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Establishment of the Heart Failure Model by Coronary Artery Ligation in Sheep (양에서 관상동맥 결찰에 의한 심부전 모델의 확립)

  • 나찬영;홍장수;박정준;김원곤;강문철;서정욱
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.1-10
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    • 2002
  • Background: Despite the relatively high mortality rates in the chronic heart failure model induced by coronary artery ligation are relatively high, this model has been a subject of continuos research because of its clinical correlation. Chronic heart failure model of large-sized animals is very useful to analyse mechanical or biological effects on circulatory system which is difficult in small-sized animals. The purpose of this study is to establish the heart failure model by coronary artery ligation in sheep. Material and Method: Among 9 Corridale sheep, the homonymous artery and the diagonal branch were ligated simultaneously in 2 sheep and remaining 7 sheep were assigned to successive ligation of both arteries at an interval of 1 hour. Both coronary arteries were ligated from the point 40% proximal to the apex of the heart. Hemodynamic and echocardiographic parameters were analyzed before the ligation of the coronary artery, after the ligation of the homonymous artery, and after additional ligation of the diagonal branch. The experimental animals were sacrificed after 2 or 3 months of growth and histopathologic studies were performed Result: Immediate postoperative death occurred in the 2 sheep that had received simultaneous ligation of the homonymous artery and diagonal branch. On the other hand, all the 7 sheep that were lifated in succession were survived up to 3 months. Arterial pressure was sifnificantly decreased immediately after ligation of the homonymous artery(p<0.05), and the cardiac output was decreased and pulmonary capillary wedge pressure was increased after further ligation of the diagonal branch(p<0.05). Central venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, left ventricular end-diastolic dimension and end-systolic dimension were markedly increased 3 months after ligation of coronary arteries. Anteroseptal akinesia or dyskinesia was developed after the ligation of coronary arteries. Histopathologic study revealed we]1-demarcated ischemic area of fibrosis. Conclusion: Using methods of successive ligation of the homonymous artery and diagonal branch, chronic heart failure model could be reliably established in sheep.

Is Video-assisted Thoracoscopic Resection for Treating Apical Neurogenic Tumors Always Safe? (흉강 첨부 양성 신경종의 흉강경을 이용한 절제술: 언제나 안전하게 시행할 수 있나?)

  • Cho, Deog Gon;Jo, Min Seop;Kang, Chul Ung;Cho, Kyu Do;Choi, Si Young;Park, Jae Kil;Jo, Keon Hyeon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.72-78
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    • 2009
  • Background: Mediastinal neurogenic tumors are generally benign lesions and they are ideal candidates for performing resection via video-assisted thoracoscopic surgery (VATS). However, benign neurogenic tumors at the thoracic apex present technical problems for the surgeon because of the limited exposure of the neurovascular structures, and the optimal way to surgically access these tumors is still a matter of debate. This study aims to clarify the feasibility and safety of the VATS approach for performing surgical resection of benign apical neurogenic tumors (ANT). Material and Method: From January 1996 to September 2008, 31 patients with benign ANT (15 males/16 females, mean age: 45 years, range: 8~73), were operated on by various surgical methods: 14 VATS, 10 lateral thoracotomies, 6 cervical or cervicothoracic incisions and 1 median sternotomy. 3 patients had associated von Recklinhausen's disease. The perioperative variables and complications were retrospectively reviewed according to the surgical approaches, and the surgical results of VATS were compared with those of the other invasive surgeries. Result: In the VATS group, the histologic diagnosis was schwannoma in 9 cases, neurofibroma in 4 cases and ganglioneuroma in 1 case, and the median tumor size was 4.3 cm (range: 1.2~7.0 cm). The operation time, amount of chest tube drainage and the postoperative stay in the VATS group were significantly less than that in the other invasive surgical group (p<0.05). No conversion thoracotomy was required. There were 2 cases of Hornor's syndrome and 2 brachial plexus neuropathies in the VATS group; there was 1 case of Honor's syndrome, 1 brachial plexus neuropathy, 1 vocal cord palsy and 2 non-neurologic complications in the invasive surgical group, and all the complications developed postoperatively. The operative method was an independent predictor for postoperative neuropathies in the VATS group (that is, non-enucleation of the tumor) (p=0.029). Conclusion: The VATS approach for treating benign ANT is a less invasive, safe and feasible method. Enucleation of the tumor during the VATS procedure may be an important technique to decrease the postoperative neurological complications.

