Saburkinė, Inga

Objectives. The present study aimed to examine the distribution of the epicardial ganglionated neural plexus in the hearts of pigs and mini-pigs, highlighting the quantitative differences of this plexus in these popular experimental animals. Materials and methods. The pressure-distended whole hearts from the eight adults mini-pigs and the five adult Landrace pigs were stained histochemically for acetylcholinesterase, and subsequently studied with a stereomicroscope. Results. In the mini-pigs and Landrace pigs, the principal mediastinal nerves accessed the heart at the same sites: the sinuses of the right cranial and the left azygos vein, yet the tiny accessing nerves – close to the pulmonary veins. In mini-pigs, the accessing mediastinal cardiac nerves were persistently determined at the roots of the left coronary artery. Within the epicardium of the Landrace and mini-pigs, nerves proceeded into discrete atrial and ventricular areas by five neural routes, so-called subplexuses: (1) the left and (2) middle dorsal, (3) dorsal right atrial, (4) right ventral, and (5) the ventral left atrial ones. Although the heart weight in the Landrace pigs was significantly larger than in the mini-pigs, both the thickness of the epicardial nerves and the areas of the epicardial ganglia were not different in these breeds in most sites. Nevertheless, the accessing cardiac nerves at the right cranial vein and the postganglionated nerves on the dorsal left ventricle and dorsal right atrial region were, correspondingly significantly, thicker or thinner in mini-pigs (p < 0.05). Similarly, only the epicardial ganglia of the ventral right atrial subplexus were significantly (p < 0.05) less in mini pigs compared with Landrace ones. Conclusions. In conclusion, the results of our study demonstrate the early and noteworthy alterations in heart neuroanatomy of the mini-pig compared with the Landrace breed. The discovered differences may impact the heart electrophysiology employing mini-pigs as animal models in the functional experiments.

This study aimed to examine the distribution and quantitative parameters of the epicardiac ventricular neural ganglionated plexus in the hearts of humans and sheep, highlighting the differences of this plexus in humans and large models. Five non-sectioned pressure distended whole hearts of the human newborns and 10 hearts of newborn German black-faced lambs were investigated applying a histochemical method for acetylcholinesterase to stain epicardiac neural structures with their subsequent stereomicroscopic examination. In humans, the ventricular nerves are spread by four epicardiac nerve subplexuses, that is, the left and right coronary as well as the left and middle dorsal. In sheep, the ventricular nerves are spread by five epicardiac nerve subplexuses, that is, the left and right coronary, the left and middle dorsal and the right ventral ones. The ventricular epicardium involved up to 129 ganglia in humans and up to 198-in sheep. The largest number of the ventricular ganglionic cells in humans were located on the ventral side, in front of the conus arteriosus, while on sheep ventricles, the most numerous neurons distributed on the dorsal wall of the left ventricle. This comparative study of the morphological patterns of the human and sheep ventricles demonstrates that the sheep heart is neuroanatomically distinct from the human one and this must be taking into consideration using the sheep model for the heart physiology experiments.

Persistent arterial hypertension initiates cardiac autonomic imbalance and alters cardiac tissues. Previous studies have shown that neural component contributes to arterial hypertension etiology, maintenance, and progression and leads to brain damage, peripheral neuropathy, and remodeling of intrinsic cardiac neural plexus. Recently, significant structural changes of the intracardiac neural plexus were demonstrated in young prehypertensive and adult hypertensive spontaneously hypertensive rats (SHR), yet structural alterations of intracardiac neural plexus that occur in the aged SHR remain undetermined. Thus, we analyzed the impact of uncontrolled arterial hypertension in old (48-52 weeks) SHR and the age-matched Wistar-Kyoto rats (WKY). Intrinsic cardiac neural plexus was examined using a combination of immunofluorescence confocal microscopy and transmission electron microscopy in cardiac sections and whole-mount preparations. Our findings demonstrate that structural changes of intrinsic cardiac neural plexus caused by arterial hypertension are heterogeneous and may support recent physiological implications about cardiac denervation occurring together with the hyperinnervation of the SHR heart. We conclude that arterial hypertension leads to (i) the decrease of the neuronal body area, the thickness of atrial nerves, the number of myelinated nerve fibers, unmyelinated axon area and cumulative axon area in the nerve, and the density of myocardial nerve fibers, and (ii) the increase in myelinated nerve fiber area and density of neuronal bodies within epicardiac ganglia. Despite neuropathic alterations of myelinated fibers were exposed within intracardiac nerves of both groups, SHR and WKY, we consider that the determined significant changes in structure of intrinsic cardiac neural plexus were predisposed by arterial hypertension.

