Background:Hemorrhagic expansion into the fourth ventricle is an independent risk factor for poor outcomes in intraventricular hemorrhage(IVH)patients.However,to date,available animal models of IVH are limited to mode...Background:Hemorrhagic expansion into the fourth ventricle is an independent risk factor for poor outcomes in intraventricular hemorrhage(IVH)patients.However,to date,available animal models of IVH are limited to models of supratentorial ventricular hemorrhage,and there are no specific models of fourth ventricle hemorrhage.This limitation hinders comprehensive basic research and the understanding of the pathophysiological changes that occur following fourth ventricle hemorrhage.Therefore,the development of an animal model of fourth ventricle hemorrhage is highly important.Methods:In this study,a novel rat model of fourth ventricle hemorrhage was established via autologous blood injection through the foramen of Magendie.Anesthetized rats were positioned in a stereotaxic apparatus with their heads tilted downward at an angle of approximately 20°relative to the vertical axis.A needle was inserted through the foramen,and autologous blood obtained from the rat's heart was injected into the fourth ventricle via a microinfusion pump.Systematic evaluations of the model were conducted using small-animal magnetic resonance imaging,histopathological analysis,and neurological function assessment.Results:The rats developed stable and reproducible fourth ventricle hematomas and ventricular dilation.They also exhibited acute-phase hydrocephalus and pathological features of perilesional brain tissue injury,with observed neurological deficits comparable to patients with fourth ventricle hemorrhage.Conclusion:This model successfully recapitulates the clinicopathological and pathophysiological characteristics of patients with fourth ventricle hemorrhage and can be utilized for further investigation into the pathophysiological mechanisms underlying posthemorrhagic hydrocephalus and perilesional brainstem tissue injury.展开更多
Background:We evaluated surgical outcomes of biventricular repair for atrioventricular septal defect(AVSD)with tetralogy of Fallot(TOF)or double-outlet right ventricle(DORV).Methods:This retrospective pilot study incl...Background:We evaluated surgical outcomes of biventricular repair for atrioventricular septal defect(AVSD)with tetralogy of Fallot(TOF)or double-outlet right ventricle(DORV).Methods:This retrospective pilot study included 12 patients who underwent biventricular repair of AVSD with TOF(n=6)or DORV(n=6)between 2004 and 2023.Right ventricular outflow tract(RVOT)reconstruction was performed using transannular patch(TAP,n=4)or pulmonary valve preservation(PVP,n=8).Clinical outcomes,including longitudinal pulmonary valve growth,RVOT obstruction,and pulmonary regurgitation,were reviewed descriptively,with particular focus on the feasibility of PVP.Results:The median age and body weight at the time of surgery were 11.7(8.3-18.8)months and 8.6(7.3-10.5)kg,respectively.The median follow-up duration was 67.9(58.7-174.3)months.The two-patch technique(n=10)was most commonly used for AVSD repair.There were no early mortalities and one late mortality.At discharge,significant(≥36 mmHg)RVOT obstruction was observed in two patients who underwent PVP.During follow-up,one patient required reoperation for significant(moderate or greater)atrioventricular valve regurgitation,and two patients in the PVP group underwent transcatheter intervention for significant RVOT obstruction.At the last follow-up,significant RVOT obstruction was present in two patients.Significant(moderate or greater)pulmonary regurgitation occurred in three patients in the TAP group.In patients who underwent PVP,the pulmonary valve annulus z-score remained within acceptable ranges,and the RVOT pressure gradient predominantly decreased to acceptable levels during follow-up.Conclusions:Mid-term outcomes of PVP in the biventricular repair of AVSD with TOF or DORV are acceptable.In selected patients,the PVP strategy may be considered a reasonable and feasible option for RVOT reconstruction.展开更多
Quantitative analysis of clinical function parameters from MRI images is crucial for diagnosing and assessing cardiovascular disease.However,the manual calculation of these parameters is challenging due to the high va...Quantitative analysis of clinical function parameters from MRI images is crucial for diagnosing and assessing cardiovascular disease.However,the manual calculation of these parameters is challenging due to the high variability among patients and the time-consuming nature of the process.In this study,the authors introduce a framework named MultiJSQ,comprising the feature presentation network(FRN)and the indicator prediction network(IEN),which is designed for simultaneous joint segmentation and quantification.The FRN is tailored for representing global image features,facilitating the direct acquisition of left ventricle(LV)contour images through pixel classification.Additionally,the IEN incorporates specifically designed modules to extract relevant clinical indices.The authors’method considers the interdependence of different tasks,demonstrating the validity of these relationships and yielding favourable results.Through extensive experiments on cardiac MR images from 145 patients,MultiJSQ achieves impressive outcomes,with low mean absolute errors of 124 mm^(2),1.72 mm,and 1.21 mm for areas,dimensions,and regional wall thicknesses,respectively,along with a Dice metric score of 0.908.The experimental findings underscore the excellent performance of our framework in LV segmentation and quantification,highlighting its promising clinical application prospects.展开更多
This article summarizes the nursing experience with a patient who underwent resection of a lateral ventricle trigone meningioma via a contralateral interhemispheric approach.Key nursing measures included preoperative ...This article summarizes the nursing experience with a patient who underwent resection of a lateral ventricle trigone meningioma via a contralateral interhemispheric approach.Key nursing measures included preoperative health education and psychological care,baseline neurological assessment,and comprehensive physiological preparation.Postoperative care focused on intensive vital sign monitoring and support,comprehensive neurological evaluation and early rehabilitation,as well as a proactive strategy for preventing secondary epilepsy and controlling intracranial infection.Through active treatment and systematic nursing care,the patient achieved an uncomplicated recovery and was discharged on postoperative day 9.The successful implementation of these structured nursing interventions contributed to favorable postoperative outcomes,offering a valuable reference for the perioperative management of similar complex neurosurgical cases.展开更多
We report the case of a rare complex cardiac anomaly involving situs solitus,concordant atrioventricular connection with left-hand ventricular topology,and L-looped ventricles.The ventricles had a superior-inferior re...We report the case of a rare complex cardiac anomaly involving situs solitus,concordant atrioventricular connection with left-hand ventricular topology,and L-looped ventricles.The ventricles had a superior-inferior relationship with an inferiorly located right ventricle,which had a double outlet with far posteriorly located great arteries.The left atrium was elongated,with juxta-positioned atrial appendages on the right side.The 3D-printed model using a computed tomography scan taken on the fourth day of birth demonstrated the anatomy clearly and helped us decide on the surgical management.展开更多
