Functional significance of the left adrenal vein and the gonadal veins

Owing to the investigation of changeability variants of the left adrenal, anastomosis of the inferior diaphragmatic and ovarian (testicular) veins--tributaries of the human left renal vein, three variants in inflow of the left adrenal vein in comparison to the left ovarian (testicular) vein have been revealed. In the first variant, that occurs in 70% of cases, the left adrenal vein flows into the left renal vein by 15 cm more medially from the ostium of the ovarial (testicular) vein. The second variant occurs in 11%. The left adrenal and ovarian (testicular) ostia are situated at the same level. The distance from the hilus renalis to the place, where the ostia mentioned get into the renal vein, is about 39 mm. In the third variant (19%) the left adrenal vein gets into the left renal vein nearer to the hilus renalis than the ovarian (testicular) veins. An average distance from the hilus renalis to the ostium of the left adrenal vein is 33 mm. The second variant, when the left adrenal vein gets into the left renal vein, contributes to appearance of the primary varicocele at the left. When the operation for nephrectomy is made at the left, our data make it possible to recommend a purposeful ligation of the left renal vein more laterally to the ostium of the ovarian (testicular) vein. In 80% this ligation will not disturb the function of the left adrenal vein.     

Functional anatomy of the canine mediastinal cardiac nerves located at the base of the heart

The major canine cardiopulmonary nerves which arise from the middle cervical and stellate ganglia and the vagi course toward the heart in the dorsal mediastinum where they form, at the base of the heart dorsal to the pulmonary artery and aorta, the dorsal mediastinal cardiac nerves. In addition, the left caudal pole and interganglionic nerves project onto the left lateral side of the heart as the left lateral cardiac nerve. These nerves contain afferent and (or) efferent axons which, upon stimulation, modify specific cardiac regions and (or) systemic pressure. In addition, with the exception of the left lateral cardiac nerve, stimulation of each of these nerves produces compound action potentials in the cranial ends of the majority of the major cardiopulmonary nerves demonstrating that axons in each dorsal mediastinal cardiac nerve interconnect with axons in the majority of the cardiopulmonary nerves. Axons in the left lateral cardiac nerve connect primarily with axons in the left caudal pole and left interganglionic nerves. The dorsal mediastinal nerves project distally onto the heart as coronary nerves accompanying the right or left coronary arteries. These innervated the ventricular myocardium which is supplied by their respective vessels. The left lateral cardiac nerve projects directly onto the lateral epicardium of the left ventricle. The dorsal mediastinal and left lateral cardiac nerves are the major sympathetic cardiac nerves. Thus, the cardiac nerves located in the mediastinum at the base of the heart are not simple extensions of cardiopulmonary nerves, but rather have a unique anatomy and function of their own.     

The Nature of the Disorder of Function in Chronic Postinfarction Aneurysm of the Left Ventricle

Assessment of left ventricular function in five patients with chronic postinfarction left ventricular aneurysm was carried out at the time of left heart catheterization and compared with that in six normal subjects. One patient was investigated before and after surgical resection of the aneurysm. The presence of the aneurysm placed the left ventricle at a mechanical disadvantage in systole and increased the resistance to diastolic filling (impedance). This was true even in patients with normal cardiac indices who were not badly disabled. Resection of the aneurysm corrected both these abnormalities, and, as well, lowered the time-tension index at a time when calculated left ventricular work was much increased. These differences between normals and patients with aneurysms, and the changes occurring as a result of resection of an aneurysm, show that the presence of the aneurysm places the left ventricle at a mechanical disadvantage in systole as well as altering its diastolic filling characteristics.     

血清胱抑素C 水平与糖尿病心室重构关系的临床研究

目的:研究血清胱抑素C水平与糖尿病心室重构的关系。方法:选择2013年10月~2015年10月在我院进行诊治的糖尿病患者90例,检测血清胱抑素C水平,按照糖尿病患者血清胱抑素C水平的中位数,分为正常组(胱抑素C水平1.65mg/L)和升高组(胱抑素C水平1.65mg/L)。行超声心动图检测左室舒张末内径、左房内径、左室舒张末容积、室间隔厚度和左室后壁厚度,并计算出左室质量指数。对两组的这些指标进行比较,并分析血清胱抑素C与糖尿病心室重构的相关性。结果:与正常组相比,升高组的胱抑素C、左室舒张末内径、左房内径、室间隔厚度、左室后壁厚度、左室质量指数和脑钠肽水平均明显增高(P0.05);经过相关性分析,血清胱抑素C水平与左室舒张末内径、左房内径、室间隔厚度、左室后壁厚度、左室质量指数和脑钠肽均呈正相关(P0.05);Logistic回归分析显示左室舒张末内径、左房内径、室间隔厚度、左室后壁厚度、左室质量指数和脑钠肽等是胱抑素C水平升高的危险因素。结论:血清胱抑素C水平与糖尿病患者的心功能和心室重构具有明显相关性,可作为衡量糖尿病患者心室重构程度的一项参考指标。     

Ovulation and the movement of the conceptus in the first 35 days of pregnancy in thoroughbred mares.

