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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES The p- cymene is a monoterpene aromatic biosynthetic which has many biological properties , including cardiovascular. Em system actions on the in vivo study, p- cymene showed hypotensive activity through a central effect. Therefore, we sought to investigate the effect of p-cymene on the peripheral vascular resistance in the superior mesenteric artery of rats Rats were sacrificed by exsanguination under anesthesia and the superior mesenteric artery was removed, sectioned and kept in vats containing nutrient solution Tyrode. For recording of isometric contractions, each ring was suspended by cotton thread attached to a force transducer connected to a data acquisition system. In mesenteric artery rings with functional endothelium precontracted with phenylephrine (FE) (control), p- cymene (10-8 - 3x10 -2M) induced relaxation (Emáx = 77.1 ± 3.53% , n = 5) in a concentration-dependent manner not was attenuated after removal of endothelium (Emáx = 72 ± 4.03 %, n = 7) or pre-contracted with 80 mM KCl (Emáx = 79.37 ± 5.25 % n = 6) , suggesting a possible effect independent of the endothelium and surrounding channels for Ca2 +. In preparations without functional endothelium and pre-contracted with FEN and incubated with tetraethylammonium (TEA), tetraethylammonium (TEA), a blocker of non-selective for K+ channels, p- cymene induced relaxation (Emáx = 50.56 ± 4.09 %, n = 8) which was not significantly different from that obtained without functional endothelium in rings pre-contracted with FEN without blocking . Thus, possibly there is no involvement of K + channels for this purpose. Furthermore, incubation with p- cymene (3x10-3, 10-2 and 3x10-2M) was able to antagonize the contractions induced by CaCl2 (3x10-7 - 3x10-2M), and sodium orthovanadate (Na3VO4) (10-5 - 3x10-2M) a non-selective inhibitor of protein tyrosine fosfatase.These results it can be concluded that p- cymene produces vasorelaxant effect independent of the endothelium. The pharmacological evidence suggest that the mechanism of action of p- cymene vasorelaxant involves channels for Ca2+ and voltage sensitive desensitization of the Ca2+ contractile elements. O p-cimeno é um monoterpeno aromático biossintético que apresenta inúmeras propriedades biológicas, incluindo ações sobre o sistema cardiovascular. Em estudo in vivo, o p-cimeno demonstrou atividade hipotensora, através de um efeito central. Diante disso, buscou-se investigar o efeito do p-cimeno sobre a resistência vascular periférica em artéria mesentérica superior de ratos. Para tanto, ratos Wistar foram eutanasiados por dessangramento sob anestesia e a artéria mesentérica superior foi removida, seccionada e mantidas em cubas contendo solução nutritiva de Tyrode. Para o registro das contrações isométricas, cada anel foi suspenso por linha de algodão fixada a um transdutor de força conectado a um sistema de aquisição de dados. Em anéis de artéria mesentérica com endotélio funcional pré-contraídos com fenilefrina (FEN) (controle), o p-cimeno (10-8 - 3x10-2M) induziu relaxamento (Emáx = 77,1 ± 3,53%; n = 5) de maneira dependente de concentração.Este efeito não foi atenuado após a remoção do endotélio (Emáx =72 ± 4,03%, n = 7) ou pré-contraído com KCl 80 mM (Emáx = 79,37 ± 5,25%; n = 6), sugerindo um possível efeito independente do endotélio e envolvendo canais para Ca2+. Em preparações sem endotélio funcional pré-contraídos com FEN e incubadas com tetraetilamônio (TEA), um bloqueador não seletivo dos canais para K+, o p-cimeno induziu relaxamento (Emáx= 50,56 ± 4,09%; n= 8), que não foi significativamente diferente daquele obtido em anéis sem endotélio funcional pré-contraídos com FEN sem o bloqueador. Portanto, possivelmente, não há participação dos canais para K+ neste efeito. Além disso, a incubação com o p-cimeno (3x10-3, 10-2 e 3x10-2M) foi capaz de antagonizar as contrações induzidas por CaCl2 (10-7 - 3x10-2M) e Ortovanadato de Sódio (Na3VO4) (10-5 - 3x10-2M), um inibidor não-seletivo de proteínas tirosina-fosfatase. Diante desses resultados, pode-se concluir que o p-cimeno produz efeito vasorelaxante independente do endotélio. As evidências farmacológicas sugerem que o mecanismo de ação vasorelaxante do p-cimeno envolve canais para Ca2+ sensíveis à voltagem e dessensibilização de elementos contráteis ao Ca2+.

