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Tong LY, Deng YB, Du WH, Zhou WZ, Liao XY, Jiang X. Clemastine Promotes Differentiation of Oligodendrocyte Progenitor Cells Through the Activation of ERK1/2 via Muscarinic Receptors After Spinal Cord Injury. Front Pharmacol 2022; 13:914153. [PMID: 35865954 PMCID: PMC9294397 DOI: 10.3389/fphar.2022.914153] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
The recovery of spinal cord injury (SCI) is closely associated with the obstruction of oligodendrocyte progenitor cell (OPC) differentiation, which ultimately induces the inability to generate newly formed myelin. To address the concern, drug-based methods may be the most practical and feasible way, possibly applying to clinical therapies for patients with SCI. In our previous study, we found that clemastine treatment preserves myelin integrity, decreases the loss of axons, and improves functional recovery in the SCI model. Clemastine acts as an antagonist of the muscarinic acetylcholine receptor (muscarinic receptor, MR) identified from a string of anti-muscarinic drugs that can enhance oligodendrocyte differentiation and myelin wrapping. However, the effects of clemastine on OPC differentiation through MRs in SCI and the underlying mechanism remain unclear. To explore the possibility, a rat model of SCI was established. To investigate if clemastine could promote the differentiation of OPCs in SCI via MR, the expressions of OPC and mature OL were detected at 7 days post injury (dpi) or at 14 dpi. The significant effect of clemastine on encouraging OPC differentiation was revealed at 14 dpi rather than 7 dpi. Under pre-treatment with the MR agonist cevimeline, the positive role of clemastine on OPC differentiation was partially disrupted. Further studies indicated that clemastine increased the phosphorylation level of extracellular signal–regulated kinase 1/2 (p-ERK1/2) and the expressions of transcription factors, Myrf and Olig2. To determine the relationship among clemastine, ERK1/2 signaling, specified transcription factors, and OPC differentiation, the ERK1/2 signaling was disturbed by U0126. The inhibition of ERK1/2 in SCI rats treated with clemastine decreased the expressions of p-ERK 1/2, Myrf, Olig2, and mature OLs, suggesting that ERK1/2 is required for clemastine on promoting OPC differentiation and that specified transcription factors may be affected by the activity of ERK1/2. Moreover, the impact of clemastine on modulating the level of p-ERK 1/2 was restricted following cevimeline pre-injecting, which provides further evidence that the role of clemastine was mediated by MRs. Altogether, our data demonstrated that clemastine, mediated by MRs, promotes OPC differentiation under the enhancement of Myrf and Olig2 by activating ERK1/2 signaling and suggests a novel therapeutic prospect for SCI recovery.
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Affiliation(s)
- Lu-Yao Tong
- Department of Biochemistry and Molecular Biology, Molecular Medicine and Cancer Research Center, College of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Yong-Bing Deng
- Department of Chongqing Emergency Medical Center, Chongqing University Center Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Wei-Hong Du
- Department of Biochemistry and Molecular Biology, Molecular Medicine and Cancer Research Center, College of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Wen-Zhu Zhou
- Department of Biochemistry and Molecular Biology, Molecular Medicine and Cancer Research Center, College of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Xin-Yu Liao
- Department of Biochemistry and Molecular Biology, Molecular Medicine and Cancer Research Center, College of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Xue Jiang
- Department of Biochemistry and Molecular Biology, Molecular Medicine and Cancer Research Center, College of Basic Medicine, Chongqing Medical University, Chongqing, China
- *Correspondence: Xue Jiang, ,
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Chen P, Xiong XH, Chen Y, Wang K, Zhang QT, Zhou W, Deng YB. Perioperative management strategy of severe traumatic brain injury during the outbreak of COVID-19. Chin J Traumatol 2020; 23:202-206. [PMID: 32540201 PMCID: PMC7242933 DOI: 10.1016/j.cjtee.2020.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/14/2020] [Accepted: 05/10/2020] [Indexed: 02/04/2023] Open
Abstract
Since December 2019, a pneumonia caused by a new coronavirus, i.e. COVID-19 occurred in Wuhan, Hubei Province, China. Although the epidemic in China has been bought under control, the global COVID-19 situation is still grim. Severe traumatic brain injury (TBI), as one of critical conditions in the department of neurosurgery, requires an early and effective treatment, especially surgery. There were currently no reliable guidelines on how to perform perioperative protection in TBI patients with suspected or confirmed coronavirus infection. According to the corresponding treatment regulations and guidelines issued by the authorities, we summarized the management strategy of TBI patients in perioperative period during the COVID-19 outbreak based on medical and nursing practice, in order to provide a reference for clinicians.
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Chen P, Deng YB, Hu X, Zhou W, Zhang QT, Zhang LY, Xu MH. Risk factors associated with the progression of extra-axial hematoma in the original frontotemporoparietal site after contralateral decompressive surgery in traumatic brain injury patients. Chin J Traumatol 2020; 23:45-50. [PMID: 31982270 PMCID: PMC7049639 DOI: 10.1016/j.cjtee.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/02/2019] [Accepted: 12/20/2019] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To introduced our experience with progressive extra-axial hematoma (EAH) in the original frontotemporoparietal (FTP) site after contralateral decompressive surgery (CDS) in traumatic brain injury patients and discuss the risk factors associated with this dangerous situation. METHODS This retrospective study was conducted on 941 patients with moderate or severe TBI treated in Daping Hospital, Army Medical University, Chongqing, China in a period over 5 years (2013-2017). Only patients with bilateral lesion, the contralateral side being the dominant lesion, and decompressive surgery on the contralateral side conducted firstly were included. Patients were exclude if (1) they underwent bilateral decompression or neurosurgery at the original location firstly; (2) although surgery was performed first on the contralateral side, surgery was done again at the contralateral side due to re-bleeding or complications; (3) patients younger than 18 years or older than 80 years; and (4) patients with other significant organ injury or severe disorder or those with abnormal coagulation profiles. Clinical and radiographic variables reviewed were demographic data, trauma mechanisms, neurological condition assessed by Glasgow coma scale (GCS) score at admission, pupil size and reactivity, use of mannitol, time interval from trauma to surgery, Rotterdam CT classification, type and volume of EAH, presence of a skull fracture overlying the EAH, status of basal cistern, size of midline shift, associated brain lesions and types, etc. Patients were followed-up for at least 6 months and the outcome was graded by Glasgow outcome scale (GOS) score as favorable (scores of 4-5) and unfavorable (scores of 1-3). Student's t-test was adopted for quantitative variables while Pearson Chi-squared test or Fisher's exact test for categorical variables. Multivariate logistic regression analysis was also applied to estimate the significance of risk factors. RESULTS Initially 186 patients (19.8%) with original impact locations at the FTP site and underwent surgery were selected. Among them, 66 met the inclusion and exclusion criteria. But only 50 patients were included because the data of the other 16 patients were incomplete. Progressive EAH developed at the original FTP site in 11 patients after the treatment of, with an incidence of 22%. Therefore the other 39 patients were classified as the control group. Multivariate logistic regression analysis showed that both the volume of the original hematoma and the absence of an apparent midline shift were significant predictors of hematoma progression after decompressive surgery. Patients with fracture at the original impact site had a higher incidence of progressive EAH after CDS, however this factor was not an important predictor in the multivariate model. We also found that patients with progressive EAH had a similar favorable outcome with control group. CONCLUSION Progressive EAH is correlated with several variables, such as hematoma volumes ≥10 mL at the original impact location and the absence of an apparent midline shift (<5 mm). Although progressive EAH is devastating, timely diagnosis with computed tomography scans and immediate evacuation of the progressive hematoma can yield a favorable result.