Germ Cell Differentiations during Spermatogenesis and Ultrastructural Characteristics of Mature Sperms in Male Protothaca (Notochione) jedoensis (Bivalvia: Veneridae) (수컷 살조개, Protothaca (Notochione) jedoensis (Bivalvia: Veneridae)의 정자형성과정 중 생식세포 분화와 성숙정자의 미세구조적 특징)

  • Kim, Jin-Hee;Park, Young-Jae;Lee, Ki-Young;Choi, Moon-Sul;Seo, Won-Jae;Chung, Ee-Yung
    • Development and Reproduction
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    • v.14 no.4
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    • pp.269-279
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    • 2010
  • Some characteristics of germ cell differntiations and the function of accessory cells during spermatogenesis, and mature sperm ultrastructure in male Protothaca (N.) jedoensis were investigated by transmission electron microscope observations. The morphology of the spermatozoa of this species has a primitive type and is similar to those of other species in the subclass Heterodonta. Accessory cells, which are connected to adjacent germ cells, are involved in the supplying of the nutrients for germ cell development. The morphologies of the sperm nucleus and the acrosome of this species are the cylindrical type and cap shape, respectively. Spermatozoa are approximately $46{\sim}50{\mu}m$ in length including a long sperm nucleus (about $2.44{\mu}m$ in length), an acrosome (about $0.45{\mu}m$ in length), and tail flagellum (about $42{\sim}46{\mu}m$). The axoneme of the sperm tail shows a 9+2 structure. As some characteristics of the acrosomal vesicle structures, the basal and lateral parts of basal rings show electron opaque part (region), while the anterior apex part of the acrosomal vesicle shows electron lucent part (region). These characteristics of the acrosomal vesicle were found in the family Veneridae and other several families in the subclass Heterodonta. These common characteristics of the acrosomal vesicle in the subclass Heterodonta can be used for phylogenetic and systematic analysis as a taxonomic key or a significant tool. The number of mitochondria in the midpiece of the sperm of this species are four, as one of common characteristics appear in most species in the family Veneridae and other families in the subclass Heterodonta. However, exceptionally, only three species in Veneridae of the subclass Heterodonta contain 5 mitochondria. The number of mitochondria in the sperm midpiece can be used for the taxonomic analysis of the family or superfamily levels as a systematic key or an important tool.

$Ca^{++}$ Polls in Isolated Rabbit and Turtle Heart (적출된 토끼와 자라심장에서의 $Ca^{++}$ Pool)

