AIM： To investigate the utility of esophageal capsule endoscopy in the diagnosis and grading of esophageal varices. METHODS： Cirrhotic patients who were undergoing esophagogastroduodenoscopy （EGD） for variceal scr...AIM： To investigate the utility of esophageal capsule endoscopy in the diagnosis and grading of esophageal varices. METHODS： Cirrhotic patients who were undergoing esophagogastroduodenoscopy （EGD） for variceal screening or surveillance underwent capsule endoscopy. Two separate blinded investigators read each capsule endoscopy for the following results： variceal grade, need for treatment with variceal banding or prophylaxis with beta-blocker therapy, degree of portal hypertensive gastropathy, and gastric varices. RESULTS： Fifty patients underwent both capsule and EGD. Forty-eight patients had both procedures on the same day, and 2 patients had capsule endoscopy within 72 h of EGD. The accuracy of capsule endoscopy to decide on the need for prophylaxis was 74%, with sensitivity of 63% and specificity of 82%. Interrater agreement was moderate （kappa = 0.56）. Agreement between EGD and capsule endoscopy on grade of varices was 0.53 （moderate）. Inter-rater reliability was good （kappa = 0.77）. In diagnosis of portal hypertensive gastropathy, accuracy was 57%, with sensitivity of 96% and specificity of 17%. Two patients had gastric varices seen on EGD, one of which was seen on capsule endoscopy. There were no complications from capsule endoscopy.CONCLUSION： We conclude that capsule endoscopy has a limited role in deciding which patients would benefit from EGD with banding or beta-blocker therapy. More data is needed to assess accuracy for staging esophageal varices, PHG, and the detection of gastric varices.展开更多
To determine the interdependence of intracranial pressure(ICP) and intraocular pressure(IOP) and how it affects optic nerve pressures, eight normal dogs were examined using pressure-sensing probes implanted into the l...To determine the interdependence of intracranial pressure(ICP) and intraocular pressure(IOP) and how it affects optic nerve pressures, eight normal dogs were examined using pressure-sensing probes implanted into the left ventricle, lumbar cistern, optic nerve subarachnoid space in the left eye, and anterior chamber in the left eye. This allowed ICP, lumbar cistern pressure(LCP), optic nerve subarachnoid space pressure(ONSP) and IOP to be simultaneously recorded. After establishing baseline pressure levels, pressure changes that resulted from lowering ICP(via shunting cerebrospinal fluid(CSF) from the ventricle) were recorded. At baseline, all examined pressures were different(ICP>LCP>ONSP), but correlated(P<0.001). As ICP was lowered during CSF shunting, IOP also dropped in a parallel time course so that the trans-lamina cribrosa gradient(TLPG) remained stable(ICP-IOP dependent zone). However, once ICP fell below a critical breakpoint, ICP and IOP became uncoupled and TLPG changed as ICP declined(ICP-IOP independent zone). The optic nerve pressure gradient(ONPG) and trans-optic nerve pressure gradient(TOPG) increased linearly as ICP decreased through both the ICP-IOP dependent and independent zones. We conclude that ICP and IOP are coupled in a specific pressure range, but when ICP drops below a critical point, IOP and ICP become uncoupled and TLPG increases. When ICP drops, a rise in the ONPG and TOPG creates more pressure and reduces CSF flow around the optic nerve. This change may play a role in the development and progression of various ophthalmic and neurological diseases, including glaucoma.展开更多
Objective： To assess zero drift of intra- ventricular and subdural intracranial pressure （ICP） moni- toring systems. Methods： A prospective study was conducted in pa- tients who received Codman ICP monitoring in ...Objective： To assess zero drift of intra- ventricular and subdural intracranial pressure （ICP） moni- toring systems. Methods： A prospective study was conducted in pa- tients who received Codman ICP monitoring in the neuro- surgical department from January 2010 to December 2011. According to the location of sensors, the patients were ca- tegorized into two groups： intraventricular group and sub- dural group. Zero drift between the two groups and its as- sociation with the duration of ICP monitor were analyzed. Results： Totally, 22 patients undergoing intraven- tricular ICP monitoring and 27 receiving subdural ICP moni- toring were enrolled. There was no significant difference in duration of ICP monitoring, zero drift value and its absolute value between intraventricular and subdural groups （5.38 d± 2.58 d vs 4.58 d.