Nous avons verifie l'hypothese que le monoxyde d'azote module la constriction d'origine nerveuse uniquement lorsque la contrainte de cisaillement augmente. La contrainte de cisaillement resulte du mouvement du fluide et induit une deformation des cellules endotheliales. Chez des chats anesthesies, le debit sanguin vers l'artere mesenterique superieur a ete controle en utilisant un circuit de perfusion. La contrainte de cisaillement a ete augmentee en maintenant le debit sanguin constant durant une vasoconstriction induite soit par une stimulation nerveuse (2 et 10 Hz), soit par la perfusion de norepinephrine (0,5 μg.kg -1 .min -1 ). L'augmentation de la pression de perfusion en reponse a la stimulation nerveuse a ete de 24,8 ± 4,7 mmHg (1 mmHg = 133,3 Pa) (2 Hz) et de 100,0 ± 17,8 mmHg (10 Hz). Le blocage de la NO synthase par le N G -nitro-L-arginine methyl ester (L-NAME) (2,5 mg/kg i.v.) a induit une potentialisation (74,0 ± 21,6 mmHg a 2 Hz et 151,9 ± 14,1 mmHg a 10 Hz), qui a ete inversee apres la perfusion de L-arginine (75 mg/kg i.v.). Lorsque la contrainte de cisaillement a ete maintenue constante, L-NAME n'a pas eu d'effet sur les reponses a la stimulation nerveuse. Les resultats sont en accord avec l'hypothese que si une vasoconstriction induit une augmentation de la contrainte de cisaillement, la liberation de monoxyde d'azote provoque une vasodilatation qui fait suite a une diminution de l'activite nerveuse sympathique. Cet effet n'a pas ete observe en presence de norepinephrine, ce qui suggere qu'au site de constriction, la liberation du monoxyde d'azote dependante de la contrainte de cisaillement n'agit pas directement sur le muscle lisse vasculaire dans les petits vaisseaux de resistance.

Resume Nous rapportons le troisieme cas de thrombose de l'artere mesenterique superieure au cours d'un syndrome de Behcet repondant aux criteres de la classification de Mason et Barnes. Les manifestations cliniques fonctionnelles de la patiente se resument a un angor intestinal severe associe a une alteration de l'etat general. Une revue de la litterature des atteintes vasculaires, notamment thrombotiques, de la maladie de Behcet est colligee. L'interet des techniques d'exploration arterielles digestives non invasives est discute.

Progress in operative techniques in surgery of the upper abdomen necessitates extensive preoperative diagnostic studies. Mesenterico-coeliacography along with CAT-SCAN form the basis for effective operative planning. In the angiography, the clinician is often confronted by variations in the arterial supply of the liver. These variations of the norm which are scarcely mentioned in anatomical textbooks must be carefully taken into consideration by the surgeon. In order to clarify the operative significance of these variations, we have conducted a retrospective study of the angiographies of the truncus coeliacus as well as of the arteria mesenterica superior. We found variations in 25.5% of 204 angiographies. The incidence of deviant and accessory hepatic arteries was 33.8% and of variations in the truncus coeliacus was 6.7%. These variations of the norm are discussed as to clinical and embryological aspects.

Resume Le diagnostic de pince aortomesenterique superieure primitive a grandement beneficie de techniques radiologiques modernes telles que l'echographie et le scanner. Observation. — Un garcon de 11 ans a ete hospitalise pour vomissements bilieux apparus depuis 24 heures. Le diagnostic de pince aortomesenterique superieure a ete porte a partir des resultats de l'examen radiologique de l'abdomen sans preparation, de l'echographie et de l'opacification gastroduodenale a la baryte fluide. L'echographie avail montre une augmentation du diametre de la veine renale gauche. L'enfant a ete place sous alimentation fractionnee et en decubitus lateral gauche. Le scanner realise 5 jours plus tard a confirme le diagnostic mais n'a pas montre de dilatation de la veine renale gauche. Cet enfant va parfaitement bien 1 an plus tard, sans traitement dietetique ni postural. L'echographie realisee alors, 3 heures apres un repas, a montre les memes signes que lors de la phase aigue. Conclusions. — Le scanner et l'echographie representent des techniques interessantes pour le diagnostic d'un tel syndrome. La valeur diagnostique d'une dilatation de la veine renale gauche reste a demontrer.

The essential oils are volatile organic constituents found in aromatic plants, which present several monoterpenes, such a-terpineol. Studies have demonstrated some biologic activities such as hypotensive and vasorelaxant (Guedes et al., 2004). In the present work the cardiovascular effects of a-terpineol was investigated and the pharmacodynamics of this effect was characterized. Wistar Kyoto and spontaneously hypertensive rats (SHR) were anaesthetized and polyethylene catheters were inserted into the low abdominal aorta and inferior vena cava for blood pressure measurements and administration of drugs. Isolated superior mesenteric rings (1-2 mm) were suspended by cotton threads for isometric tension recordings in Tyrode s solution (37°C, gassed with 95% O2 and 5% CO2), under 0.75g resting tension were measured by using pressure transducers, coupled to a computer set and CVMS software Miobath-4, WPI, Sarasota, EUA. In addition, the bioavailability of NO and eNOS, AKT and AMPK activity were quantified when exposing cells to α-terpineol in the cultured endothelial cells. In both SHR and normotensive rats, i.v. bolus injections of α-terpineol (1 20 mg/kg) decreased mean arterial pressure (MAP) in a dose-related manner, WKY (-103, -399, -5211, -6212 mmHg, n=10) and SHR (-375, -577, -715, -844 mmHg, n=9) associated with tachycardia. However, hypotensive and tachycardic responses were significantly attenuated after L-NAME (20 mg/kg, i.v.). The -terpineol demonstrated improves the baroreflex sensitivity. In intact isolated rat mesenteric rings -terpineol (10-12 10-5M) induced concentration-dependent relaxation of the contractions induced by phylephrine (10M) WKY Emax= 60  4 or SHR Emax= 53.7 ± 3, p