BACKGROUND The prognostic role of right ventricle dilatation and dysfunction(RVDD)has not been elucidated in patients with coronavirus disease(COVID)-related respiratory failure refractory to standard treatment needin...BACKGROUND The prognostic role of right ventricle dilatation and dysfunction(RVDD)has not been elucidated in patients with coronavirus disease(COVID)-related respiratory failure refractory to standard treatment needing extracorporeal membrane oxygenation(ECMO)support.AIM To assess whether pre veno-venous(VV)ECMO RVDD were related to inintensive care unit(ICU)mortality.METHODS We enrolled 61 patients with COVID-related acute respiratory distress syndrome refractory to conventional treatment submitted to VV ECMO and consecutively admitted to our ICU(an ECMO referral center)from 31th March 2020 to 31th August 2021.An echocardiographic exam was performed immediately before VV ECMO implantation.RESULTS Males were prevalent(73.8%)and patients with a body mass index>30 kg/m^(2) were the majority(46/61,75%).The overall in-ICU mortality rate was 54.1%(33/61).RVDD was detectable in more than half of the population(34/61,55.7%)and associated with higher simplified organ functional assessment(SOFA)values(P=0.029)and a longer mechanical ventilation duration prior to ECMO support(P=0.046).Renal replacement therapy was more frequently needed in RVDD patients(P=0.002).A higher in-ICU mortality(P=0.024)was observed in RVDD patients.No echo variables were independent predictors of in-ICU death.CONCLUSION In patients with COVID-related respiratory failure on ECMO support,RVDD(dilatation and dysfunction)is a common finding and identifies a subset of patients characterized by a more severe disease(as indicated by higher SOFA values and need of renal replacement therapy)and by a higher in-ICU mortality.RVDD(also when considered separately)did not result independently associated with in-ICU mortality in these patients.展开更多
BACKGROUND Liver cirrhosis is a chronic hepatic disease which is associated with cardiovascular abnormalities.Hyperdynamic circulation in liver cirrhosis causes functional and structural cardiac alterations.The preval...BACKGROUND Liver cirrhosis is a chronic hepatic disease which is associated with cardiovascular abnormalities.Hyperdynamic circulation in liver cirrhosis causes functional and structural cardiac alterations.The prevalence of left ventricle diastolic dysfunction(LVDD)in cirrhotic patients ranges from 25.7%to as high as 81.4%as reported in different studies.In several studies the severity of diastolic dysfunction(DD)correlated with a degree of liver failure and the rate of dysfunction was higher in patients with decompensated cirrhosis compared with compensated.Future directions of comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients.AIM To clarify the correlation between the severity of liver cirrhosis and left ventricle diastolic dysfunction in the existing literature.METHODS Through January and February of 2019 at Vilnius University we conducted a systematic review of the global existing literature on the prevalence of left ventricle diastolic dysfunction in patients with liver cirrhosis.We searched for articles in PubMed,Medline and Web of science databases.Articles were selected by using adequate inclusion and exclusion criteria.Our interest was the outcome of likely correlation between the severity of cirrhosis[evaluated by Child-Pugh classes,Model For End-Stage Liver Disease(MELD)scores]and left ventricle diastolic dysfunction[classified according to American Society of Echocardiography(ASE)guidelines(2009,2016)],as well as relative risk of dysfunction in cirrhotic patients.Subgroup analyses were performed to evaluate the ratio and grades of left ventricle diastolic dysfunction with respect to cirrhosis severity.RESULTS A total of 1149 articles and abstracts met the initial search criteria.Sixteen articles which met the predefined eligibility criteria were included in the final analysis.Overall,1067 patients(out of them 723 men)with liver cirrhosis were evaluated for left ventricle diastolic dysfunction.In our systemic analysis we have found that 51.2%of cirrhotic patients had left ventricle diastolic dysfunction diagnosed and the grade 1 was the most prevalent(59.2%,P<0.001)among them,the grade 3 had been rarely diagnosed-only 5.1%.The data about the prevalence of diastolic dysfunction in cirrhotic patients depending on Child-Pugh Classes was available from 5 studies(365 patients overall)and only in 1 research diastolic dysfunction was found being associated with severity of liver cirrhosis(P<0.005).We established that diastolic dysfunction was diagnosed in 44.6%of Child-Pugh A class patients,in 62%of Child B class and in 63.3%of Child C patients(P=0.028).The proportion of patients with higher diastolic dysfunction grades increases in more severe cirrhosis presentation(P<0.001).There was no difference between mean MELD scores in patients with and without diastolic dysfunction and in different diastolic dysfunction groups.In all studies diastolic dysfunction was more frequent in patients with ascites.CONCLUSION This systemic analysis suggests that left ventricle diastolic dysfunction is an attribute of liver cirrhosis which has not received sufficient attention from clinicians so far.Future suggestions of a comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients and give hint for better understanding of the left ventricle diastolic dysfunction pathogenesis in liver cirrhosis.展开更多
BACKGROUND:Human amniotic epithelial cells(HAECs)can differentiate into neurons,astrocytes and oligodendrocytes.They biologically secrete many active neurotrophins and have the capacity to metabolize dopamine enzymes....BACKGROUND:Human amniotic epithelial cells(HAECs)can differentiate into neurons,astrocytes and oligodendrocytes.They biologically secrete many active neurotrophins and have the capacity to metabolize dopamine enzymes.These features underlie a theoretical basis for the treatment of Parkinson's disease(PD).OBJECTIVE:To investigate the survival and differentiation of transplanted HAECs in the lateral ventricle of PD model rats,and to explore its effect on circling behavior,as well as levels of dopamine(DA),the metabolite homovanillic acid,dihydroxyphenyl acetic acid,5-hydroxyindoleacetic acid,and 5-hydroxytryptamine in the striatum.DESIGN,TIME AND SETTING:A randomized,controlled,animal study was performed at the Institute of Biochemistry and Cell Biology,Shanghai Institute for Biological Sciences,Chinese Academy of Sciences,and Shanghai Celstar Institute of Biotechnology from May 2007 to December 2008.MATERIALS:HAECs were derived from the placental chorion following caesarean delivery at the Shanghai International Matemal and Child Health Hospital.6-hydroxydopamine(6-OHDA),and mouse anti-human Vimentin monoclonal antibody were purchased from Sigma,USA;mouse anti-human nestin and tyrosine hydroxylase(TH)monoclonal antibodies were purchased from Chemicon,USA.METHODS:A total of 114 healthy,adult,Sprague Dawley rats were randomly assigned to two groups:PD model[n=90,stereotactic microinjection of 2μL 6-OHDA(3.5μg/uL)into the striatum]and control(n=24,no treatment).The 51 successful PD model rats were randomly divided into 3 subgroups(n=17):HAEC,PBS,and