Objective To evaluate the clinical reliability and feasibility of computerized endoscopic balloon manometry in vitro and in vivo, in measurement of pressure of esophageal varices. Methods Computerized endoscopic balloon manometry was used to measure the pressure of variceal model with different diameter (3 mm, 6 mm and 8 mm) and intraluminal pressures (ranging from 8 to 36 mm Hg), and the findings were compared with actual pressures. The technique was also applied in 23 patients with liver cirrhosis and esophageal varices, and its correlation with hepatic venous pressure gradient and other factors related with varices bleeding. Results The study in vitro showed that the measured intraluminal pressure was correlated significantly with the actual value ( r ≥ 0. 993, P ＜ 0. 001 ) without obvious measurement bias(95% CI = -0.13 cm H2O to 0. 33 cm H2O). The measurement in 23 patients were success with little variation coefficient (r≥0. 998) between repeated procedures. Regression analysis showed a good correlation between variceal pressure and hepatic venous pressure gradient (r=0. 858, P ＜ 0. 001 ). A higher variceal pressure was strongly associated with presence of previous bleeding episodes, vascular diameter and presence of red color signs, but did not correlate with the parameter of Child-Pugh classification ( t = 0. 31, P =0. 76). Conclusion Computerized endoscopic balloon manometry is reliable and feasible to examine esophageal variceal pressure, and is very likely to be a valuable clinical index for variceal bleeding.

OBJECTIVETo assess long term stent implantation efficacy of myocardial bridge and severe atherosclerosis lesions in the segments proximal to the myocardial bridge.

METHODSThe study population consisted of 3 groups (103 patients). Group A included 28 patients with severe atherosclerosis lesion of luminal narrowing of > or = 70% in the segments proximal to the myocardial bridge. Group B included 16 patients with symptomatic myocardial bridge lesion of systolic luminal narrowing of > or = 95%. Group C included 59 patients with severe atherosclerotic lesion of luminal narrowing of > or = 70%. All lesions were successfully treated with stent by standard interventional techniques. Quantitative coronary angiography was performed before and immediately after stent deployment. Follow-up Quantitative coronary angiography was performed at six months or later. Clinical evaluation was done at 20 months after PCI.

RESULTSThere was no significant difference in luminal diameter and stent diameter among 3 groups immediately after stent implantation (P > 0.05). At six months, restenosis occurred in 4 patients in Group A (14.3%), in 7 patients in Group B (43.7%), and in 8 patients in Group C (14.8%), respectively. The rate of restenosis was significantly lower in group A and C than in group B (P < 0.05). No significant difference was found between group A and C. Additional balloon dilating of stent were performed in all restenosis patients. Clinical evaluation at 20 months showed that all patients remained free of angina and cardiac events.

CONCLUSIONThe efficacy of intracoronary stent implantation in treating severe atherosclerosis lesion in the segments proximal to the myocardial bridge is not affected by abnormal haemodynamic changes of myocardial bridges. The rate of restenosis in intracoronary stent implantation of myocardial bridges is higher than that of atherosclerotic lesions in the segments proximal to myocardial bridge.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Atherosclerosis ; therapy ; Coronary Artery Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Myocardial Bridging ; therapy ; Stents ; Treatment Outcome

Objective To explore the effectiveness and safety of intravenous metoprolol by two injection methods in treatment for patients of atrial fibrillation anti rapid ventricular rates complicated with heart failure.Methods Patients of atrial fibrillation and rapid ventricular rates complicated with heart failure were administrated regular drug therapy for their heart failure,and then they were observed for half an hour.If their ventricular rates were above 100 beats/min and blood pressure equal to or above 100/60 mm Hg (1 mm Hg=0.133 kPa),they were randomly divided into three groups,the first one administrated with metoprolol 10 mg by minipump in an hour,the second one administrated with metoprolol 5 mg in 10 minutes by direct injection,and repeated by 5 mg 10 minutes later if their heart beats were still above 100 beats/min and blood pressure equal to or above 100/60 mm Hg,and the third one administrated with normal saline as control group.As either ventricular rates were equal to or lower than 60 beats/min or blood pressure lower than 90/60 mm Hg,drug administration would be terminated.Symptoms,physical signs, heart rate,blood pressure,rale on auscultation of the chest,parameters of haemodynamics,serum levels of brain natrium peptide (BNP) and atrial natrium peptide (ANP) were observed at 0 h and 1 h after drug injection.Results Clinical symptoms and physical signs of heart failure were improved significantly,heart rates and serum levels of BNP (F=15.929,14.534,all P

BACKGROUND:The study aimed to compare the therapeutic effect of recombinant tissue plasminogen activator (rt-PA) on the onset of acute cerebral infarction (ACI) at different time points of the first 6 hours.METHODS:A retrospective analysis was conducted in 74 patients who received rt-PA thrombolysis treatment within 4.5 hours after ACI and another 15 patients who received rt-PA thrombolysis treatment between 4.5-6 hours after ACI.RESULTS:National Institute of Health Stroke Scale (NIHSS) scores were statistically decreased in both groups (P>0.05) at 24 hours and 7 days after ACI. There was no significant difference in modified ranking scores and mortality at 90 days after the treatment between the two groups (P>0.05).CONCLUSIONS:The therapeutic effect and mortality of rt-PA treatment in patients with ACI between 4.5-6 hours after the onset of the disease were similar to those in patients who received rt-PA within 4.5 hours after the onset of this disease. Therefore, intravenous thrombolytic therapy for ACI within 4.5-6 hours after ACI was effective and safe.

