ABSTRACT
@#Objective To summarize the clinical experience in the treatment of high-risk patients with severe aortic valve disease by transcatheter aortic valve implantation (TAVI) via heart apex approach and to evaluate the early efficacy. Method Five patients who underwent TAVI via heart apex approach from September 2017 to February 2019 in Henan Thoracic Hospital were retrospectively analyzed, including 3 males and 2 females, aged 65-84 (74.6±4.5) years. Result All operations were performed through a small left incision into the thoracic cavity (3-5 cm), and then through the J-Valve transport system, the aortic valve was successfully released via heart apex after precise positioning under digital subtraction angiography. One patient developed ventricular fibrillation during the operation, and the operation was completed with the assistance of emergency femoral arteriovenous catheterization cardiopulmonary bypass; one patient underwent percutaneous coronary intervention first because of severe coronary stenosis; one patient had paroxysmal atrial fibrillation during the perioperative period, and had hepatorenal insufficiency and thrombocytopenia after the operation, and was improved after medical treatment; one patient had perivalvular leak during the operation, and was improved after re-implantation of the valve; one patient was in stable condition during operation and recovered smoothly after operation. Surgery was successful in all 5 patients. The follow-up time was 2-19 months, and the early clinical effect was good. Conclusion The short-term clinical efficacy of TAVI via heart apex approach in the treatment of high-risk severe aortic valve disease is definite and safe, but the long-term and medium-term effects need to be further evaluated.
ABSTRACT
The morphology of the hypophysis in Bactrian camel has not been described in the literature, despite it being the master of endocrine organs in vertebrates. In the present study, we examined the morphological features of the hypophysis in Bactrian camel by means of gross anatomy, light and electron microscope. Our findings showed that the gland was a protrusion of the bottom of the hypothalamus at the base of the brain with about 1.54 g in weight and 2 cm3 in volume. The hypophysis consists of two major parts: fully developed adenohypophysis and underdeveloped neurohypophysis, the adenohypophysis consists of pars distalis and pars intermedia. Seven type cells of the pars distalis could be distinguished with immunohistochemical techniques and electron micrographs: somatotroph, mammotroph, thyrotroph, corticotroph, gonadotroph, chromophobe and stellate cells which is in accordance with most mammals. Notably, the stellate cells could be obviously distinguished from chromophobe cells in histological oberservation. Moreover, the corpusculum neurosecretorium (Herring bodies) were rare in the external neurohypophysis, and mainly distributed in the internal neurohypophysis, this was different from most mammals. Results from this study would provide a necessary theoretical basis for ongoing investigations for Bactrian camels and their good adaptability in arid and semi-arid circumstances.
La morfología de la hipófisis en el camello bactriano no ha sido descrita en la literatura, a pesar de ser el maestro de los órganos endocrinos en los vertebrados. En el presente estudio, examinamos las características morfológicas de la hipófisis del camello bactriano por medio de anatomía general, microscocopía de luz y microscopía electrónica. Nuestros hallazgos mostraron que la hipófisis es una protuberancia ubicada en la porción inferior del hipotálamo, en la base del cerebro, con aproximadamente 1,54 g de peso y 2 cm3 de volumen. La hipófisis consta de dos partes principales: adenohipófisis, completamente desarrollada, y neurohipófisis, poco desarrollada; además, la adenohipófisis consta de una pars distalis y una pars intermedia. Con técnicas inmunohistoquímicas y micrografías electrónicas en la pars distalis se pudieron distinguir siete tipos de células: somatotrofas, mamotróficas, tirotrofas, corticotrofas, gonadotrofas, cromófobas y estrelladas, lo que es similar a la mayoría de los mamíferos. En la observación histológica las células estrelladas se pueden distinguir naturalmente de las células cromófobas. Además, es rara la presencia de corpusculum neurosecretorium (Cuerpos de Herring) en la neurohipófisis externa, hallándose distribuidos principalmente en la neurohipófisis interna, esto es diferente a lo encontrado en la mayoría de los mamíferos. Los resultados de este estudio proporcionarían una base teórica necesaria para las investigaciones en curso de los camellos bactrianos y su buena adaptabilidad en circunstancias áridas y semiáridas.
Subject(s)
Animals , Pituitary Gland/ultrastructure , Camelus/anatomy & histology , Pituitary Gland/anatomy & histology , Immunohistochemistry , Microscopy, ElectronABSTRACT
The adrenal gland is an important endocrine organ in vertebratesthat produces a wide variety of hormones. The anatomical results showed that the adrenal gland in Bactrian camel had a typical blood supply and innervation. Surprisingly, we found that there was a novel connection mainly consisted of fibrous tissue, blood vessels and nerve bundles between the adrenal gland and the kidney in Bactrian camel, and we named it fibrous tissue-blood vessels-nerve bundles (FBN bundle). To the best of our knowledge, this FBN bundle was the first reported in Bactrian camel, and not yet observed in other animals. While, its functions and mechanisms should be studied further. We speculated that a direct function of this novel path might be to strengthen the communication of the adrenal gland and the kidney. So this communicationpath might have importantadaptive significance for the Bactrian camel living in arid and semi-arid ecological zones.
La glándula suprarrenal es un órgano endocrino importante en los vertebrados, que produce una amplia variedad de hormonas. Los resultados anatómicos mostraron que la glándula suprarrenal en el Camello bactriano tiene un patrón de suministro sanguíneo e inervación típico. Excepcionalmente, se encontró una conexión infrecuente que consistió principalmente en tejido fibroso, vasos sanguíneos y haces nerviosos entre la glándula suprarrenal y el riñón del Camello bactriano, denominándose haz de tejido fibroso-vasos sanguíneos-nervio (Haz FSN). Este paquete de haces de nervios es el primero reportado en el Camello bactriano, y aún no se observa en otros animales, en consecuencia sus funciones y mecanismos deben ser estudiados. Creemos que podría existir una función directa de esta nueva vía para mejorar la comunicación de la glándula suprarrenal y el riñón. Así, esta vía de comunicación podría tener un importante significado adaptativo para el Camello bactriano, quien vive en zonas ecológicas áridas y semiáridas.