model.The HAEC and PBS groups were respectively injected with 10μL PBS solution containing 1×10^5/mL HAECs or 10 pL PBS into the lateral ventricle.The model group was not treated.MAIN OUTCOME MEASURES:TH protein expression in the striatum was evaluated by immunohistochemistry 5 weeks after HAEC transplantation.At 10 weeks,HAEC survival in the lateral ventricle was investigated by immunofluorescent staining;differentiation of HAECs in the lateral and third ventricles was examined by TH immunohistochemistry;concentrations of DA,homovanillic acid,dihydroxyphenyl acetic acid,5-hydroxyindoleacetic acid,and 5-hydroxytryptamine in the striatum,as well as DA concentration in the cerebrospinal fluid,were measured with high-performance liquid chromatography-electrochemical detection.Circling behavior of PD model rats was consecutively observed for 10 weeks following intraperitoneal injection of amphetamine 1 week after successful model establishment.RESULTS:tn the HAEC group,the number of TH-positive cells significantly increased in the striatum,and circling behavior significantly decreased,compared with the PBS and model groups(P〈0.01).In addition,monoamine concentrations in the striatum,as well as DA concentrations in the cerebrospinal fluid,significantly increased,compared with the PBS group(P〈0.05-0.01).Moreover,a large number of nestin-,vimentin-,and TH-positive cells were observed in the lateral and third ventricles following HAEC injection.CONCLUSION:HAECs survived for 10 weeks with no overgrowth following transplantation into the lateral ventricle of PD model rats.Moreover,the cells differentiated into dopaminergic neurons,which increased DA secretion.HAEC transplantation improved cycling behavior in PD model rats.展开更多
Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enc...Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.展开更多
Understanding cardiac blood flow behaviors is of importance for cardiovascular research and clinical assessment of ventricle functions.Patient-specific Echo-based left ventricle(LV)fluid-structure interaction(FSI)mode...Understanding cardiac blood flow behaviors is of importance for cardiovascular research and clinical assessment of ventricle functions.Patient-specific Echo-based left ventricle(LV)fluid-structure interaction(FSI)models were introduced to perform ventricle mechanical analysis,investigate flow behaviors,and evaluate the impact of myocardial infarction(MI)and hypertension on blood flow in the LV.Echo image data were acquired from 3 patients with consent obtained:one healthy volunteer(P1),one hypertension patient(P2),and one patient who had an inferior and posterior myocardial infarction(P3).The nonlinear Mooney-Rivlin model was used for ventricle tissue with material parameter values chosen to match echo-measure LV volume data.Using the healthy case as baseline,LV with MI had lower peak flow velocity(30%lower at beginejection)and hypertension LV had higher peak flow velocity(16%higher at begin-filling).The vortex area(defined as the area with vorticity>0)for P3 was 19%smaller than that of P1.The vortex area for P2 was 12%smaller than that of P1.At peak of filling,the maximum flow shear stress(FSS)for P2 and P3 were 390%higher and 63%lower than that of P1,respectively.Meanwhile,LV stress and strain of P2 were 41%and 15%higher than those of P1,respectively.LV stress and strain of P3 were 36%and 42%lower than those of P1,respectively.In conclusion,FSI models could provide both flow and structural stress/strain information which would serve as the base for further cardiovascular investigations related to disease initiation,progression,and treatment strategy selections.Large-scale studies are needed to validate our findings.展开更多
We examined a new method for visualization of the primo vascular system in the rat brain involving lateral ventricle injection of trypan blue. Results showed that the primo vascular system in the lateral ventricles an...We examined a new method for visualization of the primo vascular system in the rat brain involving lateral ventricle injection of trypan blue. Results showed that the primo vascular system in the lateral ventricles and arachnoid mater of the brain were preferentially stained relative to blood vessels and fascia. The primo-vessels along blood vessels in the brain were clearly exhibited. In addition, the primo vascular system was evident between the fourth ventricle and the quadrigeminal cistern. Our experimental findings indicate that this new technique of lateral ventricle injection of trypan blue can visualize the primo vascular system in lateral ventricles and arachnoid mater of rats in situ.展开更多
The aim of this work is to develop an improved region based active contour and dynamic programming based method for accurate segmentation of left ventricle （LV） from multi-slice cine short axis cardiac magnetic reso...The aim of this work is to develop an improved region based active contour and dynamic programming based method for accurate segmentation of left ventricle （LV） from multi-slice cine short axis cardiac magnetic resonance （MR） images. Intensity inhomogeneity and weak object boundaries present in MR images hinder the segmentation accuracy. The proposed active contour model driven by a local Gaussian distribution fitting （LGDF） energy and an auxiliary global intensity fitting energy improves the accuracy of endocardial boundary detection. The weightage of the global energy fitting term is dynamically adjusted using a spatially varying weight function. Dynamic programming scheme proposed for the segmentation of epicardium considers the myocardium probability map and a distance weighted edge map in the cost matrix. Radial distance weighted technique and conical geometry are employed for segmenting the basal slices with left ventricle outflow tract （LVOT） and most apical slices. The proposed method is validated on a public dataset comprising 45 subjects from medical image computing and computer assisted interventions （MICCAI） 2009 segmentation challenge. The average percentage of good endocardial and epicardial contours detected is about 99%, average perpendicular distance of the detected good contours from the manual reference contours is 1.95 mm, and the dice similarity coefficient between the detected contours and the reference contours is 0.91. Correlation coefficient and the coefficient of determination between the ejection fraction measurements from manual segmentation and the automated method are respectively 0.9781 and 0.9567, for LV mass these values are 0.9249 and 0.8554. Statistical analysis of the results reveals a good agreement between the clinical parameters determined manually and those estimated using the automated method.展开更多
