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1.
J Anat ; 244(6): 1040-1053, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38284175

ABSTRACT

That the highly trabeculated ventricular walls of the developing embryos transform to the arrangement during the fetal stages, when the mural architecture is dominated by the thickness of the compact myocardium, has been explained by the coalescence of trabeculations, often erroneously described as 'compaction'. Recent data, however, support differential rates of growth of the trabecular and compact layers as the major driver of change. Here, these processes were assessed quantitatively and visualized in standardized views. We used a larger dataset than has previously been available of mouse hearts, covering the period from embryonic day 10.5 to postnatal day 3, supported by images from human hearts. The volume of the trabecular layer increased throughout development, in contrast to what would be expected had there been 'compaction'. During the transition from embryonic to fetal life, the rapid growth of the compact layer diminished the proportion of trabeculations. Similarly, great expansion of the central cavity reduced the proportion of the total cavity made up of intertrabecular recesses. Illustrations of the hearts with the median value of left ventricular trabeculation confirm a pronounced growth of the compact wall, with prominence of the central cavity. This corresponds, in morphological terms, to a reduction in the extent of the trabecular layer. Similar observations were made in the human hearts. We conclude that it is a period of comparatively slow growth of the trabecular layer, rather than so-called compaction, that is the major determinant of the changing morphology of the ventricular walls of both mouse and human hearts.


Subject(s)
Heart Ventricles , Animals , Humans , Mice , Heart Ventricles/anatomy & histology , Heart Ventricles/embryology , Gestational Age
2.
ACS Appl Mater Interfaces ; 15(1): 1525-1534, 2023 Jan 11.
Article in English | MEDLINE | ID: mdl-36538477

ABSTRACT

The top-gate structure is currently adopted in various flat-panel displays because of its diverse advantages such as passivation from the external environment and process compatibility with industries. However, the mobility of the currently commercialized top-gate oxide thin-film transistors (TFTs) is insufficient to drive ultrahigh-resolution displays. Accordingly, this work suggests metal-capped Zn-Ba-Sn-O transistors with top-gate structures for inducing mobility-enhancing effects. The fabricated top-gate device contains para-xylylene (PPx), which is deposited by a low-temperature chemical vapor deposition (CVD) process, as a dielectric layer and exhibits excellent interfacial and dielectric properties. A technology computer-aided design (TCAD) device simulation reveals that the mobility enhancement in the Al-capped (Zn,Ba)SnO3 (ZBTO) TFT is attributed not only to the increase in the electron concentration, which is induced by band engineering due to the Al work function but also to the increased electron velocity due to the redistribution of the lateral electric field. As a result, the mobility of the Al-capped top-gate ZBTO device is 5 times higher (∼110 cm2/Vs) than that of the reference device. These results demonstrate the applicability of top-gate oxide TFTs with ultrahigh mobility in a wide range of applications, such as for high-resolution, large-area, and flexible displays.

3.
J Anat ; 241(1): 173-190, 2022 07.
Article in English | MEDLINE | ID: mdl-35128670

ABSTRACT

Shrews occupy the lower extreme of the seven orders of magnitude mammals range in size. Their hearts are large relative to body weight and heart rate can exceed a thousand beats a minute. It is not known whether traits typical of mammal hearts scale to these extremes. We assessed the heart of three species of shrew (genus Sorex) following the sequential segmental analysis developed for human hearts. Using micro-computed tomography, we describe the overall structure and find, in agreement with previous studies, a large and elongate ventricle. The atrial and ventricular septums and the atrioventricular (AV) and arterial valves are typically mammalian. The ventricular walls comprise mostly compact myocardium and especially the right ventricle has few trabeculations on the luminal side. A developmental process of compaction is thought to reduce trabeculations in mammals, but in embryonic shrews the volume of trabeculations increase for every gestational stage, only slower than the compact volume. By expression of Hcn4, we identify a sinus node and an AV conduction axis which is continuous with the ventricular septal crest. Outstanding traits include pulmonary venous sleeve myocardium that reaches farther into the lungs than in any other mammals. Typical proportions of coronary arteries-to-aorta do not scale and the shrew coronary arteries are proportionally enormous, presumably to avoid the high resistance to blood flow of narrow vessels. In conclusion, most cardiac traits do scale to the miniscule shrews. The shrew heart, nevertheless, stands out by its relative size, elongation, proportionally large coronary vessels, and extent of pulmonary venous myocardium.


