The effects of intracellular and extracellular pH on the inwardly rectifying K+ (IRK) channel of the bovine aortic endothelial cells (BAECs) were examined using whole-cell patch-clamp technique. The IRK current, efficiently blocked by Ba2+ (200microM), is the most prominent membrane current in BAECs, which mainly determines the resting membrane potential. The expression of Kir2.1 was observed in BAECs using reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. Intracellular alkalinization, elicited by the extracellular substitution of NaCl with NH4Cl (30 mM), significantly augmented the amplitude of IRK current. On the contrary, the amplitude of IRK current was attenuated by the Na-acetate (30 mM)-induced intracellular acidification. The changes in extracellular pH also closely modulated the amplitude of IRK current, which was decreased to 40.2+/-1.3% of control upon switching the extracellular pH to 4.0 from 7.4. The extracellular pH value for half-maximal inhibition (pK) of IRK current was 5.11. These results demonstrate that the activity of IRK channel in BAECs, probably Kir2.1, was suppressed by proton at both sides of plasma membrane.
Cell Membrane ; Endothelial Cells* ; Hydrogen-Ion Concentration* ; Membrane Potentials ; Membranes ; Patch-Clamp Techniques ; Protons

The serous borderline tumors(SBTs) are divided into 3 groups, typical SBT with nonin-vasive implants, SBTs with invasive implants, and a recently described tumor, desinated mic-ropapillary serous carcinoma(MPSC). These tumors are associated with extraovarian implants, espicially peritoneum. Invasiveness of implants has prognostic significance in disease progre-ssion and recurrence. Micropapillary serous carcinoma and SBTs with invasive implants sho-uld be classified as carcinoma and treated accordingly. We report a case of borderline malign-ant ovarian surface papilloma with invasive peritoneal implant.
Papilloma* ; Peritoneum ; Recurrence

Inverted papilloma of the urinary tract is a rare finding, and it is almost benign in its histologic morphology and clinical behavior. Despite several published reports, the prognostic significance and potential clinical behavior of this malady remains unclear. The most commonly associated clinical symptoms are hematuria and obstruction of the urinary tract. Most inverted papillomas of urinary tract occur in the bladder and only rarely in the ureter, renal pelvis and urethra. We report here on one case of inverted papilloma in the prostatic urethra. This was diagnosed by transrectal ultrasonography and confirmed by its histology.
Hematuria ; Kidney Pelvis ; Papilloma, Inverted* ; Ultrasonography ; Ureter ; Urethra* ; Urinary Bladder ; Urinary Tract

To identify the presence of inwardly rectifying K+ channels and its characteristics, membrane currents were measured using a whole-cell patch clamp from isolated gastric myocytes of guinea-pig. Change of external K+ concentration from 5 to 90 mM induced an inward current at a holding potential of 80 mV. The high K+-induced inward current was blocked by Ba2+ and Cs+, but not by glibenclamide. With 90 mM K+ in bath, the Ba2+- and Cs+-sensitive currents showed strong inward rectification. Ten mM TEA weakly blocked the inward current only at potentials more negative than 50 mV. With 90 mM K+ in bath, hyperpolarizing step pulses from 10 mV induced inward currents, which were inactivated at potentials more negative than 70 mV. Reduction of external K+ to 60 mM decreased the amplitudes of the currents and shifted the reversal potential to more negative potential. The inactivation of inward K+ current at negative clamp voltage was not affected by removing external Na . These results suggest that the inwardly rectifying K+ channels may exist in gastric smooth muscle.
Baths ; Glyburide ; Membranes ; Muscle Cells* ; Muscle, Smooth ; Tea

BACKGROUND: The quality control for genetic tests would be of great importance as the test volume and clinical demands increase dramatically. Diagnostic genetics subcommittee of KSQACL performed two trials for cytogenetics and molecular genetics surveys in 2009. METHODS: A total of 67 laboratories participated in the cytogenetic surveys, 30 laboratories participated in the FISH surveys, and 94 laboratories participated in the molsecular genetics surveys in 2009. RESULTS: Almost of them showed acceptable results. However, some laboratories showed unacceptable results for the karyotype nomenclature and detection of complex cytogenetic abnormalities in hematologic neoplasms, and most of them except one showed acceptable results in FISH surveys. The molecular genetics surveys included various tests: M. tuberculosis detection, hepatitis B (HBV) and C virus (HCV) detection and quantification, human papilloma virus (HPV) genotyping, Influenza A (H1N1) detection, gene rearrangement tests for leukemias and lymphomas, apolipoprotein E (APOE) genotyping, methylenetetrahydrofolate reductase (MTHFR) genotyping, hereditary breast and ovarian cancer genes (BRCA1 and BRCA2), and genetic tests for achondroplasia (FGFR3), FMS-like tyrosine kinase 3 (FLT3), JAK2, BRAF, hereditary disorders such as spinal muscular atrophy, Huntington disease (HD), spinocerebellar ataxia (SCA), Prader-Willi/Angelman syndrome (PWS/AS), mitochondrial encephalopathy with lactic acidosis and strokelike episodes (MELAS), myoclonic epilepsy ragged red fiber (MERRF), wilson disease (ATP7B) and cancer-associated genes (KRAS). Molecular genetic surveys showed excellent results in most of the participants. CONCLUSIONS: External quality assessment program for genetic analysis in 2009 was proved to be helpful in continuous education and evaluation of quality improvement.
Achondroplasia ; Acidosis, Lactic ; Apolipoproteins ; Breast ; Chromosome Aberrations ; Cytogenetics ; Epilepsies, Myoclonic ; fms-Like Tyrosine Kinase 3 ; Gene Rearrangement ; Hematologic Neoplasms ; Hepatitis B ; Hepatolenticular Degeneration ; Humans ; Huntington Disease ; Influenza, Human ; Karyotype ; Korea ; Leukemia ; Lymphoma ; Methylenetetrahydrofolate Reductase (NADPH2) ; Mitochondrial Encephalomyopathies ; Molecular Biology ; Muscular Atrophy, Spinal ; Ovarian Neoplasms ; Papilloma ; Quality Control ; Quality Improvement ; Spinocerebellar Ataxias ; Tuberculosis ; Viruses