AIM： To investigate the effect of long-lasting somatostatin analogue octreotide （Oct） injected into the third cerebral ventricle （TCV） on gastric acid secretion in rats. METHODS： TCVs were cannulated in male Wis...AIM： To investigate the effect of long-lasting somatostatin analogue octreotide （Oct） injected into the third cerebral ventricle （TCV） on gastric acid secretion in rats. METHODS： TCVs were cannulated in male Wistar rats anesthetized with sodium pentobarbital. One week later acute gastric lumen perfusion was carried out and gastric acid was continuously washed with 37℃ saline by a perfusion pump. Gastric perfusion samples were collected every 10 min and titrated by 0.01 moL/L NaOH to neutral. On the basis of subcutaneous （sc） injection of pentagastrin （G-5, 160 μg/kg）, Oct （0.025 μg, 0.05 μg, 0.1 μg, n=12 in each group） or vehicle （pyrogen-free physiological saline, n = 10） was injected into the TCV, Before and after the TCV injection, 1 h total acid output （TAO） was determined and experimental data were expressed in change rate （%） of TAO. RESULTS： Oct （0.025, 0.05 and 0.1 μg） injected into the TCV resulted in change rate of 1.56% （P〉0.05）, 20.21% （P〈 0.01） and 37.82% of TAO （P〈 0.001）, respectively. Moreover, comparison in change rate of TAO among these 3 doses showed P〈 0.05 between 0.025μg and 0.05 μg, P〈 0.01 between 0.025 μg and 0.ling, and P〈 0.05 between 0.05μg and 0.1 μg. However, sc injection of 0.05 μg Oct had no effect on G-5 stimulated gastric acid secretion. CONCLUSION： Octreotide injected into the third cerebral ventricle inhibits gastrin-induced gastric acid secretion in a dose-dependent manner.展开更多
A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells （3.8 x 106-7.3 x 107） were...A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells （3.8 x 106-7.3 x 107） were injected into the lateral ventricles. Mild injury of lateral ventricular blood vessels occurred in only two cases （8.3%）. Seven cases （29.2%） experienced a fever. Clinical manifestations were improved to varying degrees in eight cases （28.0%） within 3 months after transplantation. Patient condition did not worsen, and no patient experienced severe adverse reactions.展开更多
Regional pressure differences between sites within the left ventricular cavity have long been identified,and the potential clinical value of diastolic and systolic intraventricular pressure differences(IVPDs)is of inc...Regional pressure differences between sites within the left ventricular cavity have long been identified,and the potential clinical value of diastolic and systolic intraventricular pressure differences(IVPDs)is of increasing interest.This study concluded that the IVPD plays an important role in ventricular filling and emptying and is a reliable indicator of ventricular relaxation,elastic recoil,diastolic pumping,and effective left ventricular filling.Relative pressure imaging,as a novel and potentially clinically applicable measure of left IVPDs,enables early and more comprehensive identification of the temporal and spatial characteristics of IVPD.In the future,as research related to relative pressure imaging continues,this measurement method has the possibility to become more refined and serve as an additional clinical aid that can replace the gold standard cardiac catheterization technique for the diagnosis of diastolic dysfunction.展开更多
The interpretability of deep learning models has emerged as a compelling area in artificial intelligence research.The safety criteria for medical imaging are highly stringent,and models are required for an explanation...The interpretability of deep learning models has emerged as a compelling area in artificial intelligence research.The safety criteria for medical imaging are highly stringent,and models are required for an explanation.However,existing convolutional neural network solutions for left ventricular segmentation are viewed in terms of inputs and outputs.Thus,the interpretability of CNNs has come into the spotlight.Since medical imaging data are limited,many methods to fine-tune medical imaging models that are popular in transfer models have been built using massive public Image Net datasets by the transfer learning method.Unfortunately,this generates many unreliable parameters and makes it difficult to generate plausible explanations from these models.In this study,we trained from scratch rather than relying on transfer learning,creating a novel interpretable approach for autonomously segmenting the left ventricle with a cardiac MRI.Our enhanced GPU training system implemented interpretable global average pooling for graphics using deep learning.The deep learning tasks were simplified.Simplification included data management,neural network architecture,and training.Our system monitored and analyzed the gradient changes of different layers with dynamic visualizations in real-time and selected the optimal deployment model.Our results demonstrated that the proposed method was feasible and efficient:the Dice coefficient reached 94.48%,and the accuracy reached 99.7%.It was found that no current transfer learning models could perform comparably to the ImageNet transfer learning architectures.This model is lightweight and more convenient to deploy on mobile devices than transfer learning models.展开更多
The cardiovascular system with a lumped parameter model is treated, in which the Starling model is used to simulate left ventricle and the four-element Burattini & Gnudi model is used in the description of...The cardiovascular system with a lumped parameter model is treated, in which the Starling model is used to simulate left ventricle and the four-element Burattini & Gnudi model is used in the description of arterial system. Moreover, the feedback action of arterial pressure on cardiac cycle is taken into account. The phenomenon of mechanical periodicity (MP) of end diastolic volume (EDV) of left ventricle is successfully simulated by solving a series of one-dimensional discrete nonlinear dynamical equations. The effects of cardiovascular parameters on MP is also discussed.展开更多
A 17-year-old adolescent with non-operated double inlet left-ventricle and severe stenosed parachute mitral valve is reported. He was admitted with repetitive syncope related to intermittent atrial fibrillation. Life-...A 17-year-old adolescent with non-operated double inlet left-ventricle and severe stenosed parachute mitral valve is reported. He was admitted with repetitive syncope related to intermittent atrial fibrillation. Life-threatening syncope combined with pre- and post-capillary pulmonary hypertension together with his single ventricle pathophysiology led to the decision for left atrial decompression by percutaneous static atrial septum ballooning after transseptal needle perforation. Aiming to create a restrictive atrial septum defect, unloading of the left atrium without disturbing the balanced hemodynamics was directed for a long-term palliation or as a basis for a further surgical follow-up approach.展开更多
Lateral ventricular meningiomas（LVMs） are especially rare,and they often remain “silent” until they become very large. Several surgical approaches exist,but the optimal surgical strategy for them remains a challen...Lateral ventricular meningiomas（LVMs） are especially rare,and they often remain “silent” until they become very large. Several surgical approaches exist,but the optimal surgical strategy for them remains a challenge. The incidence,clinical features,radiological manifestations,pathological findings,and especially the surgical strategy in 21 patients with LVMs were analyzed retrospectively. The mean age of patients was 42.7 years（range,17 to 78 years）. Raised intracranial pressure was the main presenting symptom. The definite diagnosis of LVMs in most cases was made by computed tomography（CT） or magnetic resonance imaging（MRI）. Six patients were subjected to plain CT scans,15 to contrast MR scans,and 4 to a magnetic resonance angiogram（MRA）. Large tumors were seen in most cases with an average diameter of more than 4.3 cm. Of the 21 cases of LVMs in our series,LVMs were resected in 16 cases via a posterior parieto-occipital transcortical approach,2 cases via a transcallosal approach,and 3 cases via a posterior middle temporal gyrus approach. In 8 out of 21 cases,the tumors were located in the left lateral ventricle. The gross total surgical excision was achieved in 18（86%） patients,and all LVMs were pathologically confirmed to be benign. Nine patients were followed up（range： 11 months–4.6 years）. Eight（88.9%） cases obtained good recovery and one（11.1%） obtained moderate disability. Four approaches are available for the surgical treatment of LVMs. The choice of surgical approaches depends on tumor location,laterality,size and extension,and the function of the brain must be taken into account. Intracapsular resection and piecemeal resection of LVMs can be safely and easily performed. Preoperative MRA scan is important to know the feeder of LVMs and peripheral blood supply.展开更多
