Choroidal nevi in a white population: the Blue Mountains Eye Study

BACKGROUND: Current knowledge on splanchnic haemodynamics in Crohn's disease is limited. AIMS: To investigate which features of Crohn's disease affect splanchnic haemodynamics, and to establish whether portal vein (PV) and superior mesenteric artery (SMA) blood supply reflects clinical or biochemical activity of Crohn's disease. METHODS: Seventy nine patients with Crohn's disease and 40 controls were evaluated by Doppler ultrasound (US). The mean velocity of PV and SMA flow, the volume of blood flow of the PV and SMA, and the resistance index of SMA were studied. A series of clinical, biochemical, and US variables including Crohn's disease activity index, serum C reactive protein concentrations, disease duration and its anatomical location, smoking habits, abdominal complications, and current medical therapy, as well as the maximum bowel wall thickness as measured by US, were determined. The relation between PV and SMA blood flow and these variables was assessed by univariate and multivariate analysis. RESULTS: Patients with Crohn's disease had significantly higher PV and SMA flow and a lower SMA resistance index than controls. Stepwise multiple regression analysis identified bowel wall thickness and location of the disease as the main predictive variables of both PV and SMA blood flow variation, accounting for 36% and 45% of their variability, respectively. No relation was found between splanchnic haemodynamics and disease activity. CONCLUSION: A hyperdynamic mesenteric circulation does exist in Crohn's disease; however splanchnic blood flow does not reflect the clinical or biochemical activity of the disease, but seems to be linked more to other Crohn's disease characteristics, such as maximum bowel thickness and anatomical location.     

Relationship between splanchnic, peripheral and cardiac haemodynamics in liver cirrhosis of different degrees of severity

OBJECTIVE: To investigate the relationships between changes in splanchnic and systemic haemodynamics in liver cirrhosis. DESIGN AND METHODS: Abdominal and peripheral duplex-Doppler sonography and Doppler echocardiography were performed in 42 cirrhotic patients with (group A, ascitic) or without ascites (group NA, non-ascitic) and in a control group of 36 healthy volunteers. RESULTS: There were significant differences (P < 0.05 at ANOVA) between the three groups in portal vein flow velocity (controls, groups NA and A, respectively, 29.2, 21.4 and 20.0 cm/s), portal diameter (9.3, 12.2 and 12.0 mm), superior mesenteric artery (SMA) resistance index (RI) (0.889, 0.854 and 0.816), femoral artery RI (0.988, 0.974 and 0.945), mean arterial pressure (MAP) (101.4, 102.0 and 87.3 mmHg), peripheral vascular resistance (1579, 1404 and 1094 dyn/cm5/s) and cardiac index (CI) (2.91, 3.46 and 3.77 l/min/m2). Multiple regression analysis identified renal interlobular- and SMA RI (respectively, r = -0.58 and r = 0.51) in group A as the two regional vascular beds correlated to MAP. CONCLUSION: The deterioration of the cirrhotic hyperdynamic circulation in the presence of ascites and the correlation between MAP and mesenteric and renal resistances are consistent with the peripheral arterial vasodilation hypothesis. The positive correlation between MAP and SMA RI in ascitic patients shows a link between this region and the general circulation. This seems to suggest that splanchnic hyperafflux plays a part in the formation of ascites.     

Anti-GBM glomerulonephritis in mice lacking nitric oxide synthase type 2

To determine the relationship between quantitative Doppler parameters of portal, hepatic, and splanchnic circulation and hepatic venous pressure gradient (HVPG), variceal size, and Child-Pugh class in patients with alcoholic cirrhosis, we studied forty patients with proved alcoholic cirrhosis who underwent Doppler ultrasonography, hepatic vein catheterization, and esophagoscopy. The following Doppler parameters were recorded: time-averaged mean blood velocity, volume flow of the main portal vein flow, and resistance index (RI) of the hepatic and of the superior mesenteric artery. Doppler findings were compared with HVPG, presence and size of esophageal varices, and Child-Pugh class. There was a significant inverse correlation between portal velocity and HVPG (r = -.69), as well as between portal vein flow and HVPG (r = -.58). No correlation was found between RI in the hepatic artery or superior mesenteric artery and HVPG. No correlation was found between portal vein measurements and presence and size of varices. Severe liver failure was associated with lower portal velocity and flow. In patients with alcoholic cirrhosis, only portal vein blood velocity and flow, but neither hepatic nor mesenteric artery RI, are correlated to the severity of portal hypertension and to the severity of liver failure.     

