Vein Volume Research Articles

Case reports of portal vein thrombosis and bile duct stenosis after stereotactic body radiation therapy for hepatocellular carcinoma

The aim of this study was to evaluate portal vein and bile duct toxicity after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC). We retrospectively reviewed 63 patients who were administrated SBRT once for HCC. The prescribed doses were from 48 Gy in four fractions to 60 Gy in eight fractions. Portal vein thrombosis and bile duct stenosis were evaluated. The dose received by 2% of the volume (D2 ) of the portal vein and bile duct was calculated. Portal vein thrombosis was observed in three patients (4.8%). Common points of these patients were Child-Pugh class B and D2 of the portal vein 40 Gy or more (BED3 ≥200 Gy). Bile duct stenosis was observed in one patient (1.6%). The patient had a history of cholangiocarcinoma and left hepatic lobectomy. Portal vein thrombosis may be necessary to be considered when SBRT for HCC is administrated to patients in higher Child-Pugh class with higher D2 of the portal vein.

Internal jugular and vertebral vein volume flow in patients with clinically isolated syndrome or mild multiple sclerosis and healthy controls: results from a prospective sonographer-blinded study

We evaluated internal jugular vein and vertebral vein volume flow using ultrasound, in patients with clinically isolated syndrome or mild multiple sclerosis and controls, to determine whether volume flow was different between the two groups. In patients and controls, internal jugular vein volume flow increased from superior to inferior segments, consistent with recruitment from collateral veins. Internal jugular vein and vertebral vein volume flow were greater on the right in supine and sitting positions. Internal jugular vein volume flow was higher in the supine posture. Vertebral vein volume flow was higher in the sitting posture. Regression analyses of cube root transformed volume flow data, adjusted for supine/sitting, right/left and internal jugular vein/vertebral vein, revealed no significant difference in volume flow in patients compared to controls. Our findings further refute the concept of venous obstruction as a causal factor in the pathogenesis of multiple sclerosis. Control volume flow data may provide useful normative reference values.

Fluid circulation and deformational gradient in north-Pyrenean flyschs: Example from the Saint-Jean-de-Luz basin (France)

Abstract The relationships between fluid circulation and deformation are one of the issues of the sedimentary basin study. In the Cretaceous flysch of the Saint-Jean-de-Luz basin, the evolution of folds geometry and the increasing volume of calcite-filled fractures and veins evidence a northward deformational gradient along the French Basque coast. A combined approach is proposed to assess the corresponding physical and chemical conditions: the microthermometric study of fluid inclusions in calcite sampled in different generations of veins and fractures and the X-ray diffraction analysis of clay minerals from adjacent marl layers. Salinity of the trapped H2O–CaCl2–NaCl fluids increases with depth in the series, in good agreement with salinity gradients reported in sedimentary basins. Dispersion of the data also increases with depth from 0.3 to 1.3 wt.% NaCl eq. in the shallowest formation (Haizabia flysch) to 9.1 to 23.0 wt.% NaCl eq. in the deepest formation (Guethary flysch). Minimal trapping temperatures of the fluids in the Haizabia and Socoa flyschs (79 and 102 °C, respectively) are consistent with the temperatures estimated from the depth of burial, which did not exceed 5 km, in good agreement with the stability of the smectite–illite–kaolinite assemblage found in marls. In addition, the kaolinite proportion significantly decreases with depth in the series, as a potential consequence of climate changes and diagenetic transformations, whereas the increasing dispersion of illite crystallinity data might indicate fluid–mineral interactions. We propose a synthetic model of fluid circulation in the folded series that involves the mixing of mainly-horizontal fluid circulation (potentially meteoric) with an upward flow of high-salinity fluid throughout the deepest formations (potentially related to underlying evaporite-rich layers). The northward deformational gradient, as exposed along the French Basque coast, is likely to be responsible for such a vertical circulation, by increasing the volume of fracture (particularly cross-cutting fractures) in the deeply buried formations.

