• 한국임상수의학회지
• /
• 제21권2호
• /
• pp.219-228
• /
• 2004

심장 전도계에 관련된 심장 질환은 심장 전도계의 원발성 결함이나 형태학적 심장 질환 및 약물 중독 같은 속발성 원인에 의해 발생한다. 특히 선천성 심장 전도 장애의 경우, 이온 채널, 이온 채널에 관련한 세포질성 단백질, gap-junction 단백질, transcription factors (심장 발생에 관련된 유전자들) 및 kinase subunit을 전사하는 유전자의 돌연변이가 원발성 선천성 심장 전도장애의 원인으로 밝혀지고 있다. 사람의 부정맥 발생에 관련된 발병기전에 커다란 진보가 이루어지고 있음에도 불구하고, 개의 경우, 저먼 세퍼드의 급사 증후군 (sudden death syndrome)을 제외한 다른 전도 장애에 대한 연구는 극히 미비한 상태이다. 본 종설에서는 지금까지 밝혀진 심장 부정맥 발생의 분자 유전학적 고찰과 이와 관련된 사람의 유전학적 질환들과 이와 유사한 개의 선천성 심장 전도 장애에 대해 연구 고찰하였다.

• Journal of Chest Surgery
• /
• 제22권5호
• /
• pp.760-765
• /
• 1989

Cardiac injury remains one of the most spectacular injuries which the present day cardiac surgeon is called upon to treat. Eight consecutive patients with penetrating or blunt injury to the heart underwent operation at the Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital from April 22 88 to April 6 89. l. Among the 8 cases of cardiac injured patients, 7 cases were penetrating injury [stab injury] and one case was blunt injury [traffic accident]. 2. The site of cardiac injury was LV mainly and the next RV, SVC-RA junction in order. 3. The all patients were admitted to our hospital via ER and most of cases, CVP was elevated above 15 cmH2O and 7 of 8 cases were shock state. 4. In 6 of 8 cases revealed cardiomegaly in simple chest X * ray. 5. 7 cases were operated through the median sternotomy, 1 case the right anterolateral thoracotomy. 6. Associated injuries in penetrating cardiac injury were hemothorax, pneumothorax, sternal fracture, lung laceration, LAD transaction in blunt injury, hemoperitoneum.

• Applied Microscopy
• /
• 제50권
• /
• pp.20.1-20.9
• /
• 2020

Arthropods have an open circulatory system with a simple tubular heart, so it has been estimated that the contractile pumping structure of the cardiac muscle will be less efficient than that of vertebrates. Nevertheless, certain arthropods are known to have far superior properties and characteristics than vertebrates, so we investigated the fine structural features of intercalated discs and cardiac junctions of cardiac muscle cells in the black widow spider Latrodectus mactans. Characteristically, the spider cardiac muscle has typical striated features and represents a functional syncytium that supports multiple connections to adjacent cells by intercalated discs. Histologically, the boundary lamina of each sarcolemma connects to the basement membrane to form an elastic sheath, and the extracellular matrix allows the cells to be anchored to other tissues. Since the intercalated disc is also part of sarcolemma, it contains gap junctions for depolarization and desmosomes that keep the fibers together during cardiac muscle contraction. Furthermore, fascia adherens and macula adherens (desmosomes) were also identified as cell junctions in both sarcolemma and intercalated discs. To enable the coordinated heartbeat of the cardiac muscle, the muscle fibers have neuronal innervations by multiple axons from the motor ganglion.

• Applied Microscopy
• /
• 제50권
• /
• pp.9.1-9.8
• /
• 2020

The fine structural characteristics of cardiac muscle cells and its myofibril organization in the orb web spider N. clavata were examined by transmission electron microscopy. Although myofibril striations are not remarkable as those of skeletal muscles, muscle fibers contain multiple myofibrils, abundant mitochondria, extensive sarcoplasmic reticulum and transverse tubules (T-tubules). Myofibrils are divided into distinct sarcomeres defined by Z-lines with average length of 2.0 ㎛, but the distinction between the A-band and the I-bands is not clear due to uniform striations over the length of the sarcomeres. Dyadic junction which consisted of a single T-tubule paired with a terminal cisterna of the sarcoplasmic reticulum is found mainly at the A-I level of sarcomere. Each cell is arranged to form multiple connections with neighboring cells through the intercalated discs. These specialized junctions include three types of intercellular junctions: gap junctions, fascia adherens and desmosomes for heart function. Our transmission electron microscopy (TEM) observations clearly show that spider's cardiac muscle contraction is controlled by neurogenic rather than myogenic mechanism since each cardiac muscle fiber is innervated by a branch of motor neuron through neuromuscular junctions.

• Journal of Chest Surgery
• /
• 제28권12호
• /
• pp.1144-1149
• /
• 1995

Adenocarcinoma involving esophago-gastric junction[EGJ is usually originated from the gastric cardia and it presents unique clinical manifestations, requires special surgical care, and bears a much poor prognosis. We analyse the clinical data of 109 adenocarcinoma involving EGJ operated between August, 1987 and March, 1994. Curative resection of primary tumor including esophagus and lymph node dissection was possible on 102 cases[93.5% . Among these cases, 89 cases were advanced state over the stage III. The operative mortality was 1.8% and postoperative morbidity was 16.5%. The overall 3 year and 5 year survival rate was 48.5%, 34.1% each, and median survival was 27.5 month in the curative resected cases. The treatment failure was mainly distant metastsis including lymph node, except one local recurrence.Among many factors influencing long term results of resected adenocarcinoma involving EGJ, the only effort a surgeon can make is to attain completeness of tumor removal by dissecting all involved lymph node and ensuring adequate tumor free margins of both esophageal and cardiac side.