基金Natural Science Foundation of Hubei Province,Grant/Award Number:2024AFB877the Chongqing Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science&Technology Bureau),Grant/Award Number:2023GGXM003+3 种基金Chongqing Municipal Health Commission,Grant/Award Number:YXGD202451Organization Department of Chongqing Municipal Party Committee,Grant/Award Number:cstc2024ycjh-bgzxm0103National Natural Science Foundation of China,Grant/Award Number:82371361Jingmen Science and Technology Bureau,Grant/Award Number:2024ZDYF012。
文摘Background:Hemorrhagic expansion into the fourth ventricle is an independent risk factor for poor outcomes in intraventricular hemorrhage(IVH)patients.However,to date,available animal models of IVH are limited to models of supratentorial ventricular hemorrhage,and there are no specific models of fourth ventricle hemorrhage.This limitation hinders comprehensive basic research and the understanding of the pathophysiological changes that occur following fourth ventricle hemorrhage.Therefore,the development of an animal model of fourth ventricle hemorrhage is highly important.Methods:In this study,a novel rat model of fourth ventricle hemorrhage was established via autologous blood injection through the foramen of Magendie.Anesthetized rats were positioned in a stereotaxic apparatus with their heads tilted downward at an angle of approximately 20°relative to the vertical axis.A needle was inserted through the foramen,and autologous blood obtained from the rat's heart was injected into the fourth ventricle via a microinfusion pump.Systematic evaluations of the model were conducted using small-animal magnetic resonance imaging,histopathological analysis,and neurological function assessment.Results:The rats developed stable and reproducible fourth ventricle hematomas and ventricular dilation.They also exhibited acute-phase hydrocephalus and pathological features of perilesional brain tissue injury,with observed neurological deficits comparable to patients with fourth ventricle hemorrhage.Conclusion:This model successfully recapitulates the clinicopathological and pathophysiological characteristics of patients with fourth ventricle hemorrhage and can be utilized for further investigation into the pathophysiological mechanisms underlying posthemorrhagic hydrocephalus and perilesional brainstem tissue injury.
文摘Background:We evaluated surgical outcomes of biventricular repair for atrioventricular septal defect(AVSD)with tetralogy of Fallot(TOF)or double-outlet right ventricle(DORV).Methods:This retrospective pilot study included 12 patients who underwent biventricular repair of AVSD with TOF(n=6)or DORV(n=6)between 2004 and 2023.Right ventricular outflow tract(RVOT)reconstruction was performed using transannular patch(TAP,n=4)or pulmonary valve preservation(PVP,n=8).Clinical outcomes,including longitudinal pulmonary valve growth,RVOT obstruction,and pulmonary regurgitation,were reviewed descriptively,with particular focus on the feasibility of PVP.Results:The median age and body weight at the time of surgery were 11.7(8.3-18.8)months and 8.6(7.3-10.5)kg,respectively.The median follow-up duration was 67.9(58.7-174.3)months.The two-patch technique(n=10)was most commonly used for AVSD repair.There were no early mortalities and one late mortality.At discharge,significant(≥36 mmHg)RVOT obstruction was observed in two patients who underwent PVP.During follow-up,one patient required reoperation for significant(moderate or greater)atrioventricular valve regurgitation,and two patients in the PVP group underwent transcatheter intervention for significant RVOT obstruction.At the last follow-up,significant RVOT obstruction was present in two patients.Significant(moderate or greater)pulmonary regurgitation occurred in three patients in the TAP group.In patients who underwent PVP,the pulmonary valve annulus z-score remained within acceptable ranges,and the RVOT pressure gradient predominantly decreased to acceptable levels during follow-up.Conclusions:Mid-term outcomes of PVP in the biventricular repair of AVSD with TOF or DORV are acceptable.In selected patients,the PVP strategy may be considered a reasonable and feasible option for RVOT reconstruction.
基金Hefei Municipal Natural Science Foundation,Grant/Award Number:2022009Suqian Guiding Program Project,Grant/Award Number:Z202309Suqian Traditional Chinese Medicine Science and Technology Plan,Grant/Award Number:MS202301。
文摘Quantitative analysis of clinical function parameters from MRI images is crucial for diagnosing and assessing cardiovascular disease.However,the manual calculation of these parameters is challenging due to the high variability among patients and the time-consuming nature of the process.In this study,the authors introduce a framework named MultiJSQ,comprising the feature presentation network(FRN)and the indicator prediction network(IEN),which is designed for simultaneous joint segmentation and quantification.The FRN is tailored for representing global image features,facilitating the direct acquisition of left ventricle(LV)contour images through pixel classification.Additionally,the IEN incorporates specifically designed modules to extract relevant clinical indices.The authors’method considers the interdependence of different tasks,demonstrating the validity of these relationships and yielding favourable results.Through extensive experiments on cardiac MR images from 145 patients,MultiJSQ achieves impressive outcomes,with low mean absolute errors of 124 mm^(2),1.72 mm,and 1.21 mm for areas,dimensions,and regional wall thicknesses,respectively,along with a Dice metric score of 0.908.The experimental findings underscore the excellent performance of our framework in LV segmentation and quantification,highlighting its promising clinical application prospects.
文摘This article summarizes the nursing experience with a patient who underwent resection of a lateral ventricle trigone meningioma via a contralateral interhemispheric approach.Key nursing measures included preoperative health education and psychological care,baseline neurological assessment,and comprehensive physiological preparation.Postoperative care focused on intensive vital sign monitoring and support,comprehensive neurological evaluation and early rehabilitation,as well as a proactive strategy for preventing secondary epilepsy and controlling intracranial infection.Through active treatment and systematic nursing care,the patient achieved an uncomplicated recovery and was discharged on postoperative day 9.The successful implementation of these structured nursing interventions contributed to favorable postoperative outcomes,offering a valuable reference for the perioperative management of similar complex neurosurgical cases.