ASSA13-02-3 The Impact of Volume of Pulmonary Veins Antrum and Left Atrium on Recurrence of Atrial Fibrillation After Radiofrequency Catheter Ablation in A Mid and Short-Term Period

<h3>Background and Objective</h3> The purpose of this research is to reconstruct 3-dimensional (3D) structure of the pulmonary veins and the left atrium through multislice computed tomography (MSCT), and then compare the variation of ostia, the antrum volume of pulmonary veins and the left atrium volume in AF patients with and without recurrence. <h3>Methods</h3> We consecutively enrolled sixty-five AF patients who accept RFCA therapy from June 2008 to January 2009, patients were followed up for one year from the day of RFCA. All patients were injected with intravenous constrast medium before being evaluated by 16-slice computed tomography (MSCT). The 3D reconstruction of PVs and left atrium was transformed into AW4.2 system, and we calculated the variation of pulmonary veins by Cardiac IQ software. Diameters of PVs ostia were measured by virtual endoscopy. The antrum volume of PVs and the left atrium volume were calculated by software volume rendering (VR). <h3>Results</h3> Pulmonary vein anatomical variations type in two groups showed no significant differences. The antrum volume of the bilateral PVs in the patients with recurrence was significantly larger than that in the patients without recurrence, left (3.84 ± 0.75 vs. 3.24 ± 0.49cm³, P &lt; 0.05), right (4.95 ± 1.48 vs. 4.54 ± 1.11cm³, P &lt; 0.01). The left atrium volume in the patients with recurrence group was also significantly larger than in the patients without recurrence group (99.85 ± 22.67 vs. 91.23 ± 17.31, P &lt; 0.05), The antrum volume of bilateral PVs justified with left atrial volume had no significant difference between the two groups. <h3>Conclusions</h3> The maximum and minimum diameter of PVs ostia, the left atrium volume of bilateral PVs and left atrium in patients with recurrence group were significantly larger than no recurrence group. But it had no relationship with the atrium volume of bilateral PVs justified by left atrium volume.

Anatomical and physiological changes in the venous system of lower limbs in pregnant women and findings associated with the symptomatology

Quantify the volume and diameter of veins in the lower limbs of primigravidae and associate the presence of venous signs and symptoms with the vascular measurements. A cross-sectional study assessed 64 lower limbs of 32 healthy women of whom 16 were primigravidae between 22 and 36 weeks pregnant, and 16 nulligravidae. The women were submitted to physical assessment, air plethysmography and vascular ultrasound. The volumes and diameters of the main veins in the lower limbs were compared between pregnant and non-pregnant women. In the group of pregnant women, the attempt was also made to associate such measurements to the presence of vascular signs and symptoms. The average venous volume of the lower limbs (110.1 ± 30.2 and 94.7 ± 27.3 mL; p = 0.036), as well as the diameters of the common femoral (12.72 ± 2.27 and 10.14 ± 1.24 mm; p < 0.0001), saphenous (4.81 ± 1.15 and 3.55 ± 0.98 mm; p < 0.0001) and popliteal (6.87 ± 1.68 and 5.36 ± 1.07 mm; p < 0.0001) veins were, respectively, greater in the pregnant women compared with the control group. In pregnant women with venous stasis symptoms, a venous diameter of the saphenous vein compared to those without no symptoms (5.05 ± 1.19 and 4.09 ± 0.70 mm; p = 0.011) was noted. Anatomical and functional changes in the venous system during pregnancy were detected by the air plethysmography and the vascular ultrasound in primigravidae. In pregnant women, the presence of venous stasis symptoms found an anatomical and functional substrate detected in the differences in diameter of the saphenous vein.

Estimation of the Congestion Area Volume in Potential Living Donor Remnant Livers

