Double-chambered left ventricle with a thrombus in an asymptomatic patient:A case report

BACKGROUND Double-chambered left ventricle(DCLV)is an extremely rare congenital disease in which the left ventricle(LV)is divided by abnormal muscle tissue.Due to its rarity,there is a lack of data on the disease,including its diagnosis,treatment,and prognosis.Accordingly,we report a case in which DCLV was diagnosed and followed up.CASE SUMMARY A 45-year-old man presented to our hospital due to abnormal findings on an electrocardiogram recorded during a health check.He had no specific cardiac symptoms,comorbidities or relevant past medical history.Echocardiography revealed that the LV was divided into two by muscle fibers.There were no findings of ischemia on coronary angiography and coronary computed tomography angiography performed to exclude differential diagnoses.After comprehensive analysis of the images,DCLV was diagnosed.As it seemed to be asymptomatic DCLV,we decided the patient was to be observed without administering any medication.However,follow-up echocardiography revealed a thrombus in the accessory chamber(AC).Anticoagulant medication was initiated,the thrombus resolved,and the patient is currently undergoing follow-up without any specific symptoms.CONCLUSION Asymptomatic,uncomplicated DCLV was diagnosed through multimodal imaging;however,a thrombus in the AC occurred during the follow-up.The findings highlight that multimodal imaging is essential in diagnosing DCLV,and that anticoagulation is important in its management.

Single Ventricle in a 40-Year-Old Male Patient “Natural Evolution and Single Ventricle-Associated Complications in Adults: A Case Report”

Single ventricle is an uncommon congenital cardiac pathology with high mortality at early ages. However, due to new strategies and timely surgical treatment, it is increasingly seen in adults, which has increased the survival rate. This condition is characterized by a heart with a single functional ventricular cavity. The aim of this article is to report the case of a 40-year-old male with single ventricle, who underwent several surgeries in his childhood. After these surgical procedures, the patient lost medical follow-up and presented complications derived from the disease itself. Heart Failure is a common complication in people with single ventricle, and pharmacological heart failure therapies have been ineffective in mitigating the need of the heart transplantation. That’s why it is essential to develop and apply new pharmacological techniques for the management of these patients in childhood as well as in adulthood. This would allow not only to avoid various comorbidities, but also to improve the quality of life of the patients.

Measurement of lateral ventricle volume of normal infant based on magnetic resonance imaging

Background:Many neurophysiological diseases during infancy stage are associated with the morphology and size of the lateral ventricle.This research aims to measure the normal value range of lateral ventricle volume of normal infant and thus provide basic data for clinical treatment.Method:By retrospective analysis of magnetic resonance inspection (MRI) cranial image of 165 infants in the Department of Pediatric Neurosurgery,Beijing Tiantan Hospital,the infants were divided into four groups according to their age,including the first group (1~3 month,n =12),the second group (4~6 month,n =33),the third group (7~9 month,n =51),and the fourth group (10~12 month,n =69).On Neurosoft image workstation,it can measure the sectional area of the lateral ventricle volume at each layer of axis T2W image and calculate the lateral ventricle volume using the Cavalieri method.Moreover,the correlations between lateral ventricle volume and gender,side difference,and month age were analyzed.Results:95% confidence interval of total bilateral ventricle volume of normal infant:11920.22~14,266.28 mm3 for male infant and 9922.22~12,263.17 mm3 for female infant;95% confidence interval of left side ventricle volume:6254.72~7546.94 mm3 for male infant and 5206.03~6479.99 mm3 for female infant;95% confidence interval of right side ventricle volume:5041.56~6743.29 mm3 for male infant and 4695.00~5804.40 mm3 for female infant.The lateral ventricle volume of the male infant was normally larger than that of the female infant (p < 0.05).For both male and female infants,the left side ventricle volume was larger than the right ventricle volume (p < 0.01).There was no significant difference in lateral ventricle volume between infants over 3 months old.Conclusion:The normal value range of lateral ventricle volume of the infant can be obtained via referring MRI image.The lateral ventricle volume of infant varies upon gender and ventricle side.

NONLINEAR DYNAMICS MODFLING OF MECHANICAL PERIODICITY OF END DIASTOLIC VOLUME OF LEFT VENTRICLE

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.