Subject(s)
Heart Ventricles , Heart , Animals , Coronary Vessels/anatomy & histology , Heart/anatomy & histology , Heart Atria , Heart Rate , Humans , Shrews , X-Ray Microtomography
4.
BMC Complement Med Ther ; 20(1): 176, 2020 Jun 05.
Article in English | MEDLINE | ID: mdl-32503533

ABSTRACT

BACKGROUND: Glucocorticoids (GCs) are anti-inflammatory drugs widely used to treat acute and chronic inflammatory diseases. However, despite their excellent efficacy, the long-term use of GCs is relatively limited owing to their adverse effects. Recent studies have sought to reduce these adverse effects by developing dissociated GCs that bind to GC receptors (GRs) to induce potent anti-inflammatory effects without the transcription of GC response element (GRE)-promoted genes. Some species of the genus Salsola are used in traditional Chinese medicine to treat cancer, hypertension, and inflammation. In this study, we investigated the potential dissociated GC activities and underlying mechanisms of Salsola komarovii (SK), which is native to Korea. METHODS: To determine whether SK ethanol extract (SEE) directly interacts with the GR, an in vitro fluorescence polarization based-GR competitor assay was performed. The effect of SEE on the transcriptional activity of nuclear factor (NF)-κB and GRE was confirmed in HepG2 cells using the Cignal reporter assay. The anti-inflammatory effect of SK was determined by assessing lipopolysaccharide (LPS)-induced interleukin (IL)-6 production. To confirm whether SEE induces GRE-driven gene expression, preadipocyte differentiation followed by lipid deposition was performed in the presence of SEE. RESULTS: SEE exhibited GR binding activity in the fluorescence polarization competitive binding assay and induced GR nuclear translocation. It also interfered with the nuclear translocation of NF-κB and the NF-κB-dependent transcriptional activity based on the immunofluorescence analysis and reporter assay, respectively. SEE exerted anti-inflammatory effects by reducing LPS-induced IL-6 production as effectively as hydrocortisone (positive control). SK did not induce GRE-driven gene expression and preadipocyte differentiation, which is one of the major adverse effects of GCs. CONCLUSIONS: Collectively, these results suggest that SK could be a novel and safe anti-inflammatory agent with dissociated GC properties and, therefore, it has great potential for use in treating inflammatory disorders.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Glucocorticoids/pharmacology , NF-kappa B/metabolism , Plant Extracts/pharmacology , Receptors, Glucocorticoid/metabolism , Salsola/chemistry , Cell Line , Hep G2 Cells , Humans , Republic of Korea
5.
Nanoscale ; 11(17): 8510-8517, 2019 Apr 25.
Article in English | MEDLINE | ID: mdl-30990501

ABSTRACT

The coordination structure between small molecules and metalloporphyrins plays a crucial role in functional reactions such as bio-oxidation and catalytic activation. Their vertical, tilting, and dynamic structures have been actively studied with diffraction and resonance spectroscopy for the past four decades. Contrastingly, real-space visualization beyond simple protrusion and depression is relatively rare. In this paper, high-resolution scanning tunnelling microscopy (STM) images are presented of di-, tri-, and tetra-atomic small molecules (O2, NO2, and NH3, respectively) coordinated to Co-porphyrin on Au(111). A square ring structure was observed for O2, a rectangular ring structure for NO2, and a bright-center structure for NH3 at 80 K. The symmetries of experimental STM images were reproduced in density functional theory (DFT) calculations, considering the precession motion of the small molecules. Thus, this study shows that the structure of small molecules coordinated to metalloporphyrins can be visualized using high-resolution STM and DFT calculations.

