A Case of Quadricuspid Aortic Valve with Multiple Fenestrations / 日本心臓血管外科学会雑誌

A 73-year-old man diagnosed with severe aortic regurgitation by transthoracic echocardiography was referred to our hospital. Quadricuspid aortic valve was diagnosed on preoperative transesophageal echocardiography. We performed aortic valve replacement with a bioprosthetic valve. In the operation, the accessory cusp was found to be located between the right coronary and noncoronary cusps, and the cusps had multiple fenestrations near the commissures.

Dehiscences and fenestrations: methodological care necessary to avoid errors in diagnosis and measurement

ABSTRACT The low prevalence of gingival recessions observed in orthodontic clinical practice may be assigned to the fact that in studies in which dehiscences and bone fenestrations are described as frequent, they were diagnosed based on: 1) dry skull studies; 2) areas with periosteal reflection together with flap; and 3) imaging techniques with low sensitivity to detect these defects, which have a delicate structure and function. In areas of pseudo-dehiscences and fenestrations, the periosteum and the alveolar cortical bone are very thin; also, they either have been removed during preparation of the dry specimens in the areas for analysis, or, alternatively, have not been investigated using an ideal imaging method.

RESUMO A ausência de prevalência elevada das recessões gengivais relacionadas à prática clínica ortodôntica se explica, provavelmente, porque, nos trabalhos em que as deiscências e fenestrações ósseas são descritas como frequentes, essas foram diagnosticadas a partir de: 1) estudos em crânios secos; 2) áreas com rebatimento periosteal junto com o retalho; e 3) uso de métodos imagiológicos que falham em sensibilidade para captá-las, pela sua delicadeza estrutural e funcional. Nessas áreas de pseudodeiscências e fenestrações, existe periósteo e cortical óssea alveolar muito fina, que foram eliminados nos procedimentos de preparação dos espécimes secos, nas áreas para a análise ou, então, não se aplicou um método imagiológico ideal.

Endoscopic Multiple Wide Fenestrations of Intraventricular Arachnoid Cyst Arising in Lateral Ventricle

Intraventricular arachnoid cyst is an uncommon disease and a few surgical experiences have been reported. The authors present an experience of neuroendoscopic surgery in a 4-year-old-male patient with a large arachnoid cyst arising from the right lateral ventricle, who had suffered from generalized tonic clonic seizure. On operation, various portions of the cyst could be easily approached without unwanted parenchymal injury because most of the cystic membrane was movable and not adherent to the ventricular wall except choroid plexus area, which could be considered as origin site of the cyst. Marked shrinkages by electrocoagulation and multiple wide fenestrations of the cyst were obtained through the endoscopic working channel without difficulty. Postoperative brain computed tomography demonstrated decreasing ventricular size with no evidence of cystic recurrence. The postoperative course was uneventful for eight months follow-up period. We suggest that endoscopic procedure has definite advantages as the surgical method of choice for the treatment of intraventricular arachnoid cysts.

Atrial Morphology Related to Secretory Function and Transport of Metabolites : I. Fenestrations of Basal Lamina in Rat Atrial Endocardium / 대한해부학회지

It was well known that atrial myocytes systhesize atrial natriuretic peptide[ANP], and secrete it into the atrial lumen through the atrial endocardium. But the mechanism for regulation of ANP secretion has not been clearly elucidated, because there was little information of the atrial morphology concerning basal lamina. Basal lamina is surmised as one of barriers that control the movement of ANP, a large molecule. This study was attempted to elucidate the morphological characteristics of basal lamina and connective tissue fibers of atrial endocardial layer by scanning electron microscopy. Basal lamina was exposed by removal of the overlying endothelium. This was achieved by using OsO4 maceration, immersion in aqueous boric acid or EDTA treatment. After removal of the endothelial cell, the specimens were exposed to ultrasonic vibration in case of need. The external surface of basal lamina showed a fairly smooth appearance on the whole, although a few irregular folds are often encountered. Fenestrations, 0.1-1 micrometer in diameter, were randomly observed on the basal lamina, and they were circular to oval in shape. Margin of fenestrations was somewhat distinct and some was divided into two parts by linear structures. The structural differences of fenestrations between right and left atria were not found. The fibroreticular lamina under the basal lamina was revealed by removal of the endothelial cells and their basal lamina. This layer was consisted of interwoven fine fibers. These fine fibers were repeatedly divided and fused, forming reticular network. Some fine fibers connected with basal lamina. Some connective tissue fibers below fibroreticular layer were collected into thick bundles running parallel to myocytes. Above results may serve as a basis for the physiological and morphological studies of atrium.