Influence of sulphur hot spring water upon wound healing of rat skin was studied. To provide local inflammation, croton oil was injected intradermally into a previously shaved area of rat abdominal skin. Those rats were taken bath with sulphur hot spring water at 37°C for 10min a day, every second day. The increased ratio of hexosamine to hydroxyproline was observed in skin necrotized with croton oil at 4th day, because of increases in hexosamine and decreases in hydroxyproline concentrations with inflammation. After that, hexosamine and hydroxyproline concentrations of necrotic skin returned to control, uninjured levels in 10 days. In bathing with sulphur hot spring water, changes in hexosamine and hydroxyproline concentrations of necrotic area did not alter to bathing with deionized water and to non-bathing of rats.
Although influence of bathing with sulphur hot spring water was examined on glutathione metabolism in rat liver and kidney, it was observed that reduced glutathione concentration, and GSH-reductase, GSH-peroxidase and γ-glutamyl transpeptidase activities unchanged in liver and kidney for the bathing period of 14 days.

The effect of oral administration of sulphur hot spring water on chronic liver damaged rat was studied. The liver damaged rats were produced by injection of carbon tetrachloride (150l of CCl₄ per 100g of body weight) twice a week. Sulphur hot spring water was administrated ad libitum as drinking water throughout experimental period. At 40 and 88 days, rats were sacrificed for histological and biochemical examinations.
When tap water was administrated to CCl₄-poisoning rats for 88 days, extensive vacuolar degeneration of parenchymal cells were observed in liver. While in administration of sulphur hot spring water, there were mild vacuolar degeneration in parenchymal cells of liver.
Although GSH content and GSH-peroxidase activity of liver unchanged in CCl₄-poisoning, and were unaffected with administration of sulphur hot spring water, GSH-reductase activity increased with administration of sulphur hot spring water for 88 days. The increased lipoperoxide and hydroxyproline in liver with CCl₄-poisoning were slightly lowered by administration of hot spring water.
In plasma, furthermore, LDH, GPT and GOT activities which increased markedly by CCl₄-poisoning decreased strikingly by administration of hot spring water at 88 days. Whereas ALP, CE and LAP activities little changed by CCl₄-poisoning, and were scarcely affected with administration of hot spring water. Among other plasma components, though total cholesterol and cholesteryl ester levels decreased by CCl₄-poisoning, those levels were not sustained with sulphur hot spring water administration.

Patient 1 was a 62-year-old woman who had been treated for hypertension for three years. Stanford A type acute aortic dissection occurred accompanied by right coronary ischemia. CABG and graft replacement of the ascending aorta were performed 8 hours after the onset of coronary ischemia, but after cardiopulmonary bypass the patient could not be weaned from the RVAD because of right ventricular infarction. On the 8th day after operation, she died due to right heart failure. Patient 2 was a 72-year-old male. Stanford A acute aortic dissection occurred and right coronary ischemia appeared during UCG examination in the ICU. CABG and graft replacement of the ascending aorta and the aortic arch were carried out less than 1 hour from the onset of coronary ischemia. The postoperative course was satisfactory and uncomplicated. If the dissection extends to the aortic root, it is important to monitor the ECG carefully to detect myocardial ischemic changes. In cases with coronary ischemia, early operation and CABG are mandatory.

A 47-year-old woman complained of dyspnea on exertion. Ultrasonic cardiography revealed coronary sinus type atrial septal defect. At operation, the drainage veins to the left atrium from the coronary arteries were observed but no anomalies of the vena cave or any other veins were observed. The defect was closed with a pericardial patch under cardiopulmonary bypass. The post-operative course was uneventful. Coronary arteriography performed on the 14th post operative day confirmed that the coronary veins drained individually into the corresponding atria. Unroofed coronary sinus is rare and difficult to diagnose prior to operation. Ultrasonic cardiography and coronary arteriography are considered useful for preoperative diagnosis.