Persistent arterial hypertension leads to structural and functional remodeling of the heart resulting in myocardial ischemia, fibrosis, hypertrophy, and eventually heart failure. Previous studies have shown that individual neurons composing the intracardiac ganglia are hypertrophied in the failing human, dog, and rat hearts, indicating that this process involves changes in cardiac innervation. However, despite a wealth of data on changes in intrinsic cardiac ganglionated plexus (GP) in late-stage disease models, little is known about the effects of hypertension on cardiac innervation during the early onset of heart failure development. Thus, we examined the impact of early hypertension on the structural organization of the intrinsic cardiac ganglionated plexus in juvenile (8-9 weeks) and adult (12-18 weeks) spontaneously hypertensive (SH) and age-matched Wistar-Kyoto (WKY) rats. GP was studied using a combination of immunofluorescence confocal microscopy and transmission electron microscopy in whole-mount preparations and tissue sections. Here, we report intrinsic cardiac GP of SH rats to display multiple structural alterations: (i) a decrease in the intracardiac neuronal number, (ii) a marked reduction in axonal diameters and their proportion within intracardiac nerves, (iii) an increased density of myocardial nerve fibers, and (iv) neuropathic abnormalities in cardiac glial cells. These findings represent early neurological changes of the intrinsic ganglionated plexus of the heart introduced by early-onset arterial hypertension in young adult SH rats.

Calcitonin gene-related peptide (CGRP) is localized in C and Aδsensory fibers and associated with innervation of smooth muscles inthe heart and vasculature. There are two mechanisms that CGRP participatesin regulating cardiovascular events. 1) Locally, CRPP is released to increase blood flow in the skin: vasodilation plays a role in regulating inflammation and enhances wound healing. 2) Systemically,CGRP, in animal studies, demonstrates that cardiovascular disease like hypertension can be reduced due to its vasodilator activity.However, the mechanism regarding when and how it is released is not fully understood.Transverse cryosections of ventricles of Spontaneously Hypertensive rats (SHR, n=3) and Wistar Kyoto rats (WKY, n=3) were examined.All animals were male and one-year-old. First, neural structures were stained immunohistochemically for protein gene product 9.5(PGP 9.5 – general neuronal marker) and CGRP. Then, nerve fractions stained by PGP 9.5 and CGRP were measured using the thre shold function and expressed as percentages from the total nerve cross-section area. Results were described as mean ± standard error and compared by Student t-test, p-value<0.05.The most prominent intrinsic nerves occurred within the epicardium and on the surface level of the myocardium. The rest of the myocardium and endocardium contained only a mesh work of nerve fibers. Epicardiac nerves were arranged similarly on both right and left ventricles. The nerves cross-sections appeared in various sizes, although on average were comparable in both groups (WKY 611±50 vs.SHR 797±118 μm2, p=0.152). Nevertheless, the area fraction stainedwith PGP9.5 was more significant in the normotensive group (WKY75±1.5% vs. SHR 69±0.8%, p<0.000). On the other hand, the CGRParea fraction significantly (almost twice) decreased in the hypertensive group, probably due to lowered vasodilative activity (WKY 9.9±0.7vs. SHR 5.4±0.2, p<0.000).Due to the potent vasodilating effects, there are changes in themyocardial tissue CGRP in the hypertensive group compared to the normotensive group. This study was supported by Grant No. S-MIP-19-23 from the Research Council of Lithuania.