Patients who have complex endocarditis with involvement of both the aortic and mitral valves and intervalvular fibrous skeleton are among the most difficult to treat and still have the highest surgical mortality and morbidity rates. We report one case of aortic and mitral valve replacement with reconstruction of the fibrous skeleton performed in a 55-year-old female patient who had an aortic annular abscess and both the aortic and mitral prosthetic valve endocarditis with destruction of the fibrous skeleton. Previously, she had undergone redo double valve replacement. Transesophageal echocardiogram showed the paravalvular defect at the noncoronary aortic sinus and abnormal sinus tract along the fibrous skeleton. Emergent operation was performed due to positive blood cultures of staphylococcus epidermidis and persistent sepsis despite appropriate antibiotic therapy. After aortotomy extended to the roof of left atrium, both prosthetic valves and destroyed fibrous skeleton were completely resected and the aortic annular abscess was debrided and closed with a bovine pericardial patch. Reconstructions of both aortic and mitral annuli and the fibrous skeleton were done by using two separate bovine pericardial patches in triangular shape and mechanical valves were implanted. Postoperatively, adequate antibiotic therapies were continued and the patient was discharged at the postoperative 72 days without evidence of recurrence of endocarditis. Transthoracic echocardiogram of the postoperative 8 months shows no paravalvular leakage or recurrence of endocarditis and the patient has been followed up with no symptom.
Abscess ; Endocarditis* ; Female ; Heart Atria ; Humans ; Middle Aged ; Mitral Valve* ; Mortality ; Recurrence ; Sepsis ; Sinus of Valsalva ; Skeleton* ; Staphylococcus epidermidis

BACKGROUND: The optimal therapeutic strategies for patients with coarctation of the aorta(CoA) and ventricular septal defect(VSD) remain controversial. This study was undertaken to determine the outcome and the need for reintervention following single-stage repair of coarctation with VSD in infants younger than 6 months. MATERIAL AND METHOD: Thirty three consecutive patients who underwent single-stage repair of CoA with VSD, from January 1995 to December 2000, at Sejong General Hospital were reviewed retrospectively. Mean age and body weight at repair were 54+/-37 days(12 days-171 days) and 3.9+/-1.1 kg(1.5~6 kg), respectively. The surgical repair of CoA was performed under deep hypothermic circulatory arrest(CA) in the early period of the study and under regional cerebral perfusion through a direct innominate arterial cannulation without CA in the later period. The technique used in the repair of the CoA was resection and extended end-to-end anastomosis(EEEA; n=16) and extended side-to-side anastomosis(ESSA; n=2) in the early period, and resection and extended end-to-side anastomosis(EESA; n=15) in the later period. The simultaneous closure of VSD was done with a Dacron patch(n=16) and autologous pericardium(n=17). Aortic arch hypoplasia was present in 29 patients(88%) and its types were distal(n=18), complete(n=5), and complex(n=6). RESULT: All procedures without CA were performed in 18 patients(55%) and repair of CoA without CA in 20 patients(61%). The total bypass and aortic crossclamp time were 163+/-68 minutes and 52+/-27 minutes, respectively, and the mean time used for CA was 27+/-11 minutes. There were four early postoperative deaths(12.1%). Twenty nine hospital survivors were followed up for a mean of 38+/-26 months(6 months-78 months) and recurrent coarctation has occurred in 5 patients(17.2%). Two patients underwent balloon aortic angioplasty for recurrent coarctation and the need for reoperation was not present. Actuarial freedom from recoarctation at 1 and 4 years were 85% and 78%, respectively. Actuarial freedom from recoarctation at 4 years was 92% after EESA and 77% after EEEA(p=NS). There was no late death. CONCLUSION: Single-stage repair of aortic coarctation and VSD using extended anastomosis can be performed with the acceptable operative mortality and provides adequate correction of coarctation and low risk of recoarctation.
Angioplasty ; Aorta, Thoracic ; Aortic Coarctation* ; Body Weight ; Catheterization ; Freedom ; Heart Septal Defects, Ventricular* ; Hospitals, General ; Humans ; Infant* ; Mortality ; Perfusion ; Polyethylene Terephthalates ; Reoperation ; Retrospective Studies ; Survivors

