Histologic Changes of Pulmonary Arteries in Congenital Heart Disease with Left-to-Right Shunt (Part 1): Correlated with Preoperative Pulmonary Hemodynamics. Emphasizing the Significance of Pulmonary Arterial Concentration

The hemodynamic findings related to the histologic changes in the small pulmonary arteries in congenital heart disease were analyzed with a left-to-right shunt. A lung biopsy was performed during the repair because of pulmonary arterial (PA) hypertension (mean PA pressure > or = 15 mmHg) in 38 patients. There were 13 patients whose age ranged from 2 years to 25 years old. A preoperative cardiac catheterization was performed to locate the site of the defect and to determine the preoperative hemodynamic findings. Among them, 29 patients had pulmonary vascular resistance (PVR) > 2.5 unit/m2. The lung biopsy specimens were investigated microscopically for the Heath- Edward grade, morphometric analysis of medial wall thickness (MWT) and the rate of the decrease in the pulmonary arteriolar concentration (PAC) obtained by the alvoelo-arterial ratio divided by patients' age. All patients were in the Heath-Edward grade I to III (29 patients in grade I). This grade correlated with the MWT, but did not correlate with a decrease in the PAC. The MWT and the rate of the decrease in the PAC did not accompany each other, but either one had the tendency dominate the pattern in individual patients. The MWT had a close correlation with the mean PA pressure and PVR, and an even closer correlation in patients with a high PVR and those older than 2 years of age. The rate of the decreased in the PAC showed a weak correlation with the shunt volume in patients over 2 years of age or with a large shunt. In the high flow group (PVR 2.0, n=14) the MWT was significantly thinner and the rate of the decrease in the PAC was significantly higher than the high resistance group (PVR > 2.5 unit/m2, Qp/Qs2 < 2.0, n=13). The rate of the decrease in the PAC correlated with the patients' age, but the MWT did not. The lung biopsy results in patients who had both left-to-right shunts and pulmonary hypertension showed that the rate of the decrease in the PAC was weakly related to the shunt volume and the MWT was related to the PA pressure and PVR. Either an increased MWT or the rate of the decrease in the PAC tended to dominate. These phenomena were prominent in patients older than 2 in whom a wide range of individual variations were noted in the morphometric pattern. The medial hypertrophy and the rate of the decrease in the PAC may be induced by different stimuli or that medial hypertrophy may play a role in preventing PAC decrease.

Usefullness of Thermography in Migraine Diagnosis

Background : The reports from researchers present new imaging diagnosis, which makes it possible to observe the vascular change(temperature change) of face in migraine. However, we do not have enough study for thermography to find out migraine in Korea. thus, this study was performed in order to apply thermography to migraine patients. Methods : From November in 1989 to July in 1999, patients with headache who visited to Korea University Hospital Family Medicine were undertaken. Among them, 6 patients who were appropriated for the International Headache Society criteria for migraine were performed facial thermography. Results : Six patients who were appropriate for IHS criteria for migraine were undertaken in this study. When they had headache attack, we tested thermography. Asymmetry of heat loss on supraorbital and frontotemporal areas was not significantly different in three of them. The others showed the difference of heat loss more than 0.5 degrees C in supraorbital and frontotemporal areas. It was in headache side that heat loss was showed. Two of patients who showed heat loss were enable to follow up and one of them showed the disappearance of asymmetrical heat loss. Conclusions : As a result, facial thermograms demonstrated the significant differences in heat loss from the temple and orbits in migraine patients. We concluded thermography in migraine patients is suitable for clinical use

Vascular effects of the inferior alveolar nerve injection of 2% lidocaine hci with 1:100,000 epinephrine

An experimental study on the vascular changes of rat molar periodontal ligament following orthodontic tooth movement using vascular corrosion casting method / 대한치과교정학회지

This study was undertaken to investigate the three dimensional vascular changes of periodontal ligament following orthodontic tooth movement. Experimental tooth movement was carried out in 96 Sprague-Dawley rats with the weight of 250g. They were divided into four experimental groups (each 24 rats). The left maxillary first molar was moved mesially with 25g force in group I, and with 75g force in group II. Each three animals were sacrificed after 1, 6, 12, 24 hours, and 3, 7, 14, 21 days. In group III, 25g mesial force was applied for 3 days, and in group IV, 75g mesial force was applied for 3 days. Then the appliances were removed, and each three animals were sacrificed after 1, 6, 12, 24 hours, and 3, 7, 14, 21 days from removal of appliance. The contralateral molars were used for control group. Casting media was injected via left ventricle and polymerized in warm water. After corrosion of surrounding soft tissue, three dimensional vascular changes were examined using scanning electron microscopy. The findings of this study were as follows: 1. Pressure side of group I and II showed degenerative vascular changes such as vascular compression, reduction of vasculature, leakage of casting media. But, regenerative changes were dominant after 7 days of tooth movement. Although the degenerative vascular changes were more severe in group II, which was exposed to heavy force, the timing of these changes was not different between two groups. 2. Periodontal vasculature was reestablished by the growth of new capillaries and their differentiation and union from the remaining periodontal vessels and vessels of alveolar bone marrow. Although vascular regeneration was more rapid in group I, which was exposed to light force, the vasculature was not fully normalized in both groups even after 21 days. 3. There was no remarkable changes in tension side of group I and II, but looping of capillary, new capillary growth, dilation of vessels, redirection of vessels in the direction of tensile force were occurred. 4. In pressure side of group III and IV, in which appliance was removed after 3 days of orthodontic force, bone resorption was continued even after removal of appliance. Regeneration of vasculature was initiated after 1-6 hours, and it was more rapid in group III than group IV. In both groups, the vasculature was not fully normalized even after 21 days. 5. After removal of appliance, tension side of group III and IV showed vascular compression and loss of vasculature.