• Journal of Chest Surgery
• /
• 제25권12호
• /
• pp.1455-1460
• /
• 1992

Anomalous drainage of the right superior vena cava into the left atrium is a very rare congenital cardiac anomaly. Recently a patient with this venous anomaly was surgically corrected and forms the basis of this report. Patient findings were as follows: The patient has no other symptom but cyanosis which prompted cardiac evaluation Chest PA and electrocariogram were usual. Cross-sectional echocardiogram showed normally connected heart without intracardiac defect, Inferior vena cava drained normally into right atrium and coronary sinus was not dilated. Contrast, given into the right atrium, appeared in the left atrium This rare venous anomaly was confirmed by surgery. Surgical correction consisted of division of superior vena cava above the junction of left atrium and reanastomosis into right atrial appendage. Postoperative digital subtracion angiography confirmed the successful repair. She has doing well for 6months since operation. Systemic venous anomalies without intracardiac defect are very rare. However this anomalies should be considered in the differential diagnosis of cyanosis. The successfully corrected case is reported and literature is reviewed.

• Journal of Chest Surgery
• /
• 제41권5호
• /
• pp.633-635
• /
• 2008

둔상에 의한 심장 파열은 비교적 드문 경우이나 높은 사망률을 가진다. 41세 남자는 가드레일에 부딪히는 교통사고를 겪고 병원으로 이송되었다. 치명적인 심장 손상의 가장 흔한 증상은 활력 증후의 변화이나 상기 환자의 활력 증후는 정상이었다. 흉부 CT에서는 심막삼출액이 관찰되었고 심장초음파 검사에서는 저명한 심장눌림증 소견은 관찰되지 않았지만 우심방이 약간 눌려 있었다. 심장 손상이 의심되어 진단 및 치료를 위해 수술하였다. 좌심방과 좌측 아래폐정맥이 만나는 부위에 2cm 열상이 관찰되었고 프롤린 $#4{\sim}0$로 봉합하였다. 저자들은 둔상에 의해 생긴 좌심방 파열 환자를 성공적으로 치료하여 보고하는 바이다.

• The Korean Journal of Physiology and Pharmacology
• /
• 제23권3호
• /
• pp.203-217
• /
• 2019

The present study was designed to examine the effect of heme oxygenase-1 (HO-1) induction by cobalt protoporphyrin (CoPP) on the cardiac functions and morphology, electrocardiogram (ECG) changes, myocardial antioxidants (superoxide dismutase [SOD] and glutathione [GSH]), and expression of heat shock protein (Hsp) 70 and connexin 43 (Cx-43) in myocardial muscles in isoproterenol (ISO) induced myocardial infarction (MI). Thirty two adult male Sprague Dawely rats were divided into 4 groups (each 8 rats): normal control (NC) group, ISO group: received ISO at dose of 150 mg/kg body weight intraperitoneally (i.p.) for 2 successive days; ISO + Trizma group: received (ISO) and Trizma (solvent of CoPP) at dose of 5 mg/kg i.p. injection 2 days before injection of ISO, with ISO at day 0 and at day 2 after ISO injections; and ISO + CoPP group: received ISO and CoPP at a dose of 5 mg/kg dissolved in Trizma i.p. injection as Trizma. We found that, administration of ISO caused significant increase in heart rate, corrected QT interval, ST segment, cardiac enzymes (lactate dehydrogenase, creatine kinase-muscle/brain), cardiac HO-1, Hsp70 with significant attenuation in myocardial GSH, SOD, and Cx-43. On the other hand, administration of CoPP caused significant improvement in ECG parameters, cardiac enzymes, cardiac morphology; antioxidants induced by ISO with significant increase in HO-1, Cx-43, and Hsp70 expression in myocardium. In conclusions, we concluded that induction of HO-1 by CoPP ameliorates ISO-induced myocardial injury, which might be due to up-regulation of Hsp70 and gap junction protein (Cx-43).

• Journal of Yeungnam Medical Science
• /
• 제33권2호
• /
• pp.146-149
• /
• 2016

Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett's esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett's esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.

• Journal of Chest Surgery
• /
• 제29권2호
• /
• pp.136-146
• /
• 1996

Studies on normal human embryos and on malformed human hearts have been two main sources of the information on the developmental cardiology, Recent advances in the biological technology has opened a new era and descriptive embryology is being shifted into dynamic developmental biology. In this review, we discuss the current understanding on the cardiac embryology relevant to clinical practices of pediatric cardiology. Classical cardiac embryology starts with understanding on five segments of a straight heart tube : the sinus venosus, the primitive atria, the embryonic left ventricle, the embryonic right ventricle and the truncus arteriosus. Key steps in the normal morphogenetic process are the complex spiral septation of ventriculoarterial junction and two jumping connections : between the embryonic right atrium and embryonic right ventricle, and between the embryonic left ventricle and the aorta. Only after these two steps are successfully completed, the third fetal stage tak s place, when myocardial growth and remodeling take place There are two outstanding progresses on the cardiac embryology during recent five-year period. One is immunohistochemical mapping of the conduction system in the developing heart and the other is the understanding on the neural crest cell migration followed by molecular detection of the microdeletion of chromosome 22. A balanced progress of classical morphological studies, modern biological technics and advanced clinical medicine is an urgent task for doctors and scientists dealing with children with sick hearts.