Septal Volume Research Articles

Feasibility of septal body volume reduction for patients with nasal obstruction.

Septal body hypertrophy, like inferior turbinate hypertrophy, can result in changes to the nasal cross-sectional area and resistance to airflow. The aim of this study is to evaluate the efficacy of septal body volume reduction (SBVR) for the treatment of septal body hypertrophy in patients with nasal obstruction. Prospective randomized study. The study was conducted on two groups (51 patients) with symptoms and signs of nasal obstruction associated with septal body and inferior turbinate hypertrophy that were refractory to medical therapy. In the turbinoplasty only (ITR) group (n = 25), conventional turbinoplasty was only performed on the inferior turbinate. In the septal body reduction (SBR) group (n = 26), concurrent bilateral microdebrider-assisted SBVR was performed during the turbinate surgery. The nasal symptoms, including nasal obstruction, rhinorrhea, itching, and sneezing, had significantly improved at 3 months after treatment in both groups (P < 0.001). Improvement of nasal obstruction in the SBR group was greater than that in the ITR group at 3 months (P < 0.05). Acoustic rhinometry demonstrated a significant increase in the cross-sectional area and nasal volume in both groups 3 months after surgery. The postoperative change in nasal volume was higher in the SBR group (P < 0.05). No adverse reactions such as bleeding, infection, adhesions, or olfactory changes were encountered in the SBR group. Combined SBVR and turbinoplasty appears to be more effective than turbinoplasty alone for the treatment of nasal obstruction in patients with inferior turbinate and septal body hypertrophy.

Potential reduction of interstitial myocardial fibrosis with renal denervation.

BackgroundHypertensive cardiomyopathy is characterized by myocyte hypertrophy and interstitial fibrosis. The effects of renal denervation (RD) on the heart are poorly understood. New magnetic resonance imaging techniques (extracellular volume fraction) permit the quantitative assessment of myocardial fibrosis. Our aim was to study the effects of RD on myocardial fibrosis.Methods and ResultsTwenty‐three patients with resistant hypertension undergoing RD and 5 resistant hypertensive controls were prospectively included. Cardiac magnetic resonance imaging at 1.5 T was performed before RD and at 6‐month follow‐up. Indexed left ventricular mass, septal extracellular volume fraction, and indexed absolute extracellular volume (a quantitative measure of extracellular matrix) were quantified. All data are reported as mean±SD deviation (median). Decreases in systolic (161.96±19.09 [160] versus 144.78±16.48 [143] mm Hg, P<0.0001) and diastolic (85.61±12.88 [83] versus 80.39±11.93 [81] mm Hg, P=0.018) blood pressures and in indexed left ventricular mass (41.83±10.20 [41.59] versus 37.72±7.44 [38.49] g/m1.7, P=0.001) were observed at follow‐up only in RD patients. No significant differences in extracellular volume were found (26.24±3.92% [26.06%] versus 25.74±4.53% [25.63%], P=0.605). A significant decrease in absolute extracellular volume was observed after 6 months in RD patients exclusively (10.36±2.25 [10.79] versus 9.25±2.38 [9.79] mL/m1.7, P=0.031). This effect was observed independently of blood pressure reduction.ConclusionsRD significantly decreases left ventricular mass, while extracellular volume remains stable. Our results suggest that the observed left ventricular mass decrease was due not exclusively to a reversion of myocyte hypertrophy but also to an additional reduction in collagen content, indicating interstitial myocardial fibrosis.