6.
Ann Dermatol ; 30(4): 432-440, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30065583

ABSTRACT

BACKGROUND: Skin hydration is a common problem both in elderly and young people as dry skin may cause irritation, dermatological disorders, and wrinkles. While both genetic and environmental factors seem to influence skin hydration, thorough genetic studies on skin hydration have not yet been conducted. OBJECTIVE: We used a genome-wide association study (GWAS) to explore the genetic elements underlying skin hydration by regulating epidermal differentiation and skin barrier function. METHODS: A GWAS was conducted to investigate the genetic factors influencing skin hydration in 100 Korean females along with molecular studies of genes in human epidermal keratinocytes for functional study in vitro. RESULTS: Among several single nucleotide polymorphisms identified in GWAS, we focused on Single Stranded DNA Binding Protein 3 (SSBP3) which is associated with DNA replication and DNA damage repair. To better understand the role of SSBP3 in skin cells, we introduced a calcium-induced differentiation keratinocyte culture system model and found that SSBP3 was upregulated in keratinocytes in a differentiation dependent manner. When SSBP3 was overexpressed using a recombinant adenovirus, the expression of differentiation-related genes such as loricrin and involucrin was markedly increased. CONCLUSION: Taken together, our results suggest that genetic variants in the intronic region of SSBP3 could be determinants in skin hydration of Korean females. SSBP3 represents a new candidate gene to evaluate the molecular basis of the hydration ability in individuals.

8.
Nanoscale ; 9(47): 18635-18643, 2017 Dec 07.
Article in English | MEDLINE | ID: mdl-29027558

ABSTRACT

Oxygen-containing functional groups such as epoxy, hydroxyl, carboxylic, and carboxyl groups have a great influence on the luminescence properties of graphene oxide quantum dots (GOQDs). Understanding their roles is essential for the design and optimization of GOQD performance. Herein, we investigate the effect of epoxide functional groups in GOQDs on the luminescence mechanism through passivation of the epoxide functional groups using the alkyl ligand oleylamine. Luminescence in the as-synthesized GOQDs has two separate origins: intrinsic states derived from localized sp2 carbon subdomains and extrinsic states formed by oxygen-functional groups. When the oleylamine ligand is conjugated on the GOQDs, intrinsic PL emission from the localized sp2 carbon subdomains decreases. This is discussed in detail, based on optical characterization and first-principles density functional theory calculations, which reveal that the role of the epoxide functional groups is to form localized sp2 carbon subdomains emitting intrinsic PL. To the best of our knowledge, this is the first investigation of the role of epoxide functional groups on the luminescence mechanism in GOQDs.

10.
Dalton Trans ; 45(42): 16673-16681, 2016 Nov 14.
Article in English | MEDLINE | ID: mdl-27711671

ABSTRACT

Based on density functional theory calculations, we investigated the axial bindings of diatomic molecules (NO, CO, and O2) to metalloporphyrins and their spin switching behaviors. These binding reactions provide the ways to control molecular states and spins in metalloporphyrin systems that can be used in bio-sensing and spintronic applications. To microscopically understand the non-trivial axial binding structures and spin-switching behaviors of diatomic molecules (NO, CO, and O2) adsorbed onto Co-tetraphenylporphyrin (CoTPP), we performed spin-polarized density functional theory (DFT) calculations for various CoTPP systems on Au(111), Ag(111), and Cu(111) substrates. We also systematically evaluated the effects of van der Waals and Hubbard U corrections by directly comparing the electronic structure with the results of scanning tunnelling microscopy. From the calculation results, we have found that a NO molecule, almost 60° tilted away from the axial direction, is coordinated with CoTPP with a binding energy of 1.2-1.7 eV depending on substrates, and the spin state of CoTPP is completely switched off due to the charge transfer from NO to CoTPP. On the other hand, CO and O2 molecules rather weakly interact with a binding energy of 0.4-0.8 eV, and a spin polarization of ∼1µB is still present at CoTPP. A CO molecule is expected to be almost straightly coordinated along the axial direction of CoTPP, but O2 is tilted similarly to the NO case. Regarding the substrate effects, we have found that there is noticeable charge transfer from Ag(111) and Cu(111) to CoTPP, but no significant charge transfer from Au(111) to CoTPP. These findings of the axial coordination and spin states for NO, CO, and O2 adsorbed CoTPP systems will be useful for understanding bio-sensing mechanisms and designing molecular spintronic systems.

