PURPOSE: The complications of ischemic spinal cord injury on the descending and thoracoabdominal aorta remain a problem in spite of surgery and anesthesia advance. The protective effects of aprotinin and pentoxifylline was assessed from a rabbit spinal cord ischemia model in order to prevent ischemia reperfusion injury from the spinal cord. METHOD: In 36 rabbits, left vertical flank incision and retroperitoenal approach were done and ischemia was induced with clamping of the aorta just distal to left renal artery and proximal to aortic bifurcation for 20 min. In Group A, Aprotinin was given 30,000 KIU/kg was given as a intravenous injection after anesthesia, and was followed by 10,000 KIU/hr by continuous infusion in group A (n=12). Also in group B, Pentoxifylline 40mg/kg was given as a intravenous injection after anesthesia, and was followed by 30 mg/hr by continuous infusion in group B (n=12). Similar volume of saline solution was used in control group C (n=12). Physiological parameters were monitored in animals before aortic occlusion, during aortic occlusion, after aortic occlusion. Their neurological outcome was clinically evaluated up to 48 hour postischemia. After 48 hour of the operation, all rabbits' victim were induced and their spinal cord, abdominal aorta, and its branches were processed for histopathological examination. RESULT: Mean aortic pressure, heart rate and arterial blood gas analysis showed no statistical difference in 3 groups. Bladder function also revealed no statistical difference. The average motor function score was significantly higher in aprotinin group (group A) than control group (group C) at 24 (P=0.026) and 48 hour (P=0.018) after the ischemic insult. But the average motor function score was similar in pentoxifylline group (group B) and control group (group C) at 24 and 48 hour after the ischemic insult. Histological observations were revealed fewer ischemic damage in aprotinin group (group A) than control group (group C) but in pentoxifylline group (group B) and control group (group C), ischemic damages were more than moderate degree. CONCLUSION: The results suggest that aprotininreduces spinal cord injury and preserves neurologic function in transient spinal cord ischemia of rabbits but pentoxifylline is not effective.
Anesthesia ; Animals ; Aorta ; Aorta, Abdominal ; Aprotinin* ; Arterial Pressure ; Blood Gas Analysis ; Constriction ; Heart Rate ; Injections, Intravenous ; Ischemia ; Pentoxifylline* ; Rabbits ; Renal Artery ; Reperfusion Injury ; Sodium Chloride ; Spinal Cord Injuries ; Spinal Cord Ischemia* ; Spinal Cord* ; Urinary Bladder

No abstract available.
Fistula*

Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tomy. The patients were divided into three groups: Group I(n=10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30ml + normal saline 30 ml + morphine 10 mg), and Group III(n=10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mcg +normal saline 10 ml). The results were as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A significant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.
Analgesia ; Analgesia, Patient-Controlled* ; Bupivacaine ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Intercostal Nerves* ; Morphine ; Pain, Postoperative ; Postoperative Complications ; Thoracotomy ; Tidal Volume ; Vital Signs

Fracture of the sternum has been considered as a serious iniury and also associated with major complications such as myocardial, major thoracic vascular, and spinal injury. Retrospective datas from blunt trauma victims admitted to our hospital were analyzed to determine significance of sternal fractures and possible associated injures. 101 sternal fractures by blunt trauma were admitted from january, 1986 to december, 1995. Frequency was about 3.51% of the nonpenetrating chest trauma. The ratio of male to female was 1.82 versus 1. Most common cause in the sternal fracture was high decelerating injury(73 cases). Most common fracture site was sternal body(75 cases). Average days of admission were 26 days. Abnormal ECG findings were sinus bradycardia(7cases), complete or incomplete RBBB(6 cases), sinus tachycardia(4 cases), specific S-T change(3 cases), 1st degree A-V block(2 cases), LVH(1 case), PVC(1 case), and Low voltage(1 case). CPK-MB was increased about 32.1% of sternal fractures. Except of expired 2 patients, patients were treated with conservative treatment(94 cases) and open reductions and steel wire fixations(5 cases). Complication after operation was wound infection(1 case). Causes of death were 1 hypovolemia and 1 acute respiratory distress syndrome. In conclusion, although sternal fracture is less frequent, and mostly treats with conservative treatment, it shoud be carefully observed because of critical associated injuries.
Cause of Death ; Electrocardiography ; Female ; Humans ; Hypovolemia ; Male ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Spinal Injuries ; Steel ; Sternum ; Thorax ; Wounds and Injuries