Growth trajectories of some major ammonoid sub-clades revealed by serial grinding tomography data

Molluscs such as ammonoids record their growth in their accretionary shells, making them ideal for the study of evolutionary changes in ontogeny through time. Standard methods usually focus on two-dimensional data and do not quantify empirical changes in shell and chamber volumes through ontogeny, which can possibly be important to disentangle phylogeny, interspecific variation and palaeobiology of these extinct cephalopods. Tomographic and computational methods offer the opportunity to empirically study volumetric changes in shell and chamber volumes through ontogeny of major ammonoid sub-clades in three dimensions (3-D). Here, we document (1) the growth of chamber and septal volumes through ontogeny and (2) differences in ontogenetic changes between species from each of three major sub-clades of Palaeozoic ammonoids throughout their early phylogeny. The data used are three-dimensional reconstructions of specimens that have been subjected to grinding tomography. The following species were studied: the agoniatitid Fidelites clariondi and anarcestid Diallagites lenticulifer (Middle Devonian) and the Early Carboniferous goniatitid Goniatites multiliratus. Chamber and septum volumes were plotted against the septum number and the shell diameter (proxies for growth) in the three species; although differences are small, the trajectories are more similar among the most derived Diallagites and Goniatites compared with the more widely umbilicate Fidelites. Our comparisons show a good correlation between the 3-D and the 2-D measurements. In all three species, both volumes follow exponential trends with deviations in very early ontogeny (resolution artefacts) and near maturity (mature modifications in shell growth). Additionally, we analyse the intraspecific differences in the volume data between two specimens of Normannites (Middle Jurassic).

Dysmorphogenic effects of first trimester-equivalent ethanol exposure in mice: a magnetic resonance microscopy-based study.

The first trimester of human development and the equivalent developmental period in animal models is a time when teratogenic ethanol (EtOH) exposure induces the major structural birth defects that fall within fetal alcohol spectrum disorder (FASD). Previous FASD research employing an acute high dose maternal intraperitoneal EtOH treatment paradigm has identified sensitive periods for a number of these defects. Extending this work, this investigation utilized high resolution magnetic resonance microscopy (MRM)-based analyses to examine the dysmorphology resulting from maternal dietary EtOH intake occurring during selected first trimester-equivalent time periods. Female C57Bl/6J mice were acclimated to a liquid 4.8% EtOH (v/v)-containing diet, then bred while on standard chow. Dams were again provided the EtOH-containing liquid diet for a period that extended either from the beginning of gestational day (GD) 7 to the end of GD 11 or from the beginning of GD 12 to the end of GD 16. On GD 17, a subset of fetuses was selected for MRM-based analyses. Group comparisons were made for litter characteristics and gross dysmorphology, as well as whole and regional brain volumes. EtOH-induced stage of exposure-dependent structural brain abnormalities were observed. The GD 7 to 11 EtOH-exposed group presented with a significant decrease in cerebellar volume and an increase in septal volume, while GD 12 to 16 EtOH treatment resulted in a reduction in right hippocampal volume accompanied by enlarged pituitaries. Additionally, the GD 12 to 16 EtOH exposure caused a high incidence of edema/fetal hydrops. These results illustrate the teratogenic impact of maternal dietary EtOH intake occurring at time periods approximately equivalent to weeks 3 through 6 (GD 7 to 11 in mice) and weeks 7 through 12 (GD 12 to 16 in mice) of human gestation, further documenting EtOH's stage of exposure-dependent neuroteratogenic end points and highlighting the vulnerability of selected brain regions during the first trimester. Additionally they suggest that clinical attention should be paid to fetal hydrops as a likely component of FASD.

Comparison of human septal nuclei MRI measurements using automated segmentation and a new manual protocol based on histology

