No abstract available.
Ganglia, Spinal* ; Longitudinal Ligaments*

No abstract available.
Aorta, Thoracic* ; Rupture*

The recent advancements in surgical techniques and perioperative care have improved postoperative morbidity and survival after gastric cancer surgeries. However, anastomotic leakage, the most serious complication post-gastrectomy, continues to occur. In esophageal and colorectal cancer surgeries, the omentum is used as a physical barrier and increases blood perfusion to prevent leakage to the anastomotic site. However, the use of the omentum as an anastomotic barrier after gastrectomy has not been reported yet. The authors aimed to evaluate the efficacy and safety of omental free-shaped flap reinforcement on the anastomosis and dissected area following reconstruction after gastrectomy for preventing and treating anastomotic leakage. They reported that omental free-shaped flap reinforcement on the anastomosis might prevent anastomotic leakage post-gastrectomy. The omental flap also prevented further deterioration when leakage occurred. However, anastomosis-related complications, such as anastomotic stenosis and delayed gastric emptying, after an omental patch technique need to be evaluated further.

No abstract available.
Heart* ; Thoracic Surgery*

No abstract available.
Brain Neoplasms* ; Brain* ; Tomography, Emission-Computed, Single-Photon*

To preserve function of the acoustic nerve and brainstem during posterior fossa surgery, the authors monitored(brainstem auditory evoked potentials) in 42 cases of posterior fossa surgery who were operated at the Department of Neurosurgery of Yonsei University College of Medicine from March, 1983 to February, 1987. The results were summarized as followings : 1) There were 28 cases of hemifacial spasm, 13 cases of trigeminal neuralgia and 1 case of cerebellopontine angle tumor. 2) Among the 41 cases of neurovascular decompression, there were 10 cases(24%) with hearing impairment postoperatively. But there was no postoperative auditory dysfunction in 13 cases of hemifacial spasm in which caudal approach was utilized. 3) There was no postoperative auditory dysfunction in the patients who showed intraoperative BAEPs of Types I, II, and III which were characterized by no loss of waves, but 10 cases(77%) who showed BAEPs of types IV, V and VI which were characterized by loss of the waves showed auditory dysfunction postoperatively.
Brain Stem* ; Cochlear Nerve ; Decompression ; Evoked Potentials, Auditory, Brain Stem* ; Hearing Loss ; Hemifacial Spasm ; Humans ; Monitoring, Intraoperative ; Neuroma, Acoustic ; Neurosurgery ; Trigeminal Neuralgia

We studied local cerebral blood flow with Tc-99m HMPAO SPECT in 15 patients with olivopontocerebellar atrophy(OPCA) and 15 age-matched control subjects without neurological desease. The diagnosis of OPCA was based upon the history and physical findings and upon the exclusion of other cerebellar ataxia by means of laboratory investigations. Computed tomographic scan and MRI revealed some degree of atrophy of the cerebellum in most patient with OPCA, and many also had atrophy of the brain stem. SPECT studies in these patients revealed decreased cerebral blood flow in the cerebellum in comparison with the normal control subjects(p<0.001). Two patients with minimal atrophy or no structural changes in the cerebellum also showed decreased perfusion. Tc-99m HMPAO SPECT may be useful as a diagnostic test in patients with OPCA. Some instances suggest that Tc-99m HMPAO SPECT may show abnormal finding earlier than other neuroimaging methods.
Atrophy ; Brain Stem ; Cerebellar Ataxia ; Cerebellum ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Olivopontocerebellar Atrophies* ; Perfusion ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

