• 제목/요약/키워드: aorta morphology

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Morphology of the aortic arch branching pattern in raccoon dogs (Nyctereutes procyonoides, Gray, 1834)

  • Euiyong Lee;Young-Jin Jang;In-Shik Kim;Hyun-Jin Tae;Jeoungha Sim;Dongchoon Ahn
    • Journal of Veterinary Science
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    • 제25권2호
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    • pp.32.1-32.14
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    • 2024
  • Background: Aortic arch (AA) branching patterns vary among different mammalian species. Most previous studies have focused on dogs, whereas those on raccoon dogs remain unexplored. Objectives: The objective of this study was to describe the AA branching pattern in raccoon dogs and compare their morphological features with those of other carnivores. Methods: We prepared silicone cast specimens from a total of 36 raccoon dog carcasses via retrograde injection through the abdominal aorta. The brachiocephalic trunk (BCT) branching patterns were classified based on the relationship between the left and right common carotid arteries. The subclavian artery (SB) branching pattern was examined based on the order of the four major branches: the vertebral artery (VT), costocervical trunk (CCT), superficial cervical artery (SC), and internal thoracic artery (IT). Results: In most cases (88.6%), the BCT branched off from the left common carotid artery and terminated in the right common carotid and right subclavian arteries. In the remaining cases (11.4%), the BCT formed a bicarotid trunk. The SB exhibited various branching patterns, with 26 observed types. Based on the branching order of the four major branches, we identified the main branching pattern, in which the VT branched first (98.6%), the CCT branched second (81.9%), the SC branched third (62.5%), and the IT branched fourth (52.8%). Conclusions: The AA branching pattern in raccoon dogs exhibited various branching patterns with both similarities and differences compared to other carnivores.

Importance of pulmonary valve morphology for pulmonary valve preservation in tetralogy of Fallot surgery: comparison of the echocardiographic parameters

  • Choi, Su Jin;Kwon, Jung Eun;Roh, Da Eun;Hyun, Myung Chul;Jung, Han Na;Lee, Young Ok;Cho, Joon Yong;Kim, Yeo Hyang
    • Clinical and Experimental Pediatrics
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    • 제63권5호
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    • pp.189-194
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    • 2020
  • Background: The decision to use transannular patching (TAP) during tetralogy of Fallot (TOF) repair depends on the pulmonary valve annulus size; the z score of the pulmonary annulus is the most commonly used predictor. However, definitive results are not obtained with z scores as different z score data sets are used for different parameters. Purpose: This study aimed to identify the echocardiographic and other key factors that warranted a change in the surgical method during TOF surgery. Methods: Sixty-two patients were enrolled and divided into a pulmonary valve (PV) preservation group and a TAP group. Their medical records were reviewed. Results: The z score for PV annulus (PVA), ratio of the PVA to aortic annulus size, and ratio of PVA to descending aorta (DAO) size were significantly different between the PV preservation and TAP groups (-1.72±1.52 vs. -3.07±1.94, P=0.004; 0.62±0.12 vs. 0.50±0.14, P=0.002; and 1.32±0.32 vs. 1.07±0.36, P=0.008, respectively). For TAP repair, the PVA z score had a sensitivity of 65.4% and specificity of 73.1%, ratio of PVA to aortic annulus size had a sensitivity of 73.1% and specificity of 65.4%, and ratio of PVA to DAO size had a sensitivity of 69.2% and specificity of 57.7%. The TAP group showed more monocuspid PVs (P=0.011), while the PV preservation group showed more tricuspid PVs (P=0.027). Commissurotomy was more frequently performed in the PV preservation group than in the TAP group (P=0.001). Of patients with commissurotomy, 58% showed a PV z score<-2. Conclusion: Although various echocardiographic parameters may serve as predictors for determining surgical methods for TOF patients, the PV morphology and tissue characteristics should also be considered.