Transvaginal color Doppler study of the uteroplacental circulation in early pregnancy

OBJECTIVE: To compare resistance index (RI) and pulsatility index (PI) values of blood flow in arteries of uteroplacental circulation in normal and threatened abortion first trimester pregnancies. STUDY DESIGN: We have analysed 36 pregnant woman between 5th and 12th weeks of pregnancy--17 patients with threatened abortion as a test group and 19 patients with normal intrauterine pregnancy taken as controls. In all patients transvaginal ultrasonography with pulse color Doppler was performed. The RI and PI values were calculated for blood flow velocity waveforms obtained from uterine artery and its branches--arcuate, radial and spiral arteries. RESULTS: In the test group we have analysed 17 flow velocity waveforms from uterine artery (mean RI 0.852; SD 0.080, mean PI 2.324; SD 0.693), 16 from arcuate artery (mean RI 0.638; SD 0.049, mean PI 1.315; SD 0.064,), 17 from radial artery (mean RI 0.638; SD 0.049, mean PI 1.009; SD 0.177) and 15 from spiral artery (mean RI 0.548; SD 0.068, mean PI 0.804; SD 0.160); in controls we have analysed 16 flow velocity waveforms from uterine artery (mean RI 0.866; SD 0.066, mean PI 2.469; SD 0.618), 17 from arcuate artery (mean RI 0.728; SD 0.123, mean PI 1.352; SD 0.362), 19 from radial artery (mean RI 0.630; SD 0.092, mean PI 1.017; SD 0.261) and 16 from spiral artery (mean RI 0.511; SD 0.100, mean PI 0.760; SD 0.202). CONCLUSION: There was no significant difference in mean RI and PI values between normal and abnormal pregnancies. A gradual statistically significant decrease of RI and PI values during time of pregnancy we have observed only in radial arteries in both groups. For other vessels in the control group the RI and PI values tended to decrease during the time of pregnancy while in the test group some even rose up.     

Effect of feed interval and feed type on splanchnic haemodynamics

AIM: To study the effect of enteral feeding on splanchnic blood flow velocity in preterm infants. METHOD: Coeliac axis and superior mesenteric artery (SMA) blood flow velocity were measured longitudinally in a cohort of 61 babies using Doppler ultrasound. RESULTS: Babies fed 1 hourly had significantly higher preprandial SMA peak systolic velocity (PSV) than those fed 3 hourly (70 vs 53 cm/s). Those fed 1 hourly showed no postprandial change whereas those fed 3 hourly showed significant postprandial hyperaemia. This hyperaemia had longer latency (42 vs 27 mins) and smaller amplitude (31 vs 25 mins) after expressed breast milk compared with preterm formula. The addition of long chain polyunsaturated fatty acids to the formulas had no effect on the postprandial response. CONCLUSION: Hourly bolus feeding leads to a persistent hyperaemic state in the SMA. The composition of feeds is an important determinant of the postprandial response of the SMA to 3 hourly feeding.     

