• Title/Summary/Keyword: SA node

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A literature study on the diagnostic value of the cervical lymph node in the application of large intestine tonification of Sa-Am acupuncture (대장정격(大腸正格)의 활용에 있어 경두부(頸項部) 결핵(結核)의 진단의의(診斷意義)에 관한 문헌고찰(文獻考察))

  • Kim, Kwang-Sung;Yim, Yun-Kyoung
    • Korean Journal of Acupuncture
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    • v.23 no.3
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    • pp.29-35
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    • 2006
  • Objectives & Methods : This study aimed to investigate the diagnostic value of the cervical lymph node in the application of large intestine tonification of Sa-Am acupuncture. Results & Conclusions : Cervical lymph node appeared in 76% of the cases for which large intestine tonifying Sa-am acupuncture was used in ${\ulcorner}$Sa-Am-Do-In-Chim-Gu-Yo-Kyul(舍岩道人鍼灸要訣)${\urcorner}$. We suggest that cervical lymph node can be used as an important diagnostic point for the application of large intestine tonification of Sa-Am acupuncture.

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The Gradient Model of the Rabbit Sinoatrial Node

  • Dobrzynski, H.;Lei, M.;Jones, S.A.;Lancaster, M.K.;Boyett, M.R.
    • The Korean Journal of Physiology and Pharmacology
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    • v.6 no.4
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    • pp.173-181
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    • 2002
  • The sinoatrial (SA) node is a complex and inhomogeneous tissue in terms of cell morphology and electrical activity. There are two models of the cellular organisation of the sinoatrial node: the gradient and mosaic models. According to the gradient model there is a gradual transition in morphology and electrical properties of SA node cells from the centre to the periphery of the SA node. In the mosaic model, there is a variable mix of atrial and sinoatrial node cells from the centre to the periphery. This review focuses on the cellular organisation of the rabbit sinoatrial node in terms of the expression of connexin (Cx40, Cx43 and Cx45), L-type $Ca^{2+}$ channel and $Na^+-Ca^{2+}$ exchanger proteins. These immunocytochemical data, together with morphological and electrophysiological data, obtained from the intact sinoatrial node and isolated sinoatrial node cells support the gradient model of the cellular organisation of the SA node. The complex organisation of the sinoatrial node is important for the normal functioning of the sinoatrial node: (i) it allows the sinoatrial node to drive the surrounding hyperpolarized atrial muscle without being suppressed by it; (ii) it helps the pacemaker activity of the sinoatrial node continue under a wide range of physiological and pathophysiological conditions; (iii) it helps protect the sinoatrial node from reentrant arrhythmias.

Inhibitory action of adenosine on sinus rate in isolated rabbit SA node (토끼 동방결절 박동수에 대한 아데노신의 작용)

  • Chae, Hurn;Suh, Kyung-Phlill;Kim, Ki-Whan
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.199-212
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    • 1983
  • The inhibition/influences of adenine compounds on the heart have been described repeatedly by many investigators, since the first report by Druny and Szent-Gyorgyi [1929]. These studies have shown that adenosine and adenine nucleotides have an over-all effect similar to that of acetylcholine [ACh] by slowing and weakening the heartbeat. The basic cellular and membrane events underlying the inhibitory action of adenosine on sinus rate, however, are not well understood. Furthermore, the physiological role of adenosine in regulation of the heartbeat remains still to be elucidated. Therefore, this study was undertaken in order to examine the response of rabbit SA node to adenosine and to compare the response to that of ACh. Isolated SA node preparation, whole atrial pair, or left atrlal strip was used in each experiment. Action potentials of SA node were recorded through the intracellular glass microelectrodes, which were filled with 3M KCI and had resistance of 30-50 M. All experiments were performed in a bicarbonate-buffered Tyrode solution which was aerated with 3% $CO_2-97%$ $O_2$ gas mixture and kept at $35^{\circ}C$. Spontaneous firing rate of SA node at 35C [Mean + SEM, n=16] was 154 + 3.3 beats/min. The parameters of action potentials were: maximum astolic potential [MDP], -731.7mV: overshoot [OS], 9 + 1.4mV; slope of pacemaker potential [SPP], 94 3.0mV/sec.Adenosine suppressed the firing rate of SA node in a dose dependent manner. This inhibitory effect appeared at the concentration of $10^{-6}M$ and was potentiated in parallel with the increase in adenosine concentration. Changes in action potential by adenosine were dose-dependent increase of MDP and decrease of SPP until $10^{-4}$. Above this concentration, however, the amplitude of action potential decreased markedly due to the simultaneous decrease of both MDP and OS. All these effects of adenosine were not affected by pretreatment of atropine [2mg/l] and propranolol [$5{\times}10^{-6}M$]. ACh [$10^{-6}M$] responses on action potential were similar to those of adenosine by increasing MDP and decreasing SPP. These effects of ACh disappeared by pretreatment of atropine [2mg/1]. Inhibition/effects of adenosine and ACh on sinus rate were enhanced synergistically with the simultaneous administration of adenosine and ACh. Marked decrease of overshoot potential was the most prominent feature on action potential. Dipyridamole [DPM], which is known to block the adenosine transport across cell membrane, definitely potentiated the action of adenosine . Adenosine suppressed the sinus rate and atrial contractility in the same dosage range, even in the reserpinized preparation. Above` results suggest that adenosine suppresses pacemaker activity, like ACh, by acting directly on the membrane of SA node, increasing MDP and decreasing SPP.