Septal nuclei, located in basal forebrain, are strongly connected with hippocampi and important in learning and memory, but have received limited research attention in human MRI studies. While probabilistic maps for estimating septal volume on MRI are now available, they have not been independently validated against manual tracing of MRI, typically considered the gold standard for delineating brain structures. We developed a protocol for manual tracing of the human septal region on MRI based on examination of neuroanatomical specimens. We applied this tracing protocol to T1 MRI scans (n=86) from subjects with temporal epilepsy and healthy controls to measure septal volume. To assess the inter-rater reliability of the protocol, a second tracer used the same protocol on 20 scans that were randomly selected from the 72 healthy controls. In addition to measuring septal volume, maximum septal thickness between the ventricles was measured and recorded. The same scans (n=86) were also analyzed using septal probabilistic maps and DARTEL toolbox in SPM. Results show that our manual tracing algorithm is reliable, and that septal volume measurements obtained via manual and automated methods correlate significantly with each other (p<.001). Both manual and automated methods detected significantly enlarged septal nuclei in patients with temporal lobe epilepsy in accord with a proposed compensatory neuroplastic process related to the strong connections between septal nuclei and hippocampi. Septal thickness, which was simple to measure with excellent inter-rater reliability, correlated well with both manual and automated septal volume, suggesting it could serve as an easy-to-measure surrogate for septal volume in future studies. Our results call attention to the important though understudied human septal region, confirm its enlargement in temporal lobe epilepsy, and provide a reliable new manual delineation protocol that will facilitate continued study of this critical region.

Effects of exogenous surfactant on the non‐heart‐beating donor lung graft in experimental lung transplantation – a stereological study

The use of non-heart-beating donor (NHBD) lungs may help to overcome the shortage of lung grafts in clinical lung transplantation, but warm ischaemia and ischaemia/reperfusion injury (I/R injury) resulting in primary graft dysfunction represent a considerable threat. Thus, better strategies for optimized preservation of lung grafts are urgently needed. Surfactant dysfunction has been shown to contribute to I/R injury, and surfactant replacement therapy is effective in enhancing lung function and structural integrity in related rat models. In the present study we hypothesize that surfactant replacement therapy reduces oedema formation in a pig model of NHBD lung transplantation. Oedema formation was quantified with (SF) and without (non-SF) surfactant replacement therapy in interstitial and alveolar compartments by means of design-based stereology in NHBD lungs 7 h after cardiac arrest, reperfusion and transplantation. A sham-operated group served as control. In both NHBD groups, nearly all animals died within the first hours after transplantation due to right heart failure. Both SF and non-SF developed an interstitial oedema of similar degree, as shown by an increase in septal wall volume and arithmetic mean thickness as well as an increase in the volume of peribron-chovascular connective tissue. Regarding intra-alveolar oedema, no statistically significant difference could be found between SF and non-SF. In conclusion, surfactant replacement therapy cannot prevent poor outcome after prolonged warm ischaemia of 7 h in this model. While the beneficial effects of surfactant replacement therapy have been observed in several experimental and clinical studies related to heart-beating donor lungs and cold ischaemia, it is unlikely that surfactant replacement therapy will overcome the shortage of organs in the context of prolonged warm ischaemia, for example, 7 h. Moreover, our data demonstrate that right heart function and dysfunctions of the pulmonary vascular bed are limiting factors that need to be addressed in NHBD.

Live/Real Time Three-Dimensional Transesophageal Echocardiographic Assessment of Ventricular Septal Volume and Mass before and after Myectomy in Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is the most common genetically transmitted cardiomyopathy. In patients resistant to medical management, myectomy is the surgical procedure of choice to reduce the symptoms of left ventricular outflow obstruction. Two-dimensional transesophageal echocardiography (2DTEE) has become part of the operative procedure by decreasing the incidence of postoperative complications. However, because of the three-dimensional geometry of left ventricular outflow tract, it is unable to comprehensively assess the location and severity of the obstruction and to provide accurate guidance during myectomy. In this study, 10 patients with HCM underwent live/real time three-dimensional transesophageal echocardiography (3DTEE) intra-operatively to measure the volume of the resected septum. This volume correlated well with the volume of the resected septal muscle directly obtained using a graduating cylinder containing water (r=0.9, P<0.000). 3DTEE may be potentially used as an adjunct to guide the surgeon in performing an adequate myectomy with a lower incidence of residual obstruction and complications such as an iatrogenic ventricular septal defect.

Noninvasive assessment of alveolar microvascular recruitment in conscious non-sedated rats

Recruitment of alveolar microvascular reserves, assessed from the relationship between pulmonary diffusing capacity (DLCO) and perfusion (Q˙c), is critical to the maintenance of arterial blood oxygenation. Leptin-resistant ZDF fatty diabetic (fa/fa) rats exhibit restricted cardiopulmonary physiology under anesthesia. To assess alveolar microvascular function in conscious, non-sedated, non-instrumented, and minimally restrained animals, we adapted a rebreathing technique to study fa/fa and control non-diabetic (+/+) rats (4–5 and 7–11mo old) at rest and during mild spontaneous activity. Measurements included O2 uptake, lung volume, Q˙c, DLCO, membrane diffusing capacity (DMCO), capillary blood volume (Vc) and septal tissue-blood volume. In older fa/fa than +/+ animals, DLCO and DMCO at a given Q˙c were lower; Vc was reduced in proportion to Q˙c. Results demonstrate the consequences of alveolar microangiopathy in the metabolic syndrome: lung volume restriction, reduced Q˙c, and elevated membrane resistance to diffusion. At a given Q˙c, DLCO is lower in rats and guinea pigs than dogs or humans, consistent with limited alveolar microvascular reserves in small animals.

P04.09: Reference curve of the fetal ventricular septum volume by VOCAL method: preliminary study

<scp>P04</scp>.09: Reference curve of the fetal ventricular septum volume by <scp>VOCAL</scp> method: preliminary study

Morphometric analysis of the maxillary sinus in patients with nasal septum deviation

The aim of this study was to evaluate the relationship between nasal septum deviation, which is common in the general population, and maxillary sinus volume. A retrospective assessment was made for 96 patients with nasal septum deviation without coexisting sinonasal morbidity and compared to 60 healthy individuals. A three-dimensional reconstruction of computed tomography images was used to assess a total of 312 maxillary sinus volumes. Septal deviation angles and volumes were also measured to standardize and determine the severity of the septal deviations. Septal deviations were right-sided in 36.5% of the cases (n = 35) and left-sided in 63.5% (n = 61). Deviation angles varied between 5° and 24.4°, with a mean value of 12.9 ± 5.0. The mean value for the deviation volume was 4.6 ± 1.5 cm(3) (range 1.7-9.4). The right and left maxillary sinus volumes were 11.8 ± 4.7 cm(3) and 11.5 ± 4.4 cm(3), respectively, in control group. Statistically significant discrepancy was observed between the ipsilateral and contralateral maxillary sinus volumes, in regard to the side of the septal deviation in study group. Maxillary sinus volumes were found to be significantly smaller on the ipsilateral side of septal deviation compared with the contralateral side.

Importance of Mucosal Closure in Nasal Septal Perforation Repair

JAMA Facial Plastic SurgeryVol. 15, No. 4 LettersImportance of Mucosal Closure in Nasal Septal Perforation Repairis accompanied byPolyethylene Implants in Nasal Septal RestorationDavid H. Burstein and Russell W. H. KridelDavid H. BursteinDivision of Facial Plastic Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, The University of Texas Health Science Center at Houston, HoustonFacial Plastic Surgery Associates, HoustonSearch for more papers by this author and Russell W. H. KridelCorresponding Author: Russell W. H. Kridel, MD, Facial Plastic Surgery Associates, 6655 Travis St, Ste 900, Houston, TX 77030 E-mail Address: rkridel@todaysface.comDivision of Facial Plastic Surgery, Department of Otorhinolaryngology–Head and Neck Surgery, The University of Texas Health Science Center at Houston, HoustonFacial Plastic Surgery Associates, HoustonSearch for more papers by this authorPublished Online:18 Jul 2013https://doi.org/10.1001/jamafacial.2013.1504AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Importance of Mucosal Closure in Nasal Septal Perforation Repair." JAMA Facial Plastic Surgery, 15(4), pp. 322–323FiguresReferencesRelatedDetailsCited byLong-term Results of Combined Rhinoplasty and Septal Perforation Repair Seung-No Hong, Somasundran Mutsumay, and Hong Ryul Jin17 November 2016 | JAMA Facial Plastic Surgery, Vol. 18, No. 6Related articlesPolyethylene Implants in Nasal Septal Restoration18 Jul 2013JAMA Facial Plastic Surgery Volume 15Issue 4Jul 2013 InformationCopyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.To cite this article:David H. Burstein and Russell W. H. Kridel.Importance of Mucosal Closure in Nasal Septal Perforation Repair.JAMA Facial Plastic Surgery.Jul 2013.322-323.http://doi.org/10.1001/jamafacial.2013.1504Published in Volume: 15 Issue 4: July 18, 2013PDF download