Seven patients underwent surgical repair of the distal aortic arch aneurysm from January 1990 to October 1997. They were 5 men and 2 women ranging from 63 to 78 years of age (mean, 72.7 years). All patients were operated with a median sternotomy only. There was one operative death, which was ruptured case. However, there were no major complications in non-ruptured cases. This retrospective study suggests that it is possible to repair the distal aortic arch aneurysm through a median sternotomy approach alone, when 1) descending aorta originates with normal size just distal to sacciform aneurysm, 2) the maximum diameter of the aneurysm is over 70mm and 3) distal involvement of the aneurysm does not extend beyond the bifurcation of the trachea. It is useful to retract descending aorta proximally by three threads with pledget for distal anastomosis in inclusion technique.

The patient was a 52-year-old man with a history of antiphospholipid syndrome (APS), renal dysfunction and myasthenia gravis (MG). On May 2, 1998, he had sudden chest pain while sleeping. Enhanced computed tomography revealed acute aortic dissection (DeBakey type I). We performed emergency graft replacement of the ascending aorta and the aortic arch under extracorporeal circulation. Because of perioperative anuria, we used peritoneal dialysis (PD) just after the operation. Two days after the operation, we performed re-intubation nine hours after the extubation of the tracheal tube, and performed re-extubation three days later. For a while, his postoperative course was uneventful, but because of gradual worsening of APS, we administered more prednisolone, but 74 days after the operation, he died of multiple organ failure caused by an opportunistic infection, sepsis, and disseminated intravascular coagulation. This was very rare case of acute aortic dissection with MG and APS. After administration of more glucocorticoids, it is important to be wary of opportunistic infections.

The patient was a 63-year-old man with a history of multiple mononeuritis with hypergammaglobulinemia since 1980. The symptoms gradually worsened, and he had been bed-ridden since 1992. On February 28, 1997, he had sudden dyspnea after defecation. Echocardiography demonstrated a large thrombus in the right atrium and the right ventricle. Enhanced chest computed tomography revealed thrombi in the bilateral pulmonary arteries. The patient was considered to have acute pulmonary thromboembolism, and an emergency operation was indicated. Thrombectomy was performed under extracorporeal circulation through a median sternotomy. No thrombi were found in the right atrium or the right ventricle, and thrombi in the bilateral pulmonary arteries were removed completely. Four days after the operation, a Greenfield filter was implanted in the vena cava inferior because venography detected a thrombus in the right common iliac vein. The postoperative course was uneventful. No pulmonary rethromboembolisms were noticed after the operation. The long duration of being bed-ridden seemed to be the chief cause of thrombosis in the deep veins, and hyperviscosity due to hypergammaglobulinemia may have caused hyperthrombogenicity.

Methods: We investigated patients who underwent surgical intervention for LL-OVC (L3, L4, and/or L5) with symptomatic foraminal and/or central stenosis from eight spine centers. Only patients with a minimum follow-up duration of 1 year were included. We developed new criteria to grade vertebral collapse severity (grade 1, 0%–25%; grade 2, 25%–50%; grade 3, 50%–75%; and grade 4, 75%–100%). The clinical features and outcomes were compared based on the collapse grade and surgical procedures performed (i.e., decompression alone, posterior lateral fusion [PLF], lateral interbody fusion [LIF], posterior/transforaminal interbody fusion [PLIF/TLIF], or vertebral column resection [VCR]). Results: In this study, 59 patients (average age, 77.4 years) were included. The average follow-up period was 24.6 months. The clinical outcome score (Japanese Orthopaedic Association score) was more favorable in the LIF and PLIF/TLIF groups than in the decompression alone, PLF, and VCR groups. The use of VCR was associated with a high rate of revision surgery (57.1%). No significant difference in clinical outcomes was observed between the collapse grades; however, grade 4 collapse was associated with a high rate of revision surgery (40.0%). Conclusions When treating LL-OVC, appropriate instrumented reconstruction with rigid intervertebral stability is necessary. According to our newly developed criteria, LIF may be a surgical option for any collapse grade. The use of VCR for grade 4 collapse is associated with a high rate of revision.