Obstruction and dilatation of the duodenum are caused by a variety of diseases. Chronic intermittent arteriomesenteric obstruction (AMO) is the most common of the extrinsic disorders that cause duoden

We present case reports of three recent patients to reinforce the argument that upper gastrointestinal series is the method of choice with which to document malrotation. It has been 9 years since there was a major discussion of this subject in the literature. Ultrasonography cannot confidently exclude malrotation. Radiographic study with contrast continues to be the best diagnostic tool.

Endoscopic ultrasonography (EUS)-guided celiac plexus neurolysis (EUS-CPN) is safe and effective but not beneficial for some patients with extended abdominal cancer. We compared the effectiveness of standard EUS-CPN and EUS-guided broad plexus neurolysis (EUS-BPN) that extends over the superior mesenteric artery (SMA) using a 25-gauge needle.Consecutive patients referred to our quaternary EUS centers were eligible for inclusion. To evaluate the neurolytic spread, contrast was mixed with the neurolytic agent and post-procedure computed tomography scanning was performed. The regions containing the celiac, superior, and inferior mesenteric arteries were divided on the frontal plane into six areas: upper right and left, middle right and left, and lower right and left. The number of contrast-bearing areas after EUS-CPN and EUS-BPN were related to the degree of pain relief achieved.A total of 67 patients with advanced abdominal cancer were included (34 EUS-CPN and 33 EUS-BPN). The qualitative variables of the two groups did not differ significantly. The EUS-BPN group had more patients with six contrast-bearing areas (42%) than the EUS-CPN group (0%). These patients had significantly better short-term and long-lasting pain relief than patients with less than five contrast-bearing areas. EUS-BPN patients exhibited significantly greater reductions in days 7 and 30 visual analog pain scale scores than EUS-CPN patients.Our preliminary data suggested that EUS-BPN using a 25-gauge needle provides patients with advanced abdominal cancer with better pain relief than standard EUS-CPN, and without incurring serious complications. Moreover, it seems that broad neurolysis over the SMA may provide superior analgesia.

O pseudoaneurisma de artéria mesentérica superior é uma doença rara, porém com alta taxa de ruptura e mortalidade. Sua etiologia geralmente é infecciosa e comumente o diagnóstico é feito por meio de achado nos exames de imagem. Historicamente, seu tratamento de eleição tem sido o reparo cirúrgico aberto; entretanto, é associado a inúmeras complicações e dificuldades técnicas. Relatamos um caso de pseudoaneurisma de artéria mesentérica superior em um paciente portador de abscesso hepático no qual, após resolução do processo infeccioso, foi empregado, com sucesso, um tratamento minimamente invasivo endovascular, com implante de micromolas e stent não-recoberto. Pseudoaneurysm of the superior mesenteric artery is a rare disease, however it is associated to a high incidence of rupture and mortality. The etiology is usually infectious and the diagnosis is commonly made by means of occasional imaging. Historically, the treatment of choice has been open surgical repair; however it is associated to numerous complications and technical difficulties. We reported a case of a pseudoaneurysm of superior mesenteric artery in a patient with liver abscess who, after resolution of infection, underwent successfully a minimally invasive endovascular approach, with deployment of microcoils and bare stent.

This study was to ascertain the pattern of arrangements and distributions of the superior mesenteric artery (SMA) in a Nigerian population. Seventy-five cadavers certified as Nigerians were obtained from the dissecting room of the Department of Anatomy, University of Calabar after ethical approval from the Institution's Ethics Committee. Their abdomens and their contents were excise to expose the vessels. Based on the pattern of arrangements of the SMA, the cadavers were grouped into three (A, B, and C). Group A had 45 cadavers and this constituted 60% which were similar to the commonly documented patterns. Groups B and C had 20 and 10 cadavers respectively constituting 26.7% and 13.3% pattern of arrangement, some of which have not been documented before. In conclusion these peculiar patterns in this population are to be noted in surgical procedure, since damage to these variant vessels may result in severe haemorrhage that may lead to other complications. Este estudio consistió en determinar el patrón de disposición y distribución de la arteria mesentérica superior (AMS) en una población de Nigeria. Setenta y cinco cadáveres certificados como nigerianos se obtuvieron de la sala de disección del Departamento de Anatomía de la Universidad de Calabar, después de la aprobación ética del Comité Ético de la Institución. Su abdomen y sus contenidos fueron disecados para exponer los vasos. Basado en el modelo de disposición de la AMS, los cadáveres fueron agrupados en tres grupos (A, B y C). Grupo A tuvo 45 cadáveres y estos constituyeron el 60% los cuales fueron similares a los patrones comúnmente documentados. Los Grupos B y C con 20 y 10 cadáveres respectivamente, constituyeron el 26,7% y 13,3% del patrón de disposición, algunos de los cuales no se han documentado antes. En conclusión, estos patrones peculiares en esta población han sido observados en procedimientos quirúrgicos, ya que el daño a estas variantes de vasos pueden resultar en hemorragias graves que pueden conducir a otras complicaciones.