Data from 937 Thoroughbred mares, when analysed as a single population, showed no significant difference between the activity of the right and left ovaries and the frequency of location of 35-day pregnancies in the right and left uterine horns. Nor were any differences shown when the data were analysed in years or sire groups. However, significantly more ovulations occurred in the right ovary in September and December and in the left ovary in October and November. Whereas the left and right ovulations were equal in lactating and dry mares, there was a highly significant increase in the number of pregnancies in the right uterine horn in dry mares and in the left uterine horn in lactating mares.     

Anatomy of the sinoatrial node and the supply of its vascularization in man

Seventy heart preparations of persons belonging to different sex and age have been investigated, using a complex of anatomical and histological techniques. The dimensions of the sinoatrial node (SAN) vary with age and depend on various size and form of the heart. The large atrial branch of the right and left coronary arteries supplies mainly the SAN with blood. More seldom the atrial branches of both cardiac arteries, having anastomoses, realize the SAN blood supply. The character of the SAN vascularization depends on branching variations of the atrial vessels. At the right coronary variant the sources of the SAN blood supply are the SAN branch, the right intermediate or right posterior atrial branches, and at the left coronary variant--the anterior left, the posterior left and the intermediate left atrial branches. At the even variant the SAN blood supply sources are the right intermediate and the anterior left atrial or the right posterior and the left posterior atrial branches. The data obtained can be used for comparison with the results of coronography to make a skilled analysis of clinical-roentgenological observations.     

Anatomical variations of the arterial pattern in the left hemiliver

The arterial supply to the left hemiliver was studied in 70 liver casts. The arteries were divided into 15 groups according to their origin and branching pattern. The left hemiliver was supplied by one artery in 53% of cases, by two arteries in 40% and by three arteries in 7%. The left hepatic artery, which originated from the proper hepatic artery, supplied all three left segments in 39% of specimens. The replacing left hepatic artery, which originated from the left gastric artery, supplied the whole left hemiliver in 3% of cases. The incomplete, replacing left hepatic artery supplied segments 2, 3 and a part of segment 4 in 6% of cases, and only segments 2 and 3 in 11%. There was one segmental artery for segment 2 in 86%, and two in 14%. Segment 3 was supplied by one artery in 87%, and by two in 13%. Segment 4 was supplied by one artery in 39% of cases, by two arteries in 43%, by three in 14% and by four arteries in 4%.     

Anomalous origin of the left coronary artery from the pulmonary artery treated by palliative Vineberg operation in an infant

Anomalous origin of the left coronary artery from the pulmonary artery was diagnosed in an infant girl who had evidence of transmural myocardial infarction of the free wall of the left ventricle. At age 13 months, she underwent a palliative left Vineberg implant, and remained asymptomatic until she was 8 years of age. At that time, she underwent suturing of the left coronary ostium for obliteration of the left coronary shunt at the pulmonary artery. At age 13, she underwent aortocoronary bypass to the left main coronary artery, with end-to-end anastomosis. The patient remains asymptomatic to date. We believe that this is the first reported case of a Vineberg operation performed in an infant for palliation of an anomalous left coronary artery originating from the pulmonary artery. This method allows time for the development of collateral circulation to the left coronary artery before definitive surgery is performed.     

The effect of distension of the left ventricle of the heart on the length of the individual myocardial fibers

Based on the ellipsoid model of the left ventricle and the helicoidal course of the left ventricular myocardial fibers, a theory has been developed for calculating the length of the individual myocardial fibers. Numerical solutions of the final equation show that when the left ventricle is distended, the increase in length of the myocardial fibers is not uniform throughout the thickness of the myocardial wall. It was shown that with increasing dimensions of the left ventricle, the distension of the myocardial fibers becomes smaller as one advances from the endocardium to the middle layer of fibers, whereas it increases as one advances from the middle layer to the epicardial layer. The mechanism by which this effect is brought about as well as its physiological implications are discussed.     

Functional state of the left ventricle of the heart in cardiocytotoxic shock]

Changes in the cardiodynamics and the contractile myocardium function under experimental shock caused by intracoronary injection of the anticardial cytotoxic serum were studied on 20 anesthetized dogs. Along with the symptoms of disturbance of the left ventricle function (a decrease of the systolic index, stroke work index of the left ventricle, rate of the intraventricular pressure rise, indices of myocardial contractility, ejection fraction) a decrease of the end-diastolic volume and pressure in the left ventricle was observed. These data show that disturbances in the cardiodynamics were cause not only by the cytotoxic heart damage, but also by derangement of the blood flow to the left heart.     

