• Journal of Chest Surgery
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• v.31 no.8
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• pp.739-748
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• 1998

Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

• Journal of radiological science and technology
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• v.28 no.2
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• pp.105-110
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• 2005

Background/Aim : Common bile duct (CBD) stones may cause jaundice, cholangitis, or pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) may be needed whenever endoscopic procedure are failed to extract common bile duct stones. The aim of this study is to provide the standard for patient's best choice on ESWL for treatment of CBD stones resistant to endoscopic extraction. Materials and Methods : Fourty-six patients failed in endoscopic stone extraction including mechanical lithotripsy were treated by ESWL. In all patients, endoscopic sphincterotomy and nasobiliary drainage tube was done before ESWL using the ultrasonography for stone localization with a spark-gap type lithotriptor. Patients were sedated with an intravenous injection of 50 mg of Demerol. None were treated under general anesthesia. Results : Overall complete clearance rate of CBD stone was 89.1% (41/46). In 82.6% of the patients, the stones were extracted endoscopically after ESWL, and spontaneous passage was observed in 6.5%. In the clearance rate after ESWL, there were no noticeable differences with regard to number (single: 82.8%, two or three: 100%, more than three: 100%) and size of the stone (less than 33mm: 92.9%, 33 mm or larger: 83.3%), whereas there were significant differences with regard to the ratio of sum of long-axis length of the all stones to sum of long-axis length of the CBD excluding stone (1:2.4, 1:2.1) and diameter of the largest stone to diameter of CBD excluding stone (1:0.9, 1:0.4) for patients with complete clearance compared with those without. Conclusion : We propose that stones without the fragments are travelable sufficient space in CBD or extractable sufficient diameter of CBD regardless of stone size and number should be treated by other technique to prevent time and cost consuming, such as percutaneous transhepatic cholangioscopylithotomy.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.42-48
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• 2007

Purpose: The purpose of this study is to image metastaic lung melanoma model with optimal pre-conditions for animal handling by using $[^{18}F]FDG$ small animal PET and clinical CT. Materials and Methods: The pre-conditions for lung region tumor imaging were 16-22 h fasting and warming temperature at $30^{\circ}C$. Small animal PET image was obtained at 60 min postinjection of 7.4 MBq $[^{18}F]FDG$ and compared pattern of $[^{18}F]FDG$ uptake and glucose standard uptake value (SUVG) of lung region between Ketamine/Xylazine (Ke/Xy) and Isoflurane (Iso) anesthetized group in normal mice. Metastasis tumor mouse model to lung was established by intravenous injection of B16-F10 cells in C57BL/6 mice. In lung metastasis tumor model, $[^{18}F]FDG$ image was obtained and fused with anatomical clinical CT image. Results: Average blood glucose concentration in normal mice were $128.0{\pm}23.87$ and $86.0{\pm}21.65\;mg/dL$ in Ke/Xy group and Iso group, respectively. Ke/Xy group showed 1.5 fold higher blood glucose concentration than Iso group. Lung to Background ratio (L/B) in SUVG image was $8.6{\pm}0.48$ and $12.1{\pm}0.63$ in Ke/Xy group and Iso group, respectively. In tumor detection in lung region, $[^{18}F]FDG$ image of Iso group was better than that of Ke/Xy group, because of high L/B ratio. Metastatic tumor location in $[^{18}F]FDG$ small animal PET image was confirmed by fusion image using clinical CT. Conclusion: Tumor imaging in small animal lung region with $[^{18}F]FDG$ small animal PET should be considered pre-conditions which fasting, warming and an anesthesia during $[^{18}F]FDG$ uptake. Fused imaging with small animal PET and CT image could be useful for the detection of metastatic tumor in lung region.