BackgroundLiving donor liver transplantation is widely performed in adult patients. One of the problems in this setting is a small-for-size graft, which results in dysfunction and poor prognosis of a transplantation. A right liver graft was devised to overcome this problem; furthermore, inclusion of the middle hepatic vein (MHV) has been suggested to greatly improve recipient outcomes. However, extended right hepatectomy involves a surgical risk for the living donor in terms of congestion of the left paramedian sector. The volume of the venoocclusive region of a living donor liver possibly varies depending on the collateral patterns of veins draining the cranial part of segment 4 (S4). Patients and MethodsWe were analyzed the normal livers of 50 patients who underwent triphasic contrast-enhanced multidetector row computed tomography during preoperative and postoperative examinations. The patient pathologies consisted of gastric cancer (n = 25), colon cancer (n = 1), or renal cancer (n = 24). We calculated the volume of the entire liver as well as those of the right graft and left remnant lobes for comparison with the drainage volume of each hepatic vein and its branches. ResultsOn the basis of the anatomic venous drainage of the cranial part of S4 (V4sup), we classified hepatic veins as group A (n = 31), the V4sup joined the left hepatic vein or the MHV distal to the vein draining S8 area (MV8), or group B (n = 19), V4sup joined the MHV proximal to MV8. The mean volume of the congested area was 6.9% in group A and 15.9% in group B. The venoocclusive areas in the remnant livers were estimated to be larger in group B (P < .001). ConclusionThe collateral pattern of V4sup and MV8 as well as preoperative volumetric analysis are important for graft selection to decide the line of transection.

CT/99mTc-GSA SPECT fusion images demonstrate functional differences between the liver lobes

To evaluate the functional differences between the 2 liver lobes in non-cirrhotic patients by using computed tomography/(99m)Tc-galactosyl human serum albumin (CT/(99m)Tc-GSA) single-photon emission computed tomography (SPECT) fusion images. Between December 2008 and March 2012, 264 non-cirrhotic patients underwent preoperative liver function assessment using CT/(99m)Tc-GSA SPECT fusion images. Of these, 30 patients, in whom the influence of a tumor on the liver parenchyma was estimated to be negligible, were selected. Specifically, the selected patients were required to meet either of the following criteria: (1) the presence of an extrahepatic tumor; or (2) presence of a single small intrahepatic tumor. These 30 patients were retrospectively analyzed to calculate the percentage volume (%Volume) and the percentage function (%Function) of each lobe. The ratio between the %Function and %Volume (function-to-volume ratio) of each lobe was also calculated, and the ratios were compared between the 2 lobes. Furthermore, the correlations between the function-to-volume ratio and each of 2 liver parameters [lobe volume and diameter ratio of the left portal vein to the right portal vein (LPV-to-RPV diameter ratio)] were investigated. The median values of %Volume and %Function were 62.6% and 67.1% in the right lobe, with %Function being significantly higher than %Volume (P < 0.01). The median values of %Volume and %Function were 31.0% and 28.7% in the left lobe, with %Function being significantly lower than %Volume (P < 0.01). The function-to-volume ratios of the right lobe (1.04-1.14) were significantly higher than those of the left lobe (0.74-0.99) (P < 0.01). The function-to-volume ratio showed no significant correlation between the lobe volume in either lobe. In contrast, the function-to-volume ratio showed significant correlations with the LPV-to-RPV diameter ratio in both lobes (right lobe: negative correlation, r s = -0.37, P = 0.048; left lobe: positive correlation, r s = 0.71, P < 0.001). The function-to-volume ratio in the left lobe tended to be higher, and that in the right lobe tended to be lower, in accordance with the increase in the LPV-to-RPV diameter ratio. CT/(99m)Tc-GSA SPECT fusion images demonstrated that the function of the left lobe was significantly decreased compared with that of the right lobe in non-cirrhotic livers.

Relationship of pharyngeal water content and jugular volume with severity of obstructive sleep apnea in renal failure