Morphometric study of the placental vessels and its correlation with umbilical artery Doppler flow

OBJECTIVE: To determine the changes in the vessel-wall thickness and the radius of the lumen in tertiary-stem villi of the placenta with advancing gestational duration and their relationship to umbilical artery Doppler flow studies. METHODS: Placentas from 63 miscarriages and preterm and term deliveries (between 19 and 40 weeks) were used for morphometric study of the tertiary-stem villi vessels. Each woman had undergone Doppler flow study of the umbilical artery. The resistance index (RI) was determined from the Doppler flow velocity waveform. Placental paraffin sections of 4-micron thickness were stained with hematoxylin and eosin and with periodic acid-Schiff reagents. The tertiary-stem villi and their vessels were examined microscopically and assessed morphometrically using a personal computer with math co-processor and a touch-sensitive screen overlying a video monitor. The monitor received microscopic images from a video camera that was mounted on a microscope. We determined vessel-wall thickness by tracing the outer and inner circumferences of digitized vessel-wall images. RESULTS: Wall thickness, but not lumen size, of the tertiary-stem villi vessels decreased significantly overall at a rate of 0.63micron/week (P < .001). The rate of decrease was 0.64micron/week (P < .001) during the second trimester and 0.50micron/week (P < .001) during the third trimester. There was a significant correlation between the decrease in thickness and in RI (r = 0.83 [P < .001], r = 0.78 [P < .001] in the second and third trimesters, respectively). Resistance indices were all within normal limits. CONCLUSIONS: Placental tertiary-stem villi vessel-wall thickness decreases with advancing gestational age. There is a correlation between the changes in RI of the umbilical artery Doppler flow and the changes in mean wall thickness of the placental vessels.     

Hypertensive intra-arterial chemotherapy for endometrial carcinoma assessed by transvaginal Doppler ultrasound and magnetic resonance imaging

We examined the effectiveness of hypertensive intra-arterial chemotherapy for endometrial carcinoma using transvaginal Doppler ultrasound and magnetic resonance imaging. Angiotensin II, 100 mg cisplatin, and 40 mg doxorubicin were prescribed for 8 patients with endometrial carcinoma (3 stage Ia; 3 stage Ib; 2 stage II). The resistance index (RI) was obtained for intratumoral blood flow velocity waveforms by transvaginal Doppler ultrasound and changes in RI (delta RI: differences before and after chemotherapy) were calculated. The tumor volume (TV) was also evaluated, based on the T2-weighted image of magnetic resonance imaging (MRI). The decrease in tumor size [DR-T: (TV before chemotherapy--TV after chemotherapy)/TV before chemotherapy x 100] was determined. RI measurements did not correlate with TV, either before or after chemotherapy. The delta RI varied from 0.007 to 0.615 (mean: 0.207) and DR-T varied from 20.1% to 65.0% (mean: 45.5%). The correlation between delta RI and DR-T [DR-T = 23.5 + 167.2 (delta RI)-165.6 (delta RI)2; R2 = 0.772, p < 0.05] was significant. Therefore, we confirmed the effectiveness of hypertensive intra-arterial chemotherapy for endometrial carcinoma using both transvaginal Doppler ultrasound and MRI.     

Bilateral hypothalamic dopamine infusion in male Zucker rat suppresses feeding due to reduced meal size

PURPOSE: To determine whether vascular, ischemic, and inflammatory causes of bowel wall thickening in children can be differentiated at gray-scale and color Doppler ultrasonography (US). MATERIALS AND METHODS: Thirty-seven children with acute bowel disease underwent graded compression US. Findings of bowel wall thickness, wall echotexture, location of bowel involvement, and presence of color Doppler flow were evaluated. Diagnoses were classified as inflammation (n = 25), vasculitis (n = 7), or ischemia (n = 5) and were confirmed with findings from colonoscopy and biopsy, stool culture analysis, surgery, and cutaneous biopsy, and with a combination of clinical and laboratory data. RESULTS: Patient age (P = .0022), bowel wall thickness (P = .0001), and color Doppler flow (P = .0013) were statistically significantly related to disease type. Wall thickening and absence of visible color Doppler flow suggested ischemia. Older patient age and visible color Doppler flow suggested inflammation, whereas younger patient age and visible color flow suggested vasculitis. Difference in location of bowel disease in patients with ischemic versus those with vascular wall thickening was statistically significant (P = .0185). No difference was found between disease type and wall stratification. CONCLUSION: Gray-scale and color Doppler flow US can aid in differentiating ischemic, vascular, and inflammatory bowel wall thickening.     