BACKGROUND: Pulmonary artery banding (PAB)in the functional univentricular heart (UVH)is a palliative procedure for staging toward the Fontan procedure;however,it is known to be a risk factor. MATERIALS AND METHOD: The records of all 37 patients with functional UVHs who underwent surgical palliation using PAB between September 1989 and August 1999 were reviewed retrospectively.We investigated the aortic arch obstruction,the development and progression of subaortic stenosis after PAB,and risk factor of mortality according to surgical method. RESULT: In 37 neonates and infants with single ventricular physiology,aortic arch obstruction was combined in 7.There were 6 early deaths (16.2%)after PAB and 3 late deaths (8.1%)after Fontan operation.The actuarial overall survival including early mortality at 3 and 5 years were 8 0 .7+/-6.6%,72.2 +/-8.2% respectively. Among 31 patients who survived PAB,27 patients (87.1%)could become candidates for Fontan operation;22 patients(71.0%)completed Fontan operation with 3 deaths and 5 were waiting bidirectional cavopulmonary shunt(BCPS)or Fontan operation (follow-up mean 4.5 year,minimal 2 year). Subaortic stenosis developed in 8 patients after PAB (8/29,27.6%);3 cases in the patients without arch anomaly (3/22,13.6%)and 5 in those with arch anomal y (5/7,71.4%).The subaortic stenosis was managed with Damus-Kaye-Stansel procedure (DKS)in 6 patients without operative mortality and conal septum resection in 2 without long-term survivor. Analysis of risk factors established that aortic arch obstruction was strongly associated with subaortic stenosis (p<0.001).The only risk factor of late mortality was Fontan procedure without staged palliation by BCPS (p=0.001). CONCLUSION: PAB is effective as an initial palliative step in functional UVH.And the high risk group of patients with aortic obstruction can undergo effective short-term PAB as an initial palliative step,with subsequent DKS for subaortic stenosis.This strategy,initial PAB and careful surveillance,and early relief of subaortic stenosis can maintain acceptable anatomy and hemodynamics for later Fontan procedures.
Aorta, Thoracic ; Constriction, Pathologic ; Fontan Procedure ; Heart* ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Mortality ; Pulmonary Artery* ; Risk Factors ; Survivors

Patients with severe Ebstein's anomaly showing in the neonatal period, represent progressive cardiac enlargement with pulmonary hypoplasia and functional pulmonary atresia with patent ductus arteriosus-dependent pulmonary circulation. Biventricular repair in these patients had been mostly unsuccessful except for Starnes' procedure that converts the anatomy to single ventricle physiology for Fontan procedure. A 4-days old male was admitted with the diagnosis of severe Ebstein's anomaly with anatomic pulmonary atresia and severe cardiac enlargement. He successfully underwent biventricular repair with vertical plication method of atrialized right ventricle, tricupid annuloplasty, transannular right ventricular outflow tract reconstruction, atrial septal defect patch closure with fenestration, and right atrial reduction angioplasty. Postoperatively, cardiothoracic ratio was significantly reduced and mild tricuspid regurgitation was remnant in echocardiography. The patient is currently 10 months old and is fully active without restrictions.
Angioplasty ; Critical Illness* ; Diagnosis ; Ebstein Anomaly* ; Echocardiography ; Fontan Procedure ; Heart Septal Defects, Atrial ; Heart Ventricles ; Humans ; Infant ; Infant, Newborn* ; Male ; Physiology ; Pulmonary Atresia ; Pulmonary Circulation ; Tricuspid Valve Insufficiency

The effects of deep hypothermia and circulatory arrest during aortic arch reconstruction are associated with potential neurologic and myocardial injury. We describe a surgical technique that two patients underwent a modified Norwood procedure without circulatory arrest and myocardial ischemia. One was 13-day-old female patient, weighing 3.1kg, having a variant of hypoplastic left heart syndrome and another was 38-day-old male patient, weighing 3.4 kg, diagnosed Taussig-Bing anomaly with severe aortic arch hypoplasia, coarctation of the aorta, and subaortic stenosis. The arterial cannula was inserted in innominate artery directly. During Norwood reconstruction, regional high-flow perfusion into the inominate artery and coronary perfusion were maintained and there were no neurologic, cardiac, and renal complications in two patients. This technique may help protect the brain and myocardium from ischemic injury in patients with hypoplastic left heart syndrome or other arch anomalies including coarctation or interruption.
Aorta, Thoracic ; Aortic Coarctation ; Arteries ; Brachiocephalic Trunk ; Brain ; Catheterization, Peripheral ; Catheters ; Constriction, Pathologic ; Double Outlet Right Ventricle ; Female ; Humans ; Hypoplastic Left Heart Syndrome ; Hypothermia ; Male ; Myocardial Ischemia* ; Myocardium ; Norwood Procedures* ; Perfusion