In patients with end-stage renal disease (ESRD), fluid overload may contribute to their high prevalence of obstructive sleep apnea (OSA) by increasing the amount of fluid displaced from the legs into the neck overnight, and possibly compressing the upper airway (UA). Indeed, in ESRD patients, the amount of overnight rostral fluid displacement from the legs is related to the frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index, AHI). We, therefore, hypothesized that in ESRD patients, the greater the UA-mucosal water content (UA-MWC) and internal jugular vein volume (IJVVol), the higher the AHI. We studied 20 patients with ESRD on thrice weekly hemodialysis who had undergone diagnostic polysomnography (age 41.0 ± 12.3 years, with a body mass index (BMI) of 25.8 ± 6.3 kg/m(2) and an AHI of 20.2 ± 26.8). The leg fluid volume (LFV) was measured by bioelectric impedance. The IJVVol and MWC were measured by UA magnetic resonance imaging (MRI). The only significant independent correlates of the AHI were IJVVol (r = 0.801, P < 0.0001) and UA-MWC (r = 0.720, P = 0.0005) which together explained 72% of its variability. These data suggest that fluid overload via increased IJVVol, and UA-MWC, contributes to the pathogenesis of OSA in patients with ESRD. These findings help us to explain the high prevalence of OSA in ESRD patients, and attenuation of OSA in association with nocturnal dialysis. They also suggest the need for randomized trials to determine whether more aggressive fluid removal in ESRD patients will alleviate OSA.

A Model Simulation for Decreased Left Ventricular Stroke Volume in Obstructive Sleep-Disordered Breathing

Background. Increased negative intrathoracic pressures are recognized to exacerbate left ventricular dysfunction in obstructive sleep-disordered breathing. Reportedly left ventricular stroke volume (LVSV) decline appeared greater than predicted by the obstruction alone. Objectives. Whether this effect is more dependent on biventricular elasticity and fluid shifts than on breathing-related transmural pressures could be inferred from a mathematical model simulation. Design. A previously validated cardiopulmonary model in healthy subjects during inspiratory loading was modified by parameter adjustments to fit its ventricular volumes output to published clinical data of decreased LVSV in obstructed breathing. Results. Reduced left ventricular end-diastolic compliance and increased central blood volume from baseline each simulated a 20% drop in LVSV whereas twice as much change was the result of increasing a mere 400 mL to the unstressed volume of systemic veins. An intermediate value was obtained by decreasing right ventricular end-diastolic compliance and higher systemic venous compliance. Conclusions. Simulations encompassing a wide range of decreased stroke volume at comparable intrathoracic pressures suggested a prominent role of decreased myocardial distensibility (possibly coupled to fluid migration) in the stroke volume fall.

In vivo determination of a modified heat capacity of small hepatocellular carcinomas prior to radiofrequency ablation: Correlation with adjacent vasculature and tumour recurrence

Purpose: To calculate a modified heat capacity (mHC) of small hepatocellular carcinomas (HCCs) in vivo during radio frequency ablation (RFA) and to determine if mHC correlates with tumour vascularity, adjacent vessels or local recurrence.Patients and methods: This study was IRB approved and informed consent was obtained from all patients. Before formal RFA, ambient HCC temperature and temperature 1 min after heating at constant wattage were measured in 29 patients. From temperature change and wattage, individual mHCs (joules required to increase tumour temperature by 1° Celsius) were calculated. Pre‐RFA, three‐phase computerised tomography (CT) scans were reviewed blindly for hepatic arteries, hepatic veins and portal veins abutting or within 3 mm of tumour edge from which twelve vascular parameters were quantified. Tumour enhancement (homogeneous or heterogeneous on arterial phase) was also assessed. Multiple regression was used to correlate mHC with vascular parameters and tumour enhancement. Cox proportional hazard model was used to examine the relationship of mHC to local recurrence.Results: There was significant correlation of mHC with lesion enhancement (P = 0.0018), length of hepatic arteries (P < 0.0001) and total hepatic vein volume in contact with tumour (P = 0.016). No correlation was found with any non‐abutting vessel or portal vein parameter. The chance of local recurrence increased with increasing mHC.Conclusion: Because the modified heat capacity of small HCCs in our study population correlated with HCC enhancement, abutting hepatic arteries, the volume of abutting hepatic veins and local recurrence, it may be an indicator of the heat sink effect (HSE) and supports the HSE as a risk factor for local recurrence.