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Affiliation(s)
- Peng Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center of PLA, Daping Hospital, Army Medical University, Chongqing 400042 China,Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China
| | - Yong-Bing Deng
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China
| | - Xi Hu
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China
| | - Wei Zhou
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China
| | - Qing-Tao Zhang
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing, China
| | - Lian-Yang Zhang
- State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center of PLA, Daping Hospital, Army Medical University, Chongqing 400042 China,Corresponding authors.
| | - Min-Hui Xu
- Department of Neurosurgery, Daping Hospital, Army Medical University, Chongqing 400042, China,Corresponding authors.
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Xiao SR, Xu GD, Wei WJ, Peng B, Deng YB. [Antiviral effect of hepatitis B virus S gene-specific anti-gene locked nucleic acid in transgenic mice]. Zhonghua Gan Zang Bing Za Zhi 2019; 26:17-22. [PMID: 29804357 DOI: 10.3760/cma.j.issn.1007-3418.2018.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the antiviral effect of hepatitis B virus (HBV) S gene-specific anti-gene locked nucleic acid (LNA) in transgenic mice. Methods: A total of 30 HBV transgenic mice were randomly divided into blank control group (5% glucose + liposome), unrelated sequence control group, lamivudine control group, antisense LNA control group, and anti-gene LNA group, with 6 mice in each group. The mice in the lamivudine group were given lamivudine by gavage, and LNA was injected via the caudal vein. Quantitative real-time PCR was used to measure serum HBV DNA, ELISA was used to measure serum HBsAg, RT-PCR was used to measure HBV S mRNA level in the liver, and immunohistochemistry was used to measure the level of HBsAg in hepatocytes. Results: At 3, 5, and 7 days after treatment, there were significant changes in the inhibition rates of HBV DNA (37.18%, 50.27%, and 61.46%, respectively) and HBsAg (30.17%, 44.00%, and 57.76%, respectively) achieved by anti-gene LNA (P < 0.01), and there were significant differences between the anti-gene LNA group and the other four control groups (P < 0.05). In the anti-gene LNA group, the relative mRNA expression of HBV S gene was 0.33 and the percentage of HBsAg-positive hepatocytes was 31%, which were significantly different from these two indices in the control groups (P < 0.05). There were no abnormal changes in liver/renal biochemical parameters and HE staining results. Conclusion: Anti-gene LNA targeting at HBV S gene has a strong antiviral effect in transgenic mice, which provides theoretical and experimental bases for gene therapy for HBV.
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Affiliation(s)
- S R Xiao
- Centre for Medical Laboratory Science, the Affiliated Hospital of Youjiang Medical College for Nationalities, Baise 533000, China
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Deng YB, Qin HJ, Luo YH, Liang ZR, Zou JJ. Antiviral effect of hepatitis B virus S/C gene loci antisense locked nucleic acid on transgenic mice in vivo. Genet Mol Res 2015; 14:10087-95. [PMID: 26345946 DOI: 10.4238/2015.august.21.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We investigated the effects of hepatitis B virus (HBV) S/C double gene loci antisense locked nucleic acid on replication and expression of HBV in hepatitis transgenic mice. HBV mice (N = 30) were randomly divided into five groups of six mice: 5% glucose solution control, empty liposome control, single-target S, single-target C, and dual-target SC groups. An antisense locked nucleic acid fragment was injected into the mice. Serum HBsAg, serum HBV DNA, HBV C-mRNA expression in liver tissue, HbsAg and HbcAg expression in hepatocytes, serum albumin, alanine transaminase (ALT), urea nitrogen, and creatinine were detected. Liver and kidney sections were examined for the effects of antisense locked nucleic acid. The expression of HBsAg was markedly inhibited; the inhibition rates of the S, C, and SC target groups were 36.63, 31.50, and 54.87%, respectively; the replication of HBV DNA was also inhibited: 23.97, 21.13, and 35.83%, respectively. After injection at 1, 3, and 5 days, the corresponding rates for HBsAg inhibition were 14.40, 25.61, and 31.33%, and for HBV DNA inhibition they were 11.04, 19.24, and 24.13%. Compared with the control group, the differences in serum albumin, ALT, urea nitrogen, and creatinine in each group were not statistically significant, and the number of HbsAg- and HBcAg-positive cells in the mouse liver was significantly reduced. The liver and kidney tissues were normal. The gene therapy had significant inhibitory effects on the replication and expression of HBV in transgenic mice, and double-gene targeting was better than single-gene targeting.