文摘We report the case of a rare complex cardiac anomaly involving situs solitus,concordant atrioventricular connection with left-hand ventricular topology,and L-looped ventricles.The ventricles had a superior-inferior relationship with an inferiorly located right ventricle,which had a double outlet with far posteriorly located great arteries.The left atrium was elongated,with juxta-positioned atrial appendages on the right side.The 3D-printed model using a computed tomography scan taken on the fourth day of birth demonstrated the anatomy clearly and helped us decide on the surgical management.
文摘BACKGROUND The prognostic role of right ventricle dilatation and dysfunction(RVDD)has not been elucidated in patients with coronavirus disease(COVID)-related respiratory failure refractory to standard treatment needing extracorporeal membrane oxygenation(ECMO)support.AIM To assess whether pre veno-venous(VV)ECMO RVDD were related to inintensive care unit(ICU)mortality.METHODS We enrolled 61 patients with COVID-related acute respiratory distress syndrome refractory to conventional treatment submitted to VV ECMO and consecutively admitted to our ICU(an ECMO referral center)from 31th March 2020 to 31th August 2021.An echocardiographic exam was performed immediately before VV ECMO implantation.RESULTS Males were prevalent(73.8%)and patients with a body mass index>30 kg/m^(2) were the majority(46/61,75%).The overall in-ICU mortality rate was 54.1%(33/61).RVDD was detectable in more than half of the population(34/61,55.7%)and associated with higher simplified organ functional assessment(SOFA)values(P=0.029)and a longer mechanical ventilation duration prior to ECMO support(P=0.046).Renal replacement therapy was more frequently needed in RVDD patients(P=0.002).A higher in-ICU mortality(P=0.024)was observed in RVDD patients.No echo variables were independent predictors of in-ICU death.CONCLUSION In patients with COVID-related respiratory failure on ECMO support,RVDD(dilatation and dysfunction)is a common finding and identifies a subset of patients characterized by a more severe disease(as indicated by higher SOFA values and need of renal replacement therapy)and by a higher in-ICU mortality.RVDD(also when considered separately)did not result independently associated with in-ICU mortality in these patients.
文摘BACKGROUND Liver cirrhosis is a chronic hepatic disease which is associated with cardiovascular abnormalities.Hyperdynamic circulation in liver cirrhosis causes functional and structural cardiac alterations.The prevalence of left ventricle diastolic dysfunction(LVDD)in cirrhotic patients ranges from 25.7%to as high as 81.4%as reported in different studies.In several studies the severity of diastolic dysfunction(DD)correlated with a degree of liver failure and the rate of dysfunction was higher in patients with decompensated cirrhosis compared with compensated.Future directions of comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients.AIM To clarify the correlation between the severity of liver cirrhosis and left ventricle diastolic dysfunction in the existing literature.METHODS Through January and February of 2019 at Vilnius University we conducted a systematic review of the global existing literature on the prevalence of left ventricle diastolic dysfunction in patients with liver cirrhosis.We searched for articles in PubMed,Medline and Web of science databases.Articles were selected by using adequate inclusion and exclusion criteria.Our interest was the outcome of likely correlation between the severity of cirrhosis[evaluated by Child-Pugh classes,Model For End-Stage Liver Disease(MELD)scores]and left ventricle diastolic dysfunction[classified according to American Society of Echocardiography(ASE)guidelines(2009,2016)],as well as relative risk of dysfunction in cirrhotic patients.Subgroup analyses were performed to evaluate the ratio and grades of left ventricle diastolic dysfunction with respect to cirrhosis severity.RESULTS A total of 1149 articles and abstracts met the initial search criteria.Sixteen articles which met the predefined eligibility criteria were included in the final analysis.Overall,1067 patients(out of them 723 men)with liver cirrhosis were evaluated for left ventricle diastolic dysfunction.In our systemic analysis we have found that 51.2%of cirrhotic patients had left ventricle diastolic dysfunction diagnosed and the grade 1 was the most prevalent(59.2%,P<0.001)among them,the grade 3 had been rarely diagnosed-only 5.1%.The data about the prevalence of diastolic dysfunction in cirrhotic patients depending on Child-Pugh Classes was available from 5 studies(365 patients overall)and only in 1 research diastolic dysfunction was found being associated with severity of liver cirrhosis(P<0.005).We established that diastolic dysfunction was diagnosed in 44.6%of Child-Pugh A class patients,in 62%of Child B class and in 63.3%of Child C patients(P=0.028).The proportion of patients with higher diastolic dysfunction grades increases in more severe cirrhosis presentation(P<0.001).There was no difference between mean MELD scores in patients with and without diastolic dysfunction and in different diastolic dysfunction groups.In all studies diastolic dysfunction was more frequent in patients with ascites.CONCLUSION This systemic analysis suggests that left ventricle diastolic dysfunction is an attribute of liver cirrhosis which has not received sufficient attention from clinicians so far.Future suggestions of a comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients and give hint for better understanding of the left ventricle diastolic dysfunction pathogenesis in liver cirrhosis.