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Gender-Related Differences in a Process of the Age-Dependent Alterations of the Elements in Monkey Sino-Atrial Node

  • Satoh, Hiroyasu;Tohno, Setsuko;Minami, Takeshi;Oishi, Takao;Hayashi, Motoharu;Tohno, Yoshiyuki
    • The Korean Journal of Physiology and Pharmacology
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    • v.14 no.5
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    • pp.249-256
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    • 2010
  • Gender differences in the trace elements of monkey sino-atrial (SA) node were investigated in a process of age-dependent alterations. Sixty hearts from Japanese and rhesus monkeys (30 male and 30 female) used were aged ranging from 1-day- to 30-year-old. The elements were analyzed using an inductively coupled plasma-atomic emission spectrometer (ICP-AES). Advancing age decreased all the trace elements. Ca, P, S and Mg significantly decreased. The correlation coefficients of Ca and P were $-0.178{\pm}0.081$ (p<0.05) and $-0.088{\pm}0.022$ (p<0.05) in male (n=30), and $-0.095{\pm}0.026$ (p<0.05) and $-0.069{\pm}0.017$ (p<0.05) in female (n=30), respectively. The age-dependent coefficients for Fe/Ca, Zn/Ca, Fe/P, Fe/S, Zn/S, Fe/Mg and Zn/Mg were exhibited markedly in male, but all was less in female. In gender-related differences, only a ratio of P/Ca (p<0.05) was significantly observed with ageing. The trace elements such as Cu, Se and Sn were less detected in the SA nodes. These results indicate that the age-dependent changes in the ratios of elements are appeared more rapidly in male monkey SA node, and the gender difference is observed in ratio of P/Ca. The different attenuations may be involved with the age- and gender-related SA nodal functions.

Is Lymph Node Size a Reliable Factor for Estimating Lymph Node Metastasis in Early Gastric Cancer?

  • Kim, Dong Jin;Kim, Wook
    • Journal of Gastric Cancer
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    • v.18 no.1
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    • pp.20-29
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    • 2018
  • Purpose: Pre-operative lymph node (LN) size is a valuable parameter for determining treatment strategy for gastric cancer. However, a correlation between LN size and metastasis has not been established. Materials and Methods: Thirty-six LN-positive (LNP) and matched 36 LN-negative (LNN) patients were included, and pathology slides of the LNs of these patients were reviewed. All the LNs were measured along the long-axis (LA) and short-axis (SA), manually. Results: Average retrieved LNs were $37.3{\pm}19.8$ and $40.5{\pm}11.6$ in the LNN and LNP groups, respectively. In total 2,800 LNs, including 136 metastatic LNs (MLNs) and 2,664 non-metastatic LNs (nMLNs), were evaluated. Mean length was significantly more in MLNs along both, the LA and SA (MLN_LA vs. nMLN_LA: $4.97{\pm}3.84$ vs. $3.37{\pm}2.40mm$, MLN_SA vs. nMLN_SA: $3.86{\pm}3.19$ vs. $2.43{\pm}1.59mm$; P<0.001). However, 92.6% (126/136) and 95.6% (130/136) of MLNs were <10 mm along the LA and SA, respectively. In addition, only 22.2% of the LNP group exhibited an MLN as the largest LN. Conclusions: Pre-operative multi-detector computed tomography has limited ability in estimating the presence of metastasis in LNs because most MLNs are less than 10 mm, and only a small proportion of the LNP group exhibits an MLN as the largest MLN.