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Affiliation(s)
- Y B Deng
- The Medical Examination Center of the Affiliated Hospital of Youjiang Nationalities Medical College, Guangxi Baise, China
| | - H J Qin
- The Medical Examination Center of the Affiliated Hospital of Youjiang Nationalities Medical College, Guangxi Baise, China
| | - Y H Luo
- The Medical Examination Center of the Affiliated Hospital of Youjiang Nationalities Medical College, Guangxi Baise, China
| | - Z R Liang
- The Medical Examination Center of the Affiliated Hospital of Youjiang Nationalities Medical College, Guangxi Baise, China
| | - J J Zou
- The Medical Examination Center of the Affiliated Hospital of Youjiang Nationalities Medical College, Guangxi Baise, China
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Deng YB, Wang XF, Li CL. A new noninvasive method for evaluation of coronary endothelial function in hypertensive patients based on change in diameter of the left main coronary artery induced by cold pressor test using echocardiography. Clin Cardiol 2009; 24:291-6. [PMID: 11303696 PMCID: PMC6655095 DOI: 10.1002/clc.4960240407] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Coronary endothelial function is frequently studied by measuring the vasodilator response of coronary arteries to acetylcholine or to cold pressor test by invasive quantitative coronary angiography. Because invasive methods have substantial inherent limitations, studies should attempt to evaluate coronary endothelial function noninvasively. HYPOTHESIS We attempted to evaluate the accuracy of measurement of the percent change in diameter of the left main trunk induced by cold pressor test with two-dimensional (2-D) echocardiography. Furthermore, we applied this method to the evaluation of coronary artery endothelial function in hypertensive patients. METHODS We measured the left main trunk diameter in 21 subjects (51 +/- 4 years) before and after cold pressor test using quantitative coronary angiography followed immediately by 2-D echocardiography. The accuracy of measurement of the left main trunk diameter and its percent change by echocardiography was evaluated by comparing the values obtained by the two methods. In addition, using echocardiography, we compared left main trunk diameter responses to cold pressor test in 16 hypertensive patients [51 +/- 5 years (mean +/- standard deviation)] and 16 matched healthy subjects (50 +/- 4 years). RESULTS Although there was only a weak correlation between the absolute values of the left main trunk diameter measured by the two methods (r = 0.61; p = 0.04), a strong correlation was found between the percent change in diameter measured by the two methods (r = 0.93; p = 0.0001). The percent change in diameter of the left main trunk induced by cold pressor test in hypertensive patients (-3.7 +/- 10.6%) was significantly lower than that in control subjects (13.2 +/- 6.8%, p = 0.0001). CONCLUSIONS Percent change in diameter of the left main trunk induced by cold pressor test can be evaluated accurately using 2-D echocardiography. Our study showed reduced vasodilation or vasoconstriction of the left main trunk after cold pressor test in hypertensive patients compared with healthy subjects, indicating impaired coronary endothelial function in hypertensive patients. The present echocardiographic method is a potentially useful new noninvasive method for evaluating coronary endothelial function.
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Affiliation(s)
- Y B Deng
- Echocardiographic Laboratory, Tongji Hospital, Huazhong University of Science and Technology, Tongji Medical College, Wuhan, China
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Abstract
BACKGROUND Multiple investigations, both in experimental models and in middle-aged patients with essential hypertension, demonstrate impaired endothelium-dependent vasodilatation. HYPOTHESIS We attempted to determine whether hypertension still exerts additional negative effect on endothelial function of large arteries in hypertensive elderly patients who may already be affected by endothelial dysfunction due to aging. METHODS We compared 13 elderly patients with hypertension [69 +/- 9 years, (mean +/- standard deviation)] with 13 matched healthy elderly subjects (72 +/- 6 years) as controls. Using high-resolution vascular ultrasound, we measured brachial artery responses to reactive hyperemia (with increased flow causing endothelium-dependent dilatation) and sublingual nitroglycerin (causing endothelium-independent dilatation). RESULTS Flow-mediated dilatation correlated inversely with age (r = -0.60, p = 0.03) in the controls. Flow-mediated dilatation was significantly impaired in hypertensive elderly patients (6.7 +/- 3.3 vs. 13.3 +/- 1.8% in controls, p < 0.0001). No significant difference could found in nitroglycerin-induced dilatation between controls (12.1 +/- 4.9%) and hypertensive elderly patients (10.2 +/- 6.8%, p = 0.5). On multivariate analysis, flow-mediated dilatation in hypertensive elderly patients was inversely related to aging (r = -0.37, p = 0.04) and mean blood pressure (r = -0.57, p = 0.03). CONCLUSIONS Our study showed decreased flow-mediated dilatation with aging even in the healthy controls, and further decline in flow-mediated dilatation in hypertensive elderly patients compared with controls. This impairment of flow-mediated dilatation in hypertensive elderly patients was related to age and mean blood pressure, indicating that aging and hypertension may independently impair endothelial function in the brachial artery of these patients.
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Affiliation(s)
- Y B Deng
- Tongji Hospital, Tongji Medical University, Wuhan, China
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Tian Y, Deng YB, Huang YJ, Wang Y. Bone marrow-derived mesenchymal stem cells decrease acute graft-versus-host disease after allogeneic hematopoietic stem cells transplantation. Immunol Invest 2008; 37:29-42. [PMID: 18214798 DOI: 10.1080/08820130701410223] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Graft-versus-host disease is a major complication of allogeneic hematopoietic stem cells transplantation, leading to serious morbidity and mortality. Mesenchymal stem cells(MSC)from bone marrow cause immunoregulation in vitro and in vivo. They also have the potential to protect from lethal GVHD after both autologous and allogeneic Hematopoietic Stem Cells Transplantation (HSCT). In this study, we investigated the mechanisms responsible for GVHD in the allo-HSCT co-transplantation with MSC condition. The model of acute GVHD in Rats was established using allogeneic HSC with donor-derived T cells transplantation, with or without additional donor-derived MSC co-transplantation. The degrees of GVHD were compared, the differentiation of CD4+, CD8+, Th1/Th2 and CD4+CD25+ T cells in vivo were assessed by flow cytometry and RT-PCR analyses. We found that MSC inhibited lethal GVHD after allo-HSCT. The value of CD8+ and CD4+ T cells and the ratio of Th1/Th2 T cell subsets decreased, at the same time the proportion of CD4+CD25+ T cells increased both in spleen lymphocytes and thymocytes in vivo after allo-HSCT with MSC co-transplantation compared with conventional allo-HSCT. Our results strongly suggested that BM-derived MSC has the function of preventing lethal GVHD after allo-HSCT by means of homeostasis of T subsets in vivo.
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Affiliation(s)
- Y Tian
- Department of Pathophysiology, Zhongshan Medical College, Sun Yat-sen University, Guangzhou, PR China
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Kimura Y, Matsumoto M, Miyauchi E, Deng YB, Iwai K, Hattori H. Noninvasive detection of endothelial dysfunction in elderly with NIDDM by ultrasonography. Echocardiography 2001; 18:559-64. [PMID: 11737964 DOI: 10.1046/j.1540-8175.2001.00559.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We compared endothelial function noninvasively in 15 elderly patients with noninsulin-dependent diabetes mellitus (NIDDM) with 12 nondiabetic elderly patients. Using high resolution ultrasound, we measured flow-mediated dilatation (FMD) of the brachial artery and sublingual nitroglycerin (NTG)-mediated dilatation. FMD was significantly impaired in subjects with NIDDM compared with control subjects. In NIDDM subjects, FMD with complications was lower than in subjects with noncomplications. However, there was no significant difference in NTG between NIDDM subjects and the control group. Hyperemic blood flow change was lower in NIDDM subjects, but not significant. These results suggest that elderly patients with NIDDM have impaired L-arginine/nitric oxide (NO) pathways and the possibility of capillary rarefaction.