基金Supported by:the Major State Basic Research Development Program of China(973 Program),No.2005CB522604the National Natural Science Foundation of China,No.30271325
文摘BACKGROUND:Human amniotic epithelial cells(HAECs)can differentiate into neurons,astrocytes and oligodendrocytes.They biologically secrete many active neurotrophins and have the capacity to metabolize dopamine enzymes.These features underlie a theoretical basis for the treatment of Parkinson's disease(PD).OBJECTIVE:To investigate the survival and differentiation of transplanted HAECs in the lateral ventricle of PD model rats,and to explore its effect on circling behavior,as well as levels of dopamine(DA),the metabolite homovanillic acid,dihydroxyphenyl acetic acid,5-hydroxyindoleacetic acid,and 5-hydroxytryptamine in the striatum.DESIGN,TIME AND SETTING:A randomized,controlled,animal study was performed at the Institute of Biochemistry and Cell Biology,Shanghai Institute for Biological Sciences,Chinese Academy of Sciences,and Shanghai Celstar Institute of Biotechnology from May 2007 to December 2008.MATERIALS:HAECs were derived from the placental chorion following caesarean delivery at the Shanghai International Matemal and Child Health Hospital.6-hydroxydopamine(6-OHDA),and mouse anti-human Vimentin monoclonal antibody were purchased from Sigma,USA;mouse anti-human nestin and tyrosine hydroxylase(TH)monoclonal antibodies were purchased from Chemicon,USA.METHODS:A total of 114 healthy,adult,Sprague Dawley rats were randomly assigned to two groups:PD model[n=90,stereotactic microinjection of 2μL 6-OHDA(3.5μg/uL)into the striatum]and control(n=24,no treatment).The 51 successful PD model rats were randomly divided into 3 subgroups(n=17):HAEC,PBS,and model.The HAEC and PBS groups were respectively injected with 10μL PBS solution containing 1×10^5/mL HAECs or 10 pL PBS into the lateral ventricle.The model group was not treated.MAIN OUTCOME MEASURES:TH protein expression in the striatum was evaluated by immunohistochemistry 5 weeks after HAEC transplantation.At 10 weeks,HAEC survival in the lateral ventricle was investigated by immunofluorescent staining;differentiation of HAECs in the lateral and third ventricles was examined by TH immunohistochemistry;concentrations of DA,homovanillic acid,dihydroxyphenyl acetic acid,5-hydroxyindoleacetic acid,and 5-hydroxytryptamine in the striatum,as well as DA concentration in the cerebrospinal fluid,were measured with high-performance liquid chromatography-electrochemical detection.Circling behavior of PD model rats was consecutively observed for 10 weeks following intraperitoneal injection of amphetamine 1 week after successful model establishment.RESULTS:tn the HAEC group,the number of TH-positive cells significantly increased in the striatum,and circling behavior significantly decreased,compared with the PBS and model groups(P〈0.01).In addition,monoamine concentrations in the striatum,as well as DA concentrations in the cerebrospinal fluid,significantly increased,compared with the PBS group(P〈0.05-0.01).Moreover,a large number of nestin-,vimentin-,and TH-positive cells were observed in the lateral and third ventricles following HAEC injection.CONCLUSION:HAECs survived for 10 weeks with no overgrowth following transplantation into the lateral ventricle of PD model rats.Moreover,the cells differentiated into dopaminergic neurons,which increased DA secretion.HAEC transplantation improved cycling behavior in PD model rats.
文摘Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.
文摘Understanding cardiac blood flow behaviors is of importance for cardiovascular research and clinical assessment of ventricle functions.Patient-specific Echo-based left ventricle(LV)fluid-structure interaction(FSI)models were introduced to perform ventricle mechanical analysis,investigate flow behaviors,and evaluate the impact of myocardial infarction(MI)and hypertension on blood flow in the LV.Echo image data were acquired from 3 patients with consent obtained:one healthy volunteer(P1),one hypertension patient(P2),and one patient who had an inferior and posterior myocardial infarction(P3).The nonlinear Mooney-Rivlin model was used for ventricle tissue with material parameter values chosen to match echo-measure LV volume data.Using the healthy case as baseline,LV with MI had lower peak flow velocity(30%lower at beginejection)and hypertension LV had higher peak flow velocity(16%higher at begin-filling).The vortex area(defined as the area with vorticity>0)for P3 was 19%smaller than that of P1.The vortex area for P2 was 12%smaller than that of P1.At peak of filling,the maximum flow shear stress(FSS)for P2 and P3 were 390%higher and 63%lower than that of P1,respectively.Meanwhile,LV stress and strain of P2 were 41%and 15%higher than those of P1,respectively.LV stress and strain of P3 were 36%and 42%lower than those of P1,respectively.In conclusion,FSI models could provide both flow and structural stress/strain information which would serve as the base for further cardiovascular investigations related to disease initiation,progression,and treatment strategy selections.Large-scale studies are needed to validate our findings.
基金the National Natural Science Foundation of China for Youths (General Program),No.30801464the National Basic Research Program of China (973 Program),No.2007CB512705the GIST Systems Biology Program of Korea in 2010
文摘We examined a new method for visualization of the primo vascular system in the rat brain involving lateral ventricle injection of trypan blue. Results showed that the primo vascular system in the lateral ventricles and arachnoid mater of the brain were preferentially stained relative to blood vessels and fascia. The primo-vessels along blood vessels in the brain were clearly exhibited. In addition, the primo vascular system was evident between the fourth ventricle and the quadrigeminal cistern. Our experimental findings indicate that this new technique of lateral ventricle injection of trypan blue can visualize the primo vascular system in lateral ventricles and arachnoid mater of rats in situ.
基金supported by Department of Science and Technology, Ministry of Science and Technology, India (No. DST/TSG/ICT/2010/08)
文摘The aim of this work is to develop an improved region based active contour and dynamic programming based method for accurate segmentation of left ventricle （LV） from multi-slice cine short axis cardiac magnetic resonance （MR） images. Intensity inhomogeneity and weak object boundaries present in MR images hinder the segmentation accuracy. The proposed active contour model driven by a local Gaussian distribution fitting （LGDF） energy and an auxiliary global intensity fitting energy improves the accuracy of endocardial boundary detection. The weightage of the global energy fitting term is dynamically adjusted using a spatially varying weight function. Dynamic programming scheme proposed for the segmentation of epicardium considers the myocardium probability map and a distance weighted edge map in the cost matrix. Radial distance weighted technique and conical geometry are employed for segmenting the basal slices with left ventricle outflow tract （LVOT） and most apical slices. The proposed method is validated on a public dataset comprising 45 subjects from medical image computing and computer assisted interventions （MICCAI） 2009 segmentation challenge. The average percentage of good endocardial and epicardial contours detected is about 99%, average perpendicular distance of the detected good contours from the manual reference contours is 1.95 mm, and the dice similarity coefficient between the detected contours and the reference contours is 0.91. Correlation coefficient and the coefficient of determination between the ejection fraction measurements from manual segmentation and the automated method are respectively 0.9781 and 0.9567, for LV mass these values are 0.9249 and 0.8554. Statistical analysis of the results reveals a good agreement between the clinical parameters determined manually and those estimated using the automated method.
