Surgical Anatomical Landmarks for Petrous Apex

BACKGROUND AND OBJECTIVES: Anatomical knowledge of the petrous apex is essential to otolaryngologist to explore the skull base lesions. This study was designed to investigate the surgical anatomy of the petrous apex and the middle cranial fossa. MATERIALS AND METHODS: We dissected 32 temporal bones in order to establish the anatomical relationships of petrous apex structures. We measured distances and angles between different structures so that surgeons can rely on to work in this area. RESULTS: The results of the present study showed distances and angles of the different petrous apex structures. The angle between posterior point-foramen spinosum and porus was 90 degree. CONCLUSION: We could suggest the new indicators to identify the internal acoustic canal.ope

비트 펄프가 in vitro 반추위 발효성상과 한우 거세우의 성장, 반추위 발효와 미생물 및 혈액 성상에 미치는 영향

학위논문(석사)--서울대학교 대학원 :농업생명과학대학 농생명공학부,2019. 8. 백명기.본 연구에서는 비트 펄프가 in vitro 반추위 발효성상과 한우 거세우의 성장, 반추위 발효와 미생물 및 혈액 성상에 미치는 영향을 조사하였다. 실험 1 (In vitro)에서는 캐뉼라가 설치된 Holstein 거세우를 사용하여 발효성상을 비교하였다. 실험1 결과, 6, 12 및 24h에 옥수수보다 비트펄프에서 C2 농도와 C2:C3 비율이 높았다 (P 0.05). However, acetate proportion (P = 0.001) at 4th week, insulin concentration (P = 0.01) at 12th week and relative abundances of cellulolytic bacteria including Fibrobacter succinogenes (P = 0.01) and Ruminococcus albus (P = 0.04) at 12th weeks were higher in BP group compared with corn group, whereas propionate and butyrate proportion, or non-esterified fatty acid (NEFA) at 12th week (P < 0.04) was lower in BP group compared with corn group. Therefore, this experiment suggests that BP could be a good energy source for increasing the acetate proportion without impairing cattle performance in the fattening period.Ⅰ. Introduction 1 Ⅱ. Literature review . 3 1. Energy sources lipid metabolism in ruminants . 3 1.1 Energy sources in ruminants 3 1.1.1 Energy metabolism . 3 1.1.2 Grain . 5 1.1.3 Beet pulp 6 1.2 Energy and lipid metabolism 7 2. Effects of beet pulp on growth performance, rumen fermentation, and lipid metabolsim in ruminants 11 2.1 Effect of beet pulp on growth performance . 11 2.2 Effect of beet pulp on ruminal fermentation . 13 2.3 Effect of beet pulp on blood metabolites . 15 Ⅲ. Materials and methods 31 1. Experiment 1(In vitro experiment) 31 2. Experiment 2 (In vivo feeding trials) . 35 2.1 Animals, diet, and experimental design 35 2.2 Blood collection . 40 2.3 Blood analysis . 40 2.4 Analysis of chemical composition of diets 41 2.5 Rumen fluid collection and analysis . 41 2.6 gDNA extraction and quantitative real-time PCR for analyzing microorganisms 41 3. Statistical analysis . 45 Ⅳ. Results 46 1. Experiment 1 46 1.1 Dry matter degradability 46 1.2 Rumen fermentation characteristics 46 2. Experiment 2 53 2.1 Growth Performance . 53 2.2 Rumen fermentation characteristics and microbial population 53 2.3 Blood metabolites 63 Ⅴ. Discussion . 65 Ⅵ. Literature cited 71 Ⅶ. Summary in Korean 80 Ⅷ. Acknowledgement . 81Maste