Coelomogenesis during the abbreviated development of the echinoid Heliocidaris erythrogramma and the developmental origin of the echinoderm pentameral body plan

The development of the coeloms is described in an echinoid with an abbreviated larval development and shows the early morphogenesis of the coeloms of the adult stage. The development is described from images obtained by laser scanning confocal microscopy. The development in Heliocidaris erythrogramma is asymmetric with a larger left coelom forming on the larval-left side and a smaller right coelom forming on the larval-right side. The right coelom forms after the development of the left coelom is well advanced. The hydrocoele forms from the anterior part of the left coelom. The five lobes of the hydrocoele from which the pentamery of the adult derives take shape on the outer, distal wall of the anterior part of the left coelom. The hydrocoele separates from the more posterior part of the left coelom, which becomes the left posterior coelom. The lobes of the hydrocoele are named, based on the site of the connexion of the stone canal to the hydrocoele. The mouth is assumed to form by penetration through only the outer, distal wall of the hydrocoele and the ectoderm. Both larval and adult polarities are evident in this larva. A comparison with coelomogenesis in the asteroid Parvulastra exigua, which also has an abbreviated development, leads to predictions of homology between the echinoderm and chordate phyla that do not require the hypothesis of a dorsoventral inversion event in chordates.     

Simulation of Left Atrial Function Using a Multi-Scale Model of the Cardiovascular System

During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to characterize the left atrium, first, because this theory has known limitations, and second, because it is still uncertain whether the load independence hypothesis holds. In this study, we aim to bypass this uncertainty by relying on another kind of mathematical model of the cardiac chambers. In the present work, we describe both the left atrium and the left ventricle with a multi-scale model. The multi-scale property of this model comes from the fact that pressure inside a cardiac chamber is derived from a model of the sarcomere behavior. Macroscopic model parameters are identified from reference dog hemodynamic data. The multi-scale model of the cardiovascular system including the left atrium is then simulated to show that the physiological roles of the left atrium are correctly reproduced. This include a biphasic pressure wave and an eight-shaped pressure-volume loop. We also test the validity of our model in non basal conditions by reproducing a preload reduction experiment by inferior vena cava occlusion with the model. We compute the variation of eight indices before and after this experiment and obtain the same variation as experimentally observed for seven out of the eight indices. In summary, the multi-scale mathematical model presented in this work is able to correctly account for the three roles of the left atrium and also exhibits a realistic left atrial pressure-volume loop. Furthermore, the model has been previously presented and validated for the left ventricle. This makes it a proper alternative to the time-varying elastance theory if the focus is set on precisely representing the left atrial and left ventricular behaviors.     

The innervation of the human esophagus

There are usually 3 left and 4 right esophageal branches of the sympathetic chains. Besides a direct approach to the organ, they form a delicate network between aorta and esophagus. This network exchanges fibers with the vagus nerves. The vagal supply of the cranial third is rather poor. It is richest in the middle third. As a rule, the left anterior, left posterior, right anterior and right posterior main branches can be prepared. There are relatively few communications between right and left ramuli. Above the esophageal hiatus, always quite distinct anterior vagal chords are found, while posteriorly there are usually only very thin nerve bundles.     

Distribution of the pulmonary artery and vein in the lung of the white handed gibbon

The lungs of four white handed gibbons (Hylobates agilis) were examined. The right pulmonary artery runs across the ventral side of the right upper lobe bronchiole, and then traverses the dorsal side of the right middle lobe bronchiole. Thereafter, it runs along the dorso-lateral side of the right bronchus, between the dorsal bronchiole system and the lateral bronchiole system, and gradually follows the dorsal side of the right bronchus. During its course, it gives off arterial branches which run along each bronchiole. The left pulmonary artery runs across the dorsal side of the left middle lobe bronchiole and then along the left bronchus as in the right lung. The branches of the pulmonary artery run mainly along the dorsal or lateral side of the bronchiole, while the pulmonary veins run mainly the medial side of the bronchioles or between them. However, in a few portions, the pulmonary veins run the lateral side of the bronchioles. Finally, they enter the left atrium with four large veins i.e. the common trunk of the right upper lobe vein and right middle lobe vein, right lower lobe pulmonary venous trunk, left middle lobe vein, and left lower lobe pulmonary venous trunk.     