Objective:To investigate the serum Vitamin A level of 2-6 years old children in Shenyang kindergarden. Method:A total of 2 000 children aged 2-6 years old in Shenyang kindergarden were selected. And fluorescence micro spectrophotometry was used to detect. Results:Serum Vitamin A level of 2 000 children fluctuated at 0.700-1.751μmol/L,the mean was (1.074±0.257)μmol/L. There was no vitamin A deficiency (VAD) and sub-Vitamin A deficiency (SVAD) . The incidence of suspect SVAD was 52.7%. Conclusions:VAD and SVAD may be eradicated in 2-6 years old in Shenyang kindergarden, but there is increasing tendency in suspect SVAD. Decreasing and eradicating susptect SVAD is important work of our current and next step.

Objective To evaluate the CT findings of lymphofollicular thymic hyperplasia in adult myasthenia gravis (MG).Methods The CT findings of thymus area of 134 adult patients with lymphofolficular thymic hyperplasia in MG were reviewed,all of them with surgically and histologically proven diagnosis,and compared with the CT findings of 165 normal subjects.Results In the group of patient,CT showed enlargement of thymus in 31 patients,5 patients had nodule or mass(＜3 cm);thus 36 cases(26.9%)can confirmed diagnose by CT with thymic hyperplasia.CT showed 2 masses(＞3 em) and 9 patients(6.7%)had normal size thymus with soft-tissue density,it can considered with thymic hyperplasia.The spotty or streak shadow showed in other patients,though it could not be certain diagnosed as thymic hyperplasia,but could not be except it.The thymus area tissue complete replacement by fatty density were not found in patient group.The CT findings of patients had marked difference when compared with group of normal subjects(P＜0.01),except the spotty or streak shadows.Conclusion CT scan is an important method in diagnosing thymic lymphofollicular hyperplasia of MG in adult.

Nutcracker syndrome occurs when the left renal vein (LRV) is compressed between the superior mesenteric artery and the aorta, and this syndrome is often characterized by venous hypertension and related pathologies. However, invasive studies such as phlebography and measuring the reno-caval pressure gradient should be performed to identify venous hypertension. Here we present a case of Nutcracker syndrome where the LRV and intra-renal varicosities appeared homogeneously hyperintense on magnetic resonance (MR) fast-spin-echo T2-weighted imaging, which suggested markedly stagnant intravenous blood flow and the presence of venous hypertension. The patient was diagnosed and treated without obtaining the reno-caval pressure gradient. The discomfort of the patient lessened after treatment. Furthermore, on follow-up evaluation, the LRV displayed a signal void, and this was suggestive of a restoration of the normal LRV flow and a decrease in LRV pressure.
Abdominal Pain/etiology ; Adult ; Constriction, Pathologic ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Kidney Diseases/complications/*pathology/surgery ; Magnetic Resonance Imaging/*methods ; Male ; Renal Veins/*pathology/surgery ; Stents ; Syndrome ; Vascular Diseases/complications/*pathology/surgery ; Young Adult

The publisher and authors would like to draw the reader's attention to an error in the following article. The Usefulness of Fast-Spin-Echo T2-Weighted MR Imaging in Nutcracker Syndrome: a Case Report. Korean J Radiol 2010;11:373-377. On page 373, the first author's name has been incorrectly spelled as Heong-Leng Wong. The correct spelling is Heong-Ieng Wong.

Biomarkers, Tumor ; analysis ; Fatty Acid-Binding Proteins ; analysis ; Humans ; Receptors, Retinoic Acid ; analysis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Two-Dimensional Difference Gel Electrophoresis ; methods ; Up-Regulation ; Urinary Bladder Neoplasms ; chemistry

BACKGROUNDGranulocyte colony-stimulating factor (G-CSF) seems to improve cardiac function and perfusion when used systemically through mobilization of stem cells into peripheral blood, but results of previous clinical trials remain controversial. This study was designed to investigate safety and efficacy of subcutaneous injection of G-CSF on left ventricular function in patients with impaired left ventricular function after ST-segment elevation myocardial infarction (STEMI).

METHODSThirty-three patients (22 men; age, (68.5 +/- 6.1) years) with STEMI and with comorbidity of leukopenia were included after successful primary percutaneous coronary intervention within 12 hours after symptom onset. Patients were randomized into G-CSF group who received G-CSF (10 microg/kg of body weight, daily) for continuous 7 days and control group. Results of blood analyses, echocardiography and angiography were documented as well as possibly occurred adverse events.

RESULTSNo severe adverse events occurred in both groups. Mean segmental wall thickening in infract segments increased significantly at 6-month follow up compared with baseline in both groups, but the longitudinal variation between two groups had no significant difference (P > 0.05). The same change could also be found in longitudinal variation of wall motion score index of infarct segments (P > 0.05). At 6-month follow-up, left ventricular end-diastolic volume of both groups increased to a greater extent, but there were no significant differences between the two groups when comparing the longitudinal variations (P > 0.05). In both groups, left ventricular ejection fraction measured by echocardiography ameliorated significantly at 6-month follow-up (P < 0.05), but difference of the longitudinal variation between two groups was not significant (P > 0.05). When pay attention to left ventricular ejection fraction measured by angiocardiography, difference of the longitudinal variation between groups was significant (P = 0.046). Early diastolic mitral flow velocity deceleration time changed significantly at 6- month follow-up in both groups (P = 0.05).

CONCLUSIONSMobilization of stem cells by G-CSF after reperfusion of infarct myocardium is safe and seems to offer a pragmatic strategy for recovery of myocardial global function.

Aged ; Angiocardiography ; Coronary Angiography ; Echocardiography ; Female ; Granulocyte Colony-Stimulating Factor ; adverse effects ; pharmacology ; therapeutic use ; Humans ; Leukopenia ; drug therapy ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; therapy ; Ventricular Function, Left ; drug effects