마우스 동맥경화증에서 CD137의 역할

학위논문 (박사)-- 서울대학교 대학원 : 수의학과, 2014. 2. 김대용.The tumor necrosis factor receptor superfamily (TNFRSF), which includes CD40, LIGHT, and OX40, plays important roles in the development of atherosclerosis. CD137 (4-1BB), a member of the TNFRSF, is an activation-induced T cell co-stimulatory molecule. Signaling via CD137 up-regulates survival genes, enhances cell division, induces cytokine production, and prevents activation-induced cell death in T cells. CD137 has been reported to be expressed in human atherosclerotic plaque lesions. However, limited information is available on the precise role of CD137 in the development of atherosclerosis using mice models. To study the roles of CD137 in atherogenesis, we generated CD137 deficient apolipoprotein E knockout (ApoE-/-CD137-/-) mice and CD137 deficient low density lipoprotein receptor knockout (Ldlr-/-CD137-/-) mice. We found that CD137 is a significant atherosclerosis promoting factor mainly expressed on T cells infiltrated into atherosclerotic plaque lesions. Moreover, our finding showed that deficiency of CD137 strongly attenuates formation of atherosclerotic plaque lesion in ApoE-/- and Ldlr-/- mice, which implicates CD137 as a potential therapeutic target for atherosclerosis disease control. Atherosclerotic plaques contain blood-borne inflammatory and immune cells such as macrophages and T cells, as well as vascular cells. Formation of atherosclerotic plaque lesions are characterized by inflammation, lipid accumulation, cell death, and fibrosis. Adaptive immunity, in particular T cells, is highly involved in atherosclerosis. When the naive T cell encounters antigen-presenting cell such as macrophages and dendritic cells that presents an antigenic peptide including oxidized low density lipoprotein (oxLDL), T cells undergo activation and become effector T cells secreting Th1 cytokine such as interferon gamma (IFN-γ), which promotes the development of atherosclerosis. Enhanced T cell activation by co-stimulatory receptors significantly increases inflammatory cytokine release by monocyte/macrophages, further exacerbating inflammation and promoting atherosclerosis. Here, we studied functional mechanisms of CD137 in atherosclerosis. We found that CD137 functionally induces activation of T cell by generation of IFN-γ. In turn, IFN-γ induces monocytes/macrophages and endothelial cells to augment pro-inflammatory cytokine production through a positive feedback mechanism, thereby facilitating formation of atherosclerotic plaque. Over time, mature plaques advance to a vulnerable plaque, being more prone to rupture, causing subsequent atherothrombotic vascular disease such as myocardial infarction. Vulnerable plaques generally have a large necrotic core, and thin fibrous caps, attributable to the death of macrophages and vascular smooth muscle cells (VSMCs). Vulnerable plaques also contain elevated levels of proteases, including matrix metalloproteinases (MMPs), which might degrade the extracellular matrix and weaken fibrous caps. Our previous results suggested that CD137/CD137L signaling facilitates atherosclerosis. However, there is no report whether CD137 signaling affects plaque stability of advanced atheroma or not. To answer this question, we tried to elucidate whether CD137 can induce advanced plaque phenotype in atherosclerotic model mice. To solve the mechanism of CD137 in plaque stability, we focused on T cells, macrophages, and VSMCs, which are major cells involved in plaque stability. We found CD137 expression in these cells in atherosclerotic plaque lesion. Next, we investigated the functional mechanisms and signaling pathways of CD137 on these cells. Finally, we tried to confirm whether the in vivo activation of CD137 signaling using agonistic anti-CD137 mAb can exacerbate plaque stability in plaque of high fat diet fed Ldlr-/- mice. These observations could support the role of CD137 in stability of advanced atherosclerotic plaque. In summary, we show that 1) CD137 is a significant atherosclerosis-promoting factor mainly expressed on T cells infiltrated into atherosclerotic plaque lesions. Deficiency of CD137 reduces atherosclerosis in both normal chow diet fed ApoE-/- and high fat diet fed Ldlr-/- mice. 2) CD137 signaling induces activation of T cell by generation of IFN-γ, which leads to another phase of recruitment and activation of macrophages. The activated macrophages produce TNF-α and MCP-1, which cause endothelial CD137 expression. The endothelial CD137 signaling induces the production of MCP-1 and cell adhesion molecules, leading to enhancement of leukocyte recruitment to the atherosclerotic plaque. Therefore, CD137 signaling facilitates atherosclerosis through a positive feedback mechanism to T cells, macrophages, and endothelial cells. 3) In advanced atheroma, we found that CD137 induces advanced atherosclerotic plaque phenotype exhibiting enhanced plaque necrosis, decreased collagen and VSMCs content, and enhanced macrophage infiltration. CD137 facilitates T cell activation leading to the production of INF-γ, and increases macrophage derived MMP-9 through phosphorylation of p38 MAPK and ERK1/2 pathways. Moreover, activation of CD137 signaling inhibited Bcl-2, and then by up-regulated cleaved caspase-3, leads to apoptosis of VSMCs.ABSTRACT ……………………………..