Chemical analysis of ice vein microenvironments: II. Analysis of glacial samples from Greenland and Antarctica

AbstractChemical constituents trapped within glacial ice provide a unique record of climate, as well as repositories for biological material such as pollen grains, fungal spores, viruses, bacteria and dissolved organic carbon. Past research suggests that the veins of polycrystalline ice may provide a liquid microenvironment for active microbial metabolism fueled by concentrated impurities in the veins. Despite these claims, no direct measurements of impurity concentration in ice veins have been made. Using micro-Raman spectroscopy, we show that sulfate and nitrate concentrations in the veins of glacial ice from Greenland (Greenland Ice Sheet Project 2) and Antarctic (Newall Glacier and a Dominion Range glacier) core samples were 104 and 105 times greater than the concentrations measured in melted (bulk) core water. Methanesulfonate was not found in the veins, consistent with its presence as particulate matter within the ice. The measured vein concentration of molecular anions implies a highly acidic (pH &lt; 3) vein environment with high ionic strength (mM-M). We estimate that the vein volume provides 16.7 and 576 km3 of habitable space within the Greenland and Antarctic ice sheets, respectively, which could support the metabolism of organisms that are capable of growing in cold, high ionic strength solutions with low pH.

Phase contrast MRI quantification of pulsatile volumes of brain arteries, veins, and cerebrospinal fluids compartments: Repeatability and physiological interactions

To study measurement repeatability and physiological determinants on measurement stability for phase contrast MRI (PC-MRI) measurements of cyclic volume changes (ΔV) of brain arteries, veins, and cerebrospinal fluid (CSF) compartments. Total cerebral blood flow (tCBF), total internal jugular flow (tJBF) and spinal CSF flow at C2-C3 level and CSF in the aqueduct was measured using five repetitions in 20 healthy subjects. After subtracting net flow, waveforms were integrated to calculate ΔV of arterial, venous, and cerebrospinal fluid compartments. The intraclass correlation coefficient (ICC) was used to measure repeatability. Systematic errors were investigated by a series of phantom measurements. For ΔV calculated from tCBF, tJBF and both CSF waveforms, the ICC was ≥0.85. ΔV from the tCBF waveform decreased linearly between repetitions (P = 0.012). Summed CSF and venous volume being shifted out from the cranium was correlated with ΔV calculated from the tCBF waveform (r = 0.75; P < 0.001). Systematic errors increased at resolutions <4 pixels per diameter. Repeatability of ΔV calculated from tCBF, tJBF, and CSF waveforms allows useful interpretations. The subject's time in the MR system and imaging resolution should be considered when interpreting volume changes. Summed CSF and venous volume changes was associated with arterial volume changes.

In vitro and in vivo inhibitory effects and mechanism of 9-nitrocamptothecin liposomes on HepG2 cell

Objective To observe the inhibitory effect and mechanism of 9-nitrocamptothecin liposomes on HepG2 liver carcinoma cells. Methods HepG2 cells were incubated with 9-nitrocampto-thecin(9NC) or with 9-nitrocamptothecin liposomes(9NC-LP) for 24 h, 48 h and 72 h. Cell viability was then measured by the MTT assay. Cell cycle and apoptosis were evaluated by flow cytometry.Western Blot was used to determine the expression of cell cycle and apoptosis related proteins. HepG2tumor-bearing mouse models were then established. The HepG2 tumor-bearing mice were randomly divided into control group, free liposomes group, DMSO group, 9NC low dose group, 9NC high dose group, 9NC-LP low dose group and 9NC-LP high dose group. There were 10 mice in each group.Drugs were administered by tail vein and tumor volume and body weight were observed 28 days after administration. Then animals were sacrificed and the expression of proteins from tumor homogenates was analyzed by Western blotting. Results In vitro, HepG2 cell viability was apparently inhibited by 9NC and 9NC-LP, and the inhibitory effect increased in a time-dependent and dose-dependent manner.Both S and G2/M phase arrests were observed after incubation with drugs. HepG2 cells were completely arrested in S phase with 9NC concentration over than 0.1 μmol/L after incubation for 24 h,while more than 95% of cells arrested in G2/M phase when 9NC concentration was 0.1 μmol/L after incubation for 72 h. In vivo, compared with the control group, the average tumor volume was reduced in both the 9NC and 9NC-LP group (P 50% of animals died 14 days after drug administration. Conclusion 9NC and 9NC-LP can inhibit HepG2 cell growth via cell cycle arrest and apoptosis induction. 9NC-LP has a more potent anti-tumor effect and fewer side effects in vivo,which means 9NC-LP is a promising compound for cancer therapy via intravenous administration. Key words: 9-Nitrocamptothecin; Liposomes; Liver carcinoma; Cell cycle; Apoptosis