11.
Adv Mater ; 28(26): 5255-61, 2016 Jul.
Article in English | MEDLINE | ID: mdl-27153519

ABSTRACT

The photoluminescence (PL) origin of bright blue emission arising from intrinsic states in graphene quantum dots (GQDs) is investigated. The bright PL of intercalatively acquired GQDs is attributed to favorably formed subdomains composed of four to seven carbon hexagons. Random and harsh oxidation which hinders the energetically favorable formation of subdomains causes weak and redshifted PL.

12.
Nutr Res Pract ; 10(2): 131-8, 2016 Apr.
Article in English | MEDLINE | ID: mdl-27087895

ABSTRACT

BACKGROUND/OBJECTIVES: Citrus and its peels have been used in Asian folk medicine due to abundant flavonoids and usage of citrus peels, which are byproducts from juice and/or jam processing, may be a good strategy. Therefore, the aim of this study was to examine antioxidant and anti-inflammatory effects of bioconversion of Jeju Hallabong tangor (Citrus kiyomi × ponkan; CKP) peels with cytolase (CKP-C) in RAW 264.7 cells. MATERIALS/METHODS: Glycosides of CKP were converted into aglycosides with cytolase treatment. RAW 264.7 cells were pre-treated with 0, 100, or 200 µg/ml of citrus peel extracts for 4 h, followed by stimulation with 1 µg/ml lipopolysaccharide (LPS) for 8 h. Cell viability, DPPH radical scavenging activity, nitric oxide (NO), and prostagladin E2 (PGE2) production were examined. Real time-PCR and western immunoblotting assay were performed for detection of mRNA and/or protein expression of pro-inflammatory mediators and cytokines, respectively. RESULTS: HPLC analysis showed that treatment of CKP with cytolase resulted in decreased flavanone rutinoside forms (narirutin and hesperidin) and increased flavanone aglycoside forms (naringenin and hesperetin). DPPH scavenging activities were observed in a dose-dependent manner for all of the citrus peel extracts and CKP-C was more potent than intact CKP. All of the citrus peel extracts decreased NO production by inducible nitric oxide synthase (iNOS) activity and PGE2 production by COX-2. Higher dose of CKP and all CKP-C groups significantly decreased mRNA and protein expression of LPS-stimulated iNOS. Only 200 µg/ml of CKP-C markedly decreased mRNA and protein expression of cyclooxygenase-2 in LPS-stimulated RAW 264.7 cells. Both 100 and 200 µg/ml of CKP-C notably inhibited mRNA levels of interleukin-1ß (IL-1ß) and IL-6, whereas 200 µg/ml CKP-C significantly inhibited mRNA levels of TNF-α. CONCLUSIONS: This result suggests that bioconversion of citrus peels with cytolase may enrich aglycoside flavanones of citrus peels and provide more potent functional food materials for prevention of chronic diseases attributable to oxidation and inflammation by increasing radical scavenging activity and suppressing pro-inflammatory mediators and cytokines.