Juxtaductal stenosis가 동반된 PA/VSD환자에서 체폐단락술 부위에 따른 폐동맥 크기의 변화 (Pulmonary Arterial Growth Pattern after Shunt Operation in Patients of Pulmonary Atresia with Ventricular Septal Defect Associated with Juxtaductal Stenosis)

  • 이교준;박영환;최재영;조범구
    • Journal of Chest Surgery
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    • 제31권9호
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    • pp.861-866
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    • 1998
  • 심실중격결손이 동반된 폐동맥폐쇄(PA/VSD)는 폐동맥의 형태 및 공급원이 매우 다양하고, 폐동맥의 발육부전 과 협착 및 폐동맥지 연결이상 유무가 교정수술시의 문제점으로 대두되고 있으므로, 저자들은 동맥관인접협 착(juxtaductal stenosis)이 동반되어 있는 환자들을 대상으로 체폐단락술전후 폐동맥 크기의 변화를 비교하 여, 수술방법 및 시기를 결정하는데 도움이 되고자 본 연구를 하였다. 1991년 7월부터 1996년 7월까지 연세대 학교 심장혈관센터에서 심실중격결손이 있는 폐동맥폐쇄환자중 동맥관인접협착이 동반되어 체폐단락술을 시행 한 59례가 있었으며, 수술전후의 심도자술 및 심혈관조영술을 시행한 29례를 대상으로 하였다. 우측(10례, Group I) 및 좌측단락술(19례, Group II)에서 단락술전후의 하행대동맥, 양측폐동맥 및 동맥관인접협착 부위의 직경을 측정하여, 수술부위에 따른 수술전후 변화를 비교하였다. 두 군에서, 하행대동맥직경에 대한 동측 폐동 맥직경의 비(ratio)가 수술전 0.78$\pm$0.31에서 수술후 1.01$\pm$0.26로, 또한 수술전 0.67$\pm$0.18에서 수술후 0.84$\pm$ 0.27로 각각 유의하게 증가하였으며, 편측 폐동맥직경의 비는 수술전 0.92$\pm$0.28에서 수술후 1.05$\pm$0.15로, 또한 수술전 0.94$\pm$0.27에서 수술후 1.08$\pm$0.37로 각각 증가하였으나 통계학적으로 유의하지는 않았다. 동맥관 인접협착 부위의 변화는 수술전 0.43$\pm$0.27에서 수술후 0.39$\pm$0.25로, 또한 수술전 0.32$\pm$0.10에서 수술후 0.30$\pm$0.16로 감소하는 경향을 보였으나 통계학적으로 유의하지 않았으며, 2례의 경우에서는 수술후 단절된 소견을 보였다. 체폐단락술을 통한 폐동맥혈류의 확보는 폐혈관 성장에 좋은 효과가 있으므로 폐혈류 감소 및 폐동맥 발육부전환자에서 추천되는 치료법이나 심실중격결손을 동반한 폐동맥폐쇄의 경우에는 동맥관인접협착의 변화가 중요한 것으로 생각된다. 본 연구 결과에서는 체폐단락술을 시행한 동측의 폐동맥이 성장함을 확인할 수 있었고, 동맥관인접협착은 악화될 가능성이 있는 것으로 생각되었다. 또한, 좌측 체폐단락술을 시행하여, 2례의 좌측 폐동맥의 단절을 경험하였다. 그러므로, 체폐단락술을 시행한 경우에는, 보다 철저한 술후 추적 및 검사가 요구되며, 동맥관인접협착이 동반된 측의 폐동맥에 단락술을 시행한 경우에는 조기에 완전 교정술을 고려하여야 할 것으로 사료된다.

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흰쥐 절치치수의 Odontoblast에 관한 Freeze-Fracture 연구 (A Freeze-fracture Study on the Odontoblast of Dental Pulp in the Rat Incisor)