An Interpretable CNN for the Segmentation of the Left Ventricle in Cardiac MRI by Real-Time Visualization

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.

Effect of rheumatic mitral stenosis on end-diastolic volume of left ventricle

Objective To investigate the relations between the pathological contraction of the valve and sub-valvular apparatus in rheumatic mitral stenosis and end-diastolic volume of left ventricle. Method From 1990-2004, 90 patients with only moderate or severe rheumatic mitral stenosis （mitral group）, and 24 patients with combined moderate or severe rheumatic mitral stenosis and significant aortic regurgitation （ combined valves group）, diagnostically confirmed by surgery and pathology, were measured using echocardiaogram the end-diastolic volume and diameter, stroke volume and ejection fraction of left ventricle. Result Compared with mitral group combined valves group showed slight increases of end-diastolic volume and diameter （116.49 ± 37.93 ml and 136.72±70.67 ml, respectively; 49.34 ± 6.71 mm and 51.08 ± 8.32 mm, respectively; both P 〈 0.05）, and slight decreases of ejection fraction, but significant increases of stroke volume （71.37 ± 25.01 ml and 91.06 ± 36.67 ml, respectively; P〈0.05） of left ventricle. Conclusion The pathological shortening of mitral valve and sub-valvular apparatus caused by long-term rheumatic disease is the main cause of decreased left ventricular volume in mitral stenosis.

Long-Term Outcomes of Systemic-to-Pulmonary Artery Shunt in Patients with Functional Single Ventricle and Heterotaxy Syndrome

Objectives: We sought to determine the long-term outcomes and mortality-associated factors after systemic-topulmonaryartery shunt (SPS) in patients with heterotaxy syndrome. Methods: We retrospectively analyzed allpatients with a functional single ventricle and heterotaxy syndrome who underwent SPS at our center from January2001 to April 2022. Results: This study involved 84 patients. Restrictive pulmonary blood flow requiringearly modulation was presented in 34 (40%) patients. Compared with patients without restrictive pulmonaryblood flow (N = 50 [60%]), the postnatal survival of these 34 patients was significantly lower at 10 years (log rank:p = 0.04), but the statistical significance disappeared at 20 years (log rank: p = 0.18). Among 31 patients whounderwent SPS, 11 (35%) had extracardiac total anomalous pulmonary venous connection (TAPVC). The survivalrate after SPS was 80% at 10 years. Cox regression analysis showed that extracardiac TAPVC (hazard ratio6.44, 95% confidence interval 1.23–33.7, p = 0.03) and pulmonary venous obstruction (PVO) at TAPVC repair(hazard ratio 11.2, 95% confidence interval 2.13–58.5, p = 0.004) were significantly associated with death. In25 patients who underwent bidirectional cavopulmonary shunt (BCPS), surgical interventions on the pulmonaryartery (PA) were performed after SPS in 7 of 9 patients with PA coarctation, 3 of 4 with non-confluent PAs, and4 of 12 with normal PAs. At SPS, primary central PA plasty was performed in three patients with PA coarctationand 2 with non-confluent PAs. There was no significant difference in the PA index before BCPS between patientswith and without primary central PA plasty (p = 0.49). Among 20 patients who underwent total cavopulmonaryconnection (TCPC), adverse events occurred in 7 (35%) patients, including death in 1 (5%), intervention for pulmonaryarteriovenous malformation (PAVM) in 3 (15%), and surgical intervention for PVO in 3 (15%). TheB-type natriuretic peptide concentration was significantly higher in patients with than without adverse events(p = 0.02). The adverse event-free survival rate after TCPC was 69% at 10 years. Conclusion: ExtracardiacTAPVC and PVO at TAPVC repair were significantly associated with death after SPS in patients who had heterotaxysyndrome with a single ventricle. Surgical interventions on the PA were frequently required after SPS inpatients with PA coarctation or non-confluent PAs. Although satisfactory survival was achievable after TCPC,late-onset PAVM and PVO remain concerns.

Right ventricle dysfunction does not predict mortality in patients with SARS-CoV-2-related acute respiratory distress syndrome on extracorporeal membrane oxygenation support

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.