Effects of Adenosine on the Action Potentials of Rabbit SA Nodal Cells (동방결절 활동전압에 대한 아데노신 효과)

  • Kim, Ki-Whan;Ho, Won-Kyung
    • The Korean Journal of Physiology
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    • v.18 no.1
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    • pp.19-35
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    • 1984
  • Since the first report of Drury and $Szent-Gy{\ddot{o}}rgyi$ in 1929, the inhibitory influences of adenosine on the heart have repeatedly been described by many investigators. These studies have shown that adenosine and adenine nucleotides have overall depressant effects, similar to those of acetylcholine. Heart beats become slow and weak. It is also well known that adenosine is a potent endogenous coronary vasodilator. Many investigations on the working mechanisms of adenosine have been focused mainly on the effects of the coronary blood flow. However, the cellular mechanisms underlying the inhibitory action of adenosine on sinus node are not well understood yet. Thus, this study was undertaken to examine the behavior of rabbit SA node under influence of adenosine. In these series of experiments three kinds of preparations were used: whole atrial pair, left atrial strip, and isolated SA node preparations. The electrical activity of SA node was recorded with conventional glass microelectrodes 30 to 50 $M{\Omega}$. The preparations were superfused with bicarbonate-buffered Tyrode solution of pH 7.35 and aerated with a gas mixture of $3%\;CO_2-97%\;O_2$ at $35^{\circ}C$. In whole atrial pair, adenosine suppressed sinoatrial rhythm in a dose-dependent manner. Effect of adenosine on atrial rate appeared at the concentration of $10^{-5}M$ and was enhanced in parallel with the increase in adenosine concentration. Inhibitory action of adenosine on pacemaker activity was more prominent in the preparation pretreated with norepinephrine, which can steepen the slope of pacemaker potential by increasing permeability of $Ca^{+2}$. Calcium ions in perfusate slowly produced a marked change in sinoatrial rhythm. Elevation of the calcium concentration from 0.3 to 8 mM increased the atrial rate from 132 to 174 beats/min, but over 10 mM $Ca^{+2}$ decreased. The inhibitory effect of adenosine on sinoatrial rhythm developed very rapidly. Atrial rate was recovered promptly from the adenosine-induced suppression by the addition of norepinephrine, but extra $Ca^{+2}$ was less suitable to restore the suppression of atrial rate. Adenosine suppressed also atrial contractility in the same dosage range that restricted pacemaker activity, even in the reserpinized preparation. In isolated SA node preparation, spontaneous firing rate of SA node at $35^{\circ}C$(mean{\pm}SEM, n=16) was $154{\pm}3.3\;beats/min. The parameters of action potentials were: maximum diastolic potential(MDP), $-73{\pm}1.7\;mV: overshoot(OS), $9{\pm}1.4\;mV: slope of pacemaker potential(SPP), $94{\pm}3.0\;mV/sec. Adenosine suppressed the firing rate of SA node in a dose-dependent manner. This inhibitory effect appeared at the concentration of $10^{-6}M$ and was in parallel with the increase in adenosine concentration. Changes in action potential by adenosine were dose-dependent increase of MDP and decrease of SPP until $10^{-4}M$. Above this concentration, however, the amplitude of action potential decreased markedly due to the simultaneous decrease of both MDP and OS. All these effects of adenosine were not affected by pretreatment of atropine and propranolol. Lowering extra $Ca^{2+}$ irom 2 mM to 0.3 mM resulted in a marked decrease of OS and SPP, but almost no change of MDP. However, increase of perfusate $Ca^{2+}$ from 2 mM to 6 or 8 mM produced a prominent decrease of MDP and a slight increase of OS and SPP. Dipyridamole(DPM), which is known to block the adenosine transport across the cell membrane, definately potentiated the action of adenosine. The results of this experiment suggest that adenosine suppressed pacemaker activity and atrial contractility simultaneously and directly, by decreasing $Ca^{2+}-permeability$ of nodal and atrial cell membranes.

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Primary Rhabdomyosarcoma of the Right Atrium -A Case Report- (원발성 우심방 횡문 근육종 -1례 보고-)

  • 안정태
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.412-415
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    • 1995
  • Primary cardiac tumors are extremely rare and about 20-25% of primary cardiac tumors are malignant. Recently we have experienced a case of primary cardiac rhabdomyosarcoma originated on the right atrial wall. Patient was 41 years-old women and chief complaints were pitting edema and exertional dyspnea. Emergency operation was performed to relieve symptoms by pericardial effusion that hac been seen on the echocardiogram and large soft mass in right atrial cavity on the MRI. About 700ml amounts of bloody pericardial effusion was collected into the pericardial cavity. 4X5X5 cm sized ingrowing soft mass in the right atrial cavity and two small sized outgrowing masses were inspected. A tumor was invaded into the SA node and superior limbic portion of fossa ovalis. And then mass & right atrial free wall was resected but areas of SA node and fossa ovalis were not resected. Defect of right atrial wall was reconstruced with bovine patch. She was discharged after 2 weeks without any problems and she has been treated with chemotherapy.