13.
Phys Chem Chem Phys ; 18(16): 10882-6, 2016 Apr 28.
Article in English | MEDLINE | ID: mdl-27040040

ABSTRACT

Photocatalysts use sustainable solar light energy to trigger various catalytic reactions. Metal-free nanomaterials have been suggested as cost-effective and environmentally friendly photocatalysts. In this work, we propose thickness-controlled graphite oxide (GO) as a metal-free photocatalyst, which is produced by exfoliating thick GO particles via stirring and sonication. All GO samples exhibit photocatalytic activity for degrading an organic pollutant, rhodamine B under visible light, and the thickest sample shows the best catalytic performance. UV-vis-NIR diffuse reflectance absorption spectra indicate that thicker GO samples absorb more vis-NIR light than thinner ones. Density-functional theory calculations show that GO has a much smaller band gap than that of single-layer graphene oxide, and thus suggest that the largely-reduced band gap is responsible for this trend of light absorption.


Subject(s)
Environmental Pollutants/chemistry , Graphite/chemistry , Light , Organic Chemicals/chemistry , Oxides/chemistry , Catalysis , Microscopy, Electron, Transmission , Photoelectron Spectroscopy
14.
Nutr Res Pract ; 9(6): 599-605, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26634048

ABSTRACT

BACKGROUND/OBJECTIVES: Citrus flavonoids have a variety of physiological properties such as anti-oxidant, anti-inflammation, anti-cancer, and anti-obesity. We investigated whether bioconversion of Citrus unshiu with cytolase (CU-C) ameliorates the anti-adipogenic effects by modulation of adipocyte differentiation and lipid metabolism in 3T3-L1 cells. MATERIALS/METHODS: Glycoside forms of Citrus unshiu (CU) were converted into aglycoside forms with cytolase treatment. Cell viability of CU and CU-C was measured at various concentrations in 3T3L-1 cells. The anti-adipogenic and lipolytic effects were examined using Oil red O staining and free glycerol assay, respectively. We performed real time-polymerase chain reaction and western immunoblotting assay to detect mRNA and protein expression of adipogenic transcription factors, respectively. RESULTS: Treatment with cytolase decreased flavanone rutinoside forms (narirutin and hesperidin) and instead, increased flavanone aglycoside forms (naringenin and hesperetin). During adipocyte differentiation, 3T3-L1 cells were treated with CU or CU-C at a dose of 0.5 mg/ml. Adipocyte differentiation was inhibited in CU-C group, but not in CU group. CU-C markedly suppressed the insulin-induced protein expression of CCAAT/enhancer-binding protein α (C/EBPα) and peroxisome proliferator-activated receptor gamma (PPARγ) as well as the mRNA levels of CEBPα, PPARγ, and sterol regulatory element binding protein 1c (SREBP1c). Both CU and CU-C groups significantly increased the adipolytic activity with the higher release of free glycerol than those of control group in differentiated 3T3-L1 adipocytes. CU-C is particularly superior in suppression of adipogenesis, whereas CU-C has similar effect to CU on stimulation of lipolysis. CONCLUSIONS: These results suggest that bioconversion of Citrus unshiu peel extracts with cytolase enhances aglycoside flavonoids and improves the anti-adipogenic metabolism via both inhibition of key adipogenic transcription factors and induction of adipolytic activity.

15.
Exp Dermatol ; 24(12): 942-6, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26174610

ABSTRACT

A two-stage genomewide association (GWA) analysis was conducted to investigate the genetic factors influencing ultraviolet (UV)-induced skin pigmentation in Korean females after UV exposure. Previously, a GWA study evaluating ~500 000 single nucleotide polymorphisms (SNPs) in 99 Korean females identified eight SNPs that were highly associated with tanning ability. To confirm these associations, we genotyped the SNPs in an independent replication study (112 Korean females). We found that a novel SNP in the intron of the WW domain-containing oxidoreductase (WWOX) gene yielded significant replicated associations with skin tanning ability (P-value = 1.16 × 10(-4) ). To understand the functional consequences of this locus located in the non-coding region, we investigated the role of WWOX in human melanocytes using a recombinant adenovirus expressing a microRNA specific for WWOX. Inhibition of WWOX expression significantly increased the expression and activity of tyrosinase in human melanocytes. Taken together, our results suggest that genetic variants in the intronic region of WWOX could be determinants in the UV-induced tanning ability of Korean females. WWOX represents a new candidate gene to evaluate the molecular basis of the UV-induced tanning ability in individuals.