A doença de Crohn (DC) é caracterizada por inflamação crônica, de caráter recorrente, na qual períodos de atividade se interpõem a períodos de remissão. A diminuição da integridade da barreira mucosa intestinal faz parte da etiopatogênese da doença, permitindo a apresentação de antígenos ao sistema imune e determinando o início ou a manutenção do processo inflamatório. Além disso, alterações vasculares caracterizadas por neovascularização, congestão e diminuição da resistência ao fluxo sanguíneo também são evidentes. A detecção de atividade inflamatória, fundamental para o tratamento, é muitas vezes difícil. O objetivo desse estudo é avaliar a medida do volume de fluxo da artéria mesentérica superior (AMS) pelo Doppler e o teste da permeabilidade intestinal em pacientes com DC em atividade e remissão. Foram incluídos 40 pacientes, que se submeteram aos dois testes e foram divididos, de acordo com os critérios do Índice de Atividade da Doença de Crohn (CDAI), em dois grupos: grupo1 28 pacientes com DC em remissão e grupo 2 12 pacientes com DC em atividade. As médias do volume de fluxo da AMS foram significativamente maiores nos pacientes com DC em atividade quando comparados aos pacientes em remissão (626ml/min e 376ml/min, respectivamente; p=0,001), assim como as médias da relação entre as taxas de excreção urinária de lactulose e manitol (TL/M) (0,083 e 0,027, respectivamente; p=0,02). A medida do volume de fluxo da AMS apresentou sensibilidade de 83% e especificidade de 82%, para o teste da permeabilidade intestinal, esses índices foram de 100% e 39%, respectivamente. O índice de concordância entre os dois exames foi de 0,37. Assim, pode-se concluir que pacientes com DC em atividade apresentaram aumento do volume de fluxo da AMS e da TL/M quando comparados aos pacientes em remissão; resultados alterados da medida de fluxo da AMS pelo Doppler e do teste da permeabilidade intestinal se associaram com a atividade da DC; a medida do volume de fluxo da AMS pelo Doppler apresentou bom desempenho na avaliação da atividade inflamatória e o teste da permeabilidade intestinal apresentou alta sensibilidade, mas baixa especificidade para o diagnóstico de atividade em pacientes com DC, tomando-se por base a avaliação pelo CDAI. Crohns disease (CD) is a condition characterized by chronic relapsing inflammation, with remission periods disrupted by periods of disease activity. Increased gut permeability plays an important role in disease etiopathogenesis, allowing antigen presentation to immune system and thus trigging or maintaining inflammatory process. Vascular changes are also evident, including neovascularization, congestion and reduced vascular resistance to blood flow. Assessment of disease activity is a major clinical problem, wich has implications for the treatment and the patient. The aim of this study is to evaluate measurement of superior mesenteric artery (SMA) blood flow with Doppler ultrasound (US) and permeability intestinal test in CD patients in activity and remission. Forty patients were submitted to both tests and separated in two groups, according Crohns Disease Activity Index (CDAI): 28 patients with quiescent disease made up group 1 and 12 patients with active disease made up group 2. In group 2, the flow volume values were significantly higher than those in group 1 (626ml/min versus 376ml/min; p=0,001) as were lactulose to manitol urinary excretion ratio (L/MR) (0,083 versus 0,27; p=0,02). SMA flow volume has a sensitivity of 83% and a specificity of 82% for the diagnosis of disease activity. For intestinal permeability test, these indexes were 100% and 39%, respectively. The Kappa agreement index of both exams were 0,37. Our results suggest that patients with active CD had increased SMA flow volume and L/MR than patients in remission; abnormal results of SMA flow volume and intestinal permeability test were associated with CD activity; SMA flow volume had a good performance in assessment of disease activity and intestinal permeability test had high sensibility but low specificity.

Contexto: A eventual relação entre a aterosclerose das artérias dos membros inferiores com a aterosclerose das artérias intestinais foi pouco estudada. Objetivo: Avaliar pela ecografia vascular (Doppler) presença de lesões com estenose 70% na artéria mesentérica superior e/ou tronco celíaco em doentes com arteriopatia obstrutiva crônica dos membros inferiores. Método: Foram estudados dois grupos, cada um com 60 doentes (40 homens e 20 mulheres). O grupo-caso foi composto por doentes com arteriopatia obstrutiva crônica dos membros inferiores, claudicação intermitente limitante ou dor de repouso e/ou lesões tróficas de extremidade, sem queixas gastrintestinais. O grupo-controle foi constituído por enfermos sem doença arterial obstrutiva dos membros inferiores e sem queixas gastrintestinais. Consideraram-se fatores de risco presença de diabetes melito, hipertensão arterial, obesidade, angina/infarto, tabagismo e dislipidemia. Todos os doentes foram submetidos a ecografia vascular do tronco celíaco e da artéria mesentérica superior. Os doentes do grupo-caso foram separados pela presença de claudicação intermitente limitante (N = 12) ou lesão trófica e/ou dor de repouso (N = 48). Resultados: Houve associação significante entre idade (p = 0,04) e cardiopatia isquêmica (p = 0,04) com aterosclerose da artéria mesentérica superior. Os fatores de risco não mostraram associação significante com presença de estenose do tronco celíaco. Observou-se associação significante entre arteriopatia dos membros inferiores e lesão estenótica da artéria mesentérica superior (p = 0,006) e do tronco celíaco (p < 0,001). Conclusões: Na ecografia vascular, o achado de arteriopatia periférica sugere presença de lesão estenótica em artéria mesentérica superior e/ou tronco celíaco. A aterosclerose na artéria mesentérica superior está associada com cardiopatia isquêmica e idade avançada. Background: The occasional relationship between arterial atherosclerosis of lower limbs and atherosclerosis of intestinal arteries has not been fully studied yet. Objective: To assess the presence of lesions with ≥ 70% stenosis in the superior mesenteric artery and/or in the celiac trunk in patients with chronic obstructive arteriopathy of the lower limbs using vascular ultrasound (Doppler). Method: Two groups were involved, a study group and a control group, each comprising 60 patients (40 men and 20 women). The study group consisted of patients with chronic obstructive arterial disease of the lower limbs, limiting intermittent claudication or rest pain, and/or trophic lesions of the extremities but no gastrointestinal complaints. The control group comprised patients without obstructive arterial disease of the lower limbs or gastrointestinal complaints. The presence of diabetes mellitus, arterial hypertension, obesity, angina/infarct, smoking or dyslipidemia was considered a risk factor. All patients were submitted to vascular ultrasound of the celiac trunk and superior mesenteric artery. The patients of the study group were divided according to the presence of limiting intermittent claudication (n = 12) or trophic lesion and/or rest pain (n = 48). Results: A significant association was found between age (p = 0.04) and presence of ischemic cardiopathy (p = 0.04) with atherosclerosis of the superior mesenteric artery. The risk factors showed no significant association with presence of stenosis of the celiac trunk. A significant association was found between the presence of arteriopathy of the lower limbs and stenotic lesion of the superior mesenteric artery (p = 0.006) and the celiac trunk (p < 0.001). Conclusions: On vascular ultrasound, a finding of peripheral arteriopathy of the lower limbs suggests the presence of stenotic lesion in the superior mesenteric artery and /or the celiac trunk. The atherosclerosis in the superior mesenteric artery is associated with ischemic cardiopathy and advanced age.

Visceral arterial injuries account for a small but important portion of major abdominal vascular trauma. A case of proximal superior mesenteric artery trauma is presented. The advantages and drawbacks of the surgical approaches to these injuries are discussed. On the basis of a review of the literature describing the management of these injuries, ligation of the proximal superior mesenteric artery for trauma cannot be recommended. Prompt surgical intervention with revascularization offers the best chance for the survival of these critically injured patients.

Klinische Untersuchung: stark reduzierter AZ und EZ, Gewichtsabnahme von mehr als 10 kg wahrend der letzten 3 Wochen (Grose 164 cm, Gewicht 48 kg). Abdomen wirkt eingefallen, epigastrisch sind hochgestellte Darmgerausche mit stenosetypischer Peristaltik auskultierbar. Bei klinischem Verdacht auf eine adhasionsbedingte Symptomatik im oberen Dunndarm wird der orale Kostaufbau gestoppt und eine weiterfuhrende Diagnostik eingeleitet. In der Abdomenubersichtsaufnahme Luft in Projektion auf das Duodenum, im ubrigen Abdomen nur wenig Luft nachweisbar. Zur weiteren Abklarung Magen-Darm-Passage nach oraler Gabe von wasserloslichem jodhaltigem Kontrastmittel (Abb. 1). Zusatzlich wurde eine Abdomen-CT durchgefuhrt. Eine den Darm komprimierende Raumforderung last sich nicht nachweisen (Abb. 2).