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Temperature-dependency of $Ca^{2+}$ Effect on the Electrical Activity of Rabbit SA Node (동방결절 전기적 특성에 대한 $Ca^{2+}$ 효과의 온도에 따른 변화)

  • Ho, Won-Kyung;Kim, Ki-Whan;Hwang, Sang-Ik
    • The Korean Journal of Physiology
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    • v.21 no.1
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    • pp.1-12
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    • 1987
  • There is evidence that the effect of extracellular $Ca^{2+}$ on heart rate is temperature-dependent: at $38^{\circ}C$ excess $Ca^{2+}$ induces positive chronotropic response, whereas at $30^{\circ}C$ there is no significant chronotropic effect of $Ca^{2+}$. The cause of this temperature-dependency, however, remains still unclear. Therefore, this study was undertaken to investigate the chronotropic effect of external $Ca^{2+}$ at different temperature in the isolated rabbit atria and in the small strips of SA node cut perpendicularly to crista terminalis. In the isolated atria, the $Ca^{2+}$ effect was temperature-dependent: at $35^{\circ}C$ excess $Ca^{2+}$ evoked positive chronotropic response, while at $30^{\circ}C$ there was no significant changes in sinus rate. On the contrary, in the small SA strips external $Ca^{2+}$ induced negative chronotropic effect. At $35^{\circ}C$ changes in $Ca^{2+}$ concentration from 2 to 4, 6, and 10 mM decreased the sinus rate by $2.7{\pm}1.6%$, $11.2{\pm}3.7%$ and $23.2{\pm}8.1%$ respectively. Lowering the temperature to $30^{\circ}C$, the negative chronotropic effect of $Ca^{2+}$ became greater. With intracellular microelectrodes transmembrane potential was recorded in the small SA strips at $30^{\circ}C$, $35^{\circ}C$ and $38^{\circ}C$. As temperature increased from 30 to $38^{\circ}C$, sinus rate was accelerated by $13/min/^{\circ}C$, $APD_{50}$(action ptential duration from peak to 50% repolarization) decreased by $5\;msec/^{\circ}C$, and amplitude of action potential was slightly decreased. With an increase in $Ca^{2+}$ concentrations from 0.5 to 6 mM, overshoot increased and MDP decreased. These $Ca^{2+}$ effects on the overshoot and MDP of action potentials were not altered by temperature. But the $Ca^{2+}$ effects on the rates of diastolic depolarization, systolic depolarization and repolarization were modified by temperature. Discrpancy of the chronotropic effects of $Ca^{2+}$ between isolated atria and small SA strips was discussed.

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Local Difference of Na-Pump Activity in the Rabbit Sinoatrial Node (토끼 동방결절 부위에 따른 Na-Pump활동도의 차이에 관한 연구)

  • Seo, Jong-Jin;Moon, Hyung-Ro;Earm, Yung-E
    • The Korean Journal of Physiology
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    • v.19 no.2
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    • pp.113-125
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    • 1985
  • Electrophysiological difference of the central and peripheral area of the sinoatrial node in the rabbit was studied by glass microelectrode technique. Effects of $K^+,\;Na^+,\;Cs^+,$ adrenaline and ouabain on the action potential of the two areas were investigated, and transient hyperpolarization ($K^+-induced$ hyperpolarization) which developed following readmission of potassium after having pre-treated with $K^+-free$ Tyrode solution for 10 minutes was analyzed. The results obtained were as follows ; 1) The frequency of the spontaneous action potential recorded in the periphery of the SA node was faster than the central area. Reduction by $Cs^+$ and increase by O mM $K^+$, $10^{-6}M$ adrenaline and $10^{-6}M$ ouabain in the frequency of action potential were noticed more prominently in the peripheral than the central area. On the contrary, the frequency in the central area was more decreased than the Peripheral area by 13 mH $K^+$ and 1 mM $Co^{2+}$. 2) The amplitude of the K+_induced hyperpolarization was very small in the central area but large in the peripheral area. Transient hyperpolarization was abolished by ouabain and low sodium, and decreased by cooling the tissue $(17^{\circ}C)$. 3) By changing the concentration of $Ca^{2+}$ in the perfusate, the amplitude and the rate of transient hyperpolarization were increased in the high $Ca^{2+}$ concentration. It could be concluded that the central area of the SA node is less susceptible to the inhibition of Na-Pump and more susceptible to Ca-blocker and high concentration of $K^+$. The Na-Pump activity of the central area measured by means of transient hyperpolarization is found to be much less active than that of the peripheral area.

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