  • Kim, In-Kyo;Lee, Joong-Woo;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.9 no.1
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    • pp.13-22
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    • 1975
  • From the study of movements of $Ca^{++}$ in frog cardiac muscle, Niedergerke (1963) postulated that $Ca^{++}$ necessary for the cardiac contraction is stored in a specific pool. Langer et al (1967) and DeCaro (1967) also found a close relationship between the change of $Ca^{++}$ flux kinetics and the change of contractile force. According to the studies of several investigators, Ca II (Bailey and Dressel 1968) or phase I and II (Langer 1965, Langer et al 1967, 1971) in the $Ca^{++}$ washout curve was associated with cardiac contractility. This investigation was aimed to elucidate the anatomical region of the contractile active $Ca^{++}$ pool. At the same time, it was assumed in this study that $Ca^{++}$ in the sarcoplasmic reticulumn represents one of the major intracellular $Ca^{++}$ pool and cardiac contractility was also dependent on the intracellular $Ca^{++}$ concentration. Consequently, this experiment was performed at different temperatures to activate to activate inhibit the deactivating process of activated $Ca^{++}$ in the intracellular space to see if changes in the contractility decay curve existed at different temperatures. The isolated hearts of rabbits and turtles (Amyda maackii) were attached to the perfusion apparatus according to the method employed by Bailey and Dressel (1968). The isolated hearts were initally perfused with a full Ringer solution containing 2 mg/ml of inulin for 1 hr, and then $Ca^{++}$ and inulin-free Ringer solution was perfused while the isometric tension was recorded and a serial sample of perfusion fluid dripping from the cardiac apex was collected for 10 sec throughout experimental period. The above procedure was performed at $23^{\circ}C$, $30^{\circ}C$ and $38^{\circ}C$ on the rabbit heart and $10{\sim}13^{\circ}C$, $10^{\circ}C$, $25^{\circ}C$, $30^{\circ}C$ and $35^{\circ}C$ on the turtle heart. After determination of $Ca^{++}$ and inulin concentration of the samples, the $Ca^{++}$, inulin washout curve and the contractile tensin decay curve were analysed according to the method of Riggs (1963). The results were summarized as follows; 1. In the rabbit heart, there are 2 inulin compartments, 3 $Ca^{++}$ compartments and sing1e exponential decay of contractile tension. In the turtle heart, there are $1{\sim}2$ inulin compartments, $1{\sim}2$ $Ca^{++}$ compartments and $1{\sim}2$ phases of contractile tension decay. The fact that the inulin space was divided into 3 compartments in the washout curve in these hearts indicates the presence of heterogeneity in cardiac perfusion, i.e., overfused and underperfused area. 2. Ca I a9d Ca II in these hearts were found to have $Ca^{++}$ in the ECF compartments because their half times in the washout curves were far smaller than those of the inulin washout curves in the rabbit heart and similar to those of the inulin washout curves in the turtle heart. Ca III in the rabbit heart may have originated from the intracellular $Ca^{++}$ store. But no Ca III in the turtle heart was found. This may be due to the fact that the iutracellular $Ca^{++}$ pool in the turtle heart was too small to detect using this experimental procedure since sarcoplasmic reticulumn in the turtle heart is poorly developed. 3. In the rabbit heart, there were no chages in the half time of Ca I, Ca II, inulin I and inulin II at different temperatures, but the half time of Ca III was significantly prolonged at lower temperatures, and the half time of the contractile tension decay tended to be prolonged at lower temperatures but this was not significant. In the turtle heart, there were no changes in the half time of Ca I, Ca II, inulin 1, inulin II and phase I of the contractile tension decay at different temperatures, but the half time of phase II of the contractile tension decay was significantly prolonged at lower temperatures. This finding indicates that intracellu!ar $Ca^{++}$ in these hearts was also responsible particulary for maintaining the cardiac contractility at the lower temperatures. 4. The half times of contractile tension decay were shorter than those of Ca II in the $Ca^{++}$ washout curves in both animal hearts. According to the above results it was shown that $Ca^{++}$ in ECF is primarily and $Ca^{++}$ in the intracellular space is partially associated with the cardic contractility.

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A STUDY OF THE STRESS DISTRIBUTION OF THE ABUTMENT AND SUPPORTING TISSUES ACCORDING TO THE SLOPES AND TYPES OF CHIDING FLAMES OF THE LAST ABUTMENT IN DISTAL EXTENSION REMOVABLE PARTIAL DENTURE USING THREE DIMENSIONAL FINITE ELEMENT ANALYSIS METHOD (국소의치 최후방 지대치 유도면의 기울기와 형태가 지대치 및 지지조직의 응력분산에 미치는 영향)

  • Kim, Yang-Kyo;Lee, Cheong-Hee;Jo, Kwang-Hun
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.5
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    • pp.581-596
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    • 1999
  • The purpose of this study was to investigate the stress distribution of the abutment and sup-porting tissues according to the slopes and types of the guiding plane of distal extension removable partial dentures. The 3-dimensional finite element method was used and the finite element models were prepared as follows. Model I : Kratochvil type guiding plane with $90^{\circ}$ to residual ridge Model II : Kratochvil type guiding plane with $95^{\circ}$ to residual ridge Model III : Kratochvil type guiding plane with $100^{\circ}$ to residual ridge Model IV : Krol type guiding plane with $90^{\circ}$ to residual ridge Distal extension partial denture which right mandibular first and second molar were lost was used and the second premolar was prepared as primary abutment with RPI type retainer. Then 150N of compressive force was applied to central fossae of the first and second molars and von Mises stress and displacement were measured. The results were as follows 1. Model I and Model IV showed a similar stress distribution pattern and the stress was concentrated on the apex of the root of the abutment. 2. The stress was increased and concentrated on mesial side of the root of the abutment in Model II. The stress was concentrated on buccal and mesiobuccal side of the root of the abutment in Model IV. 3. In Model I, the root of the abutment displaced and twisted a little in clockwise. In Model IV, the root of the abutment displaced to distolingually at apical region of the root and mesiobuccally at cervical region of the root. 4. In Model II, the root of the abutment displaced to mesiolingually at apical region of the root and more displaced and twisted in counterclockwise at cervical region of the root. In Model III, the root of the abutment displaced to mesiobucally at apical region of the root and more displaced and twisted in clockwise at cervical region of the root.

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Changes in midpalatal suture area and adjacent periodontal tissues of individual tooth following rapid palatal expansion in young adult dogs ; Histomorphologic and immunohistochemical study (유성견 급속 구개확장시 정중구개봉합부 및 치아주위 조직 변화에 관한 조직형태학적 및 면역조직화학적 연구)

  • Lee, Ju-Young;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.317-333
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    • 2000
  • The purpose of this study was to determine the proliferative activity of the osteoblasts and fibroblasts in the midpalatal area and to investigate the adjacent periodontal tissues of individual tooth following rapid expansion of the palate. Ten young adult dogs, aged approximately ten months, were used in the experiment. The experimental design was consisted of 1 week expansion group(Group E1, 3 dogs), 2 week expansion group(Group E2, 3 dogs), 2 week expansion and 2 week retention group(Group E3, 3 dogs), and control group(Group C, 1 dog). For each group, expansion screw was activated one time per day(1/4 turn;$90^{\circ}$) following Hyrax-screw application. The experimental animals in each group were sacrificed at 1, 2 and 4 weeks following palatal expansion. Maxillary tissue blocks were obtained and prepared ior the histomorphologic and immunohistochemical studies. Light mcroscope, polarizing microscope, and soft X-ray apparatus were used in this study, and following results were obtained. 1. In polarizing microscopic study, the expansion groups(E1 & E2) showed blue color representing bone resorption and new bone formation in midpalatal suture area. E3 groups skewed less blue color compared to the E1 and E2 group. But yellow color increased by calcification in the E3 groups. 2. Immunohistochemical study revealed that positive responses of the osteoblasts to PCNA and undifferentiated fibroblasts to EGF in E1 group were somewhat increased. Positive response to PCNA and EGF were increased in fibroblasts and the osteoblasts forming new bone in E2 group. In E3 group, the positive response cell concentrated the periphery of edge of palatal process in both PCNA and EGF. 3. Throughout the expansion period(E1 & E2), light microscopic study showed the edges of the extensive resorption and new palatal processes, indicating bone remodeling within the suture. E3 group exhibited less remodeling of midpalatal suture area. E2 group and E3 group showed cementum formation and resorption at the apex of 3rd premolar and 1st molar E3 group exhibited extensive hyalinized zone on the cervical portion of buccal side of 1st molar. 4. Soft X-ray analysis of E1 group showed hypomineralized defect and microfractures in various parts of the suture areas when compared with control animals. There was no significant difference in the degree of mineralization in the midpalatal suture region between the C and E3 groups. Tooth axis showed tipping of 3rd premolar and 1st molar in the E2 group and E3 group. Based upon these experimental results, it is concluded that the undifferentiated mesenchymal cells always presented in midpalatal suture area following RPE. Differentiated osteoblasts and fibroblasts possess proliferating cellular activity until the 2 week retention period. The posterior teeth are tend to tip buccally as RPE force applied. Retention group exhibited irreversible response with severe hyalinized zone on the buccal surface of the first molar.

