No abstract available.
Heart Septal Defects, Ventricular* ; Pulmonary Artery* ; Pulmonary Atresia*

BACKGROUND: There has been a change in the causes of aortic stenosis when comparence of rheumatioc aortic stenosis in recent year. Therefore, we studied the etiology factor of pure aortic stenosis. METHODS: The gross surgical pathologic features of the aortic valves were reviewed in 92 patients with pure aotic stenosis whom underwent aortic valve replacement at Yonsei University, Cardiovascular center between July 1989 and June 1994. RESULTS: The three most frequent causes were 1) calcification of congenital bicuspid valve in 30%, 2) degenerative calcification of aortic valve in 22%, 3) rheumatioc valvular change in 48%. The mean age at the time of aortic valve replacement for the entire series of patients was 54.4 years. The range of age was from 18 years to 77 years. Males predominated for degenerative disease and congenital bicuspid valves, but there were reversed rheumatic origin. One or more complications occured in 17% of patients undergoing operation. The surgical mortality was 3.3%. CONCLUSION: Our data suggest that more common cause of aortic stenosis is non-rheumatic disease rather than rheumatinc origin.
Adult* ; Aortic Valve ; Aortic Valve Stenosis ; Constriction, Pathologic* ; Humans ; Male ; Mitral Valve ; Mortality

PURPOSE: To evaluate the effect of combined immunosuppressive treatment with FK 506-cyclophosphamide on surgical angiogenesis in non-vascularized bone xenografts. MATERIALS AND METHODS: Twenty-seven hamster-to-rat non-vascularized bone xenografts were performed. For surgical angiogenesis, recipient origin saphenous arteriovenous bundles were implanted into the medullary canals of graft bones. Immunosuppression with FK 506-cyclophosphamide was performed in group 1, not in group 2, control group. At postoperative 4 weeks, microangiography with microfil was conducted. Decalcified bones were cleared and the area of newly formed capillary, capillary density, were quantitatively evaluated using Scion image program. Bone specimens stained with hematoxylin-eosin were evaluated histologically also. RESULTS: There was no significant difference of capillary densities between immunosuppressed group and non-immunosuppressed control group (0.37+/-0.03/0.39+/-0.02, P=0.58). On histological examination, both groups showed neoangiogenesis into the medullary canals and endosteal bones. CONCLUSION: FK 506-cyclophosphamide immunosuppression did not suppress the angiogenesis in non-vascularized bone xenografts, FK 506-cyclophosphamide combination of immunosuppression will be useful even in the condition of surgical angiogenesis.
Capillaries ; Heterografts ; Immunosuppression ; Silicone Elastomers ; Transplants

PURPOSE: To evaluate the effect of combined immunosuppressive treatment with FK 506-cyclophosphamide on surgical angiogenesis in non-vascularized bone xenografts. MATERIALS AND METHODS: Twenty-seven hamster-to-rat non-vascularized bone xenografts were performed. For surgical angiogenesis, recipient origin saphenous arteriovenous bundles were implanted into the medullary canals of graft bones. Immunosuppression with FK 506-cyclophosphamide was performed in group 1, not in group 2, control group. At postoperative 4 weeks, microangiography with microfil was conducted. Decalcified bones were cleared and the area of newly formed capillary, capillary density, were quantitatively evaluated using Scion image program. Bone specimens stained with hematoxylin-eosin were evaluated histologically also. RESULTS: There was no significant difference of capillary densities between immunosuppressed group and non-immunosuppressed control group (0.37+/-0.03/0.39+/-0.02, P=0.58). On histological examination, both groups showed neoangiogenesis into the medullary canals and endosteal bones. CONCLUSION: FK 506-cyclophosphamide immunosuppression did not suppress the angiogenesis in non-vascularized bone xenografts, FK 506-cyclophosphamide combination of immunosuppression will be useful even in the condition of surgical angiogenesis.
Capillaries ; Heterografts ; Immunosuppression ; Silicone Elastomers ; Transplants

OBJECTIVE: The nitric oxide synthases(NOS) are a group of isoenzymes that convert L-arginine to L-citrulline and generate nitric oxide(NO). The constitutive form of NOS is present in endothelium, adrenal gland, brain, and platelets, while the inducible form of NOS is present in macrophages, hepatocytes, vascular smooth muscle cell and endothelial cells. To determine whether NO has a role in anterior pituitary cell function, immunohistochemistry and molecular techniques were used to study NOS expression in rat pituitary gland. MATERIALS AND METHODS: We treated the rats with two NOS inhibitors: N-mono-methyl amine(NMMA), which is an inhibitor of NOS activity, and aminoguanidine, which a selective inhibitor of the inducible NOS isoform and two NO donors; sodium nitroprusside(SNP), s-nitro-acetyl-penicillamine(SNAP) as well as L-arginine. Rat growth hormone was measured in the serum using radioimmunoassay and NOS producing cells in the anterior lobe of the pituitary was detected by immunohistochemical stains. Also mRNA was extracted from the pituitary and performed RT-PCR using inducible NOS primer. RESULTS: Serum growth hormone levels were increased significantly by administration of NOS inhibitors, such as NMMA and aminoguanidine. Immunohistochemical stains for neuronal and inducible NOS showed strong positivity in the folliculostellate cells and weak positivity in the anterior pituitary cells in the control and various experimental groups. RT-PCR in inducible NOS showed more brighter band in the 222 base pairs in the aminoguanidine treated group than normal control group. CONCLUSION: These data suggest that pituitary NOS may play a pivotal role in the control of growth hormone secretion.
Adrenal Glands ; Animals ; Arginine ; Base Pairing ; Brain ; Coloring Agents ; Endothelial Cells ; Endothelium ; Growth Hormone ; Hepatocytes ; Humans ; Immunohistochemistry ; Isoenzymes ; Macrophages ; Muscle, Smooth, Vascular ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Pituitary Gland ; Pituitary Gland, Anterior* ; Radioimmunoassay ; Rats* ; RNA, Messenger ; Sodium ; Tissue Donors

