BACKGROUND: Ischemic preconditioning enhances the tolerance of myocardium against ischemia/reperfusion injury, with the enhancement of the recovery of post-ischemic myocardial function. This study was disigned to assess whether the protective effect of ischemic preconditioning could provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rate heart. MATERIAL AND METHOD: Fourty four Spargue-Dawley rats, weighing 300-450gm, were divided into four groups. Group 1(n=7) and group 3 (n=12) were subjected to 30 minutes of aerobic Langendorff perfusion without ischemic preconditioning and then preserved in saline solution at 2-4 degree C for 4 hours and 5 respectively. Group 2 (n=7) and group 4 (n=18) were perfused in the same way for 20 minutes, followed by 3 minutes of global mormothermic ischemia and 10 minutes of perfusion and then preserved in the same cold saline solution for 4 hours and 5 hours respectively. Heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured at 15 minutes during perfusion as baseline. Spontaneous defibrillation time was measured after reperfusion. Heart rate, LVDP, and coronary flow were also recorded at 15 minutes, 30 minutes, and 45 minutes during reperfusion. Samples of the apical left ventricular wall were studied using a transmission electron microscope. Time of spontaneous defibrillation (TSD) was significantly longer in group 4 than in group 1 (p<0.001), and TSD in group 1 was significantly longer in comparision to that of group 2 (p<0.05). Heart rate at 45 minutes was significantly higher in group 1 than in group 4 (p<0.05). Heart rate at 15 min was significantly higher in group 2 than in group 1(p<0.001) and in group 4 than in group 3 (p<0.05). Left ventricular developed pressure (LVDP) at 30 minutes and 45 minutes was higher in group 1 than in group 4 (p<0.01), LVDP at 45 minutes was higher in group 4 than in group 3 (p<0.05). Rate-pressure product (RPP) at 30 minutes and 45 minutes was higher in group 1 than in group 4 (p<0.05). RPP at 15 minutes was higher in group 2 than in group 1 (p<0.01). RPP at 30 minutes and 45 minutes was higher in group 4 than in group 3 (p<0.05). Group 2 showed relatively less sarcoplasmic edema and less nuclear chromatin clearance than group 1. Group 4 showed less myocardial cell damage than group 3, group 4 showed less myocardial cell damage than group 3, group 4 showed more myocardial cell edema than group 1. CONCLUSION: Ischemic preconditioning enhanced the recovery of postischemic myocardial function after 4 hours and 5 hours preservation. However, it was not demonstrated that ischemic preconditioning could definitely provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rat heart.
Animals ; Chromatin ; Edema ; Heart Rate ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Myocardial Ischemia ; Myocardium ; Perfusion ; Rats* ; Reperfusion ; Sodium Chloride

No abstract available.
Heart Septal Defects, Ventricular*

No abstract available.
Endocarditis* ; Humans

BACKGROUND: To evaluate the efficacy of cellulose mesh with fibrin glue to decrease recurrence rate after bullectomy for a treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: 222 patients underwent a bullectomy for primary spontaneous pneumothorax in our institute between April. 1996, and June, 2000. Patients were divided into four groups by period and operation method. Group 1(n=25) underwent video-assited thorasic surgery(VATS) and mechanical pleurodesis between 1996 and 1997. Group 2(n=53) underwent axillary thoracotomy and mechanical pleurodesis between the same period. Group 3(n=110) undewent VATS and mechanical pleurodesis between 1998 and April, 2000. Group 4(n=34) underwent VATS and reinforcement with absorbable cellulose mesh and fibrin glue between 1998 and June, 2000. The data of recurrence rate, duration of air leakage, and duration of chest tube drainage evaluated by each group were compared and analysed using general linear model procedure. RESULT: There were 203 men and 19 women. Mean age was 23.2+9.6 years. Recurrent rate in group 1 was 25%, 3.8% in group 2 and 4.5% in group 3. Threre was no recurrence of pneumothorax in group 4. All recurrent cases after bullectomy were developed at the period of surgeon' s experience of bullectomy if it was less than 2 years. Chest tube indwelling period in group 4 was shorter compared to that of group 1,group 2(p<0.0006) and group 3(p<0.0001). There was no postoperative air- leakage in group 4. Recurrence rate was higher in minimal and moderate size pneumothorax than that in massive pneumothorax. In the 12 recurred cases, nine cases had blebs near the suture line. CONCLUSION: The covering of the suture area with an bsorbable cellulose mesh and the application of the fibrin glue on the mesh in wedge resection of blebs are effective and shorter tube indwelling period was resulted. There were no postoperative air leakage through chest tube after this additional procedure and no recurrence in short term follow-up period. Recurrence rate was higher in small size pneumothorax than that in large sizepneumothorax. Recurrence rate was also influenced by the experience of surgeon.
Blister ; Cellulose ; Cellulose, Oxidized* ; Chest Tubes ; Drainage ; Female ; Fibrin Tissue Adhesive* ; Fibrin* ; Follow-Up Studies ; Humans ; Linear Models ; Male ; Pleurodesis ; Pneumothorax* ; Recurrence ; Sutures* ; Thoracic Surgery, Video-Assisted ; Thoracotomy

BACKGROUND: Video-assisted thoracic sympathicotomy plays an important role as an effective method for the treatment of axillary hyperhidrosis. People with axillary hyperhidrosis were not satisfied by the occurrence of the high rate of disabling compensatory hyperhidrosis and axillary resweating. Therefore, by comparing and assessing the clincal results according to the level and extent of sympathicotomy in axillary hyperhidrosis, we aim to determine which method will result in maximal benefits. MATERIAL AND METHOD: Among 70 patients suffering from axillary hyperhidrosis having undergone thoracoscopic sympathicotomy from January 2001 through December 2003, 57 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into two groups, Group I (n=25): patients having undergone R3, 4, 5 sympathicotomy which consist of blocking the interganglionic neural fiber on the third, fourth, and fifth rib, Group II (n=32): patients having undergone R3,4 sympathicotomy which consist of blocking the interganglionic neural fiber on the third and fourth rib. The study parameters were satisfaction rate and degree of compensatory sweating. RESULT: There was no difference on age and sex, family history, combined hyperhidrosis, and mean follow up month between the two groups. Patients expressing satisfaction were 88.0% in group and 56.3% in groups II with statistically significant difference (p=0.02). Moderate to severe compensatory sweating were 52.0% (embrassing 6 patients, disabling 7 patients) in group I and 62.5% (embrassing 5 patients, disabling 15 patients) in groups II with no significance in the statistical analysis. CONCLUSION: R3, 4, 5 sympathicotomy was an effective means of treating axillary hyperhidrosis because of higher long term satisfaction rate.
Follow-Up Studies ; Humans ; Hyperhidrosis* ; Interviews as Topic ; Quality of Life ; Surveys and Questionnaires ; Ribs ; Sweat ; Sweating

No abstract available.
Hospitals, General* ; Humans ; Outpatients*

No abstract available.
Aortic Coarctation* ; Arm* ; Subclavian Artery*

Necrotizing fasciitis, an uncommon, often fulminant bacterial infection, rarely originates in the chest wall. Although it can occur in any region of the body, the abdominal wall, perineum, and extremities are the most common sites of infection. It is characterized by wide spread fascial necrosis with relative sparing of skin and underlying muscle. Diagnosis is often extremely difficult and relies on a high index of suspicion. Prompt surgical intervention is essential. We experienced a patient with idiopathic necrotizing fasciitis in the chest wall and reported with brief review of literature.
Abdominal Wall ; Bacterial Infections ; Diagnosis ; Extremities ; Fasciitis, Necrotizing* ; Humans ; Necrosis ; Perineum ; Skin ; Thoracic Wall* ; Thorax*

BACKGROUND: Bullectomy through a transaxillary minithoracotomy have been widely used in the treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: From September 1997 to September 1998, 22 consecutive cases of those who underwent transaxillary mini thoracotomy with Finochieto rib spreader(group F) and 24 consecutive cases with Naruke thoraco-opener(group N) at Taegu Fatima Hospital were reviewed retrospectively to compare the clinical results of transaxillary minithoracotomy with different rib spreaders in the opera tive treatments of primary spontaneous pneumothorax. RESULT: There were no significant differences in operative time, hospital stay, postoperative hospital stay, the duration of the indwelling chest tube, and the number of postoperative recurrences and complications in the two group. CONCLUSION This technique may be useful in the operative treatments of primary spontaneous pneumothorax.
Chest Tubes ; Daegu ; Length of Stay ; Operative Time ; Pneumothorax* ; Recurrence ; Retrospective Studies ; Ribs ; Thoracotomy

The distribution of enkephalin, dynorphin, substance P and neurotensin in the periaqueductal gray[PAG] has been well established by immunohistochemical methods. However, there is little information about the regional distribution of these neuropeptide mRNA-containing neurons in the PAG. The present study was undertaken [1] to elucidate the distribution of these neuropeptide mRNA-containing neurons and to determine of the PAG, [2] to know how peptide expression relates to the proposed functional subdivisions of the PAG and [3] to know how neuropeptide mRNA levels in the PAG change following peripheral neuropathy The results obtained are as follows ; 1. Preproenkephalin[pENK] mRNA-containing neurons are found mostly in the ventrolateral portion at all levels of the PAG. 2. Prodynorphin[pDYN] mRNA-containing neurons are concentrated mostly in the ventrolateral portion at the caudal level of the PAG. 3. Preprotachykinin[pTAK] mRNA-containing neurons are localized mainly in the ventrolateral portion at all levels of the PAG. There is small numbers of pTAK mRNA-containing neurons in the dorsolateral and dorsal portion at all levels of the PAG. 4. Proneurotensin[pNT] mRNA-containing neurons are concentrated mostly in the medial part of ventrolateral portion of the caudal and mid PAG. 5. Peripheral neuropathy induces an increase of pNT mRNA levels in the PAG, while pENK, pDYN and pTAK mRNAs levels show no change. The present results indicate that the pENK, pDYN, pTAK or pNT mRNA-containing neurons are found mainly in the ventrolateral PAG, the area where analgesia is most easily produced and that neurotensin in the PAG may play an important role in modulating chronic neuropathic pain.
Analgesia ; Animals ; Dynorphins ; Enkephalins ; Gene Expression* ; In Situ Hybridization ; Neuralgia* ; Neurons* ; Neuropeptides* ; Neurotensin ; Periaqueductal Gray* ; Peripheral Nervous System Diseases ; Rats* ; RNA, Messenger ; Substance P