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Left ventricular dysfunction measured by tissue Doppler imaging and strain rate imaging in hypertensive adolescents (고혈압 청소년에서 tissue Doppler imaging과 strain rate imaging을 이용한 좌심실 기능 이상에 대한 연구)

  • Ahn, Hye Mi;Jung, Sun Ok;Kwon, Jung Hyun;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.72-79
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    • 2010
  • Purpose: Left ventricular (LV) hypertrophy and impaired diastolic function may occur early in systemic hypertension. Diastolic dysfunction is associated with increased cardiovascular risk. Tissue Doppler imaging (TDI)-derived tissue velocity and strain rate are new parameters for assessing diastolic dysfunction. The aim of this study is to determine whether TDI and strain rate imaging (SRI) would improve the ability to recognize early impaired diastolic and systolic functions compared with conventional echocardiography in hypertensive adolescents. Methods: We included 38 hypertensive patients with systolic blood pressure above 140 mmHg or diastolic blood pressure above 90 mmHg. Ejection fraction and myocardial performance index (MPI) were estimated by conventional echocardiography. Peak systolic myocardial velocity, early diastolic myocardial velocity (Em), and peak late diastolic myocardial velocity (Am) were obtained by using TDI and SRI. Results: In the hypertensive group, interventricular septal thickness was significantly increased on M-mode echocardiography. Em/Am was significantly decreased at the mitral valve annulus. Among hypertensive subjects, the E strain rate at basal, mid, and apex was significantly decreased. Systolic strain was significantly decreased at the septum in the hypertensive group. Conclusion: Strain rate might be a useful new parameter for the quantification of both regional and global LV functions and could be used in long-term follow up in hypertensive patients. Early identification by SRI of subjects at risk for hypertensive and ventricular dysfunction may help to stratify risk and guide therapy. Further studies, including serial assessment of LV structure and function in a larger number of adolescents with hypertension, is necessary.

TI-201 Redistribution SPECT and N-13 Ammonia PET Images in Patients with Old Myocardial Infarction and Left Ventricular Dysfunction: Segmental Comparison and Discordance Analysis (좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 TI-201 재분포 SPECT와 휴식기 N-13 Ammonia PET: 분절 비교 및 불일치 분석)

  • Choi, Joon-Young;Lee, Kyung-Han;Kim, Young-Hwan;Lee, Eun-Jeong;Chung, Hyun-Woo;Lee, Su-Jin;Lee, Sang-Hoon;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.218-224
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    • 2004
  • We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose dipyridamole - 4hr redistribution TI-201 SPECT showed one or more severe fixed defects. Regional perfusion and metabolism were evaluated visually and quantitatively with 5-segment myocardial model. Results: There were high concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis (R=0.81, p<0.001) between redistribution TI-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients showed SPECT-PET discordant pattern with abnormal TI-201 defect and near normal N-13 ammonia uptake (Group II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted in PET images with severe inferior wall defects nearly identical to those seen in redistribution TI-201 SPECT images. Conclusion: Redistribution TI-201 SPECT images showed high concordant rate and correlation with rest N-13 ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left hemidiaphragm and cardiac blood pool.