  • 김명국
    • Applied Microscopy
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    • 제16권2호
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    • pp.1-13
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    • 1986
  • The purpose of this study was to investigate the morphology and intercellular junctions of the odontoblast of dental pulp in the rat incisor by means of the freeze fracture electron microscopy. Twenty male Sprague-Dawley rats weighing $150{\sim}200g$ were used. After being anesthetized by an intraperitoneal injection of 0.5 ml sodium pentobarbital per kg in body weight(60 mg/ml) the animals were perfused with 2.5% glutaraldehyde-2% paraformaldehyde fixative in 0.1 M cacodylate buffer, pH 7.2 through the ascending aorta for one hour. The incisors were carefully extracted from the jaws and demineralized by suspending them in 0.1 M EDTA in 3% glutaraldehyde (pH 7.2) for two weeks. After demineralization, the specimens were obtained from the portion divided into five equal parts. For freeze-fracture replication, demineralized tissues were infiltrated for several hours with 10%, 25% glycerol in 0.1M cacodylate buffer as a cryoprotectant and then frozen in liquid Freon 22 and stored in liquid nitrogen. Fracturing and replication were done in Balzers BAF 400D high-vacuum freeze-fracture apparatus at $-120^{\circ}C$ under routine $5X10^{-7}$ Torr vacuum. The tissue was immediately replicated with platinum unidirectionally at $45^{\circ}$ angle and reinforced with carbon at $90^{\circ}$ angle unidirectionally or by using a rotary stage. The replication process was monitored by a quartz-crystal device. The replicas were immersed in 100% methanol overnight. The tissue was then digested from the replica by clorox (laundry bleach), placed into 5% EDTA, and washed repeatedly with distilled water. The replicas were picked up on 0.3% formvar-coated 75 mesh grids and examined in the JEOL 100B electron microscope. The results were as follows; 1. Both in thin sections and freeze-fracture replicas, three types of intercellular junctions were recognizable in the plasma membrane of odontoblast: gap junction, tight junction and desmosome-like junction. 2. The nuclear pores were evenly distributed over the nuclear envelope. The pore complex formed a ring about 70 nm in diameter. 3. Gap junctions were found between odontoblasts as well as odontoblasts and neighbouring pulp cells (fibroblast, subodontoblastic cell process, nerve-like fibre). Gap junctions, which were round, ellipsoid and pear-shaped and 600 nm in diameter, were observed in the odontoblast. 4. Numerous round and ellipsoid gap junctions could be frequently seen on the plasma membranes in cell body and apical part of the odontoblasts. On the P face, the junctions were recognized as a cluster of closely packed particles, measuring about 9 nm in diameter, and on the E face, the junctions were recognized as a shallow grooves.

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고과당식이 투여 랫드모델에서 홍삼과 상엽 복합투여에 대한 혈관염증 및 지방간염 억제 효과 (Inhibitory Effect of Combination with Korean Red Gnseng and Morus Alba in High Fructose-induced Vascular Inflammation and Steatohepatitis)

  • 이윤정;윤정주;이소민;고민철;김혜윰;안유미;고정현;이기병;이호섭;최경민;권태오;강대길
    • 동의생리병리학회지
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    • 제26권5호
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    • pp.724-731
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    • 2012
  • This study was designed to elucidate whether combination with Korean red ginseng and Morus alba L. (MPM), traditional treatment for diabetes, ameliorates on high fructose-induced steatohepatitis and vascular inflammation. Animals were divided into four groups; Control receiving tap water, fructose-fed, rosiglitazone-treated fructose-fed rats, and MPM-treated fructose-fed rats both receiving supplemented with 60% fructose (n=10). The MPM or rosiglitazone groups initially received a high-fructose diet alone for 8 weeks, with supplementation with MPM or rosiglitazone, peroxisome proliferators-activated receptor gamma ($PPAR{\gamma}$) agonist, occurring during the final 6 weeks. Treatment with MPM significantly prevented the increase in c-reactive protein (CRP) levels in the high fructose group. MPM suppressed high fructose diet-induced vascular inflammation marker expression such as intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin. MPM also reduced intima/media thickness of thoracic aorta. Histologic observation and oil red O staining demonstrated hepatic tissue damage and lipid accumulation were severe in high fructose group. Treatment with MPM ameliorated hepatic tissue morphology with minimized steatosis. In addition, MPM attenuated hepatitis by inhibition of monocyte chemoattractant protein-1 (MCP-1) expression. MPM-fed group showed lower serum GOT and GPT levels comparing with high fructose group. MPM and rosiglitazone (positive control) significantly decreased the size of epididymal adipocytes. Taken together, the administration of MPM inhibited high fructose-induced steatohepatitis and vascular inflammation. These results suggested that MPM is useful in the prevention or treatment of metabolic syndrome-related disorders such as fatty acid metabolism and vascular homeostasis.

A Three-Dimensional Deep Convolutional Neural Network for Automatic Segmentation and Diameter Measurement of Type B Aortic Dissection

  • Yitong Yu;Yang Gao;Jianyong Wei;Fangzhou Liao;Qianjiang Xiao;Jie Zhang;Weihua Yin;Bin Lu
    • Korean Journal of Radiology
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    • 제22권2호
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    • pp.168-178
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    • 2021
  • Objective: To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). Materials and Methods: Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. Results: The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). Conclusion: The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.