±2.24 d, 0.77 mmHg±2.18 mmHg vs 1.03 mmHg±2.06mmHg, 1.68 mmHg~.l.55 mmHgvs 1.70mmHg.t_l.53 mmHg, respectively; all P〉0.05）. Absolute value of zero drift in both groups significantly rose with the increased duration of ICP monitoring （P〈0.05） while zero drift value did not. Moreover, daily absolute value in the intraventricular group was sig- nificantly smaller than that in the subdural group （0.27 mm Hg_＋ 0.32 mm Hg vs 0.29 mm Hg_-_＊0.18 mm Hg, P〈0.05）. Conclusion： This study demonstrates that absolute value of zero drift significantly correlates with duration of both intraventricular and subdural ICP monitoring. Due to the smaller daily absolute value, ICP values recorded from intraventficular system may be more reliable than those from subdural system.展开更多
AIM:The present study was designed to investigate the contribution of membrane hyperpolarization to endothelium-dependent relaxations induced by serotonin in the porcine coronary artery.METHODS:Rings with and without ...AIM:The present study was designed to investigate the contribution of membrane hyperpolarization to endothelium-dependent relaxations induced by serotonin in the porcine coronary artery.METHODS:Rings with and without endothelium of porcine coronary arteries were suspended in conventional organ chambers for the measurement of isometric force.The cell membrane potential of the vascular smooth muscle cells was measured using glass microelectrodes,in the presence of indometacin,ketanserin,and/or N^(ω)-nitro-L-arginine.RESULTS:Serotonin induced a transient endothelium-,and concentration-dependent relaxation in rings contracted with prostaglandin F_(2α)in the presence of N^(ω)-nitro-L-arginine(maximal relaxation;19%).The N^(ω)-nitro-L-arginine resistant relaxation was abolished by high K^(+)and tetrabutylammonium chloride.Serotonin also caused an endothelium-,concentration-dependent membrane hyperpolarizations with a maximal amplitude of-8.8mV.The nitro-L-arginine resistant relaxations and hyperpolarizations were abolished by methiothepin,but not by glibenclamide.The time course of the endothelium-dependent relaxations and hyperpolarizations was similar.CONCLUSION:These results suggest a contribution of cell membrane hyperpolarization to theendothelium-dependent relaxations induced by serotonin in the porcine coronary artery.展开更多
基金The funding for this project was obtained from a ScrippsHealth Educational Grant, No. 02-007
文摘AIM： To investigate the utility of esophageal capsule endoscopy in the diagnosis and grading of esophageal varices. METHODS： Cirrhotic patients who were undergoing esophagogastroduodenoscopy （EGD） for variceal screening or surveillance underwent capsule endoscopy. Two separate blinded investigators read each capsule endoscopy for the following results： variceal grade, need for treatment with variceal banding or prophylaxis with beta-blocker therapy, degree of portal hypertensive gastropathy, and gastric varices. RESULTS： Fifty patients underwent both capsule and EGD. Forty-eight patients had both procedures on the same day, and 2 patients had capsule endoscopy within 72 h of EGD. The accuracy of capsule endoscopy to decide on the need for prophylaxis was 74%, with sensitivity of 63% and specificity of 82%. Interrater agreement was moderate （kappa = 0.56）. Agreement between EGD and capsule endoscopy on grade of varices was 0.53 （moderate）. Inter-rater reliability was good （kappa = 0.77）. In diagnosis of portal hypertensive gastropathy, accuracy was 57%, with sensitivity of 96% and specificity of 17%. Two patients had gastric varices seen on EGD, one of which was seen on capsule endoscopy. There were no complications from capsule endoscopy.CONCLUSION： We conclude that capsule endoscopy has a limited role in deciding which patients would benefit from EGD with banding or beta-blocker therapy. More data is needed to assess accuracy for staging esophageal varices, PHG, and the detection of gastric varices.