RELATIONSHIP BETWEEN THE DEVELOPMENTAL STAGE AND CHRONOLOGICAL AGE, AND THE CHANGES OF TOOTH POSITION IN RELATION TO THE TOOTH DEVELOPMENT ON MANDIBULAR PERMANENT TEETH (하악 영구치아의 발육과 연령과의 관계 및 치아 발육에 따른 치아의 위치 변화)

  • Kim, Hyun-Mi;Yang, Seung-Duck;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.607-617
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    • 2002
  • The purposes of this study were to evaluate the timing of tooth calcification and the change of tooth position with tooth developmental stage on the mandibular teeth. Seven hundred seventy two children(male:446, female:326), 3 to 12 years of age were examined radiographically with panoramic film. Dental development was determined by inspecting radiographs and assigning a rating according to consecutive stages defined by Moorrees, and tooth cusp position and root terminus position were measured from the lower border of mandibular body and calculated the position index to evaluate the movement of tooth with developmental stage. The results were as follows. 1. There were no significant differences between boys and girls in the timing of calcification until crown completion, but timing of calcification tend to be faster in girls than in boys after root initiation stage. 2. In terms of mean age, crown completion of central incisor in boys and girls occurred at the age of 3.71, 4.05 years, at 4.44, 4.60 years for the lateral incisor, at 5.35, 5.11 years for the canine, at 6.62, 6.36 years for the first premolar, at 7.36, 7.17 years of second premolar, at 3.51, 3.69 years of first molar, and at 7.90, 7.64 years for the second molar respectively. Apex 1/2 closed stage of central incisor occurred at the age of 8.70 in boys, 8.18 in girls, at 9.55, 8.99 years for the lateral incisor, at 12.48, 11.60 years for the canine, at 12.30, 12.01 years for the first premolar, at 12.19, 12.26 years of second premolar, at 9.12, 8.87 years of first molar, and at 12.59, 12.45 years for the second molar respectively. 3. There was no noticeable movement of cusp tip until crown completion (Crc), but showed rapid movement toward occlusion plane after root initiation(Ri) and again maintain stable position after root completion stage(Rc). 4. Root terminus position was stable until root 1/4 formation stage(R1/4), followed by rapid movement toward occlusal plane and was stable again after root 3/4 formation stage(R3/4). 5. Developmental stage at the time of alveolar bone penetration by cusp tip varied with each of the permanent teeth. 6. Canine tooth follicle was at the lowest position in the mandibular body during the early stage of calcification, followed by second premolar, first premolar, lateral incisor, second molar, first molar and central incisor in order.

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Spur-like Lesion on the Lateral Tibial Condyle - A Sign of Chronic ACL tear - (경골 외과의 골극 유사 병변 - 만성 전방 십자 인대 파열의 징후 -)

  • Cho Sung-Do;Ko Sang-Hun;Hwang Su-Yeon;Yang Jung-Hun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.201-205
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    • 2003
  • Purpose : Authors experienced cases of chronic ACL tear with spur-like lesion on the tibial condyle which is different from the lateral capsular sign and degenerative change and evaluated the significance of 'spur-like lesion' in relations with chronic ACL injury. Material and Method : We have 5 patients with spur-like lesion on the lateral tibial condyle in simple radiogram. The location, shape and size of the lesion were studied using radiogram and MRI. Cause of injury, associated injury and chronicity of the ACL tear were analyzed. All 5 patients were male, and mean age was 33.8 $(17\~46)$ years. Result : The spur-like lesion was located from 3.8 mm(avg.) below the articular surface of the lateral tibial condyle to the apex of the fibular head and protruded laterally or inferolaterally from just posterior to the Gerdy's tubercle with a round or sharp-end triangular shape. Average length was 6 mm and average width ortho base was 9.2 mm. The cause of injury were sports jnjury 4 cases and traffic accident in one. The chronicity of the ACL tear was average 10.7(8 months$\~$23 years) years and medial meniscus tear was shown in all cases and lateral meniscus tear in three. Conclusion : We suggest that a patient who has a history of trauma with spur-like lesion on the lateral tibial condyle of the knee is expected to have chronic ACL tear.

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