……………………………………....... i LIST OF CONTENTS ………………….………………………………….……..v LIST OF FIGURES …………………….……………………………………...... x LIST OF ABBREVIATIONS ………….……………………………………… xiii GENERAL INTRODUCTION ……….………………………………………… 1 I. Atherosclerosis …………………….………………………………………... 1 1. Development and immunological features of atherosclerosis …………………1 2. T cells in atherosclerosis …………....…………………………………........2 2-1. T helper1 (Th1) cells …………………………………………...........2 2-2. Regulatory T (Treg) cells ……………………….………………........3 II. Co-stimulatory molecules and receptors …………………………………...10 1. CD137 and CD137L ……………………………………………………....10 2. CD137 and CD137L in atherosclerosis …………………………………......11 III. Advanced, vulnerable plaque ……………………………………………..14 1. Pathological features of vulnerable plaque …………………………………14 2. TNFRSF and vulnerable plaque ……………………………………...……15 PURPOSE OF THIS STUDY ……………………………………………..….....18 PART I. The Roles of CD137/CD137L Signaling in the Pathogenesis of Atherosclerosis ………………………………………………………....21 Abstract …………………………………………………………..…………22 Introduction ………………………………………………………………....23 Materials and methods ………………………………………….....……….25 1. Experimental animals ……………………………………..…………....25 2. Identification of mouse genotype ……………………..........…………....25 a) Mouse tail DNA extraction ………………………………..……….....25 b) Polymerase chain reaction (PCR) analysis …………………………….26 3. Analysis of atherosclerotic plaque in mice ………………....…………….27 4. Immunohistochemistry ………....……………………………………....27 5. Statistical analysis ……………………………………………..……….28 Results ………………………………………………………...……….....….30 1. Expression of CD137 and CD137L in T cells and macrophages in mouse atherosclerotic plaque lesions …………………………………….……......30 2. Deficiency of CD137 reduces atherosclerosis in both normal chow diet and high fat diet fed mice ……………………………………....……………...35 Discussion ……………………………………………………….....………..39 PART II. Regulatory Mechanisms by CD137/CD137L Signaling ..…………..41 Abstract …………....………………………………………………………..42 Introduction ……………………………………………………….………...43 Materials and methods …………………………………………...………...45 1. Immunohistochemistry ………………….....………………..…………..45 2. Analysis of intracellular T cell cytokine production ……....….........……...46 3. Real time reverse transcriptase-polymerase chain reaction …...……..47 4. Macrophage migration assay ……………………………………..……..48 5. Cell culture and cytokine treatment ………………………………….......48 6. Aorta organ culture …………………………………………...………...49 7. Bone marrow transplantation …………………………….......……….....50 8. Statistical analysis ……….……….……..............….……….……….....50 Results ……………………………………………………………………....51 1. Deficiency of CD137 reduced IFN-γ production in atherosclerotic mice ......51 2. CD137 signaling enhances the production of pro-inflammatory molecules in endothelial cells ……………………………………………...…………...56 3. Reverse CD137L signaling activation by CD137 contributes to the production of MCP-1, and TNF-α in atherosclerotic plaque ………………….........…....62 Discussion …………………………………………………………………...71 PART III. The Roles of CD137 Signaling in the Stability of Advanced Atherosclerotic Plaque …………………………………………………...……...74 Abstract ………………………………………………………....…………..75 Introduction ……………………………………………………….....……...76 Materials and methods ……………………………………….......………...79 1. Experimental animals …………………………………………………..79 2. Aortic single cell, splenocytes, lymph node cells preparation and flow cytometry ……………………………………………………….………..79 3. Analysis of atherosclerosis in mice ……………………………….....…...80 4. Immunohistochemistry for atherosclerotic plaque stability of aortic root …..81 5. Preparation of Treg cells and in vitro proliferation assay of Teff cell......81 6. In vitro analysis of intracellular IFN-γ in activated T cells …………....…...82 7. Cell culture and cytokine treatment ………………………………....…...82 8. Quantitative real-time polymerase chain reaction …………………….......83 9. Flow cytometry analysis for CD137 expression …………………......…....84 10. Matrix metalloproteinase (MMP) activity ……………………………..84 11. Immuno-blot for MMP, cell signaling pathways and cell apoptosis …..…..85 12. Peritoneal macrophages survival assay ……………………….………...85 13. Statistical analysis …………………………………………………......86 Results ……………………………………………………………......……...87 1. CD137 induces advanced atherosclerotic plaque phenotype ………..……..87 2. CD137 leads to enhanced expression of IFN-γ in effector T cells …….........94 3. CD137 is expressed in macrophages and VSMCs …………………..…...100 4. CD137 signaling increases oxLDL dependent macrophage MMP-9 .....…..104 5. CD137 signaling activates MMP expression …………………..………..110 6. CD137 signaling induces apoptosis of VSMCs ………..………………...115 7. Agonistic anti-CD137 mAb treatment induces vulnerable plaque phenotype……………. ………………………………………….……...124 Discussion ………………………………………………………..………...127 CONCLUSION ………………………………………………………….……..133 REFERENCES …………………………………………………….…………..134 ABSTRACT IN KOREAN (국문초록) …………………………......………...149Docto