Effects of dietary l-arginine or N-carbamylglutamate supplementation during late gestation of sows on the miR-15b/16, miR-221/222, VEGFA and eNOS expression in umbilical vein

Placental vascular formation and blood flow are crucial for fetal survival, growth and development, and arginine regulates vascular development and function. This study determined the effects of dietary arginine or N-carbamylglutamate (NCG) supplementation during late gestation of sows on the microRNAs, vascular endothelial growth factor A (VEGFA) and endothelial nitric oxide synthase (eNOS) expression in umbilical vein. Twenty-seven landrace × large white sows at day (d) 90 of gestation were assigned randomly to three groups and fed the following diets: a control diet and the control diet supplemented with 1.0% l-arginine or 0.10% NCG. Umbilical vein of fetuses with body weight around 2.0 kg (oversized), 1.5 kg (normal) and 0.6 kg (intrauterine growth restriction, IUGR) were obtained immediately after farrowing for miR-15b, miR-16, miR-221, miR-222, VEGFA and eNOS real-time PCR analysis. Compared with the control diets, dietary Arg or NCG supplementation enhanced the reproductive performance of sows, significantly increased (P < 0.05) plasma arginine and decreased plasma VEGF and eNOS (P < 0.05). The miR-15b expression in the umbilical vein was higher (P < 0.05) in the NCG-supplemented group than in the control group. There was a trend in that the miR-222 expression in the umbilical vein of the oversized fetuses was higher (0.05 < P < 0.1) than in the normal and IUGR fetuses. The expression of eNOS in both Arg-supplemented and NCG-supplemented group were lower (P < 0.05) than in the control group. The expression of VEGFA was higher (P < 0.05) in the NCG-supplemented group than in the Arg-supplemented and the control group. Meanwhile, the expression of VEGFA of the oversized fetuses was higher (P < 0.05) than the normal and IUGR fetuses. In conclusion, this study demonstrated that dietary Arg or NCG supplementation may affect microRNAs (miR-15b, miR-222) targeting VEGFA and eNOS gene expressions in umbilical vein, so as to regulate the function and volume of the umbilical vein, provide more nutrients and oxygen from the maternal to the fetus tissue for fetal development and survival, and enhance the reproductive performance of sows.

MO‐F‐211‐07: Quantifying Magnetic Susceptibility of Veneous Blood by the Complex Sum Method in MRI

Purpose: Changes of venous blood oxygenation level leads to direct changes in the magnetic susceptibility of veins. The oxygenation level reflects the physiological state of a given vein. Therefore, susceptibility quantification of veins has been a strong interest in MRI. Here we will demonstrate a general approach to extracting magnetic susceptibilities of veins at arbitrary orientations from only two or three echoes of a standard 3D gradient echo sequence. Methods: The complex sum method is used. The complex MR signal of each voxel is added around a long cylindrical object of interest. Previous work has accurately quantified effective magnetic moments of given cylindrical objects. If an object has no MR signal, its volume and susceptibility can be further determined by the spin echo approach. On the other hand, when an object of interest (e.g., vein) has an MR signal, the susceptibility of the object and its volume may be uniquely solved using this method. Images acquired with two different echo times in a typical gradient echo sequence are sufficient to quantify the magnetic susceptibility and volume of veins. Several small isolated human cerebral veins were measured at TE=11.6 ms and 19.2 ms in 4.0T. Due to low signal to noise ratio, images at TE=19.2 ms were Bilateral filtered, to preserve the edge but reduce noise. The uncertainties of magnetic susceptibilities were quantified by the error propagation method. Results: The measured susceptibility of veins at two different echo times agrees with the value in the textbook (0.40 ppm) within the uncertainty. The volumes of venous vessels, the spin density inside and outside these vessels are also obtained. Conclusions: The in‐vivo measurements demonstrate our method can be used to quantify the magnetic susceptibility of a given narrow and long cylindrical object in human imaging.