Impact of Left Ventricular Diastolic Function on Left Atrial Mechanics in Systolic Heart Failure

The relation between left atrial (LA) mechanics and left ventricular (LV) diastolic function and adverse cardiovascular events are not well established in chronic systolic heart failure (HF). In 108 patients, we performed comprehensive echocardiography with an assessment of LA global longitudinal strain (LAε) by Velocity Vector Imaging. We also performed complete diastolic examinations including mitral inflow, pulmonary vein flow, and tissue Doppler. Death, cardiac transplantation, and HF hospitalization were tracked for 5 years. In our study cohort (age 57 ± 15 years, LV ejection fraction 25 ± 6%), mean global LA negative (εnegative), positive (εpositive), and total ε (εtotal) were -6.8 ± 4.4%, 7.7 ± 5.7%, and 14.5 ± 8.2%, respectively. All LAε indexes correlated with individual indexes of LV diastolic dysfunction, including mitral flow early (E) to late diastolic velocity ratio (p <0.05 for all), mitral deceleration time (p <0.01 for all), E to early diastolic velocity of the septal mitral annulus (e') ratio (p <0.05 for all), pulmonary vein flow systolic to diastolic velocity ratio (p <0.001 for all), and maximal LA volume index (p <0.01 for all). All LAε indexes increased across diastolic stage (p <0.001 for all). In multivariate logistic regression analysis, LAεnegative and LAεtotal were associated with the presence of LV diastolic dysfunction grade III even after adjustment for E/e' septal and LA volume index. In Cox proportional hazards analysis, lower magnitude LAεnegative predicted long-term adverse clinical events. In conclusion, more impaired LA mechanics are associated with more severe diastolic dysfunction and predict long-term adverse events in patients with chronic systolic HF.

Human amnion epithelial cells modulate hyperoxia-induced neonatal lung injury in mice

Background aimsHuman amnion epithelial cells (hAECs) prevent pulmonary inflammation and injury in fetal sheep exposed to intrauterine lipopolysaccharide. We hypothesized that hAECs would similarly mitigate hyperoxia-induced neonatal lung injury. MethodsNewborn mouse pups were randomized to either normoxia (inspired O2 content (FiO2) = 0.21, n = 60) or hyperoxia (FiO2 = 0.85, n = 57). On postnatal days (PND) 5, 6 and 7, hAECs or sterile saline (control) was administered intraperitoneally. All animals were assessed at PND 14. ResultsHyperoxia was associated with lung inflammation, alveolar simplification and reduced postnatal growth. Administration of hAECs to hyperoxia-exposed mice normalized body weight and significantly attenuated some aspects of hyperoxia-induced lung injury (mean linear intercept and septal crest density) and inflammation (interleukin-1α, interleukin-6, transforming growth factor-β and platelet-derived growth factor-β). However, hAECs did not significantly alter changes to alveolar airspace volume, septal tissue volume, tissue-to-airspace ratio, collagen content or leukocyte infiltration induced by hyperoxia. ConclusionsIntraperitoneal administration of hAECs to neonatal mice partially reduced hyperoxia-induced lung inflammation and structural lung damage. These observations suggest that hAECs may be a potential therapy for neonatal lung disease.