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Affiliation(s)
- Y Kimura
- Department of Geriatric Medicine, Kanazawa Medical University, Uchinada-machi, Kahoku-gun, Ishikawa-ken 920-0293, Japan.
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Huang CL, Li C, Deng YB. [Effect of jishentang on renal lesions in diabetic rats]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1997; 17:676-8. [PMID: 10322849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To observe the ameliorative effect of Jishentang (JST) on renal lesions in experimental diabetic rats. METHODS The diabetic rats were randomly divided into three groups: group with out treatment, group with enalapril treatment (the dose of enalapril was 1 mg/kg.d) and group with JST treatment (the dose of JST was 22.4 g/kg.d). The treatment lasted for 8 weeks. RESULTS (1) JST treatment attenuated the renal hypertrophy and ratio of kidney and body weight (P < 0.01). (2) JST treatment reduced the levels of SCr and BUN and the levels of Alb, beta 2-m and the activity of NAG in urine in diabetic rats significantly (P < 0.01). The levels of TG and TCh decreased and the levels of HDL-C increased in the serum of the JST treated diabetic rats (P < 0.01). (3) The glomerular basement membrane thickening and volume density of PAS positive staining in mesangial area were significantly decreased in JST treated diabetic rats. CONCLUSIONS JST exerted obvious ameliorative effect on renal function and structure in diabetic rats.
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Affiliation(s)
- C L Huang
- Institute of Preclinical Medicine, Norman Bethune University of Medical Sciences, Changchun
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Abstract
4DE (i.e., dynamic three-dimensional) echocardiography is a new developing technique in recent years. In our study, a three-dimensional echo scan computer system was used to acquire and store the two-dimensional information, then to reconstruct the stereoscopic image of the heart according to its space-time continuum. It can yield a better approach, which can help identify the various structures of the heart and great arteries and facilitate understanding of spatial relations and motion. In addition, it can display physiologic information such as the direction, course, size, and shape of the blood flow. We have examined 138 patients by both transthoracic and transesophageal approaches. Our preliminary experience shows that 4DE is of great value in diagnosing congenital heart disease and valvular disease.
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Affiliation(s)
- X F Wang
- George Washington University School of Medicine and Health Sciences, Washington, D.C 20037, USA
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Deng YB, Matsumoto M, Munehira J. Determination of mitral valve area in patients with mitral stenosis by the flow-convergence-region method during changing hemodynamic conditions. Am Heart J 1996; 132:633-41. [PMID: 8800036 DOI: 10.1016/s0002-8703(96)90249-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Twenty-eight patients with mitral stenosis underwent Doppler echocardiography at rest and during exercise to determine the accuracy of mitral valve area determination by the flow-convergence-region method during exercise-induced changing hemodynamic conditions. The mitral valve area calculated by using the flow-convergence-region method correlated strongly with that measured by the Gorlin formula both at rest (r = 0.85) and during exercise (r = 0.92) for all 28 patients studied. Although mitral valve area obtained by the flow-convergence-region method did not change (p = 0.1) in 16 patients with echocardiographic mitral scores > or = 12, it increased significantly during exercise (p = 0.0001) in 12 patients with echocardiographic mitral scores < 12. This study suggests that in mitral stenosis, the mitral valve area can be accurately estimated by the flow-convergence-region method both at rest and during changing hemodynamic conditions induced by supine bicycle exercise.
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Affiliation(s)
- Y B Deng
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa-ken, Japan
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Horibe N, Matsumoto M, Deng YB. Application of the flow convergence region method to the determination of stroke volume and cardiac output in patients with mitral stenosis. Can J Cardiol 1996; 12:363-9. [PMID: 8608455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE This study was undertaken to investigate the feasibility and accuracy of determination of stroke volume and cardiac output by calculating transmitral flow volume using the flow convergence region method in patients with mitral stenosis. PATIENTS AND INTERVENTIONS Fifty-six patients with rheumatic mitral stenosis were studied using imaging and Doppler echocardiography. Aliasing velocities of 20 to 23 cm/s were used to record the flow vonvergence region proximal to the stenotic mitral orifice. The stroke volume (mL) was calculated by multiplying peak transmitral flow rate which was obtained using an angle-corrected hemispheric flow convergence equation, by transmitral velocity time integral (cm) divided by peak transmitral velocity (cm/s) recorded using continuous wave Doppler method. MAIN RESULTS Stroke volume calculated using the flow convergence region method was not significantly different from that calculated using aortic Doppler two-dimensional echocardiographic method in 39 patients with pure mitral stenosis (75+/-19 [mean+/-1SD] versus 73+/-19 mL, P=0.12), and from that calculated using pulmonic Doppler two-dimensional echocardiographic method in nine patients with mitral stenosis with associated>2+ aortic regurgitation (77+/-12 versus 75+/-14 mL, P=0.49). No significant difference existed between the cardiac output obtained using the flow convergence region method and that obtained using Fick method in 12 patients with pure mitral stenosis. The stroke volume was overestimated by the flow convergence region method when compared with those obtained using aortic Doppler two-dimensional echocardiographic method in patients with mitral stenosis with associated >2+ mitral regurgitation (123+/-40 versus 67+/-15 mL, P=0.001). CONCLUSIONS The present study provided an alternative way to calculate the stroke volume and cardiac output in patients with mitral stenosis.
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Affiliation(s)
- N Horibe
- Kanazawa Medical University, Ishikawa-Ken, Japan
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Abstract
Coronary artery fistula (CAF) is an abnormal communication between a coronary artery and a cardiac chamber, great vessel, or other vascular structures. The presence of the fistula is usually identified by angiography. In this paper, the diagnosis of left coronary artery-right ventricle fistula was made by color Doppler before angiography? and it was confirmed by surgery. Color Doppler flow imaging is a non-invasive method which can reveal the proximal dilatation, the course and the draining site of CAF.