Estimation of fetal oxygen uptake in human term pregnancies

Objective. Umbilical oxygen (O2) uptake is a parameter of basic physiologic interest. It has been extensively studied in chronically catheterized animals but very few data have been obtained acutely in humans. Recent developments in ultrasound technology allow the estimation of umbilical venous blood flow in utero.Methods. In all, 26 normal term pregnancies were studied at the time of elective cesarean section in order to evaluate fetal O2 uptake as the product of umbilical blood flow and umbilical O2 veno-arterial difference. An ultrasound evaluation was performed within 1 h from delivery: umbilical vein area and flow velocity were recorded to calculate umbilical vein volume flow (Qumb). Blood samples from the umbilical vein (uv) and artery (ua) were obtained at the time of fetal extraction for respiratory gases and acid–base evaluation.Results. Umbilical O2 uptake was calculated as Qumb • (uv-ua)O2 content: an average value of 0.84 ± 0.40 mmol/min was obtained. Umbilical O2 uptake per kg was 0.25 ± 0.12 mmol/kg/min, significantly related to fetal O2 delivery.Conclusions. We estimated umbilical blood flow by ultrasound and we measured umbilical O2 uptake at term obtaining a value of umbilical O2 uptake/kg similar to what previously reported in human pregnancies and chronically catheterized animals.

Is the Palea Kavala Bi–Te–Pb–Sb ± Au district, northeastern Greece, an intrusion-related system?

Intrusion-related gold systems are generally characterized by a Au–Bi–Te ± Sn–W metal assemblage genetically linked to the emplacement of granitoids. The Palea Kavala ore system, Greece, consists of ~ 150 minor Fe–Mn (Pb ± Zn ± Ag), Fe–Mn–Au, Fe–As–Au, Fe–Cu–Au, and Bi–Te–Au occurrences that occur primarily in quartz–calcite–sulfide veins (hypogene mineralization), or as supergene bodies, in overlapping zones centered on the ~ 21–22 Ma granodioritic Kavala pluton, which intrudes metamorphic rocks of the Paleozoic Rhodope metamorphic core complex. The pluton consists mostly of granodiorite with lesser amounts of diorite, tonalite and monzodiorite, which was emplaced along the regional E–W trending Kavala–Komotini fault. The recently discovered, ~ 4 km long, E–W trending so-called Kavala vein is a sheeted quartz vein system of Bi–Te–Pb–Sb ± Au mineralization that crosscuts the Kavala pluton and the schists and gneisses of the Rhodope Massif. The Kavala vein system is comprised of quartz with lesser amounts of K-feldspar, plagioclase and muscovite. Quartz–sericite–pyrite alteration is pervasive but minor kaolinite is also present. Pyrite (~ 5% of vein volume) contains inclusions of tetradymite (some gold-bearing), bismuthinite, and cosalite. Sulfur isotope values (n = 27) of pyrite from the Kavala and Chalkero veins, as well as pyrite and galena from Garizo Hill Fe–Mn–Pb vein range from − 1.9 to 1.0‰ (with one outlier of − 4.6‰) and suggest a magmatic sulfur source. Homogenization temperatures (T h) of type I (two-phase aqueous liquid–vapor) and type II (three-phase, H 2O–CO 2-rich) fluid inclusions that homogenize into the liquid phase in quartz from the Kavala and Chalkero veins range from 216.0° to 420.0 °C (n = 216) and 255.7° to 414.0 °C (n = 112), respectively. The T h of type III (two-phase aqueous liquid–vapor), which homogenize into the vapor phase, ranges from 210.4° to 323.4 °C (n = 28). The salinities of type I and type II inclusions range from 15.9 to 22.6 wt.% NaCl equiv. and 5.5 to 11.2 wt.% NaCl equiv., respectively. Eutectic temperatures of − 58.5° to − 44.3 °C for type I inclusions suggest the presence of appreciable CaCl 2 in addition to NaCl. Clathrate melting temperatures for type II inclusions of ~−56.7 °C indicate that CO 2 is the major component of the gaseous phase, however up to ~ 6% CH 4 is present in some inclusions. The presence of a zoned metallogenetic district centered on Bi–Te–Pb–Sb ± Au mineralization within the Kavala pluton, the presence of both magnetite and ilmenite in the Kavala pluton, and the two high-temperature, high-salinity, immiscible carbonic and aqueous fluids associated with the Kavala and Chalkero veins are consistent with them being part of an intrusion-related gold system that formed along the ilmenite–magnetite buffer.