Rebuilding the lung: signals for a complex architectural task

WHAT A REMARKABLE ORGAN THE human lung is! At the end of a deep breath, the vast majority of its volume (80%) is air. More than half of the remaining volume (10%) is blood. These two phases have to be separated strictly but also brought into close contact over a large surface to allow efficient gas exchange. However, what about those remaining 10% that serves this function: the “real” lung tissue? Those few hundred grams of tissue consist of more than 40 cell types, originating from all 3 germ layers, and a sophisticated connective tissue network. Together they form an organ with a complex architecture optimized to serve its main function. The branching airway and vascular trees come in close proximity in the parenchymal region where gas exchange is facilitated by a minimized barrier thickness over a maximized surface area. This delicate parenchymal structure is stabilized by two factors: the surface tension modifying properties of the pulmonary surfactant system and the lung’s connective tissue “backbone.” A continuous network of connective tissue, consisting of collagenous and elastic fibers and the fibroblasts that produce them, forms a tensegrity structure in the lung (15). This network, however, appears as “focal” (as it is often described in cases of proliferation, e.g., in idiopathic pulmonary fibrosis, although it is actually a highly interconnected reticulum; Ref. 3) in thin histological sections, which underscores the importance of qualitative and quantitative threedimensional information for proper characterization of lung structure in health and disease. Mechanical signals that act within and on the lung are translated into biochemical signals that lead to effects at the cellular level, e.g., inducing secretion, tissue growth, or remodeling, which, in turn, affect lung mechanics (for review, see e.g., Ref. 16). One example specific to the lung is the stimulation of surfactant secretion by mechanical distension of surfactant-producing type II alveolar epithelial cells or their neighboring type I cells (reviewed in Ref. 5). An interesting and relevant model to study the effects of mechanical forces on lung structure and function is compensatory lung growth following pneumonectomy. Moreover, compensatory lung growth is a paradigmatic example for the structural plasticity of the adult lung. Can the mechanical stimuli that induce compensatory lung growth after pneumonectomy, tissue expansion vs. microvascular perfusion, be dissected? A study by Ravikumar et al. (12) in this issue of the Journal of Applied Physiology elegantly demonstrates that this is possible. In adult dogs, the right lung was replaced by an inflated silicone prosthesis for 4 mo. Then, the prosthesis was either kept inflated or deflated for another 8 mo (long-term cohort). This study design was complemented by a short-term cohort with right pneumonectomy, prosthesis inflation for 1 mo, and immediate analysis either with or without deflation. This setting allowed the temporal separation of expansion- and perfusion-related stimuli for compensatory lung growth. A comprehensive quantitative analysis of lung structure was undertaken. Noninvasive chest imaging by high-resolution computed tomography was performed before and after pneumonectomy in the inflation and deflation groups. This was followed by post mortem morphometric analysis by light and electron microscopic stereology. The prosthesis prevented mediastinal shift and lateral expansion of the left lung but allowed some caudal elongation. Capillary blood volume increased and microvascular congestion was noted at low inflation. This was accompanied by an increase in alveolar septal volume but not surface area. Subsequent deflation led to an immediate mediastinal shift and lateral expansion of the remaining left lung which, in the long-term cohort, further increased lung and alveolar septal tissue volume and surface area in comparison to the inflation group. These quantitative data demonstrate that lung tissue expansion and microvascular perfusion contribute nearly

Differences in Relative Hippocampus Volume and Number of Hippocampus Neurons among Five Corvid Species