OBJETIVO:Descrever peculiaridades da circulação mesentérica neonatal e caracterizar fatores de suscetibilidade ao desenvolvimento de doenças gastrintestinais e alterações do fluxo sanguíneo da artéria mesentérica superior por meio da dopplerfluxometria. FONTES DE DADOS: Livros-textos e publicações indexadas no Medline e SciELO nos últimos 20 anos, utilizando-se as palavras chaves: "mesenteric artery", "superior mesenteric artery", "newborn intestinal circulation", "necrotizing enterocolitis", "doppler flow velocimetry". SÍNTESE DOS DADOS: Alterações do fluxo sanguíneo mesentérico são um dos fatores predisponentes da enterocolite necrosante, doença neonatal de alta morbimortalidade que acomete principalmente prematuros. A circulação mesentérica é peculiar no período neonatal tanto em relação ao seu estado basal, quanto à sua resposta frente a estímulos fisiológicos. Variações da irrigação mesentérica podem ser inerentes à própria fase de desenvolvimento vascular intestinal do recém-nascido pré-termo, com possíveis agravos de fatores perinatais como: insuficiência placentária, asfixia, infecção, cateterismo umbilical, drogas (indometacina e cafeína), fototerapia, alimentação artificial e progressão rápida da dieta. A dopplerfluxometria permite o estudo da irrigação de órgãos-alvo e pode quantificar o fluxo sanguíneo, a resistência vascular e predizer situações de risco para doenças do trato gastrintestinal no período neonatal. CONCLUSÕES: O recém-nascido apresenta peculiaridades de irrigação sanguínea gastrintestinal. A dopplerfluxometria da artéria mesentérica superior é um método não invasivo que determina as condições circulatórias no território intestinal. OBJECTIVE:To describe peculiarities of the neonatal mesenteric circulation and to characterize the susceptibility factors to the development of gastrointestinal illnesses and alterations of the superior mesenteric artery flow by the Doppler ultrasound method. DATA SOURCES: Textbooks and publications listed in Medline and SciELO from the last 20 years were searched using the key-words: "mesenteric artery", "intestinal superior mesenteric artery", "newborn circulation", "necrotizing enterocolitis", and "Doppler flow velocimetry". DATA SYNTHESIS: Alterations in the mesenteric flow are predisposing factors for necrotizing enterocolitis, which is a neonatal illness with high morbidity and mortality that occurs mainly in premature infants. The mesenteric circulation is peculiar at the neonatal period regarding its baseline status as well as its response from physiological stimulation. Mesenteric irrigation varies according to the proper phase of intestinal vascular development. Mesenteric irrigation can be damaged by perinatal factors, such as placental insufficiency, asphyxia, infection, umbilical catheters, drugs (indomethacin and caffeine), phototherapy, artificial feeding and fast diet progression. Doppler flow velocimetry allows the study of gut irrigations and may quantify blood flow and vascular resistance. The exam can predict risk situations for gastrointestinal illnesses during the neonatal period. CONCLUSIONS: The newborn infant presents peculiarities on gastrointestinal blood circulation. Superior mesenteric artery Doppler ultrasound provides non-invasive measures of the intestinal circulatory conditions.

El conocimiento de las variaciones arteriales es importante tanto para el diagnóstico como para los procedimientos quirúrgicos a realizar en el abdomen. Esta investigación se realizó con el propósito de determinar a través de angio TAC, los niveles de origen y número de las arterias renales y mesentérica superior, con respecto a los componentes de la columna vertebral. Para ello, utilizamos los registros angiográficos de 31 pacientes, adultos, chilenos, de ambos sexos, en los cuales localizamos los puntos de origen de las arterias mencionadas, para lo cual dividimos la altura de las vértebras en tercios, considerando además al disco intervertebral. En 26 pacientes, la arteria renal en ambos lados se presentó única; en el lado derecho, la arteria renal se presentó doble en 2 personas y en el izquierdo en 3. La arteria renal derecha se originó a nivel de la vértebra Ll en 11 casos; a nivel del disco intervertebral entre Ll y L2 en 7; a nivel de la vértebra L2 en 10; entre L2 y L3 en 2. La arteria renal izquierda se originó a nivel de Ll en 9 casos, entre Ll y L2 en 6, y, de L2 en 12. La arteria mesentérica superior fue única en todos los casos, localizando su nivel de origen siempre craneal al origen de las arterias renales. Se originó a nivel de la vértebra Ll en 16 casos; a nivel de L2 en 8. Se consideraron también niveles más específicos de origen en relación a una subdivisión de las vértebras. Los resultados obtenidos complementarán el conocimiento sobre estas arterias, aportando a la anatomía quirúrgica de la región.