Structure of the cardiac systole in mammals and birds

The comparative analysis of the contractile function of the heart left ventricle in four species of homoeothermic tetrapods (chicken, quail, rat, sheep) who differ in their spatio-temporal pattern of ventricular excitation, heart rate, and heart weight was performed. The analysis of cardiac cycle structure was performed on the basis of synchronous recording of ECG, phonocardiogram, and apex cardiogram. Indices of myocardial contractility of the left ventricle calculated on the basis of the analysis of the cardiac dynamics indicate disadvantageous contractile function of the left ventricle in rodents and non-flying birds in comparison with sheep. The functioning of the left ventricle in male rats is more strained than in female rats. One fundamental factor determining a more strained functioning of the left ventricle in birds in comparison with mammals is the heart rate. The relative weight and activation pattern of the left ventricular myocardium govern the contractile function of the left ventricle to a lesser extent.     

Anomalous origin of the left coronary artery: the effects of aortocoronary vein bypass on left ventricular function

The diagnosis, angiographic evaluation and surgical treatment by aortocoronary vein bypass are described in a 3½-year-old girl with anomalous origin of the left coronary artery from the pulmonary artery. The anomaly had resulted in cardiac dilatation, diminished left ventricular contractility, an aneurysm of the left ventricular free wall and mitral regurgitation.At the postoperative cardiac catheterization the graft was demonstrated to be patent, but a significant proportion of the flow to the left coronary artery was derived from anastomotic connections with the right coronary artery. The most striking evidence of improvement was obtained from the left ventricular volume studies which showed that the end systoiic volume had decreased from 85 to 49 ml./m.² with an increase in ejection fraction from 0.39 to 0.62, suggesting enhanced left ventricular contractility after surgery.The patient continues to do well and is free from symptoms.     

Branches of the left pulmonary artery supplying the basal segments of the lung

The studies were carried out on 100 left lungs taken from dead human bodies of both sexes whose age varied from 16 to 80 years. The pulmonary artery and the bronchus were injected with a 65% solution of duracryl and then digested in sulfuric acid. The specimens obtained were then examined to determine the number and dimensions of the branches of the basal portion of the left pulmonary artery penetrating into the basal segments of the left lower pulmonary lobe. Their length was 60 mm at the most, and their diameter 9.8 mm. Three types of ramification of the basal portion of the left pulmonary artery were distinguished on the basis of the trunks, segmental and subsegmental branches present. In 70% of the cases the branches penetrating into the basal segments showed tree-like type, in 3% of the cases showed bushy-like type, and in 27% of the cases middle type.     

A Three-Dimensional Analytical (Rheological) Model of the Human Left Ventricle in Passive-Active States: Nontraumatic Determination of the In Vivo Values of the Rheological Parameters

In this paper a three-dimensional continuum model of a mammalian left ventricle is formulated. The stresses in the model satisfy the conditions of zero stress on the outer (epicardial surface-representing) boundary. The strains of the model are obtained from the actual dynamic geometry measurements (obtained from cineangiocardiography). Since the left ventricular muscle is incompressible, the dilatational strain is zero and hence the (three-dimensional) deviatric stress components are related to the corresponding strain components by Maxwell and Voigt rheological model analogues of one-dimensional systems; the parameters of the model are series and parallel elastic (SE, PE) elements and the contractile element (CE) (representing the sarcomere). The incorporation of the rheological features of the cardiac muscle into the three-dimensional constitutive equations (for the three-dimensional continuum model of the left ventricle) is a feature of this paper. A procedure is presented to determine the parameters of the constitutive equations (i.e., the SE, PE, and the parameters of the force-velocity relation for the CE) for the left ventricle of a subject from data on the dimensions and chamber pressure of the left ventricle. The values of these parameters characterize the rheology of the left ventricular muscle of the subject. In order to demonstrate clinical application of the analyses, in vivo data of the subjects' left ventricular pressure and dimensions are obtained, and the analyses are applied to the data to determine (for each subject) the values and characteristics of the elastic elements and CEs.     

Distribution of the pulmonary artery and vein of the orangutan lung

The distribution of the pulmonary artery and vein of the orangutan lung was examined. The right pulmonary artery runs obliquely across the ventral side of the right bronchus at the caudally to the right upper lobe bronchiole. It then runs across the dorsal side of the right middle lobe bronchiole. Thereafter it runs obliquely across the dorsal side of the right bronchus, and then along the dorso-medial side of the right bronchus. This course is different from that in other mammals. During its course, it gives off branches which run mainly along the dorsal or lateral side of each bronchiole. The left pulmonary artery runs across the dorsal side of the left middle lobe bronchiole, then along the dorso-lateral side of the left bronchus, giving off branches which run along each bronchiole. The pulmonary veins run mainly the ventral or medial side of, along or between the bronchioles. In the left lung, the left middle lobe vein has two trunks; one enters the left atrium, and the other enters the left lower lobe pulmonary venous trunk. This is also different from that found in most mammals. Finally, the pulmonary veins enter the left atrium with four large veins.