The relative size of the avian hippocampus (Hp) has been shown to be related to spatial memory and food storing in two avian families, the parids and corvids. Basil et al. [Brain Behav Evol 1996;47:156–164] examined North American food-storing birds in the corvid family and found that Clark’s nutcrackers had a larger relative Hp than pinyon jays and Western scrub jays. These results correlated with the nutcracker’s better performance on most spatial memory tasks and their strong reliance on stored food in the wild. However, Pravosudov and de Kort [Brain Behav Evol 2006;67:1–9] raised questions about the methodology used in the 1996 study, specifically the use of paraffin as an embedding material and recalculation for shrinkage. Therefore, we measured relative Hp volume using gelatin as the embedding material in four North American species of food-storing corvids (Clark’s nutcrackers, pinyon jays, Western scrub jays and blue jays) and one Eurasian corvid that stores little to no food (azure-winged magpies). Although there was a significant overall effect of species on relative Hp volume among the five species, subsequent tests found only one pairwise difference, blue jays having a larger Hp than the azure-winged magpies. We also examined the relative size of the septum in the five species. Although Shiflett et al. [J Neurobiol 2002;51:215–222] found a difference in relative septum volume amongst three species of parids that correlated with storing food, we did not find significant differences amongst the five species in relative septum. Finally, we calculated the number of neurons in the Hp relative to body mass in the five species and found statistically significant differences, some of which are in accord with the adaptive specialization hypothesis and some are not.

Separating in vivo mechanical stimuli for postpneumonectomy compensation: imaging and ultrastructural assessment

Following right pneumonectomy (PNX), the remaining lung expands and its perfusion more than doubles. Tissue and microvascular mechanical stresses are putative stimuli for compensatory lung growth and remodeling, but their relative contribution remains uncertain. To temporally separate expansion- and perfusion-related stimuli, we replaced the right lung of adult dogs with a customized inflated prosthesis. Four months later, the prosthesis was either acutely deflated (DEF) or kept inflated (INF). Thoracic high-resolution computed tomography (HRCT) was performed pre- and post-PNX before and after prosthesis deflation. Lungs were fixed for morphometric analysis ∼12 mo post-PNX. The INF prosthesis prevented mediastinal shift and lateral lung expansion while allowing the remaining lung to expand 27-38% via caudal elongation, associated with reversible capillary congestion in dependent regions at low inflation and 40-60% increases in the volumes of alveolar sepal cells, matrix, and fibers. Delayed prosthesis deflation led to further significant increases in lung volume, alveolar tissue volumes, and alveolar-capillary surface areas. At postmortem, alveolar tissue volumes were 33% higher in the DEF than the INF group. Lateral expansion explains ∼65% of the total post-PNX increase in left lung volume assessed in vivo or ex vivo, ∼36% of the increase in HRCT-derived (tissue + microvascular blood) volume, ∼45% of the increase in ex vivo septal extravascular tissue volume, and 60% of the increase in gas exchange surface areas. This partition agrees with independent physiological measurements obtained in these animals. We conclude that in vivo signals related to lung expansion and perfusion contribute separately and nearly equally to post-PNX growth and remodeling.

Septal nuclei enlargement in human temporal lobe epilepsy without mesial temporal sclerosis

To measure the volume of basal forebrain septal nuclei in patients with temporal lobe epilepsy (TLE) as compared to patients with extratemporal epilepsy and controls. In animal models of TLE, septal lesions facilitate epileptogenesis, while septal stimulation is antiepileptic. Subjects were recruited from 2 sites and consisted of patients with pharmacoresistant focal epilepsy (20 with TLE and mesial temporal sclerosis [MTS], 24 with TLE without MTS, 23 with extratemporal epilepsy) and 114 controls. Septal volume was measured using high-resolution MRI in association with newly developed probabilistic septal nuclei maps. Septal volume was compared between subject groups while controlling for relevant factors. Patients with TLE without MTS had significantly larger septal nuclei than patients with extratemporal epilepsy and controls. This was not true for patients with MTS. These results are interpreted with reference to prior studies demonstrating expansion of the septo-hippocampal cholinergic system in animal models of TLE and human TLE surgical specimens. Septal nuclei are enlarged in patients with TLE without MTS. Further investigation of septal nuclei and antiepileptic septo-hippocampal neurocircuitry could be relevant to development of new therapeutic interventions such as septal stimulation for refractory TLE.