El conocimiento de las variaciones arteriales es importante tanto para el diagnóstico como para los procedimientos quirúrgicos a realizar en el abdomen. Esta investigación se realizó con el propósito de determinar a través de angio TAC, los niveles de origen y número de las arterias renales y mesentérica superior, con respecto a los componentes de la columna vertebral. Para ello, utilizamos los registros angiográficos de 31 pacientes, adultos, chilenos, de ambos sexos, en los cuales localizamos los puntos de origen de las arterias mencionadas, para lo cual dividimos la altura de las vértebras en tercios, considerando además al disco intervertebral. En 26 pacientes, la arteria renal en ambos lados se presentó única; en el lado derecho, la arteria renal se presentó doble en 2 personas y en el izquierdo en 3. La arteria renal derecha se originó a nivel de la vértebra Ll en 11 casos; a nivel del disco intervertebral entre Ll y L2 en 7; a nivel de la vértebra L2 en 10; entre L2 y L3 en 2. La arteria renal izquierda se originó a nivel de Ll en 9 casos, entre Ll y L2 en 6, y, de L2 en 12. La arteria mesentérica superior fue única en todos los casos, localizando su nivel de origen siempre craneal al origen de las arterias renales. Se originó a nivel de la vértebra Ll en 16 casos; a nivel de L2 en 8. Se consideraron también niveles más específicos de origen en relación a una subdivisión de las vértebras. Los resultados obtenidos complementarán el conocimiento sobre estas arterias, aportando a la anatomía quirúrgica de la región. The knowledge of the arterial variations is very important for the diagnosis and the surgical procedures. The purpose of this study was determine the number and the originlevels of the renal and superior mesenteric arteries in relation to the vertebral bodies. For this, we used the angiographies of 31 patients, Chileans, adult, of both sexes. The angiographies were obtained by Helicoidal Computed Tomography, in these we localized the origin points of the mentioned arteries. We divided the vertebral bodies in three parts, superior, middle and inferior, considering too the intervertebral disc. In 26 patients, in both sides the renal artery was only; in the right side it was double in 2 patients and in the left side in 3. The right renal artery originated from the level of L1 vertebra in 11 cases; from the level of L1-L2 intervertebral disc in 7; from the level of the L2 vertebra in 10 and from the level of the L2-L3 intervertebral disc in 2. The left renal artery originated from the level of the Ll vertebra in 9 cases; from the level of the L1-L2 intervertebral disc in 6; from the level of the L2 vertebra in 12 and from the level of the L2-L3 intervertebral disc in 2. The superior mesenteric artery was only in all cases; it origin level was always cranial to the renal arteries origin. The origin level of the superior mesenteric artery was observed in relation to the Ll vertebra in 16 cases and to the level of the L2 vertebra in 8. We considered specifical origin levels associated to the vertebral body division. The results of this study will complete the knowledge of these arteries and are a contribution to the surgical anatomy of abdominal region.

Two cases of superior mesenteric artery syndrome are presented. In both, conclusive diagnosis was made noninvasively in the presence of acute symptoms by obtaining details of the duodenum and vessels

The essential oils are volatiles organic constituents found in aromatic plants, which present several monoterpenes. a-terpineol is an important chemical constituent of the essential oil of many plants.. Studies have demonstrated some biologic activities such as antifungal and antispasmodic. In the present work the cardiovascular effects of a-terpineol were investigated in normotensive rats. Male Wistar rats (250-350 g) were anaesthetized and polyethylene catheters were inserted into the low abdominal aorta and inferior vena cava for blood pressure measurements and administration of drugs. Arterial pressure and heart rate were measured by using a pressure transducers coupled to a computer set and CVMS software. Isolated superior mesenteric rings (1-2 mm) were suspended by cotton threads for isometric tension recordings in Tyrode s solution (37°C, gassed with 95% O2 and 5% CO2), under 0.75g resting tension. In normotensive non-anaesthetized rats (n=6), a-terpineol (1, 5, 10, 20, 30 mg/Kg i.v., randomly) injections produced hypotension (-8,6 ± 2,25; - 18,35 ± 4,35; -33,25±6,0; -51,2±4,5 e -49,5±6,5 mmHg, n=6 , respectively followed by tachycardia (44,6±5,3; 24,5±8,4; 109,8±7,3; 113,2±12,4 e 35,8±14,0 bpm, n=6, respectively). However, hypotensive and tachycardic responses were significantly attenuated after L-NAME (20 mg/Kg ,i.v.) administration i.v (-1,5±0,6; -4,9±2,0; - 6,9±2,8; -22,0±9,0 e -22,1±9,0 mmHg, n=4). In intact isolated rat mesenteric rings a- terpineol (10-12 10-5M) induced concentration-dependent relaxation of the contractions induced by phylephrine (10μM) [Emax=62.41±13.79%]. After endothelium removal the vasorelaxant elicited by a-terpineol was significantly attenuated [Emax= 20.08±4.95]. Similar results were obtained in the presence LNAME 100 or 300 μM, a competitive antagonist of NOS, hydroxocobalamin 30 μM, a NO scavenger or ODQ 10μM, a selective inhibitor of soluble guanylyl cyclase [Emax= 18.33± 3.85% Emax= 23.24± 3.93% Emax= 23.49±7.05 Emax= 20.79 ± 1.06% respectively, p

The authors report two cases in which stent grafts were used to treat visceral artery aneurysms. Case number 1 was a 42-year old woman with a history of renal colic who was found to have a right renal artery aneurysm. Two 6-mm x 20-mm Wallgraft endoprosthesis (Boston Scientific, Watertown, Mass) were placed across the aneurysm neck. Case number 2 was a 72 year-old woman with a past medical history significant for hepatic angioma and hypothyroidism. She was found to have a superior mesenteric artery aneurysm that was treated with a 6-mm x 17-mm Jostent stent graft (Jomed, GmbH, Ra). In both cases the aneurysm was completely excluded and distal end-organ flow preserved. Stent graft placement is a safe and effective treatment for visceral artery aneurysms. If this approach proves durable and reproducible, it can become the method of choice for the management of visceral artery aneurysms in selected patients.