基金supported by the National Natural Science Foundation of China (81271005, 81300767)Beijing Natural Science Foundation (7122038)+3 种基金two separate donations by the China Health and Medical Development FoundationB.A.S. was supported by the BMBF network ERA-net Neuron “Restoration of Vision after Stroke (REVIS)” (BMBF 01EW1210)by the “Hai-ju” Beijing Overseas Talents ProgramRuowu Hou was supported by the Beijing Tongren Hospital Foundation (2015-YJJ-GGL-013)
文摘To determine the interdependence of intracranial pressure(ICP) and intraocular pressure(IOP) and how it affects optic nerve pressures, eight normal dogs were examined using pressure-sensing probes implanted into the left ventricle, lumbar cistern, optic nerve subarachnoid space in the left eye, and anterior chamber in the left eye. This allowed ICP, lumbar cistern pressure(LCP), optic nerve subarachnoid space pressure(ONSP) and IOP to be simultaneously recorded. After establishing baseline pressure levels, pressure changes that resulted from lowering ICP(via shunting cerebrospinal fluid(CSF) from the ventricle) were recorded. At baseline, all examined pressures were different(ICP>LCP>ONSP), but correlated(P<0.001). As ICP was lowered during CSF shunting, IOP also dropped in a parallel time course so that the trans-lamina cribrosa gradient(TLPG) remained stable(ICP-IOP dependent zone). However, once ICP fell below a critical breakpoint, ICP and IOP became uncoupled and TLPG changed as ICP declined(ICP-IOP independent zone). The optic nerve pressure gradient(ONPG) and trans-optic nerve pressure gradient(TOPG) increased linearly as ICP decreased through both the ICP-IOP dependent and independent zones. We conclude that ICP and IOP are coupled in a specific pressure range, but when ICP drops below a critical point, IOP and ICP become uncoupled and TLPG increases. When ICP drops, a rise in the ONPG and TOPG creates more pressure and reduces CSF flow around the optic nerve. This change may play a role in the development and progression of various ophthalmic and neurological diseases, including glaucoma.
文摘Objective： To assess zero drift of intra- ventricular and subdural intracranial pressure （ICP） moni- toring systems. Methods： A prospective study was conducted in pa- tients who received Codman ICP monitoring in the neuro- surgical department from January 2010 to December 2011. According to the location of sensors, the patients were ca- tegorized into two groups： intraventricular group and sub- dural group. Zero drift between the two groups and its as- sociation with the duration of ICP monitor were analyzed. Results： Totally, 22 patients undergoing intraven- tricular ICP monitoring and 27 receiving subdural ICP moni- toring were enrolled. There was no significant difference in duration of ICP monitoring, zero drift value and its absolute value between intraventricular and subdural groups （5.38 d± 2.58 d vs 4.58 d.±2.24 d, 0.77 mmHg±2.18 mmHg vs 1.03 mmHg±2.06mmHg, 1.68 mmHg~.l.55 mmHgvs 1.70mmHg.t_l.53 mmHg, respectively; all P〉0.05）. Absolute value of zero drift in both groups significantly rose with the increased duration of ICP monitoring （P〈0.05） while zero drift value did not. Moreover, daily absolute value in the intraventricular group was sig- nificantly smaller than that in the subdural group （0.27 mm Hg_＋ 0.32 mm Hg vs 0.29 mm Hg_-_＊0.18 mm Hg, P〈0.05）. Conclusion： This study demonstrates that absolute value of zero drift significantly correlates with duration of both intraventricular and subdural ICP monitoring. Due to the smaller daily absolute value, ICP values recorded from intraventficular system may be more reliable than those from subdural system.
文摘AIM:The present study was designed to investigate the contribution of membrane hyperpolarization to endothelium-dependent relaxations induced by serotonin in the porcine coronary artery.METHODS:Rings with and without endothelium of porcine coronary arteries were suspended in conventional organ chambers for the measurement of isometric force.The cell membrane potential of the vascular smooth muscle cells was measured using glass microelectrodes,in the presence of indometacin,ketanserin,and/or N^(ω)-nitro-L-arginine.RESULTS:Serotonin induced a transient endothelium-,and concentration-dependent relaxation in rings contracted with prostaglandin F_(2α)in the presence of N^(ω)-nitro-L-arginine(maximal relaxation;19%).The N^(ω)-nitro-L-arginine resistant relaxation was abolished by high K^(+)and tetrabutylammonium chloride.Serotonin also caused an endothelium-,concentration-dependent membrane hyperpolarizations with a maximal amplitude of-8.8mV.The nitro-L-arginine resistant relaxations and hyperpolarizations were abolished by methiothepin,but not by glibenclamide.The time course of the endothelium-dependent relaxations and hyperpolarizations was similar.CONCLUSION:These results suggest a contribution of cell membrane hyperpolarization to theendothelium-dependent relaxations induced by serotonin in the porcine coronary artery.