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Affiliation(s)
- Y Yang
- Department of Echocardiography, Xiehe Hospital, Tongji Medical University, Wuhan
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Huang CL, Li C, Deng YB. [Progress on research of mechanism of Rheum palmatum in delaying the chronic renal failure]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1995; 15:506-508. [PMID: 8580699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Deng YB, Matsumoto M, Wang XF, Liu L, Takizawa S, Takekoshi N, Shimizu T, Mishima K. Estimation of mitral valve area in patients with mitral stenosis by the flow convergence region method: selection of aliasing velocity. J Am Coll Cardiol 1994; 24:683-9. [PMID: 8077539 DOI: 10.1016/0735-1097(94)90015-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES We attempted to determine the most suitable aliasing velocity for applying the hemispheric flow convergence equation to calculate the mitral valve area in mitral stenosis using a continuity equation. BACKGROUND The flow convergence region method has been used for calculating mitral valve area in patients with mitral stenosis. However, the effect of varying aliasing velocity on the accuracy of this method has not been investigated fully. METHODS We studied 42 patients with mitral stenosis using imaging and Doppler echocardiography. Aliasing velocities of 17, 21, 28, 34, 40 and 45 cm/s were used. The transmitral maximal flow rate (Q [ml/s]) was calculated using the hemispheric flow convergence equation Q = 2 x pi x R2 x AV x alpha/180, where R (cm) is the maximal radius of the flow convergence region, AV is the aliasing velocity, and alpha/180 is a factor accounting for the inflow angle (alpha). Mitral valve area (A [cm2]) was calculated according to the continuity equation A = Q/V, where V (cm/s) is the peak transmitral velocity by the continuous wave Doppler method. RESULTS Mitral valve area was progressively underestimated with increasing aliasing velocity. The actual and percent differences noted between the mitral valve area by the flow convergence region method and that by two-dimensional echocardiographic planimetry were -0.06 +/- 0.23 cm2 (mean +/- SD) and 0.09 +/- 15.7% at an aliasing velocity of 21 cm/s, increasing gradually with increasing aliasing velocity, and were -1.24 +/- 0.9 cm2 and -72.56 +/- 16.4% at an aliasing velocity of 45 cm/s. Mitral valve areas estimated by the flow convergence region method at an aliasing velocity of 21 cm/s in 11 patients with associated > 2+ mitral regurgitation (2.12 +/- 1.17 cm2) and 8 with associated > 2+ aortic regurgitation (1.28 +/- 0.71 cm2) were not significantly different using planimetry (2.24 +/- 1.39 cm2, p > 0.05 and 1.27 +/- 0.74 cm2, p > 0.05, respectively) but were significantly different by the pressure half-time method (1.59 +/- 1.12 cm2, p < 0.001 and 1.63 +/- 0.93 cm2, p < 0.01, respectively). CONCLUSIONS This study indicated the most appropriate aliasing velocity for the accurate estimation of mitral valve area in patients with mitral stenosis.
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Affiliation(s)
- Y B Deng
- Kanazawa Medical University, Ishikawa-ken, Japan
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17
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Matsumoto M, Deng YB, Takekoshi N, Watanabe F. [Two-dimensional echocardiographic assessment of myocardial infarct size and viability and the prediction of clinical course in acute myocardial infarction]. Nihon Rinsho 1994; 52 Suppl:614-20. [PMID: 12440034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- M Matsumoto
- Department of Gerontology, Kanazawa Medical University
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18
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Shiota T, Teien D, Deng YB, Ge S, Shandas R, Holcomb S, Sahn DJ. Estimation of regurgitant flow volume based on centerline velocity/distance profiles using digital color M-Q Doppler: application to orifices of different shapes. J Am Coll Cardiol 1994; 24:440-5. [PMID: 8034881 DOI: 10.1016/0735-1097(94)90301-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES In this study we investigated the centerline velocity profile method for flow computation as applied to noncircular, as well as circular, orifices using digital color flow data. BACKGROUND Recently it has been suggested that flow volume through an orifice can be estimated more accurately by computing the axial "centerline" flow velocity/distance profile proximal to the orifice. METHODS A total of seven different orifices were mounted in a constant-flow model: four circular orifices, two rectangular orifices with a major/minor axis ratio of 4:1 and 8:1 and an ovoid orifice having a major/minor axis ratio of 2:1. Three different flow rates were examined (1.68, 3.48 and 6.48 liters/min). Digital measurements of flow velocity at discrete positions along the centerline progressing toward the orifice were analyzed to yield complete flow velocity profiles for each orifice at each flow rate. RESULTS A clear separation of the flow profiles for the three different flow rates was observed independent of orifice size for all of the circular orifices. The velocity/distance acceleration curves showed highly significant correlations using multiplicative regression fits (y = ax-b, r = 0.94 to 0.99, all p < 0.0001). An equation for quantitatively correlating the a and b coefficients from the multiplicative regression fits with flow rates was derived from stepwise regression analysis: Flow rate = 23a + 3.3b - 1.5 (r = 0.97, p < 0.0001, SEE 0.46 liter/min). CONCLUSIONS In view of the various sizes and shapes encountered clinically for regurgitant orifices, the simplicity of this method for the estimation of the severity of regurgitant lesions might be of importance for clinical applications of this method.