Superior mesenteric artery blood flow in celiac disease

Measurements of the hemodynamic parameters of the superior mesenteric artery were performed in 18 patients with celiac disease. Ten were studied at the time of diagnosis, when a small bowel biopsy showed a flat mucosa. The remaining eight patients were studied after complete clinical and histological recovery induced by a gluten-free diet. Doppler ultrasound flowmetry was used to measure blood flow in physiological and fasting conditions and after a mixed liquid test meal (Ensure-Plus). The results were compared with those of healthy subjects (N = 7). Mean basal flow was 50% higher in untreated celiac disease patients than in healthy controls and patients with chronic pancreatitis (P = NS). Postprandial mesenteric blood flow was significantly increased (P < 0.002) and delayed in time (P < 0.005) in celiac disease as compared to controls. Successful treatment reduced the mesenteric blood flow in celiac disease to normal values. Our study demonstrates that pathophysiological changes in the small bowel mucosa during the active clinical phase of celiac disease induce an abnormal splanchnic circulation.     

Doppler US of helical flow in the portal vein

In helical portal venous blood flow, the usual laminar flow in the portal vein is replaced by a spiral. This changes the color Doppler ultrasound (US) appearance to one of alternating or parallel red and blue bands. Duplex US may appear to show hepatopetal, hepatofugal, or simultaneous bidirectional flow depending on placement of the cursor within the helix. Helical portal venous flow is unusual in normal individuals (2.2% of 135 patients). Its presence should prompt further scrutiny for signs of liver disease, particularly portosystemic shunts, as in 20% of 41 patients who subsequently underwent liver transplantation. It is a normal finding immediately after liver transplantation (43% of 35 patients) and transjugular intrahepatic portosystemic shunt (TIPS) creation (28% of 36 patients). In both liver transplant and TIPS recipients, helical flow is usually transient. Its persistence long after transplantation in association with a prolonged increase in portal venous velocity is a useful sign of portal vein stenosis. Helical flow may also occur in cases of neoplastic invasion or displacement of the portal vein.     

The value of colour Doppler ultrasonography for small bowel involvement of adult Henoch-Sch?nlein purpura

Three patients presented with a non-thrombocytopenic purpuric rash on their upper and lower limbs, abdominal pain, diarrhoea, and arthralgia. Grey scale ultrasound showed abnormally thickened walls of the small bowel. Colour Doppler showed blood flow signals in the diseased bowel wall in all patients. Subsequent barium and endoscopic studies showed oedematous bowel loops with petechial lesions. Biopsy from the purpuric rash of the skin demonstrated vasculitis of subdermal small vessels. The clinical diagnosis of Henoch-Sch?nlein purpura was made in each case. This paper describes the efficacy of grey scale and colour Doppler ultrasonography in the assessment of the small bowel involvement of Henoch-Sch?nlein purpura.     

Relationship between haemodynamics and morphology in pulmonary hypertension. A quantitative intravascular ultrasound study

