stretching protocols comprising 10 sets of maximal passive unilateral hip flexion, sustained for 30 seconds with equal intervals between sets. Protocols without and with the Valsalva maneuver were applied in a random counterbalanced order, separated by 48-hour intervals. Hemodynamic responses were measured by photoplethysmography pre-exercise, during the stretching sets, and post-exercise.

RESULTS:

The effects of stretching sets on systolic and diastolic blood pressure were cumulative until the fourth set in protocols performed with and without the Valsalva maneuver. The heart rate and rate pressure product increased in both protocols, but no additive effect was observed due to the number of sets. Hemodynamic responses were always higher when stretching was performed with the Valsalva maneuver, causing an additional elevation in the rate pressure product.

CONCLUSIONS:

Multiple sets of unilateral hip flexion stretching significantly increased blood pressure, heart rate, and rate pressure product values. A cumulative effect of the number of sets occurred only for systolic and diastolic blood pressure, at least in the initial sets of the stretching protocols. The performance of the Valsalva maneuver intensified all hemodynamic responses, which resulted in significant increases in cardiac work during stretching exercises.     

Orbital Fracture in a Professional Diver: Issues and Management

Background

We present a case report of a professional diver who sustained a fracture of the left orbital medial wall as well as floor exceeding 50% with orbital fat herniation blocking the maxillary sinus ostium. This may result in a closed cavity within the maxillary sinus that could potentially result in barotraumas during future diving. The aim of his surgery consists of repairing the orbital fracture and to aerating the sinus at the same sitting.

Method

A transconjunctival approach was used combined with endoscopic sinus surgery approach to the maxillary sinus. The orbital floor fracture was repaired with a titanium plate. A wide middle meatal antrostomy was performed. A size eight Foley’s catheter was inserted into the maxillary sinus and the balloon inflated to elevate and support the displaced inferior orbital floor bone fragment. The balloon was left in situ for 4 weeks to support the mobile inferior orbital fragment till adequate bone healing and stability.

Results

Patient recovered well. At 3 months post-operatively, the maxillary antrostomy remained patent, and a hyperbaric oxygen challenge test was performed with success. A repeat orbital CT scan 1 day after hyperbaric challenge showed no signs of air leakage, and the bony inferior orbital floor fracture has healed completely with the titanium plate in situ.

Conclusion

This is the first case report of repair of orbital floor fracture with simultaneous aeration of the maxillary sinus in a professional diver using a combined approach. The patient was able to resume his occupation as a professional diver following surgery.

     

健步走联合太极拳对老年高血压患者血压、血糖和血脂的影响

目的：探讨健步走联合太极拳对老年高血压患者血压、血糖和血脂的影响。方法选取2013年6月至2014年6月期间于我院进行治疗的高血压患者110例,采用随机数表法随机分为观察组和对照组,每组各55例。所有患者均正在服用相同类型的降压药物,对照组患者采用常规干预方法,观察组患者采用健步走联合太极拳干预。随访6个月后观察并比较两组患者的血压、血脂和血糖的变化情况。结果两组患者经干预治疗后的空腹血糖(FPG)、餐后2 h血糖(2 hPG)、收缩压(SBP)、舒张压(DBP)均明显低于干预前,差异均有统计学意义(P<0.05),且观察组患者治疗后的FPG、2 hPG、SBP和DBP均明显低于对照组,差异均有统计学意义(P<0.05);两组患者经干预治疗后的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇（LDL-C）均明显低于干预前,而高密度脂蛋白胆固醇(HDL-C)则明显高于干预前,差异均有统计学意义(P<0.05),且观察组患者干预后的TC、TG和LDL-C均明显低于对照组,HDL-C明显高于对照组,差异均有统计学意义(P<0.05)。结论健步走联合太极拳的运动干预措施能够控制高血压患者的血压,稳定患者的血压和血糖水平,是一种较好的运动干预措施。