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Affiliation(s)
- T Shiota
- Clinical Care Center for Congenital Heart Disease, Oregon Health Sciences University, Portland 97201
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19
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Abstract
Three-dimensional transesophageal echocardiography is a new and evolving cardiac imaging technique. We reported our experiences of its clinical applications in 59 patients. A series of special temporal longitudinal views were selected by the frame grabber. Then the computer connected each digitized endocardial surface of the longitudinal views according to their spatial position and reconstructed the three-dimensional, cardiac shaded picture with gray scale. The three-dimensional transesophageal echocardiographic images were divided into three areas. The right area was right anterior to the esophagus and included such structures as the superior vena cava, right atrium, interatrial septum, and left atrium; the size, shape, and location of an atrial septal defect could be clearly shown. In the middle area the origin and the course of the two great arteries could be visualized, thus facilitating the diagnosis of transposition of the great arteries; in patients with obstruction of the right ventricular outflow tract, the circular ridgelike narrowing in the right ventricle was clearly visualized. In the left area the contour and size of the left ventricle and left atrium and the shape and point of coaptation of the mitral valve could be demonstrated; in patients with mitral valve prolapse, part of either leaflet protruded into the left atrium and appeared as a spoonlike depression in the mitral valve. Other entities subjected to three-dimensional transesophageal echocardiographic reconstruction included cor triatriatum, left atrial myxoma, aneurysm of sinus of Valsalva, dissecting aortic aneurysm, mitral stenosis, mitral regurgitation, and mitral valve prolapse.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- X F Wang
- Cardiovascular Disease Institute, Tongji Medical University, Wuhan, People's Republic of China
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20
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Tee SD, Shiota T, Weintraub R, Teien DE, Deng YB, Sahn DJ, Omoto R, Kyo S. Evaluation of ventricular septal defect by transesophageal echocardiography: intraoperative assessment. Am Heart J 1994; 127:585-92. [PMID: 8122606 DOI: 10.1016/0002-8703(94)90667-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The miniaturization of transesophageal echocardiography (TEE) probes, together with the development of the capability for biplane imaging from the esophagus, have increased the use of TEE in pediatric cardiology. The aim of this study was to evaluate the TEE findings in patients with ventricular septal defect (VSD) before and after closure primarily by means of pediatric biplane probes. This study group included 69 patients who underwent VSD closure as an isolated repair or as a part of a definitive repair of a more complicated lesion. Ages ranged from 6 days to 15.6 years (median 1 year, 4 months), with operative weights ranging from 2.9 kg to 68 kg (median 10 kg). Preoperative and follow-up transthoracic echocardiograms (TTE) were also performed. Intraoperative TEE was performed without complication in all 69 patients. Preoperative results: (1) anatomic findings: Two muscular VSDs were detected by matrix TEE but could not be observed by TTE. A patient with preoperative TTE diagnosis of an ostium primum ASD was found to have atrioventricular (AV) canal by TEE. In three of six AV canal type VSDs, both TTE and TEE demonstrated left ventricular-right atrial shunting (2) aortic regurgitation associated with VSD: Aortic regurgitation as a result of right coronary cusp prolapse was detected in one of five supracristal VSDs in which the biplane or matrix TEE was used.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S D Tee
- Clinical Care Center for Congenital Heart Disease, Oregon Health Sciences University, Portland 97201
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21
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Zhang J, Shiota T, Shandas R, Deng YB, Weintraub R, Paik J, Liepmann D, Sahn DJ. Effects of adjacent surfaces of different shapes on regurgitant jet sizes: an in vitro study using color Doppler imaging and laser-illuminated dye visualization. J Am Coll Cardiol 1993; 22:1522-9. [PMID: 8227814 DOI: 10.1016/0735-1097(93)90566-j] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The present study was designed to estimate the influence of different-shaped adjacent surfaces on regurgitant jets as assessed by color Doppler imaging and laser-illuminated dye optical visualization. BACKGROUND Because color Doppler techniques provide real-time two-dimensional imaging of flow, the evaluation of valvular regurgitation by analysis of variance-encoded regurgitant jets by this method has been widely used in clinical studies. However, recent studies have demonstrated that color Doppler jet sizes are affected not only by several hemodynamic factors and instrument settings but also by the interaction between jets and adjacent wall surfaces. In clinical conditions, jets may interact with adjacent walls of variable shapes that might have different effects on the jet size. METHODS An in vitro model was constructed consisting of a rigid, optically clear receiving chamber that had no outlet resistance and had a pulsatile pump ejecting through 1.5, 2.3 and 3.1 mm2 inflow orifices into the chamber. The surfaces were flat or smoothly and equally curved, convex and concave aluminum positioned at 0, 2 and 4 mm from and to the side of the inflow orifices. The pump was run with stroke volumes from 0.5 to 3.0 ml and with a pulse frequency of 70 beats/min. The echocardiographic and laser beams were aimed at the inflow orifice imaging jets perpendicular to the surfaces (vertical view) through the central plane of the jet flows. Maximal jet areas were measured by both color Doppler techniques and laser-illuminated dye visualization. RESULTS Color Doppler study showed fair correlation between the jet areas and the stroke volumes (r = 0.83 to 0.99), but the jet sizes under different surface conditions were variable. All the surface jet areas at a jet-surface distance of 0 and 2 mm were smaller than free jet areas at the same stroke volume for both flat and convex surfaces (p < 0.001). Flow constraint by the concave surface resulted in the smallest jet areas (p < 0.001). The color Doppler jet areas on the curved surfaces were significantly smaller than the laser-illuminated dye visualization jet areas (p < 0.01 to 0.0001). However, at intermediate jet-surface distances (4 mm and sometimes 2 mm with higher velocity flows), jet interaction with the flat and especially with the convex surface resulted in larger jets. This effect was most pronounced on dye fluorescence studies because flow around these jets consisted mainly of low velocity vortical events with only partial surface adherence and these low velocity swirling flows were not well imaged by color Doppler technique. CONCLUSIONS Our study suggests that the different-shaped adjacent surfaces with different degrees of flow alterations resulted in variable decreases in jet size and that color Doppler imaging could not encode and image the angled and low velocity swirling events well when jets flowed along the curved surfaces. These effects need to be taken into account when interpreting color Doppler images.
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Affiliation(s)
- J Zhang
- Division of Pediatric Cardiology, University of California, San Diego Medical Center
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22
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Deng YB, Shiota T, Shandas R, Zhang J, Sahn DJ. Determination of the most appropriate velocity threshold for applying hemispheric flow convergence equations to calculate flow rate: selected according to the transorifice pressure gradient. Digital computer analysis of the Doppler color flow convergence region. Circulation 1993; 88:1699-708. [PMID: 8403315 DOI: 10.1161/01.cir.88.4.1699] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND While flow convergence methods have been promising for calculating volume flows from color Doppler images, it appears that the velocity threshold used and the transorifice pressure gradient dramatically influence the accuracy of application of the simple hemispheric flow convergence equation for calculation of flow rate. The present in vitro study was performed to determine whether the value of velocity threshold at which the shape of proximal isovelocity surface best fits given shape assumptions with different orifice sizes and flow rates is predictable as a function independent of orifice size from clinically measurable peak velocity or transorifice pressure gradient information. METHODS AND RESULTS In an in vitro model built to facilitate ultrasound imaging, steady flow was driven through circular discrete orifices with diameters of 3.8, 5.5, and 10 mm. Flow rates ranged from 2.88 to 8.28 L/min with corresponding driving pressure gradients from 14 to 263 mm Hg. At each flow rate, Doppler color-encoded M-mode images through the center of the flow convergence region were obtained and transferred into the microcomputer (Macintosh IIci) in their original digital format. Then, the continuous wave Doppler traces of maximal velocity through the orifice were derived for the calculation of driving pressure gradient. Direct numerical spatial velocity measurements were obtained from the digital color encoded M-mode velocities with computer software. For each flow rate, we could calculate flow volume from any number of velocity distance combinations with a number of assumptions and use the results to assess expected flow convergence shape based on a priori knowledge of the progression from oblate hemispheroid to hemisphere to prolate hemispheroid changes observed previously. Our results showed that for a given ratio of calculated flow rate to actual flow rate (0.7 and 1), the velocity threshold that could be used for the calculation of flow rate with a hemispheric flow convergence equation correlated well with the pressure gradient for a given orifice size, and the differences in velocity threshold that could be used this way among different orifice sizes once they were adjusted for the covariate pressure gradients were not statistically significant (P = .79 for ratio = 0.7, and P = .81 for ratio = 1). CONCLUSIONS Our present study provides an orifice size-independent quantitative method that can be used to select the most suitable velocity threshold for applying a simple hemispheric flow convergence equation based on clinically predictable pressure gradients ranging from 40 to 200 mm Hg, and it offers a correction factor that can be applied to the hemispheric flow convergence equation when the pressure gradient is less than 40 mm Hg.