Clinical implications of topographic anatomy on the ganglion impar

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Measurement of Korean Ossicles

Background and Objectives：There are several factors affecting the result of the ossiculoplasty such as the severity of the pathology, the operating technique and the reconstruction material, etc. So far, most of the ossicular materials that have been developed were not perfect and some of the commercialized materials are not suitable for Koreans. We investigated the dimensions of the Korean ossicles and the space between the handle of the malleus and the plane of the stapes in order to standardize the artificial ossicles to fit Koreans. Materials and Methods：Sixteen cadaveric Korean temporal bones which did not have any pathology of tympanic membrane and ossicles were used for this study. We dissected the temporal bones and measured the related dimensions of ossicles under a surgical microscope. Results：The dimensions of the part of ossicles are as follows：(1) length (mm),1) malleus head 3.46±0.57, neck 0.91±0.17, handle 4.40±0.29；2) incus short process 2.42±0.35, long process 3.31±0.57；3) stapes head and neck 0.79±0.19, height of crura 2.24±0.34：(2) diameter (long, short) (mm), stapes head 0.95±0.20, 0.73±0.11, footplate 2.91±0.20, 1.38±0.16. The distance between the stapes head and the malleus handle was 3±0.3 mm, and between the stapes footplate and the malleus handle 5.1±0.4 mm. The angle between a line from the malleus handle to the head of stapes and a perpendicular line of stapes footplate passing the center of stapes head was 29±7 degree. The angle between a line from the malleus handle to the stapes footplate and a perpendicular line of stapes footplate passing the center of stapes head was 17±5 degree. Conclusion：We collected normal data of dimensions of the Korean ossicles from cadaveric temporal bones. The differences in the dimensions between ossicles of the Korean and the non-Koreans were observed. The observed data from this study should be useful in the development of the artificial ossicular materials suitable for the Koreans.ope

Surgical Anatomy for the Extended Middle Fossa Approach

Background and Objectives：The extended middle fossa approach is an essential method in approaching the internal acoustic canal and the cerebellopontine angle while preserving the hearing function. This work attempted to establish some anatomical landmarks in the petrous apex as it relates to the extended middle fossa approach. Materials and Methods：We dissected 49 human skulls of Korean origin by using the extended middle fossa approach. Results：Internal acoustic canal (IAC) was identified in an attempt to find reliable distances and angles to be used in the extended middle fossa approach. In addition, the dimensions of the fundus of IAC and IAC as well as the extension ranges were obtained. Conclusion：The extended middle fossa approach is a good method in approaching the internal acoustic canal and cerebellopontine angle. In this study, we have established anatomical landmarks for using this approach in the human skulls of Korean origin.ope