A Clinical observation was made on five patients with ruptured right aortic sinus of valsalva who admitted Soonchunhyang College Hospital during the period of may, 1983-Jan., 1985. 1) Age distribution was from 18 to 46 years and four patients were male and the rest one was female. 2) Chief complaints were dyspnea, chest pain and palpitation. Continuous murmur was heard at third and fourth intercostal space along left sternal border with palpable thrill in all cases. 3) The ECG showed left ventricular hypertrophy in 4 cases and the M mode echocardiogram revealed the increased internal dimesion and the augmented motion of the left ventricle in all cases. The 2 dimensional echocardiogram revealed the aneurysmal sac in the right ventricle in 4 cases. 4) The aortogram by DSA method showed regurgitant flow from aorta to right ventricle in 4 cases. The cardiac catheterization showed a significant oxygen step up in the right ventricle in all cases. 5) Operation was done successfully in all cases, of which ventricular septal defect were in 3 cases and aortic regurgitation was in one case.
Age Distribution ; Aneurysm ; Aorta ; Aortic Valve Insufficiency ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dyspnea ; Electrocardiography ; Female ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Oxygen ; Sinus of Valsalva*

Adenoid cystic carcinoma of the esophagus is a rare tumor and has been considered to be counterpart of the salivery gland. The patient we experienced was a 60-year-old female who had a tumor in the lower third of the esophagus. The tumor was located in the submucosa and showed histologic features similar to those of the salivary gland. Electron micrsopic examination revealed ductal structures invested by basal lamina, and clusters of basaloid cells with tonofilaments and desmosomes. No myoepithelial cells were identified. Immunohistochemical studies for S-100 protein, cytokeratin and vimentin were performed. A few cells showed positive reaction to the S-100 protein. These findings suggest that the esophageal adenoid cystic carcinoma arises from the duct of submucosal gland.
Female ; Humans

Adenoid cystic carcinoma of the esophagus is a rare tumor and has been considered to be counterpart of the salivery gland. The patient we experienced was a 60-year-old female who had a tumor in the lower third of the esophagus. The tumor was located in the submucosa and showed histologic features similar to those of the salivary gland. Electron micrsopic examination revealed ductal structures invested by basal lamina, and clusters of basaloid cells with tonofilaments and desmosomes. No myoepithelial cells were identified. Immunohistochemical studies for S-100 protein, cytokeratin and vimentin were performed. A few cells showed positive reaction to the S-100 protein. These findings suggest that the esophageal adenoid cystic carcinoma arises from the duct of submucosal gland.
Female ; Humans

No abstract available.
Bronchopulmonary Sequestration*

BACKGROUND: Compensatory hyperhidrosis is the most common complication after thoracoscopic sympathetic operation in hyperhidrosis. It is not only decrease patient's satisfaction but also gives another burdens to the patients. Unfortunately remarkable treatment for compensatory hyperhidrosis does not exist yet. The purpose of this study was to evaluate the effect of decreased sweating production using 20% aluminum chloride hexahydrate on compensatory hyperhidrosis. MATERIAL AND METHOD: From May to July, 2000, 8 patients were evaluated. All of them complained of severe discomfort due to compensatory hyperhidrosis. Degree of compensatory sweating was subjectively assessed thorough questionnaire as follows: 1=absent, 2=mild, 3=moderate 4=severe, 5=disabling, Also degree of life satisfaction was subjectively assessed thorough questionnaire as follows: 1=Absolutely no satisfaction, 2= Aluminum* ; Follow-Up Studies ; Humans ; Hyperhidrosis* ; Postoperative Complications ; Surveys and Questionnaires ; Sweat ; Sweating

BACKGROUND: Recently 980-nm diode laser endovenous treatment was introduced and used as a method of treatment for varicose vein in lower extremities. The advantages of endovenous laser treatment are good cosmetic effects without incision and avoidance of complications associated with surgery. Therefore, we performed an endovenous laser treatment using a 980-nm diode laser and observed the effects and the efficiency of treatment. MATERIAL AND METHOD: From October, 2003 to March, 2004, 56 patients (84 limbs) underwent endovenous laser treatment with a 980-nm diode laser. The effects of treatment, complications and recurrences were reviewed. RESULT: The mean age of patients was 47.2 years old and the number of men and women were 21 and 35. In a total of 84 limbs, postoperative complications were transient ecchymosis(84 cases), local paresthesia (24 cases), local skin discolorization (6 cases), minimal burn (3 cases), and post operative phlebitis (1 cases). Adjuvant sclerotherapy was performed in 27 limbs and it was performed in varicose veins missed at operation and varicose veins remaining after endovenous laser treatment. In a total of 56 patients, 2 patients (3.57%) had recurrences after endovenous laser treatment and were treated with phlebectomy. CONCLUSION: Our findings demonstrated that 980-nm endovenous laser treatment had good cosmetic results with acceptable complications. This study was based on short-term results and long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence. We think that multimodality treatment with endovenous laser treatment including phlebectomy or transilluminated powered phlebectomy can help decreasing of recurrence especially in patients with tortuous varicose cluster.
Burns ; Extremities ; Female ; Follow-Up Studies ; Humans ; Lasers, Semiconductor* ; Lower Extremity* ; Male ; Paresthesia ; Phlebitis ; Postoperative Complications ; Recurrence ; Sclerotherapy ; Skin ; Varicose Veins*