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Affiliation(s)
- Y B Deng
- Clinical Care Center for Congenital Heart Disease, Oregon Health Sciences University, Portland 97201
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23
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Deng YB, Wang XF, Wang JE, Li ZA, Shiota T, Sahn DJ. Determination of most appropriate Nyquist velocity for applying hemispherical flow convergence equation to calculate flow rate using the transorifice pressure gradient: digital computer analysis of Doppler color flow convergence region. J Tongji Med Univ 1993; 13:143-50. [PMID: 8295261 DOI: 10.1007/bf02886505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Nyquist velocity and transorifice pressure gradient dramatically influence color aliasing shape and accuracy of simple hemispherical flow convergence equation for calculation of flow rate. The present in vitro study was performed to determine whether the value of Nyquist velocity, at which the shape of proximal isovelocity surface is best fit for a given shape assumption in different orifice size, and the flow rate may be a determinable and orifice size independent function of clinically measurable peak velocity or transorifice pressure gradient. Steady flow was driven through circular discrete orifices with diameter of 3.8 mm, 5.5 mm and 10 mm and flow rate ranging from 2.88 L/min to 8.28 L/min. For every flow rate, Doppler color encoded M-mode images through the center of flow convergence region were transferred into the microcomputer in their original digital format. The continuous wave Doppler traces of maximal velocity through the orifice were performed for the calculation of pressure gradient. Direct numerical spatial velocity measure using color pixel intensity was obtained from the transferred color encoded M-mode images with computer software. The shape of isovelocity surface was determined by the ratio of calculated flow rate with hemispherical flow convergence equation to the actual flow rate. Both the flow rate and orifice size influence the position of the velocity profile curve. The shape of isovelocity surface is not constant and changes with the velocities used for the calculation of flow rates for a given flow rate and orifice size or pressure gradient and also changes with the flow rate or transorifice pressure gradients for a constant Nyquist velocity and orifice size.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- Y B Deng
- Echocardiographic laboratory, Xiehe Hospital, Tongji Medical University, Wuhan
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24
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Li ZA, Wang XF, Wang JE, Deng YB, Yang Y. Visualization of patent foramen ovale by biplanar transesophageal echocardiography. J Tongji Med Univ 1993; 13:23-26. [PMID: 8326525 DOI: 10.1007/bf02886588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
It is difficult for conventional transthoracic echocardiography (TTE), by which precise and accurate images of interatrial septum (IAS) can not be acquired, to diagnose patent foramen ovale (PFO) clearly. To evaluate the diagnostic value of biplanar transesophageal echocardiography (TEE) for PFO, TTE and biplanar TEE were performed simultaneously in 270 patients. It was found that in 7 patients patent foramen ovale was detected only through longitudinal planes of biplanar TEE. IAS, which consists of primitive septum and membrane of fossa ovalis, can be directly visualized by two-dimensional images of TEE; in patients with PFO, a dull color flow, which shunts from the right atria to the left atria through the gap between primitive septum and fossa ovalis, can be detected by color Doppler flow images. Furthermore, some right-to-left shunting microbubbles through the valve of patent fossa ovalis can be discovered by cardiac acoustic contrast echocardiography. In conclusion, biplanar TEE combined with color Doppler image and cardiac acoustic contrast facilitates a definite diagnosis of patent foramen ovale as the excellent anatomic images of IAS can be obtained from multiple views under this kind of performance.
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Affiliation(s)
- Z A Li
- Echocardiography Laboratory, Xiehe Hospital, Tongji Medical University, Wuhan
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25
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Hou XH, Deng YB, Zhang JK. [Measurement of gastric emptying in non-ulcer dyspepsia]. Zhonghua Nei Ke Za Zhi 1992; 31:623-5, 658. [PMID: 1306455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Using real-time ultrasonography, we monitored gastric emptying indirectly in 26 cases of non-ulcer dyspepsia (NUD) and 13 healthy adults by determining the anteroposterior gastric measurement of a single section of the stomach in the corpus fundus immediately after drinking 500 ml water and then every 10 min. for five times. The average time for 50% gastric emptying in NUD patients (36.46 +/- 13.13, x +/- s) was longer than that in healthy adults (23.54 +/- 5.93), but the half time of gastric emptying in male with NUD was not significantly different as compared with that in male controls and female patients of NUD.
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Affiliation(s)
- X H Hou
- Institute of Gastroenterology, Union Hospital, Tongji Medical University, Wuhan
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26
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Abstract
Intravascular smoke-like echo always appears in regions of stasis, but the exact mechanism of its production is unclear. We investigated its appearance in relation to erythrocyte rouleaux formation. To study this relationship we performed a series of in vitro and animal experiments. In the in vitro study, we observed an erythrocyte suspension by ultrasonography and found it to be echo-free. Under the microscope, red blood cells were observed in a dispersed state. If an equal amount of lymphocyte separation solution was added to the suspension, smoke-like echo appeared, and red blood cells were seen in a rouleaux pattern. In animal (mongrel dogs) experiments, under physiologic conditions with normal blood flow velocity, all cardiac cavities and the inferior vena cava were echo-free. When stasis was induced experimentally in the inferior vena cava, red blood cells aggregated to form rouleaux and smoke-like echo appeared. On resumption of normal blood flow, the rouleaux dispersed to form erythrocytes again. The mechanism of production of intracardiovascular smoke-like echo is closely related to the formation of erythrocyte rouleaux. When rouleaux are formed, they become larger and appear nearer or larger than the ultrasonic wavelength. Thus reflections are produced and smoke-like echo appears.
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Affiliation(s)
- X F Wang
- Cardiovascular Disease Institute and Union Hospital, Tongji Medical University, Wuhan, People's Republic of China
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27
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Abstract
In 427 subjects TEE was performed with either a uniplane or biplane transducer; in seven cadavers the cardiac anatomic segments were observed in several levels and directions. Nine transverse and six longitudinal views were compared with the corresponding cardiac anatomic segments. Based on this correlative study, the levels of segments, insertion depth, anatomic structure identification, image characteristics, clinical applications, and the advantages as well as the limitations of biplane TEE are discussed.