Systemic right ventricle complications in levo-transposition of the great arteries: A case report and review of literature

BACKGROUND Congenitally corrected levo-transposition of the great arteries(L-TGA)is a congenital heart disease in which the ventricles and great arteries are transposed from their typical anatomy.In L-TGA,the double discordance,atrioventricular and ventriculoarterial,create an acyanotic milieu which allows patients to survive their early decades,however,progressive systemic right ventricle(sRV)dys-function creates complications later in life.sRV dysfunction and remodeling predisposes patients to intracardiac thrombus(ICT)formation.CASE SUMMARY A 40-year-old male with L-TGA presented with symptoms of acute decom-pensated heart failure.In childhood,he had surgical repair of a ventricular septal defect.In adulthood,he developed sRV dysfunction,systemic tricuspid valve(sTV)regurgitation,and left-bundle branch block for which he underwent cardiac resynchronization therapy.Transthoracic echocardiogram showed a sRV ejection fraction of 40%,severe sTV regurgitation,and a newly identified sRV ICT.ICT was confirmed by ultrasound-enhancing agents and transesophageal echocardio-graphy.Our patient was optimized with guideline-directed medical therapy and diuresis.Anticoagulation was achieved with a vitamin K antagonist(VKA)and he was later referred for evaluation by advanced heart failure and heart transplant services.CONCLUSION Anticoagulation with VKA is the mainstay of treatment in the absence of conclusive data supporting direct oral anticoagulant use in ICT in patients with congenital heart disease.This case illustrates the natural history of L-TGA and highlights the importance of surveillance and monitoring with dedicated cardiac imaging to identify complications.

Value of clinical applications of differential pressure and relative pressure imaging in the left ventricle

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.

Inadvertent Lead Malposition in the Left Ventricle during Permanent Ventricular Pacing about One Case

Inadvertent Lead Malposition in Left Ventricle is a rare and underdiagnosed incident, which may occur during implantation of cardiac electronic devices and may remain asymptomatic. We reported the case of a 71-year-old man who was implanted with a ventricular single-chamber pacemaker for a slow atrial fibrillation with syncope and whose routine transthoracic echocardiography 23 months after implantation displayed a malposition of the pacemaker lead into the Left Ventricle through a patent foramen oval. The patient was asymptomatic. The electrocardiogram showed right bundle branch block QRS-paced morphology with a positive QRS pattern in V1, a median paced QRS axis on the frontal plane at -120°, a Precordial transition on V5. At the lateral Chest X-ray the lead curved backwards to the spine. Given the age of this old patient who already received oral anticoagulant for Atrial Fibrillation and the Lead malposition discovered 23 months after pacemaker’s implantation, we decided to maintain the lead in LV and continue anticoagulation.

Proposed Simple, Efficient Free Hand Technique for Frontal External Ventricular Drain (EVD) in Case of Small Ventricle: A Report of New Technique

Background: EVD is a common procedure done in neurosurgery and the residents should master it and this is what exactly means that it should be simple, safe, fast and accurate. EVD can be done through many entry points to the different part of the lateral ventricle but the famous site is the anterior horn of the lateral ventricle which is commonly approached through Kocher’s point which is a famous point for all neurosurgeon by its measurements of allocation. The commonest problem with EVD insertion into the anterior horn is the navigation of the ventricular cavity with the right trajectory and so the location of the catheter tip in the right place near the foramen of monro to ensure CSF draining. Size of the ventricle plays significant role in the success of the procedure especially free hand technique. The more dilated ventricle, the more chance to hit the ventricular cavity especially from the first trial and vice versa. In case of small ventricle, the procedure with free hand technique seems more complicated and the chance to hit the ventricle from the first trial may reduce especially with non-expert surgeon but may succeed in the following trials with increased risk of complications with more trials. Purpose: Most EVD’s are placed with freehand technique which depends on the operator skills to navigate the ventricle with right trajectory and hit the ventricle from the first trial, because many trials may complicate the procedure and produce undesirable side effects. So the key in this free hand technique is how to ensure the success from the first trial. In case of small anterior horn of the lateral ventricle, the procedure is even more difficult with the free hand technique and the classic Kocher point needs an expert to get the right trajectory to navigate such small ventricle. Our point idea came from this prospective and aimed at raising the success of the procedure especially in the first attempt with simple technique. Method: It is a new entry point for EVD insertion through frontal burr hole gained by the intersection of two lines: the first is running vertically from the ipsilateral medial canthus downward and the second is running horizontal along the coronal suture which is usually palpable as ridge on the scalp extended lateral from the bregma. Burr hole is done just anterior to this intersection and catheter is placed in a perpendicular trajectory toward the ventricular cavity. Result: It has been used in about (n = 50 cases) fulfilling the criteria of radiological small ventricle as defined and they were candidates for EVD insertion by free hand technique. Only 3 cases (6%) out of the 50 cases failed in the first attempt but succeeded in the following trial. So high rate of success in first trial is seen in the most of cases using this technique during a period of one year of our practice without significant side effects seen. Conclusion: Our study is not conclusive and needs further studies for more evaluation. It was a suggested point other than the classic Kocher point in case of free hand EVD insertion in small ventricle. We recommend to try it and report any advantages or disadvantages to the literature.

