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Changes in the relationship between the right internal jugular vein and an anatomical landmark after head rotation.

ABSTRACT: THIS STUDY WAS PERFORMED TO ULTRASONOGRAPHICALLY DEMONSTRATE THE CHANGES IN RELATIONSHIP BETWEEN THE RIGHT INTERNAL JUGULAR VEIN (IJV) AND AN ANATOMICAL LANDMARK IN TWO DIFFERENT HEAD POSITIONS: neutral and rotated.This was a randomized clinical trial. One hundred patients scheduled for elective surgery under general anesthesia with endotracheal intubation were enrolled in this study. The patients were placed in the supine position with a neutral head position and without a pillow. The apex of the triangle formed by the sternal and clavicular heads of the sternocleidomastoid muscle and clavicle was marked (AL point : anatomical landmark point). Ultrasonography of the neck anatomy was performed and the skin was marked at the central point of the IJV (US point: ultrasonography point). The other investigator measured the distance from the AL point to the US point (AL-US distance). The patient's head was then turned 30° to the left; the same procedure was repeated and the AL-US distance was again measured. The changes in AL-US distance were calculated.The AL-US distance increased significantly after 30° head rotation compared with that in a head neutral position. The mean ± SD of the AL-US distance was 0.28 ± 0.78 cm in the neutral head position and 0.83 ± 1.03 cm in the head rotated position.The anatomical landmark point becomes more distant from the actual right IJV point and moves more medially after head rotation. We suggest minimizing the angle of head rotation and taking this distance into consideration when using the landmark-guided method.

SUBMITTER: Park SY

PROVIDER: S-EPMC3167127 | biostudies-literature | 2011 Aug

REPOSITORIES: biostudies-literature

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Changes in the relationship between the right internal jugular vein and an anatomical landmark after head rotation.

Park Sun Young SY Kim Min Jung MJ Kim Mun Gyu MG Lee Se Jin SJ Kim Sang Ho SH Ok Si Young SY Kim Soon Im SI

Korean journal of anesthesiology 20110823 2

<h4>Background</h4>THIS STUDY WAS PERFORMED TO ULTRASONOGRAPHICALLY DEMONSTRATE THE CHANGES IN RELATIONSHIP BETWEEN THE RIGHT INTERNAL JUGULAR VEIN (IJV) AND AN ANATOMICAL LANDMARK IN TWO DIFFERENT HEAD POSITIONS: neutral and rotated.<h4>Methods</h4>This was a randomized clinical trial. One hundred patients scheduled for elective surgery under general anesthesia with endotracheal intubation were enrolled in this study. The patients were placed in the supine position with a neutral head position ...[more]

PMID: 21927678

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Project description:BACKGROUND:Multiple sclerosis (MS) is an inflammatory, demyelinating and degenerative disorder of the central nervous system (CNS). Several observations support interactions between vascular and neurodegenerative mechanisms in multiple sclerosis (MS). To investigate the contribution of the extracranial venous compartment, we analysed expression profiles of internal jugular vein (IJV), which drains blood from CNS, and related plasma protein levels. METHODS:We studied a group of MS patients (n = 19), screened by echo-color Doppler and magnetic resonance venography, who underwent surgical reconstruction of IJV for chronic cerebrospinal venous insufficiency (CCSVI). Microarray-based transcriptome analysis was conducted on specimens of IJV wall from MS patients and from subjects undergoing carotid endarterectomy, as controls. Protein levels were determined by multiplex assay in: i) jugular and peripheral plasma from 17 MS/CCSVI patients; ii) peripheral plasma from 60 progressive MS patients, after repeated sampling and iii) healthy individuals. RESULTS:Of the differentially expressed genes (≥ 2 fold-change, multiple testing correction, P < 0.05), the immune-related CD86 (8.5 fold-change, P = 0.002) emerged among the up regulated genes (N = 409). Several genes encoding HOX transcription factors and histones potentially regulated by blood flow, were overexpressed. Smooth muscle contraction and cell adhesion processes emerged among down regulated genes (N = 515), including the neuronal cell adhesion L1CAM as top scorer (5 fold-change, P = 5 × 10- 4). Repeated measurements in jugular/peripheral plasma and overtime in peripheral plasma showed conserved individual plasma patterns for immune-inflammatory (CCL13, CCL18) and adhesion (NCAM1, VAP1, SELL) proteins, despite significant variations overtime (SELL P < 0.0001). Both age and MS disease phenotypes were determinants of VAP1 plasma levels. Data supported cerebral related-mechanisms regulating ANGPT1 levels, which were remarkably lower in jugular plasma and correlated in repeated assays but not between jugular/peripheral compartments. CONCLUSIONS:This study provides for the first time expression patterns of the IJV wall, suggesting signatures of altered vascular mRNA profiles in MS disease also independently from CCSVI. The combined transcriptome-protein analysis provides intriguing links between IJV wall transcript alteration and plasma protein expression, thus highlighting proteins of interest for MS pathophysiology.

Dataset Information

Changes in the relationship between the right internal jugular vein and an anatomical landmark after head rotation.

Publications

Changes in the relationship between the right internal jugular vein and an anatomical landmark after head rotation.

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