Subject(s)
Genetic Predisposition to Disease , Oxidoreductases/genetics , Skin Pigmentation/genetics , Skin Pigmentation/radiation effects , Skin/enzymology , Skin/radiation effects , Tumor Suppressor Proteins/genetics , Ultraviolet Rays/adverse effects , Adult , Asian People , Cells, Cultured , Female , Gene Knockdown Techniques , Genome-Wide Association Study , Humans , Introns , Melanocytes/enzymology , Melanocytes/radiation effects , MicroRNAs/genetics , Middle Aged , Oxidoreductases/antagonists & inhibitors , Oxidoreductases/metabolism , Phenotype , Polymorphism, Single Nucleotide , Recombinant Proteins/genetics , Recombinant Proteins/metabolism , Republic of Korea , Skin Pigmentation/physiology , Tumor Suppressor Proteins/antagonists & inhibitors , Tumor Suppressor Proteins/metabolism , WW Domain-Containing Oxidoreductase
16.
ACS Nano ; 9(7): 7722-8, 2015 Jul 28.
Article in English | MEDLINE | ID: mdl-26172541

ABSTRACT

Axial coordinations of diatomic NO molecules to metalloporphyrins play key roles in dynamic processes of biological functions such as blood pressure control and immune response. Probing such reactions at the single molecule level is essential to understand their physical mechanisms but has been rarely performed. Here we report on our single molecule dissociation experiments of diatomic NO from NO-Co-porphyrin complexes describing its dissociation mechanisms. Under tunneling junctions of scanning tunneling microscope, both positive and negative energy pulses gave rise to dissociations of NO with threshold voltages, +0.68 and -0.74 V at 0.1 nA tunneling current on Au(111). From the observed power law relations between dissociation rate and tunneling current, we argue that the dissociations were inelastically induced with molecular orbital resonances by stochastically tunneling electrons, which is supported with our density functional theory calculations. Our study shows that single molecule dissociation experiments can be used to probe reaction mechanisms in a variety of axial coordinations between small molecules and metalloporphyrins.

17.
Pediatr Int ; 57(1): 172-4, 2015.
Article in English | MEDLINE | ID: mdl-25711259

ABSTRACT

Cardiac myxoma is rare in children and often associated with cerebrovascular events. Reported herein is the case of a 9-year-old boy who presented with acute obstruction of the aortic bifurcation associated with a huge left atrial (LA) myxoma, thereby leading to acute ischemia of the lower extremities. Immediate surgical removal of the LA myxoma with concomitant percutaneous embolectomy using a Forgathy catheter was done, with relief of ischemic symptoms. Cardiac myxoma should always be considered in the case of acute embolic events in children, given that it needs immediate intervention to prevent further complications.


Subject(s)
Aorta, Abdominal , Aortic Diseases/surgery , Cardiac Surgical Procedures/methods , Embolectomy/methods , Heart Neoplasms/complications , Myxoma/complications , Neoplastic Cells, Circulating , Aortic Diseases/diagnosis , Aortic Diseases/etiology , Child , Echocardiography , Heart Atria , Heart Neoplasms/surgery , Humans , Magnetic Resonance Imaging, Cine , Male , Myxoma/diagnosis , Myxoma/surgery , Tomography, X-Ray Computed
18.
Urol Int ; 94(3): 337-41, 2015.
Article in English | MEDLINE | ID: mdl-25531837