경피적 동맥관 폐쇄술에서 최근의 기구들의 전략적 이용과 결과 (A new strategy for transcatheter closure of patent ductus arteriosus with recent-generation devices)

  • 김상이;이수현;김남균;최재영;설준희
    • Clinical and Experimental Pediatrics
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    • 제52권4호
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    • pp.488-493
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    • 2009
  • 목 적 : 경피적 동맥관 폐쇄술은 동맥관 개존증의 표준 치료로 시행되고 있다. 저자들은 동맥관의 최소 직경(MD)과 체혈류와 폐혈류의 비(Qp/Qs ratio)를 기준으로 하여 선택한 각각의 기구들로 경피적 동맥관 폐쇄술 시행한 후 추적 관찰 결과를 비교, 분석하여 새로운 기구 선택 기준의 효용성과 안전성을 알아보았다. 방 법 : 2003년 2월부터 2006년 1월까지 본원에서 동맥관 개존증을 진단받고 동맥관의 크기 및 Qp/Qs 비에 따라 CDC, PNO, ADO를 선택하여 경피적 동맥관 폐쇄술을 시행받은 138명의 환자를 대상으로 하였다. 그리고 2000년 2월부터 2003년 1월까지 본원에서 DO, PNO로 경피적 동맥관 폐쇄술을 시행받은 89명의 환자들을 대조군으로 설정하였다. 시술 전 환자의 임상적, 혈역학적 지표들을 확인하였고 시술 후 1일, 1개월, 6개월, 12개월, 그리고 12개월 이후 잔류 단락 유무 및 합병증을 평가, 비교하였다. 결 과 : 대상군 138명 모두에서 시술에 성공하였고 기구 색전도 없었으며 시술 후 12개월 이후 잔류 단락이 남아있지 않았다. 주요 합병증의 빈도는 대상군 138명 중 0명(0%), 대조군 89명 중 7명(7.9%)이었고(P<0.05) 전체 합병증의 빈도도 대상군 138명 중 2명(1.4%), 대조군 89명 중 8명(9.0%)으로(P=0.001) 대상군에서 대조군에 비하여 의미 있게 합병증의 빈도가 낮았다. 결 론 : 과거에 경피적 폐쇄가 어려웠던 큰 크기의 동맥관 개존에 ADO를 사용하게 되고 이전 기구들의 단점들이 개선된 최근 기구들을 각각의 특성에 적합하게 전략적으로 선택하여 시술함으로써 경피적 동맥관 폐쇄술의 결과가 향상되었고 더욱 안전하고 완전한 효과를 나타내게 되었다.

발살바동 동맥류의 외과적 치료 (Surgical Treatment of Aneurysm of the Sinus of Valsalva Eight Year Experience)

  • 오상준;유완준
    • Journal of Chest Surgery
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    • 제29권9호
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    • pp.983-988
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    • 1996
  • 발살바동 동맥류는 매우 드문 질환으로 1987년부터 1994년까지 인제대학교 의과대학 서울백병원 흉부외과학교실에서는 총 12례를 경험하였으며 이는 이 기간중의 심폐체외순환을 이용한 심장수술중 0.7%였다. 남자가 8례, 여자가 4례였고, 연령분포는 8세에서 38세까지로 평균 19.2세 였다. 파열이 있었던 경우는 8례였다. 발살바동 동맥류의 기원은 우측 발살바동에서 10례(83.3%), noncoronary 발살바동에서 2례 (16.6%)였다. 파열된 경우에는 우측 발살바동에서 6례, noncoronary발살바동에서 2례였으며, 우측 발살바동에서 기원한 6례중 5례가 우심실로, 1례가 우심방 및 우심실로 파열됐고, noncoronary 발살바동에서 기원한 2례중 1례가 우심방으로, 1례가 우심실로 파열됐었다. 동반된 심질환은 심실중격결손이 10례(83.3%)였고 이중 9례는 우측 발살바동에서 동반되었으며, 대동맥 판폐쇄부전이 동반된 예는 3례로서 모두 심실중격결손도 같이 동반하고 있었다. 그외 승모판폐쇄부전이 1례, 우심실양분증이 1례였다. 조기사망은 없었고, 만기사망은 술후 15개월에서 1례있었는데 심내막염으로 인하여 사망하였다. 술후 평균 29개월(4~60개월)간의 추적기간 \ulcorner만기사망 1례를 제외한 11례에서 WYHA기능적 분류로 classs I의 상태이다. 수술의 위험도나 사망률이 낮으므로 합병증의 위험이 있으면 파열이 없더라도 수술하여야 하며, 파열이 있는 경우는 진단이 되면 바로 수술을 해야할 것으로 사료된다. 대부분의 경우 대동맥판막 및 동맥류의 정확한 판단 및 교정을 위해 대동맥절개가 필요하다. 한편 동반된 심질환도 동시에 교정해주며 특히 대동맥판막에 대해서는 철저히 교정 해주어야 한다고 생각한다.

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