BACKGROUND: Intravascular ultrasound imaging of the pulmonary arteries has been demonstrated to be a reliable method of quantifying vessel diameter, luminal area and pulsatility. Simultaneous measurement of flow velocity and its response to vasodilators allows the relationship between morphology and functional compromise to be studied, especially endothelial dysfunction. METHODS: In 51 patients (mean age = 49.8 +/- 12.6 years, 17 female) we performed right heart catheterization and simultaneous intravascular ultrasound of pulmonary artery branches. The patients were divided in two groups: group 1 with normal pulmonary artery pressure and pulmonary vascular resistance, and group 2 with pulmonary hypertension (peak pulmonary artery pressure > 30 mmHg and/or mean pulmonary artery pressure > 20 mmHg). Vessel wall and lumen were studied using a 2.9 F intravascular ultrasound catheter with a 30 MHz phased array transducer. Measurement of blood flow velocity was accomplished by a Doppler flow wire (0.018 inch). The maximal flow change during acetylcholine infusion (adjusted to 10(-6); 10(-5), and 10(-4) M concentration in the blood vessel) was measured. RESULTS: There were no significant differences between groups 1 and 2 with respect to age (48.5 +/- 14.3 years vs 50.3 +/- 12.3 years; P = ns), gender (4 female/8 male vs 13 female/26 male; P = ns), luminal area of the vessel segment in which the intravascular ultrasound measurements were obtained (11.8 +/- 6.1 mm2 vs 16.7 +/- 14.3 mm2; P = ns), internal diameter (3.9 +/- 1.2 mm vs 4.2 +/- 1.7 mm; P = ns), and external diameter (6.1 +/- 1.3 mm vs 6.9 +/- 2.1 mm; P = ns). Cross-sectional images of the pulmonary artery wall demonstrated a single ring with high echodensity with a thin inner layer regarded as intima in group 1. In contrast, the majority of patients (n = 35/39) in group 2 demonstrated a thickening of the intimal layer and/or a disturbance of layering of the echogenic arterial wall. The relative wall thickness was higher in group 2 than in group 1 (22.5 +/- 10.4% vs 15.3 +/- 6.5%; P < 0.05). There were no significant correlations between pulmonary artery pressure and wall thickness pulmonary artery pressure and area change in the cardiac cycle, acetylcholine-dependent increase in pulmonary flow and morphological changes in the vessel wall. CONCLUSION: We conclude that intravascular ultrasound is capable of detecting morphological changes in the pulmonary vessel wall in pulmonary hypertension and that vessel wall hypertrophy of small pulmonary segment arteries, as detected by intravascular ultrasound, is not predictive of functional vasodilatory response of resistance vessels of the same vessel area.     

Evaluation of the association of a serum marker and second trimester ultrasonography for the screening of trisomy 21 in women of less than 38 years. Prospective study of 5,163 patients

OBJECTIVE: We evaluated the response of mixed venous-arterial carbon dioxide (pCO2) to severe intestinal ischaemia produced by gradual occlusion of the superior mesenteric artery (SMA). DESIGN: Prospective, controlled, experimental study. SETTING: Animal research laboratory. SUBJECTS: Twelve domestic pigs. INTERVENTIONS: SMA blood flow was reduced by 40%, 70% and 100% from the baseline at 60-min intervals. MEASUREMENTS AND MAIN RESULTS: Haemodynamics were monitored continuously and blood gas values were determined at 30-min intervals. During the SMA occlusion we observed the development of intramucosal acidosis, increased splanchnic oxygen extraction and an increased portal venous-arterial lactate gradient indicative of splanchnic hypoperfusion and intestinal ischaemia. Intramucosal-arterial (p < 0.001), intramucosal-portal venous (p < 0.01) and portal venousarterial (p < 0.01) pCO2 gradients increased during the SMA occlusion, whereas the mixed venous-arterial pCO2 gradient remained unchanged. The mixed venous-arterial pCO2 gradient did not correlate with the intramucosal-arterial pCO2 gradient (r = 0.13), portal venous-arterial lactate gradient (r = 0.10) or splanchnic oxygen extraction (r = 0.14). The portal venous-arterial pCO2 gradient correlated with the portal venous-arterial lactate gradient (r = 0.75, p < 0.001) and splanchnic oxygen extraction (r = 0.79, p < 0.001), but not with the intramucosal-arterial pCO2 gradient (r = 0.35). CONCLUSION: Despite clear evidence of severe splanchnic hypoperfusion, as shown by regional hypercarbia and lactate production, the mixed venous-arterial pCO2 gradient did not reflect splanchnic hypoperfusion.     