Is it possible to operate four heart valves in a patient with heart failure, congenital heart disease and pulmonary hypertension?

We describe a 60-year old man with the history of radical correction of the Tetralogy of Fallot (TOF) in the year 1964. This patient has had a long lasting decompensation of a severe right heart failure with ascites and pulmonary hypertension. On echocardiography he had residual mild pulmonary stenosis (PS) and severe pulmonary and tricuspid regurgitation (TR), moderate aortic and mitral regurgitation. He also had residual ventricular septal defect (VSD) and severe pulmonary hypertension with the maximal gradient on TR 83mmHg. He was considered unoperable by his cardiologist, however patient decided to undergo a high-risk operation. The operation comprised pulmonary and aortic valve replacement with bioprosthesis, mitral and tricuspid repair, closure of ventricular septal defect, bilateral MAZE and volume reduction of both atria. After a very complicated postoperative course with multiorgan failure he recovered and was discharged home 2 months after operation. The NYHA class improved from IV before operation to II. Twenty months after this operation he experienced infective endocarditis with a leak on the aortic bioprosthesis. He was reoperated with reimplantation of a new aortic bioprosthesis and with a very complicated postoperative course. Sildenafil was added to his therapy due to the persistent severe pulmonary hypertension. He survived and was discharged home.The presented unique high-risk complex reoperation of a congenital heart disease with pulmonary hypertension can be performed only by a very experienced cardiosurgical and cardio-anesthesiological team with a high level of the early and late postoperative care.

Systems genetics of the lateral septal nucleus in mouse: heritability, genetic control, and covariation with behavioral and morphological traits.

The lateral septum has strong efferent projections to hypothalamic and midbrain regions, and has been associated with modulation of social behavior, anxiety, fear conditioning, memory-related behaviors, and the mesolimbic reward pathways. Understanding natural variation of lateral septal anatomy and function, as well as its genetic modulation, may provide important insights into individual differences in these evolutionarily important functions. Here we address these issues by using efficient and unbiased stereological probes to estimate the volume of the lateral septum in the BXD line of recombinant inbred mice. Lateral septum volume is a highly variable trait, with a 2.5-fold difference among animals. We find that this trait covaries with a number of behavioral and physiological phenotypes, many of which have already been associated with behaviors modulated by the lateral septum, such as spatial learning, anxiety, and reward-seeking. Heritability of lateral septal volume is moderate (h 2 = 0.52), and much of the heritable variation is caused by a locus on the distal portion of chromosome (Chr) 1. Composite interval analysis identified a secondary interval on Chr 2 that works additively with the Chr 1 locus to increase lateral septum volume. Using bioinformatic resources, we identified plausible candidate genes in both intervals that may influence the volume of this key nucleus, as well as associated behaviors.

Volume of the Human Septal Forebrain Region Is a Predictor of Source Memory Accuracy

Septal nuclei, components of basal forebrain, are strongly and reciprocally connected with hippocampus, and have been shown in animals to play a critical role in memory. In humans, the septal forebrain has received little attention. To examine the role of human septal forebrain in memory, we acquired high-resolution magnetic resonance imaging scans from 25 healthy subjects and calculated septal forebrain volume using recently developed probabilistic cytoarchitectonic maps. We indexed memory with the California Verbal Learning Test-II. Linear regression showed that bilateral septal forebrain volume was a significant positive predictor of recognition memory accuracy. More specifically, larger septal forebrain volume was associated with the ability to recall item source/context accuracy. Results indicate specific involvement of septal forebrain in human source memory, and recall the need for additional research into the role of septal nuclei in memory and other impairments associated with human diseases.