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Affiliation(s)
- X F Wang
- Cardiovascular Disease Institute, Tongji Medical University, Wuhan, People's Republic of China
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Wang XF, Li ZA, Deng YB, Wang JE, Wu Y, Yang Y. Biplane transesophageal echocardiography: imaging sections and anatomic segments. J Tongji Med Univ 1991; 11:93-100. [PMID: 1816421 DOI: 10.1007/bf02888095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In order to recognize correctly the images of transesophageal echocardiography (TEE), in 410 subjects TEE was performed with uniplane or biplane transducer, and in 7 corpses the cardiac anatomic segments were observed, at various levels and in different directions, 9 transverse and 6 longitudinal views were compared with the corresponding cardiac anatomic segments. Based on this study, the authors reported the levels of segments, insertion depth, anatomic structure identification, image characteristics and clinical application of TEE, and the advantages of biplane TEE are discussed.
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Affiliation(s)
- X F Wang
- Echocardiographic Laboratory, Xiehe Hospital, Tongji Medical University, Wuhan
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Wang XF, Wang JE, Cao LS, Huang YZ, Huang HQ, Deng YB, Wu Y. Application of two-dimensional echocardiography in location of balloon of the Swan-Ganz catheter. Chin Med J (Engl) 1990; 103:117-24. [PMID: 2118027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Two-dimensional echocardiography was used to guide and locate the balloon of Swan-Ganz catheter during catheterization in 43 patients. The echoes of balloon appeared as a series of strong light spots, with a rate of detection of 100%. Under monitoring of two-dimensional echocardiography, the site of balloon and its moving route could be determined. The coincidence of echographic findings and X-ray findings showed that it can be used instead of X-ray monitoring to lessen irradiation during catheterization. The depth of catheter inserted was measured. The differential points between the echoes of balloon and tubing, the terminology of the balloon site in echocardiography and fluoroscopy, its clinical value and limitation are discussed.
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Affiliation(s)
- X F Wang
- Echocardiographic Laboratory, Union Hospital, Tongji Medical University, Wuhan
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Deng YB, Takenaka K, Sakamoto T, Hada Y, Suzuki J, Shiota T, Amano W, Igarashi T, Amano K, Takahashi H. Follow-up in mitral valve prolapse by phonocardiography, M-mode and two-dimensional echocardiography and Doppler echocardiography. Am J Cardiol 1990; 65:349-54. [PMID: 2301263 DOI: 10.1016/0002-9149(90)90300-p] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To assess the serial phonocardiographic and echocardiographic change in patients with mitral valve prolapse (MVP), phonocardiograms and echocardiograms were reviewed retrospectively in 116 patients (48 men and 68 women, mean age 27 years) who had been determined to have MVP and were reexamined 4.3 years (range 1 to 14) later by phonocardiography and echocardiography between 1971 and 1988. Follow-up phonocardiograms showed periods when 5 of 18 patients with silent MVP developed mid- or late systolic clicks. Of 57 patients with mid- or late systolic clicks, 15 had silent MVP, 6 developed a late systolic murmur with or without systolic clicks and 1 developed a pansystolic murmur. Two of 9 patients with an isolated late systolic murmur developed a pansystolic murmur. M-mode echocardiograms showed that left atrial and left ventricular dimensions at end-diastole and end-systole increased in patients with systolic murmur (33 +/- 10 vs 35 +/- 11, 46 +/- 6 vs 50 +/- 7 and 29 +/- 4 vs 31 +/- 5 mm, respectively, all p less than 0.001) and no statistically significant changes in any of these dimensions were found in patients without a systolic murmur. The degree of MVP evaluated by the anteroposterior mitral leaflet angle on the 2-dimensional echocardiogram was more severe in patients with a systolic murmur than in patients without systolic murmur (157 +/- 12 vs 131 +/- 16 degrees, p less than 0.001). The degree of prolapse did not change during the follow-up periods. The number of patients with mitral regurgitation detected by pulsed Doppler echocardiography increased from 21 of 72 (29%) to 31 of 72 (43%).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- Y B Deng
- Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan
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31
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Abstract
In this paper, we report the results of experimental and clinical studies of the pulmonary vein with Doppler echocardiography in 188 cardiac patients and normal controls. 1. The diameter of the right superior pulmonary vein (RSPV): The diameter of the RSPV was 9.8 +/- 0.2 mm in normals and significantly dilated in the groups with passive or active pulmonary hypervolemia and decreased in the group with pulmonary hypovolemia (p less than 0.001). 2. Blood flow velocity of RSPV: The blood flow velocity of the RSPV measured in normal controls by Doppler echocardiography was 35.7 +/- 3.2 cm/s and significantly decreased in the groups with passive pulmonary hypervolemia and pulmonary hypovolemia (19.6 +/- 7.8 cm/s and 25.2 +/- 9.4 cm/s, respectively) and increased in the group with active pulmonary hypervolemia (49.6 +/- 19 cm/s, p less than 0.001). 3. Blood flow of RSPV: Blood flow of the RSPV was 2.3 +/- 1.5 L/m in normals, 3.4 +/- 2.4 L/m in the group with passive pulmonary hypervolemia, 6.2 +/- 2.9 L/m in the group with active pulmonary hypervolemia and 0.7 +/- 0.5 L/m in the group with pulmonary hypovolemia. Blood flow in the active pulmonary hypervolemic group was higher than that in the passive pulmonary hypervolemic group and the hypovolemic group. There was a high correlation between the pulmonary blood flow measured by Fick's method (Qp) and RSPV flow (RSPVF) measured by echocardiography (Qp = 1.96, RSPVF 0.92, r = 0.81, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J E Wang
- Union Hospital, Cardiovascular Disease Institute, Tongji Medical University, Wuhan, China
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Wang XF, Wang JE, Cao LS, Huang YZ, Huang HQ, Wu Y, Deng YB. Left-sided contrast echocardiography with hydrogen peroxide--comparative effectiveness of pulmonary wedge injection by use of Swan-Ganz catheter and Cournand catheter. J Tongji Med Univ 1988; 8:176-81. [PMID: 3230594 DOI: 10.1007/bf02887844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Deng YB, Wang XF, Wang JE. Hydrogen peroxide myocardial perfusion contrast echocardiography: I. Experimental study. J Tongji Med Univ 1987; 7:143-7. [PMID: 3448238 DOI: 10.1007/bf02888207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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