A rat model of focal cerebral ischelma has been established by mhe tecbnique of elecvrocamtery for me middle oerebral artery occlusion (MCAO). We investigated mhe effect of naloxone pretreatment on the size of infarction and the regional cerebral blood flow (rCBF) Another purpose of this study was to determine the effecbve dose (high-or lowdose) in focal cerebral ischemia. The rats were given Img/Kg I.v. (low-dose), 4mg/Kg I.v. (high-dose) of naloxone 30 min before MCAO and infused continuously with 0.5mg/Kg/hr (low dose) or 2mg/Kg/hr (high-dose) over next I hour by am infusion pump. The control group was given normal salin of the same amount by the same method. Dunng the peDod of saline amd naloxone infusion, mean arterial blood pressure was monitored. Arterial blood gas analysis and blood glucose measuremert were performed just after MCAO. The rectal temperature of rat was maintained within 37)0.5C by a heating lamp. Twenty-fow hours after MCAO, eight 2mm-thick coronal sections of one rat brain were stained by TTC solution and the size of infarction was described as the percentage of ipsilateral hemisphere. The rCBFs were measured by an autoradiography using 14C-iodoantipyrine and the chamges of rCBFs were analyzed by three methods of (1) rCBF ratio, (2) 1 mm-serial rCBF measurement of cerebral cortex, and (3) areas of rCBF below critical values(<25, 25-50, <50ml/100g/min). The results were as follows; 1. There was no significamt chamge of blood pressure during the infusion of saline. Iow-dose and high-dose naloxones 2. Arterial blood gas amalysis amd blood glucose measurement showed that there were no significant differences of pH, PC02, PO2 and blood glucose between saline and low dose and high-dose naloxone groups 3. High-dose naloxone pretreatment reduced significantly the size of infarction(p<0.05 vs saline-treated group by Mann-Whitney U test). 4. High-dose naloxone pretreatment improved significantly the rCBF ratios of caudate head and CA 3 area (p<0.05 vs. saline-treated group by Mann-Whitney U test) There was no significant improvement of rCBF ratios in the low-dose naloxone treated group. 5. One-mm serial rCBF measurement of cerebral cortex indicated that while low-dose naloxone group showed no improvement of rCBF of cerebral cortex, high-dose nalox one pretreatment produced an improvement of rCBF in penumbra and its neighboring area 6. The area below 25ml/100g/min or rCBF was reduced significantly by high-dose naloxone pretreatment(high-dose naloxone group: 15.0+4.1mm2, saline group:23.3)5.3 mm2, p <0.05). In summary these results indicate that high-dose naloxone pretreatment reduced the size of infarction and improved the rCBFs in the focal cerebral ischemia of rats.
Animals ; Arterial Pressure ; Arteries ; Autoradiography ; Blood Gas Analysis ; Blood Glucose ; Blood Pressure ; Brain ; Brain Ischemia* ; Cerebral Cortex ; Head ; Heating ; Hot Temperature ; Hydrogen-Ion Concentration ; Infarction* ; Infusion Pumps ; Models, Animal ; Naloxone* ; Rats*

No abstract available.
Angioplasty, Balloon, Coronary* ; Emergencies*

Acetazolamide, a selective-inhibitor of carbonic anhydrase. Has been shown to induce a rapid increase in cerebral blood flow by acidifying cerebral extracellular tluid in large doses. In order to assess the cerebral blood flow reserve, we investigated 14 patients with ischemic cerebrovascular disease using Tc-99m HMPAO SPECT before and after administration of acetazolamide.The patients after acetazolamide challenge showed variable pattems of vasodilating capacity which were classified as follows: group I. Accentuation of abnormal perfusion pattem; group II, no change in abnormal perfusion pattern: and group III. Blunting of abnormal perfusion pattern. Thirty-six percent of the patients studied qualified for group I. The p?tients in group I seem to have decreased vasodilating reserve in the area of cerebral ischemia. They are most likely to benefit by medical or surgical efforts to augment CBF delivery. Tc-99m HMPAO-SPECT with acetazolamide flow challenge may serve as an objective. Clinically accessible method for assessing blood flow reserve and as a kind of guide for the therapeutic strategy.
Acetazolamide* ; Brain Ischemia ; Carbonic Anhydrases ; Humans ; Perfusion ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon