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

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

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*

No abstract available.
Bronchopulmonary Sequestration*

A 34-year-old male was admitted to our hospital complaining of chest pain. Chest computerized tomography showed pleural effusion and mass in left lower area. After open thoracotomy and mass removal originating from the parietal pleura were done. The mass was pathologically diagnosed as poorly differentiated synovial sarcoma. Synovial sarcoma of the pleura is rare. Herein we report a case of synovial sarcoma of the parietal pleura.
Male ; Humans

A 43-year-old male was admitted to our hospital complaining of dyspnea and wheezing sound at respiration. He had received esophageal exclusion and esophagogastrostomy due to spontanous esophageal rupture 1-year ago. Chest computed tomography revealed esophageal mucocele like that of mediastinal tumor. Trachea is compressed by esophageal mucocele. The operation was performed by resection of thoracic esophagus through right open thoracotomy. Herein we report a case of a tracheal compression by esophageal mucocele after surgical exclusion of the esophagus.
Adult ; Dyspnea ; Esophagus* ; Humans ; Male ; Mucocele* ; Respiration ; Respiratory Sounds ; Rupture ; Thoracotomy ; Thorax ; Trachea