Vadovėlyje anglų kalba pateikiami mokomųjų problemų, susijusių su žmogaus reprodukcine sveikata, aprašai; užduotys, skirtos studentams atlikti praktikos darbų metu; seminarų santraukos ir juose nagrinėjamų klausimų temos; saviruošos klausimai. Knygoje nagrinėjama žmogaus kūno audinių, vyro ir moters lytinės sistemos organų makroskopinė ir mikroskopinė struktūra, fiziologinių, biocheminių bei patologinių procesų, vykstančių žmogaus organizme, mechanizmai. Vadovėlis parengtas atsižvelgiant į probleminio mokymosi studijų formą ir skirtas Lietuvos sveikatos mokslų universiteto Medicinos fakulteto Medicinos studijų programos trečio kurso studentams, studijuojantiems modulio „Žmogaus reprodukcinė sveikata ir klinikinių studijų pagrindai“ dalį „Reprodukcija ir paveldėjimas“.

Background. The knowledge about the distribution of the ganglionated nerve plexus on human cardiac ventricles is considered as containing a pivotal clinical importance for general heart surgery and interventional treatment of cardiac arrhythmias. The aim of this study was to examine the distribution and structural peculiarities of the epicardiac ventricular neural ganglionated plexus in hearts of human and large popular animal models of experimental neurocardiology – pig and sheep - highlighting the differences of this plexus in humans and models. Methods. Five non-sectioned pressure distended whole hearts of the human newborns, five hearts of newborn German black-faced lambs and five hearts of the newborn piglets were investigated applying a histochemical method for acetylcholinesterase to stain epicardiac neural structures with their subsequent stereomicroscopic examination. Results. Mediastinal nerves accessed the ventral surface of human and sheep cardiac ventricles between the root of ascending aorta and pulmonary trunk. The ventral surface of the sheep (in part) and pig (completely) was supplied by several epicardial nerves extending from the right ventral (RV) ganglionated nerve subplexus on the ventral right atrium. The dorsal surface of the both ventricles of all three examined species was supplied by several epicardial nerves extending from the left (LD) and middle dorsal (MD) ganglionated nerve subplexuses on the dorsal left atrium. Human ventricles were supplied by left (LC) and right (RC) coronary and LD and MD subplexuses. LC included about 31% of all counted human ventricular epicardial nerves, RC – about 29%, while both together LD and MD – 40%. Sheep ventricles were supplied by LC, RC, LD, MD and RV subplexuses. LC involved about 12% of all counted sheep ventricular epicardial nerves, RC – about 8%, RV – 31%, both LD and MD – 50%. Pig ventricles were supplied by RV, LD and MD subpl[...].

Devynerių metų edukacinio darbo patirtis su visuomenės sveikatos ir farmacijos programų studentai parodė, jog anatomijos dalyko studijų mokomoji knyga, kurioje yra pateikti praktikos darbų ir seminarų aprašai, naudinga tiek studentams, tiek dėstytojams, nes supažindina skaitytoją su praktikos darbų ir seminarų tikslais, mokymo priemonėmis (preparatais, vaizdinėmis priemonėmis), literatūra, reikalingų terminų sąrašu, savikontrolės klausimais, kolokviumų teorinių testų ir praktinės apklausos užduočių pavyzdžiais, taip pat palengvina praktikos darbų organizavimą dėstytojams ir prozektoriams bei padeda geriau suprasti studijuojantiems. Siekdami palengvinti anatomijos studijų eigą ir pagerinti kokybę, parengėme "Žmogaus anatomijos" dalyko mokomąją knygą akušerijos programos studentams. Pateiktos knygoje įvairios užduotys padeda studentams savarankiškai ir kūrybiškai dirbti, nes (1) pirmojo tipo užduotyse pateikiama informacija apie studijuojamo objekto (organų sistemos, organo, audinio ar ląstelės) struktūrą; (2) antrojo tipo užduotys lavina vaizdinę ir motorinę atmintį, nes studentai pateiktose kontūrinėse schemose arba paveiksluose turi pažymėti studijuojamų struktūrų lietuviškus ir lotyniškus terminus; (3) pateiktos lentelėse trečiojo tipo užduotys padeda apibendrinti įsisavintą informaciją, nes studentai privalo įrašyti arterijų arba nervų, aprūpinančių pateiktus lentelėse organus, pavadinimus arba nurodyti pateiktų organų funkcijas bei vietą. Praktikos darbų arba seminarų pabaigoje pateikti kontroliniai klausimai gali būti naudingi tiek studentų savikontrolei, tiek dėstytojams apklausiant studentus. rengiant šią mokomąją knygą vartoti lietuviški ir lotyniški terminai, pateikti pastaraisiais metais išleistuose vadovėliuose.