Doppler ultrasonographic evaluation of blood flow in the superior mesenteric artery in celiac patients and in healthy controls in fasting conditions and after saccharose ingestion

We studied, by means of Doppler ultrasonography, the blood flow in the superior mesenteric artery in 12 untreated patients with celiac disease (nontropical sprue) and in 15 healthy controls; peak systolic velocity, end diastolic velocity, mean velocity, flow volume, and resistive index were measured in the fasting state and at regular intervals after ingestion of 0.5 liter of water containing 50 g of saccharose. Under fasting conditions, celiac patients showed peak systolic velocity, end diastolic velocity, mean velocity, and flow volume values significantly higher than those of normal subjects, whereas resistive index was significantly lower. After saccharose ingestion these parameters showed greater variations in normal subjects than in celiac patients. Fasting end diastolic velocity turned out to be the best parameter to distinguish celiac patients from healthy subjects. Doppler ultrasonography of the superior mesenteric artery could discriminate between normal subjects and celiac patients with overt disease. However, these data need further confirmation given the limited sample that we studied; moreover, the capability of this technique in distinguishing nontropical sprue from other gastrointestinal diseases that cause increasing splanchnic flow remains to be ascertained.     

Effects of endoscopic variceal sclerotherapy on azygos vein blood flow and systemic haemodynamics

The present study was designed to determine the systemic haemodynamic effects of obliterating oesophageal varices by endoscopic sclerotherapy. We evaluated systemic and splanchnic haemodynamics before and after the first course of sclerotherapy in cirrhotic patients. The baseline cardiac index was significantly correlated with baseline azygos vein blood flow (r = 0.64; P < 0.01) and the azygos vein blood flow and cardiac index significantly decreased (-33% and -16%, respectively; P < 0.01) following sclerotherapy. The systemic vascular resistance index was also increased significantly (+ 20%; P < 0.01) in these patients. Moreover, the per cent change in azygos vein blood flow was directly correlated with that of the cardiac index (r = 0.51; P < 0.03). We conclude from these findings that the obliteration of portosystemic collaterals by sclerotherapy significantly reverses hyperdynamic circulation in such patients via a decrease in cardiac preload. The blood flow of the portosystemic shunt per se is a leading contributor to the hyperdynamic circulation observed in patients with well-developed portal systemic collateral vessels.     

Comparison of genetic susceptibility to experimental allergic/immune-mediated blepharoconjunctivitis between Lewis and Fischer rats

BACKGROUND: Changes in hepatic architecture in cirrhosis and chronic active hepatitis affect liver vascular haemodynamics. OBJECTIVE: To determine the criteria for the diagnosis of liver cirrhosis using Doppler US. MATERIALS AND METHODS: Twenty-two children with liver disease of unknown histology were prospectively examined and compared with eight normal children. Doppler US of portal vein velocity, arterio-portal velocity ratio, loss of reverse flow component in the hepatic vein and hepatic artery visualisation were examined prior to liver biopsy. Doppler results were compared with histological activity indices. Twelve patients had cirrhosis and ten had chronic active hepatitis. RESULTS: The most sensitive method (83%) for the assessment of cirrhosis was portal vein velocity less than 20 cm/sec. Arterio-portal velocity ratio (greater than 3) and hepatic artery visualisation were less sensitive (75% and 33% respectively) but specificity was 100% for all three methods. When these three methods were evaluated together, sensitivity increased to 91% and accuracy to 96%. Loss of reverse flow component was less specific (77%) but was sensitive (75%). CONCLUSIONS: Portal vein velocity, arterio-portal vein ratio and hepatic artery visualisation together were reliable in diagnosis of cirrhosis in the paediatric age group.     

Glucocorticoids inhibit the induction of nitric oxide synthase II by down-regulating cytokine-induced activity of transcription factor nuclear factor-kappa B

PURPOSE: This study was designed to assess the correlation between flow velocity, the resistive index and visual field defects in patients with chronic open angle glaucoma in comparison with a nonglaucomatous control population. METHODS: Color Doppler imaging was used to study flow velocity in the central retinal artery and short posterior ciliary arteries of 76 patients with chronic open angle glaucoma and 28 normal subjects. Velocity and resistive index were correlated with visual field abnormalities. RESULTS: The chronic open angle glaucoma patients showed a statistically significant lowering of the end diastolic velocity and a raised resistive index in all vessels studied. The end diastolic velocity of the central retinal arteries of glaucoma patients were significantly correlated with the Mean Deviation of the visual field (right eye, p = 0.0041; left eye, p = 0.0167). The glaucoma patients showed a statistically significant lowering of the end diastolic velocity and a raised resistive index in all vessels supplying those parts of the optic disc that corresponded to visual hemifield defects. CONCLUSION: Open angle glaucoma is associated with changes in central retinal and ciliary artery flow velocity and resistive index which suggest a compromised circulation in this region.     

Cholera toxin acts as a potent adjuvant for the induction of cytotoxic T-lymphocyte responses with non-replicating antigens

OBJECTIVE: To evaluate the relation between the development of the uteroplacental circulation as assessed by Doppler velocimetry and the maternal blood relaxin concentration. METHODS: Transvaginal color Doppler investigation of the uteroplacental circulation was performed in 42 healthy women at 6-15 weeks' gestation before termination of pregnancy for psychosocial reasons. The resistance index (RI), pulsatility index (PI), and maximum peak velocity were recorded at the level of the main uterine artery, and the presence of intervillous flow was noted. Relaxin, hCG, 17 beta-estradiol (E2), and progesterone levels were measured in maternal venous blood. RESULTS: Limited intervillous flow was noted from 10 weeks' gestation and continuous intervillous flow from 12 weeks. An inverse relation was observed between the circulating levels of both E2 and progesterone and uterine artery RI and PI, whereas the relaxin level correlated positively with uterine RI and PI. Estradiol and progesterone levels also correlated positively with uterine peak systolic velocity and intervillous blood flow. Multiple linear regression analysis indicated that both hormones contributed to the decrease in downstream resistance to uterine blood flow with advancing gestational age, as assessed by uterine RI. In addition, relaxin contributed to the uterine RI and PI and to the intervillous blood flow. CONCLUSION: These data suggest that relaxin, E2, and progesterone may influence the changes in uterine blood flow that occur in early pregnancy. The role played by E2 and progesterone in the development of the uteroplacental circulation may be modulated by relaxin, constituting a novel function for this ovarian peptide.     

Effect of opioid blockade on insulin and growth hormone (GH) secretion in patients with polycystic ovary syndrome: the heterogeneity of impaired GH secretion is related to both obesity and hyperinsulinism

Amplitude-coded color Doppler sonography (ACD) has become an useful adjunct to gray-scale US and conventional color Doppler sonography (CD) for the assessment of vascular diseases and pathologic conditions that might affect or alter tissue vascularization or perfusion. Basically, all US units that generate conventional color Doppler information through autocorrelation technique are capable of displaying ACD. This technique is also referred to as power Doppler, amplitude-mode color Doppler US, color Doppler energy (CDE), or US angiography. Amplitude-coded color Doppler sonography has already emerged as a valuable adjunct to conventional CD, particularly for evaluating flow in parts of the body where CD signal is weak because of slow flow, small blood vessels, or both.     

Effects of tham, isoprenaline and propranolol on blood flow and vascular resistances of the liver after in- and outflow occlusion. Relation with the splanchnic shock

The responsibility of the portal and the hepatic artery circulations during shock states has been established by studying the effects of a 15-min occlusion of two of the following blood vessels on 23 dogs: inferior vena cava below the diaphragm, portal vein and hepatic artery. Intrahepatic vascular resistances were computed from blood pressure records in these vessels and transhepatic blood flow studies using the 133Xe clearance method. The animals were treated with THAM, plasmagel, isoprenaline, and propranolol. The tolerance of the occlusion is significantly improved when the animals are treated with the association of the four drugs. The portal and the systemic arterial blood pressures return to normal more promptly. Sinusoid and peribiliary resistances are remarkably stable if compared to the changes occurring in the control animals. The well-known benefit of THAM is improved by the apparently paradoxical association of isoprenaline and propranolol. In fact, at the doses which have been used, they counterbalance their mutual disadvantages. Finally, the analysis of the hepatic blood flow rates and vascular resistances suggests that the splanchnic shock has two components: hepatic and visceral.