ABSTRACT

OBJECTIVE: To determine whether listening to music during transrectal ultrasound (TRUS)-guided 12-core needle prostate biopsy decreases anxiety, pain and dissatisfaction among patients and results in a more comfortable and better tolerated procedure. PATIENTS AND METHODS: 76 male patients who underwent TRUS-guided prostate biopsy between March 2013 and June 2014 were randomized into the following groups: no music (group I, n = 38) or classical music (group II, n = 38) during the procedure. Before TRUS-guided prostate biopsy, lidocaine gel was instilled into the rectum. Patient anxiety levels were quantified using the State-Trait Anxiety Inventory. A visual analog scale (0-10) was used for self-assessment of satisfaction, discomfort and willingness among patients to have a repeat TRUS-guided prostate biopsy. RESULTS: Demographic characteristics, mean age, procedure duration and procedure indications did not differ statistically between the two groups. The mean anxiety level and mean pain score of group II were significantly lower than those of group I (p = 0.001 and p = 0.003, respectively). Group II also had a significantly higher mean satisfaction score than group I (p = 0.007). Before the procedure, heart rate and systolic blood pressure were similar in groups I and II; however, after the procedure, levels were lower in group II than in group I (heart rate, p = 0.014; systolic blood pressure, p = 0.011). CONCLUSION: Listening to music during TRUS-guided prostate biopsy significantly reduced patients' feelings of pain, discomfort and dissatisfaction. Music can serve as a simple, inexpensive and effective adjunct to sedation during TRUS-guided prostate biopsy. We recommend playing music during TRUS-guided prostate biopsy.


Subject(s)
Anxiety/prevention & control , Biopsy, Needle/methods , Music , Pain/prevention & control , Prostate/pathology , Aged , Biopsy , Humans , Lidocaine/therapeutic use , Male , Middle Aged , Pain Measurement , Patient Satisfaction , Pilot Projects , Prostate/diagnostic imaging , Rectum , Ultrasonography , Visual Analog Scale
19.
J Thorac Cardiovasc Surg ; 149(2): 515-20, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25454919

ABSTRACT

OBJECTIVES: We evaluated our clinical experiences on rehabilitation of native pulmonary arteries (PAs) with a central shunt using an expanded polytetrafluoroethylene (ePTFE) tube graft in management of pulmonary atresia with ventricular septal defect (VSD) and major aortopulmonary collateral arteries (MAPCAs) with diminutive PAs. METHODS: From March 1993 to June 2013, a total of 28 consecutive patients underwent surgery for pulmonary atresia with VSD and MAPCAs. We identified 15 patients who underwent a central shunt procedure using an ePTFE tube graft. Median age and weight at the initial operation were 1.91 months and 5.22 kg, respectively. Ligation of MAPCAs was performed in 3 patients concomitantly. The techniques used were a U-shaped central shunt in 13 patients, and a side-to-side aorto-ePTFE tube graft anastomosis in 2 patients. RESULTS: There was no surgical mortality, and no shunt occlusion. The mean follow-up duration was 70.7 ± 67.1 months. Complete repair was achieved in 13 patients (13 of 14 of the follow-up patients; 92.9%), and the remaining patient is waiting for complete repair. The median age at complete repair was 19.4 months. The mean PA index before the initial central shunt procedure was 22.7 ± 13.2 mm(2)/m(2), which increased to 149.4 ± 86.6 mm(2)/m(2) at the final recordings before shunt division, and 185.9 ± 84.0 mm(2)/m(2) before complete repair. There were 2 late mortality cases. The overall survival rates were 92.9%, 82.5%, and 82.5%, at 1, 5, and 10 years, respectively. CONCLUSIONS: A central shunt, using an ePTFE tube graft, is an effective initial palliative procedure for rehabilitation of the diminutive PAs in patients with pulmonary atresia with VSD and MAPCAs.


Subject(s)
Blood Vessel Prosthesis Implantation/methods , Blood Vessel Prosthesis , Heart Septal Defects/surgery , Pulmonary Artery/abnormalities , Pulmonary Artery/surgery , Pulmonary Atresia/surgery , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Palliative Care , Polytetrafluoroethylene , Treatment Outcome
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