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Mitral Valvuloplasty using New Mitral Strip (Mitracon^{(R)}$) (새로운 Strip (Mitracon^{(R)}$)을 이용한 승모판막 성형술)

  • Kang, Seong-Sik;Kim, Sang-Pil;Song, Meong-Gum
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.320-328
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    • 2008
  • Background: Numerous surgical devices for mitral repair have been used in the past with good results. In this study we describe a simple annuloplasty technique with using a new device ($Mitracon^{(R)}$). The aim of this study was to assess its efficacy and surgical results with using $Mitracon^{(R)}$. Material and Method: From May 2003 to October 2005, 46 patients (21 women and 25 men (mean age of $51.4{\pm}17.8$ years) with mitral regurgitation from various causes were treated with either the $Mitracon^{(R)}$ (the $Mitracon^{(R)}$ group) or the Capentier Edward rigid ring (the CE group). The median follow-up duration was 18.9 months. Result: The mean grade of mitral regurgitation before and immediately after surgery in the $Mitracon^{(R)}$ group and the CE group decreased from $3.2{\pm}0.8$ to $0.6{\pm}0.7$ and $3.4{\pm}0.7$ to $0.3{\pm}0.5$, respectively. There were no significant changes in the ejection fraction either between the two groups or before and immediately after surgery. No deaths were seen in either group. Early postoperative echocardiography of all 46 patients showed only trivial mitral regurgitation or none at all. Echocardiography at a median of 18.9 months also showed no progression in mitral regurgitation. The mean grade of mitral regurgitation in the $Mitracon^{(R)}$ group at this time point decreased from $3.2{\pm}0.8$ to $0.8{\pm}0.7$ (p<0.05). The CE group also showed a similar degree of decrease from $3.4{\pm}0.7$ to $0.3{\pm}0.6$ (p<0.05). The mitral valve area in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.3{\pm}0.9cm^2$. The mitral valve area in the CE group was $2.7{\pm}0.6cm^2$. The mean mitral pressure gradient in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.1{\pm}1.3$ mmHg. The mean pressure gradient in the CE group was $4.5{\pm}2.1$ mmHg, although any statistical significant difference for this between the groups was not reached. Conclusion: The present study showed the described technique to be safe and effective in the intermediate term. Because long term results are unavailable, a more extensive prospective randomized multicenter trial may be warranted to determine whether this procedure should be generally applied for repair of mitral valve disease.

Isotope Ratio of Mineral N in Pinus Densiflora Forest Soils in Rural and Industrial Areas: Potential Indicator of Atmospheric N Deposition and Soil N Loss (질소공급, 고추의 생육 및 수량에 대한 녹비작물 환원 효과)

  • Kwak, Jin-Hyeob;Lim, Sang-Sun;Park, Hyun-Jung;Lee, Sun-Il;Lee, Dong-Suk;Lee, Kye-Han;Han, Gwang-Hyun;Ro, Hee-Myong;Lee, Sang-Mo;Choi, Woo-Jung
    • Korean Journal of Soil Science and Fertilizer
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    • v.42 no.1
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    • pp.46-52
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    • 2009
  • Deposition of atmospheric N that is depleted in $^{15}N$ has shown to decrease N isotope ratio ($^{15}N/^{14}N$,expressed as ${\delta}^{15}N$) of forest samples such as tree rings, foliage, and total soil-N. However, its effect on ${\delta}^{15}N$ of mineral soil-N which is biologically active N pool has never been tested. In this study, ${\delta}^{15}N$ of mineral N($NH{_4}^+$ and $NO_3{^-}$) in forest soils from organic and two depths of mineral soil layers (0 to 20 cm and 20 to 40cm depth) of Pinus densiflora stands located at two distinct areas (rural and industrial areas) in southern Korea was analyzed to investigate if there is any difference in ${\delta}^{15}N$ of mineral N between these areas. We also evaluated potential N loss of the study sites using ${\delta}^{15}N$ of mineral N. Across the soil layers, the ${\delta}^{15}N$ of $NH{_4}^+$ ranged from +8.9 to +24.8‰ in the rural area and from +4.4 to +13.8‰ in the industrial area. Soils from organic layer (+4.4‰) and mineral layer between 0 and 20 cm (+13.8‰) of industrial area showed significantly lower ${\delta}^{15}N$ of $NH{_4}^+$ than those of rural area (+8.9 and +24.3‰, respectively), probably indicating the greater contribution of $^{15}N$-depleted $NH{_4}^+$ from atmospheric deposition to forest in the industrial area than in the rural area. Meanwhile, ${\delta}^{15}N$ of $NO_3{^-}$ was not different between the rural and industrial areas, probably because ${\delta}^{15}N$ of $NO_3{^-}$ is more likely to be altered by the N loss that causes $^{15}N$ enrichment of the remaining soil N pool. Compared with the ${\delta}^{15}N$ of soil mineral N reported by other studies (from -10.9 to +15.6‰ for $NH{_4}^+$ and -14.8 to +5.6‰ for $NO_3{^-}$), the ${\delta}^{15}N$ observed in our study was substantially high, suggesting that the study sites are more subject to the N loss. It was concluded that $NH{_4}^+$ rather than $NO_3{^-}$ can conserve the ${\delta}^{15}N$ signature of atmospheric N deposition in forest ecosystems.