Prenatal Diagnosis of an Apically Located Congenital Left Ventricular Aneurysm: A Rare Case

Congenital ventricular aneurysm is a very rare cardiac anomaly.A diagnosis can be made during the prenatal period using fetal echocardiography.This study presents a very rare apically located left ventricular aneurysm case,and the relevant literature was reviewed and discussed.In this case,a 35-year-old,gravida 2,parity 1 preg-nant woman at 24 weeks of gestation,displayed a wide aneurysmal image in the left ventricular apical wall on fetal echocardiography.There was a 1.79 mm muscular ventricular septal defect at the apical region of the interven-tricular septum.In the course of the color Doppler ultrasonography examination,an aberrantfibrous band within the left ventricle and consequent turbulentflow during systole were observed.The baby,born via cesarean section at 37 weeks of gestation,is now in its postnatal seventh month.However,during echocardiographic follow-ups,changes have been observed,including mild to moderate mitral insufficiency and a decrease in systolic function.Despite thesefindings,the clinical condition remains asymptomatic.It is of great importance to use a multidis-ciplinary approach in managing these rare cases that could lead to potential adverse outcomes during the antena-tal or postnatal periods.

Hypertrophic cardiomyopathy and left ventricular non-compaction:Distinct diseases or variant phenotypes of a single condition?

Hypertrophic cardiomyopathy(HCM)is a genetically determined myocardial disease characterized by an increased thickness of the left ventricle(LV)wall that cannot be solely attributed to abnormal loading conditions.HCM may present with an intraventricular or LV outflow tract obstruction,diastolic dysfunction,myocardial fibrosis and/or ventricular arrhythmias.Differentiating HCM from other diseases associated with LV hypertrophy,such as hypertension,aortic stenosis,or LV non-compaction(LVNC),can at times be challenging.LVNC is defined by excessive LV trabeculation and deep recesses between trabeculae,often accompanied by increased LV myocardial mass.Previous studies indicate that the LVNC phenotype may be observed in up to 5%of the general population;however,in most cases,it is a benign finding with no impact on clinical outcomes.Nevertheless,LVNC can occasionally lead to LV systolic dysfunction,manifesting as a phenotype of dilated or non-dilated left ventricular cardiomyopathy,with an increased risk of thrombus formation and arterial embolism.In extreme cases,where LVNC is associated with a very thickened LV wall,it can even mimic HCM.There is growing evidence of an overlap between HCM and LVNC,including similar genetic mutations and clinical presentations.This raises the question of whether HCM and LVNC represent different phenotypes of the same disease or are,in fact,two distinct entities.

Liver cirrhosis and left ventricle diastolic dysfunction: Systematic review

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.

Monoamine alterations and rotational asymmetry in a rat model of Parkinson's disease following lateral ventricle transplantation of human amniotic epithelial cells

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 2 μL 6-OHDA （3.5 μg/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 10 μL 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.

Left to Right Extracardial Shunt to Control Hemorrhage of Ascending Aorta and Left Ventricle: A Report of 3 Cases

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.

Patient-Specific Echo-Based Fluid-Structure Interaction Modeling Study of Blood Flow in the Left Ventricle with Infarction and Hypertension

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.

In situ staining of the primo vascular system in the ventricles and subarachnoid space of the brain by trypan blue injection into the lateral ventricle

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.

Effect of somatostatin analogue octreotide injected into the third cerebral ventricle on pentagastrin-induced gastric acid secretion in rats

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.