Although the pig is a model for heart disease, the neuroanatomy of cardiac ventricles (CV) in this species remains undetailed. We aimed to define the innervation pattern of pig CV, combining histochemistry for acetylcholinesterase, immunofluorescent labeling and electron microscopy. Forty nine examined pig hearts show that the major nerves supplying the ventral side of CV descend from the venous part of the heart hilum. Fewer in number and smaller in size, epicardial nerves supply the dorsal half of the CV. Epicardial nerves on the left ventricle are thicker than those on the right. Ventricular ganglia of various sizes distribute at the basal level of both CV. Averagely, we found 3848 ventricular neuronal somata per heart. The majority of somata were cholinergic, although ganglionic cells of different neurochemical phenotypes (positive for nNOS, ChAT/nNOS, or ChAT/TH) were also observed. Large and most numerous nerves proceeded within the epicardium. Most of endocardium and myocardium contained a network of nerve bundles and nerve fibers (NFs). But, a large number of thin nerves extended along the bundle of His and its branches. The majority of NFs were adrenergic, while cholinergic NFs were scarce yet more abundant than nitrergic ones. Sensory NFs positive for CGRP were the second most abundant phenotype after adrenergic NFs in all layers of the ventricular wall. Electron microscopy elucidated that ultrastructure of nerves varied between different areas of CV. The described structural organization of CV provides an anatomical basis for further functional and pathophysiological studies in the pig heart.

Modulį "Žmogaus reprodukcinė sveikata ir klinikinių studijų pagrindai" sudaro dvi sudėtinės lygiavertės dalys: "Reprodukcija ir paveldėjimas" ir "Klinikinių studijų pagrindai (profesinė kompetencija)". Šis vadovėlis skirtas modulio "Reprodukcija ir paveldėjimas" daliai, kurią sudaro 11 mokomųjų dalykų. Studijuojama žmogaus kūno audinių ir organų (vyro ir moters lytinės sistemos, dalies endokrininės sistemos) makroskopinė ir mikroskopinė struktūra, fiziologinių, biocheminių bei patologinių procesų, vykstančių žmogaus organizme, mechanizmai. [...]. Norėdami palengvinti studentų mokymąsi, parengėme naujovišką vadovėlį, kuriame dera teorinė medžiaga ir praktinės užduotys. [...]. Geriau pasirengti padės šis vadovėlis, kuriame pateikti mokomųjų problemų aprašai, užduotys, studentų atliekamos praktikos darbų metu, seminarų santraukos ir juose nagrinėjamų klausimų temos. Studentmas po kiekvieno praktikos darbo ir seminaro pateikiami skyreliai "Saviruošos klausimai" ir "Laukiamieji studijų rezultatai", kuriuose išvardyta tai, ką studentai turi žinoti, gebėti, perprasti ir išmokti. Tai tarsi įgytų žinių rodiklis būsimoms studijoms.