Topographical relationship of the facial and vestibulocochlear nerves in the subarachnoid space and internal auditory canal

PURPOSE: Our purpose was to investigate the topographical relationship of the facial and vestibulocochlear nerves from the brain stem through the internal auditory canal. METHODS: We dissected 15 formalin-fixed cadaveric heads and performed MR examinations in 35 healthy subjects in order to examine the topographical relationship of the facial and vestibulocochlear nerves. The cadaveric dissections and the in vivo MR imaging findings were compared indirectly. RESULTS: The relationship between the facial and vestibulocochlear nerves showed some variation among individuals and according to the location of the nerves within the cisterns or canal. Near the brain stem, 53% of the vestibulocochlear nerves were partially segmented on MR images. The vestibulocochlear nerve was completely divided into separate nerves only in the most lateral portion of the canal, except in three cadaveric dissections, in which separation of the superior vestibular nerve was seen near the brain stem. The facial and cochlear nerves were of similar size on 36% of the MR images. The superior vestibular nerve was larger than the inferior vestibular nerve on 81% of the MR images. CONCLUSION: The appearance of the facial and vestibulocochlear nerves was variable but followed certain consistent patterns.ope

Papillary muscle rupture during acute myocardial infarction

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The Morphoiogy of the Mental Foramen in Korean Adult Mandibles

When implantation or genioplasy and orthogenathic surgery being performed on patients, the position of the anterior limit of the mandibular canal and the geometrical relation between the mental foramen and the mandibular canal should be considered on the basis of clinical and anatomical aspects. In an attempt to analyze the mental canal and foramen in mandibles and the internal structure of the mandibles, ninety-three adult Korean mandibles were radiographer and fifty-two hemisected mandibles were sectioned to observe the mental foramen and the internal structure of the mandible on image analyzer. In dry mandibles, the prevalence in which the mental foramen was located beneath the mandibular second premolar was the most commonly seen one(92.0%). Among them, the prevalence in which the mental foramen located beneath the center of the mandibular second premolar, mesial of the mandibular second premolar and distal of the mandibular second premolar were 47.0%, 18.0% and 27.0%, respectively. The radiographic appearances of the mandibular canal and mental foramen were classified into four types : A continuous type which showed continuity with the mental foramen through the mandibular canal, a separated type in which the mental foramen was distinctly separated from the mandibular canal, a diffused type in which the mental foramen with indistinct border and an unidentified type in which the mental foramen could not be identified on the radiographs. These prevalences in order were 28.3%, 21.7%, 22.4% and 27.6%, respectively. On sectioned specimens, the region where the mandibular canal leads to the mental foramen was formed 'cavity' and the distance between the inferior margin of the mental foramen and the inferior margin of the mandibular canal was 2.4±0.7 mm. Taken all together, in most of the cases, the anterior border of the mandibular canal is located around the premolar region, and the mental foramen is opened nearly the second premolar. Therefore, it may be suggested that osteotomy has to be taken at the anterior place next to the canine region, at the 2.4mm below to the mental foramen on genioplasty.ope

Cutaneous Sensory Branch of the Mylohyoid Nerve

The study is aimed at the anatomical detail of the cutaneous sensory branch of the mylohyoid nerve (MHN), which is distributed to the chin, as it relates to submental surgery. Dissection was done on the both sides (16) of eight cadavers fixed in formaldehyde solution. A distance from gonion of the branch innervating the anterior digastric and mylohyoid muscle and the cutaneous sensory branch was measured. The cutaneous sensory nerve was 27.0+/-8.6 mm long and numbered 2.3 (14.4%) of 16 specimens. The area distributed by most branches (78%) was a rhombus, having all four sides equal (15 mm), extending to the mental prominence and submentum. The divergent angle of the two facing sides of the bilateral rhombi was 60 degrees. Informed surgical manipulation of the mental area may avoid unnecessary damage to the sensory nerve.restrictio