Foam Sclerotherapy Using Polidocanol (Aethoxysklerol) for Preoperative Portal Vein Embolization in 16 Patients

To evaluate the clinical safety and effectiveness of foam sclerotherapy using polidocanol for preoperative portal vein embolization (PVE) before hemihepatectomy of the liver. From March 2006 to October 2008, foam sclerotherapy using polidocanol was performed in 16 patients (male-to-female ratio of 12:4, age range 48-75 years [mean 62]) for PVE. Patients were diagnosed with Klatskin tumor (n = 13), gallbladder (GB) cancer (n = 2), or hepatocellular carcinoma (HCC) (n = 1). The foam was composed of a 1:2:1 ratio of 3% polidocanol (Aethoxysklerol; Kreussler Pharma, Wiesbaden, Germany), room air, and contrast media (Xenetix 350; Guerbet, Aulnay-Sous-Bois, France). The total amount of polidocanol used (2 to 8 mL [mean 4.6]) varied according to the volume of the target portal vein. We calculated the volume of future liver remnant (FLR) before and after PVE and evaluated complications associated with the use of polidocanol foam sclerotherapy for PVE. Technical success was achieved in all patients. All patients were comfortable throughout the procedure and did not experience pain during sclerotherapy. No periprocedural morbidity or mortality occurred. Patients underwent a liver dynamic computed tomography (CT) scan 2-4 weeks after PVE. FLR increased significantly after PVE using polidocanol foam from 19.3% (range 16-35%) before PVE to 27.8% (range 23-42%) after PVE (p = 0.001). All patients were operable for hemihepatectomy of the liver and achieved effective resection. Foam sclerotherapy using polidocanol is clinically safe and effective for preoperative PVE.

E0572 Comparison of pulmonary veins ostium, antrum and left atrial volume in patients with and without paroxysmal atrial fibrillation

ObjectiveTo the date, catheter ablation basing on pulmonary vein (PVs) isolation is effective treatment for paroxysmal atrial fibrillation (PAF). In some experimental electrophysiological center, catheter ablation has been the first...

Three-dimensional computed tomography scan analysis of hepatic vasculatures in the donor liver for living donor liver transplantation

Because hepatic vasculatures exhibit variations, a preoperative evaluation of the vascular anatomy and an estimation of the volume of the liver graft are essential for successful adult living donor liver transplantation. Using 3-dimensional (3D) computed tomography (CT), we analyzed the volumetric and anatomical relationship of the hepatic vasculatures of liver grafts. The livers of 223 potential donors were analyzed by 3D CT. Volumetric analysis was performed for each hepatic vein and its tributaries. The anatomy of the portal vein and hepatic artery was assessed along with the biliary system via intraoperative cholangiography in 110 recipients. On the basis of the anatomical presentation of the inferior right hepatic vein (IRHV), the hepatic veins were classified as follows: in type I, the IRHV was absent; in type II, the IRHV was smaller than the right hepatic vein (RHV); and in type III, the IRHV was greater than or equal to the RHV in size. The drainage volume of the middle hepatic vein (MHV) and especially its tributaries in the right lobe increased with the size of the IRHV (P < 0.001). In type III hepatic veins with a large IRHV (17% of the donors), the MHV tributaries had the largest drainage volume in the right lobe (41.2% +/- 11.8%). Furthermore, type III hepatic veins typically exhibited biliary variations in 75% of the donors. No correlation was observed between variations in the hepatic artery and portal vein. In conclusion, a right lobe graft with a large IRHV is accompanied by a large drainage volume via the MHV and by bile duct variations in 17% of livers. Therefore, anatomical and volumetric analysis is important for preoperative evaluations.