基金Supported by Returned Overseas Scholar Science Research Foundation of Ministry of Education of China, No.2005383
文摘AIM： To investigate the effect of long-lasting somatostatin analogue octreotide （Oct） injected into the third cerebral ventricle （TCV） on gastric acid secretion in rats. METHODS： TCVs were cannulated in male Wistar rats anesthetized with sodium pentobarbital. One week later acute gastric lumen perfusion was carried out and gastric acid was continuously washed with 37℃ saline by a perfusion pump. Gastric perfusion samples were collected every 10 min and titrated by 0.01 moL/L NaOH to neutral. On the basis of subcutaneous （sc） injection of pentagastrin （G-5, 160 μg/kg）, Oct （0.025 μg, 0.05 μg, 0.1 μg, n=12 in each group） or vehicle （pyrogen-free physiological saline, n = 10） was injected into the TCV, Before and after the TCV injection, 1 h total acid output （TAO） was determined and experimental data were expressed in change rate （%） of TAO. RESULTS： Oct （0.025, 0.05 and 0.1 μg） injected into the TCV resulted in change rate of 1.56% （P〉0.05）, 20.21% （P〈 0.01） and 37.82% of TAO （P〈 0.001）, respectively. Moreover, comparison in change rate of TAO among these 3 doses showed P〈 0.05 between 0.025μg and 0.05 μg, P〈 0.01 between 0.025 μg and 0.ling, and P〈 0.05 between 0.05μg and 0.1 μg. However, sc injection of 0.05 μg Oct had no effect on G-5 stimulated gastric acid secretion. CONCLUSION： Octreotide injected into the third cerebral ventricle inhibits gastrin-induced gastric acid secretion in a dose-dependent manner.
文摘A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells （3.8 x 106-7.3 x 107） were injected into the lateral ventricles. Mild injury of lateral ventricular blood vessels occurred in only two cases （8.3%）. Seven cases （29.2%） experienced a fever. Clinical manifestations were improved to varying degrees in eight cases （28.0%） within 3 months after transplantation. Patient condition did not worsen, and no patient experienced severe adverse reactions.
文摘Regional pressure differences between sites within the left ventricular cavity have long been identified,and the potential clinical value of diastolic and systolic intraventricular pressure differences(IVPDs)is of increasing interest.This study concluded that the IVPD plays an important role in ventricular filling and emptying and is a reliable indicator of ventricular relaxation,elastic recoil,diastolic pumping,and effective left ventricular filling.Relative pressure imaging,as a novel and potentially clinically applicable measure of left IVPDs,enables early and more comprehensive identification of the temporal and spatial characteristics of IVPD.In the future,as research related to relative pressure imaging continues,this measurement method has the possibility to become more refined and serve as an additional clinical aid that can replace the gold standard cardiac catheterization technique for the diagnosis of diastolic dysfunction.
基金The National Natural Science Foundation of China (62176048)provided funding for this research.
文摘The interpretability of deep learning models has emerged as a compelling area in artificial intelligence research.The safety criteria for medical imaging are highly stringent,and models are required for an explanation.However,existing convolutional neural network solutions for left ventricular segmentation are viewed in terms of inputs and outputs.Thus,the interpretability of CNNs has come into the spotlight.Since medical imaging data are limited,many methods to fine-tune medical imaging models that are popular in transfer models have been built using massive public Image Net datasets by the transfer learning method.Unfortunately,this generates many unreliable parameters and makes it difficult to generate plausible explanations from these models.In this study,we trained from scratch rather than relying on transfer learning,creating a novel interpretable approach for autonomously segmenting the left ventricle with a cardiac MRI.Our enhanced GPU training system implemented interpretable global average pooling for graphics using deep learning.The deep learning tasks were simplified.Simplification included data management,neural network architecture,and training.Our system monitored and analyzed the gradient changes of different layers with dynamic visualizations in real-time and selected the optimal deployment model.Our results demonstrated that the proposed method was feasible and efficient:the Dice coefficient reached 94.48%,and the accuracy reached 99.7%.It was found that no current transfer learning models could perform comparably to the ImageNet transfer learning architectures.This model is lightweight and more convenient to deploy on mobile devices than transfer learning models.
文摘The cardiovascular system with a lumped parameter model is treated, in which the Starling model is used to simulate left ventricle and the four-element Burattini & Gnudi model is used in the description of arterial system. Moreover, the feedback action of arterial pressure on cardiac cycle is taken into account. The phenomenon of mechanical periodicity (MP) of end diastolic volume (EDV) of left ventricle is successfully simulated by solving a series of one-dimensional discrete nonlinear dynamical equations. The effects of cardiovascular parameters on MP is also discussed.
文摘A 17-year-old adolescent with non-operated double inlet left-ventricle and severe stenosed parachute mitral valve is reported. He was admitted with repetitive syncope related to intermittent atrial fibrillation. Life-threatening syncope combined with pre- and post-capillary pulmonary hypertension together with his single ventricle pathophysiology led to the decision for left atrial decompression by percutaneous static atrial septum ballooning after transseptal needle perforation. Aiming to create a restrictive atrial septum defect, unloading of the left atrium without disturbing the balanced hemodynamics was directed for a long-term palliation or as a basis for a further surgical follow-up approach.
文摘Lateral ventricular meningiomas（LVMs） are especially rare,and they often remain “silent” until they become very large. Several surgical approaches exist,but the optimal surgical strategy for them remains a challenge. The incidence,clinical features,radiological manifestations,pathological findings,and especially the surgical strategy in 21 patients with LVMs were analyzed retrospectively. The mean age of patients was 42.7 years（range,17 to 78 years）. Raised intracranial pressure was the main presenting symptom. The definite diagnosis of LVMs in most cases was made by computed tomography（CT） or magnetic resonance imaging（MRI）. Six patients were subjected to plain CT scans,15 to contrast MR scans,and 4 to a magnetic resonance angiogram（MRA）. Large tumors were seen in most cases with an average diameter of more than 4.3 cm. Of the 21 cases of LVMs in our series,LVMs were resected in 16 cases via a posterior parieto-occipital transcortical approach,2 cases via a transcallosal approach,and 3 cases via a posterior middle temporal gyrus approach. In 8 out of 21 cases,the tumors were located in the left lateral ventricle. The gross total surgical excision was achieved in 18（86%） patients,and all LVMs were pathologically confirmed to be benign. Nine patients were followed up（range： 11 months–4.6 years）. Eight（88.9%） cases obtained good recovery and one（11.1%） obtained moderate disability. Four approaches are available for the surgical treatment of LVMs. The choice of surgical approaches depends on tumor location,laterality,size and extension,and the function of the brain must be taken into account. Intracapsular resection and piecemeal resection of LVMs can be safely and easily performed. Preoperative MRA scan is important to know the feeder of LVMs and peripheral blood supply.