Tesis - Doctorado en Medicina y Cirugía - Universidad Nacional de Córdoba. Facultad de Ciencias Médicas, 2006 La circulación esplácnica es un lecho vascular con dos principales fuentes de flujo arterial, el Tronco Celíaco y la Arteria Mesentérica Superior. Existen múltiples comunicaciones entre ambas y con la Arteria Mesentérica Inferior. Debido a que existe este rico aporte arterial, la estenosis y aún la oclusión de alguno de estos tres vasos puede ocurrir sin síntomas abdominales isquémicos manifestos. La principal causa de estenosis es de origen arterioesclerótico y ocurre con mayor frecuencia en el origen de estos vasos, siendo responsable de más de 95 por ciento de los casos de isquemia mesentérica. En pacientes con sospecha de enfermedad vascular arteriosclerótica el método de imagen históricamente utilizado fue la arteriografía, que implica exposición a radiaciones ionizante y medios de contraste iodados nefrotóxicos. El objetivo de este trabajo fue demostrar que se pueden utilizar, en un grupo de pacientes vulnerables como los diabéticos, técnicas de imagen no invasivas como el Ultrasonido Doppler y la Angiografía por Resonancia Magnética en la detección de estenosis en el Tronco Celíaco y Arteria Mesentérica Superior, y establecer la relación de sexo, edad, factores de riesgo y enfermedad vascular concomitante con la enfermedad aterosclerótica y de los vaos esplácnicos (AU) María Elena Castrillón.

Submitted by Ana Quininha (ana.quininha@chlc.min-saude.pt) on 2011-07-07T15:15:09Z No. of bitstreams: 1 RPCCTV 2006 155.pdf: 235150 bytes, checksum: 5e0af9581fd337247dad3c86f4167921 (MD5) Made available in DSpace on 2011-07-07T15:15:09Z (GMT). No. of bitstreams: 1 RPCCTV 2006 155.pdf: 235150 bytes, checksum: 5e0af9581fd337247dad3c86f4167921 (MD5) Previous issue date: 2006

J Vasc Surg 2003;37:1131.

A case of a “double hepatomesenteric artery”, i.e. two persisting hepatic arteries arising from the superior mesenteric artery, is reported. Also observed was a lack of systematisation of the pancreaticoduodenal arteries. The variant, which does not appear to have been previously reported in the literature, was observed when dissecting the vessels of the duodenal bulb in a preserved male cadaver injected with neoprene latex. Its embryological origin, as well as the clinical, radiological (diagnostic or interventional) and surgical implications, are discussed.

International audience; The authors report the case of a 39-year-old man with a common origin of three arteries-the celiac, superior mesenteric, and inferior mesenteric arteries-that has not been described previously in the literature, to their knowledge. This variant, which they call the celiac-bimesenteric trunk, is documented with a selective angiogram, and an embryologic explanation is offered.

Submitted by Gestor HospitalBraga (bibliotecaria@hospitaldebraga.com.pt) on 2016-10-14T13:28:25Z No. of bitstreams: 1 Sindroma de Fraley Boletim Hospital São Marcos XVII 1 45 a 47 2001.pdf: 2155439 bytes, checksum: c02def8dbe0d136c937815bbfbf3f91a (MD5) Made available in DSpace on 2016-10-14T13:28:25Z (GMT). No. of bitstreams: 1 Sindroma de Fraley Boletim Hospital São Marcos XVII 1 45 a 47 2001.pdf: 2155439 bytes, checksum: c02def8dbe0d136c937815bbfbf3f91a (MD5) Previous issue date: 2001

Aneurysms of the superior mesenteric artery (SMA) and its branches are rare. We describe three patients with aneurysms in the SMA or its branches found at angiography in our department. The importance of mesenteric aneurysms and different procedures for treatment are discussed.

A hepatic artery coursing within the portacaval space was seen in 30 (18.3%) of 164 consecutive patients in whom this region was seen with ultrasonography. In 12 subjects (40%) this vessel represented the right hepatic artery arising from the proximal celiac artery. In the other 18 subjects (60%) this vessel arose from the superior mesenteric artery. It should not be assumed that a hepatic artery traversing the portacaval space arises from the superior mesenteric artery until its origin is clearly documented.

"Damage control" is an accepted technique for the treatment of the patient with exsanguinating injuries to the abdomen and intraoperative coagulopathy. We describe the use of an intraluminal shunt to maintain temporary vascular continuity of the superior mesenteric artery during rewarming and correction of coagulopathy in the intensive care unit following a gun shot wound to the abdomen. Successful complex reconstruction was achieved at definitive laparotomy using an autogenous vein interposition graft.