In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35(r)). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm (range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm (range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm (range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four (mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm (range 1.74~4.89) and 2.19 mm (range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six (mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm (range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm (range 1.02~3.60) and 2.30 mm (range 1.39~4.39). 5) The right coronary artery dominant was 163 cases (93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people.
Adult ; Arteries ; Computer Systems ; Coronary Artery Bypass ; Coronary Disease ; Coronary Vessels ; Humans ; Pathology* ; Single Person ; Transplants

BACKGROUND: We studied clinical and angiographic findings of 16 Korean patients who had isolated laft coronary ostial steonsis and compared them with those of the patients with non-ostial left main stenosis. The aim of this study is to find the characteristics of the patients with isolated left voronary ostial stenosis. METHODS: Medical records and coronary angiograms were reviewed. We divided the patients with left main stenosis into four groups by lesion location and associated lesion. Clinical and angiographic findings of each group were compared. RESULTS: Twenty four patients(0.15%) had left coronary ostial stenosis and among them sixteen patients(0.1) had an isolated lesion. Their mean age was 48 years and 62% were female. Only 6 patients had coronary risk factors. Two patients were diagnosed as having Takayasu's srteritis. At treadmill exercise test, 7 out of 11 patients lhowed positive results at stage I. Eight patients had undergone surgical treatment. Comoared with the patients who had non-ostial left main stenosis, left ostial group showed lower mean age, female preponderance and lower incidence of coronary risk factors. There was no difference in the results of treadmill exercise test and hemodynamic parameters. CONCLUSION: Isolated left coronary ostial stenosis in Korea also predominantly occured in young female patients who had less risk factors as previous reports. But the incidence of this lesion and nonatherosclerotic origin seemed to be higher. And most of the patients with the left coronary ostial stenosis had isolated ostial stenosis.
Constriction, Pathologic* ; Exercise Test ; Female ; Hemodynamics ; Humans ; Incidence ; Korea* ; Medical Records ; Risk Factors

BACKGROUND: We studied clinical and angiographic findings of 16 Korean patients who had isolated laft coronary ostial steonsis and compared them with those of the patients with non-ostial left main stenosis. The aim of this study is to find the characteristics of the patients with isolated left voronary ostial stenosis. METHODS: Medical records and coronary angiograms were reviewed. We divided the patients with left main stenosis into four groups by lesion location and associated lesion. Clinical and angiographic findings of each group were compared. RESULTS: Twenty four patients(0.15%) had left coronary ostial stenosis and among them sixteen patients(0.1) had an isolated lesion. Their mean age was 48 years and 62% were female. Only 6 patients had coronary risk factors. Two patients were diagnosed as having Takayasu's srteritis. At treadmill exercise test, 7 out of 11 patients lhowed positive results at stage I. Eight patients had undergone surgical treatment. Comoared with the patients who had non-ostial left main stenosis, left ostial group showed lower mean age, female preponderance and lower incidence of coronary risk factors. There was no difference in the results of treadmill exercise test and hemodynamic parameters. CONCLUSION: Isolated left coronary ostial stenosis in Korea also predominantly occured in young female patients who had less risk factors as previous reports. But the incidence of this lesion and nonatherosclerotic origin seemed to be higher. And most of the patients with the left coronary ostial stenosis had isolated ostial stenosis.
Constriction, Pathologic* ; Exercise Test ; Female ; Hemodynamics ; Humans ; Incidence ; Korea* ; Medical Records ; Risk Factors

A 12-year-old intact male Dalmatian dog presented hyporexia and vomiting for 1 week. Blood analysis revealed increased liver enzyme activity. Histopathological examination of the liver confirmed chronic hepatitis with fibrosis and necrosis. Copper staining revealed marked copper accumulation (2,770 ppm; normal range, 200 to 400 ppm), prominent in the centrilobular region, and compatible with copper-associated chronic hepatitis. However, copper metabolism domain containing 1 (COMMD1) mutation predisposing to copper accumulation in the liver tissue was not identified. The dog received medications but died 1 month after first visit. This is the first case of primary copper-associated hepatitis without COMMD1 mutation in a Dalmatian dog in South Korea.

Cardiopulmonary bypass in children is associated with capillary leak, which results in an increase in total body water after open heart surgery. The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery. Study A: Twenty-six consecutive children aged 0.1~10 years(median 7 months) underwent cardiac operation incorporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~150l/min for 3~14 min. After modified ultrafiltration, elevation of hematocrit(28.3%+/-3.6% vs. 33.8%+/-4.0%, p<0.001), increased systolic blood pressure(66.7+/-11.2mmHg vs. 76.2+/-11.8mmHg, p<0.02), and decreased central venous pressure(7.8+/-3.7mmHg vs. 6.9+/-2.9mmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n=14) or modified ultrafiltration(n=12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0+/-2.4 cmH2O vs. 22.4+/-2.3cmH2O, p< 0.03). Modified ultrafiltration after cardiopulmonary bypass in children improves early hemo- dynamics and pulmonary mechanics, and represents an excellent option for perioperative management of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.
Body Water ; Capillaries ; Cardiopulmonary Bypass ; Child ; Diagnosis ; Filtration ; Heart* ; Hemodynamics ; Humans ; Mechanics ; Thoracic Surgery* ; Ultrafiltration*