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Time-Dependent Regional Myocardial Denervation as a Nonspecific Response to Transmyocardial Laser Revascularization Tomohiro Asai, MD, Shu Yamamoto, MD, Kozo Ishino, MD, Takushi Kohmoto, MD, Mitsuhito Kuriyama, MD, Gentaro Kato, MD, Yu Oshima, MD, Noriyoshi Yamamoto, MD, Kenji Notohara, MD, Shigeru Okada, MD, Shunji Sano, MD The Annals of Thoracic Surgery Volume 80, Issue 4, Pages (October 2005) DOI: /j.athoracsur Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions
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Fig 1 Representative transmyocardial revascularization (TMR) channels created by (A) laser and (B) ultrasound. The channel remnants were cut perpendicular to the channel axis. All channel remnants are infiltrated with vascular-rich granulation tissue in both laser and ultrasound TMR groups. (Masson’s Trichrome stain, scale bar: 1 mm.) The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions
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Fig 2 Typical mean arterial pressure recordings during topical epicardial bradykinin application to the epicardial surface before treatment. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions
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Fig 3 Western blot analyses of tissue tyrosine hydroxylase (TH) content 2 weeks after treatment. (A) Representative blots showing the reduction of TH content in both laser and ultrasound TMR-treated regions. (B) Averages of densitometric measurements of each band are shown. For quantitative comparison among different regions, TH band intensities were normalized to that of the lateral wall of the left ventricle region of the sham group; the intensity of the lateral wall of the left ventricle region of the sham group = 100%. (Apex = apical region of the left ventricle; Base = anterior basal region of the left ventricle; Mid = mid-anterior region of the left ventricle; LCx = lateral wall of the left ventricle; TMR = transmyocardial revascularization.) The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions
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Fig 4 Representative immunohistochemical staining of the Protein Gene Product 9.5 (PGP 9.5 [Novocastra, Newcastle, UK]) in the (A) sham-operated, (B) laser transmyocardial revascularization (TMR), and (C) ultrasound TMR, and synaptophysin immunohistochemical staining of the (D) sham operated, (E) laser TMR, and (F) ultrasound TMR of the myocardium adjacent to the TMR channel remnant. Note that the edge of the channel remnants are indicated with arrows [↓]) 2 weeks after treatment. The PGP 9.5 and synaptophysin immunoreactive fibers are present in the interstitial spaces in the sham-operated myocardium (stained in brown and indicated by arrowheads [▾]), whereas there are almost no immunoreactive fibers seen in either TMR groups (original magnification, ×100, scale bar: 200 μm). The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions
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Fig 5 (A) Numbers of Protein Gene Product (PGP) 9.5 (Novocastra, Newcastle, UK) positive nerve fibers (per mm2). (B) Numbers of Synaptophysin (Novocastra) positive nerve fibers (per mm2). (apex = apical region of the left ventricle; base = anterior basal region of the left ventricle; mid = mid-anterior region of the left ventricle; TMR = transmyocardial revascularization.) The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions
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