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

A 70-year old male with dilated cardiomyopathy was admitted to our hospital because of a renal stone, and a supra-renal abdominal aortic aneurysm was detected during work-up. We performed a hybrid surgery using an endovascular stent because of his co-morbidities. The operation consisted of removal of the renal stone, de-branching of the visceral artery and both renal arteries from the abdominal aorta, reperfusion of the de-branched arteries with retrograde bypass surgery using two Y-graft from the left external iliac artery, and deployment of stent graft in the abdominal aorta. Therefore, we report a case of hybrid surgery for supra-renal abdominal aortic aneurysm.
Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Arteries ; Cardiomyopathy, Dilated ; Chimera ; Humans ; Iliac Artery ; Male ; Renal Artery ; Reperfusion ; Stents ; Transplants

A 38-year-old male was admitted to our hospital due to painful swelling of his right popliteal fossa. He had been kicked in his right popliteal fossa during a soccer game about three weeks earlier. Computerized tomographic angiography of the lower extremity demonstrated a 4-cm-wide, 3-cm-long aneurysmal change of the popliteal artery. He underwent aneurysmectomy and graft interposition using a great saphenous vein graft. Pathologic findings of the resected specimen were consistent with those of a pseudoaneurysm.
Adult ; Aneurysm ; Aneurysm, False ; Angiography ; Humans ; Leg Injuries ; Lower Extremity ; Male ; Popliteal Artery ; Saphenous Vein ; Soccer ; Transplants

A 38-year-old male was admitted to our hospital due to painful swelling of his right popliteal fossa. He had been kicked in his right popliteal fossa during a soccer game about three weeks earlier. Computerized tomographic angiography of the lower extremity demonstrated a 4-cm-wide, 3-cm-long aneurysmal change of the popliteal artery. He underwent aneurysmectomy and graft interposition using a great saphenous vein graft. Pathologic findings of the resected specimen were consistent with those of a pseudoaneurysm.
Adult ; Aneurysm ; Aneurysm, False ; Angiography ; Humans ; Leg Injuries ; Lower Extremity ; Male ; Popliteal Artery ; Saphenous Vein ; Soccer ; Transplants

A 50-year old man was admitted to our hospital because he complained of sudden abdominal pain. Multidetector abdominal CT showed proximal occlusion of the superior mesenteric artery. Emergency open laparotomy and Fogarty thrombectomy were done on admission day and repeat Fogarty thrombectomy and partial resection of the small bowel were done the next day. We report here on a case of superior mesenteric artery occlusion.
Abdominal Pain ; Angiography ; Emergencies ; Humans ; Laparotomy ; Mesenteric Artery, Superior* ; Middle Aged ; Thrombectomy* ; Thrombosis ; Tomography, X-Ray Computed

A one day old female infant was brought to the emergency room suffering from shortness of breath. An x-ray revealed the gastrointestinal tract in the right thoracic cavity. An emergency operation demonstrated eventration of the diaphragm, and a plication was performed. The baby was discharged without complication and has been followed up in the out patient clinic. Congenital diaphragmatic eventuation requiring emergency operation is rare.
Diaphragm ; Diaphragmatic Eventration* ; Dyspnea ; Emergencies* ; Emergency Service, Hospital ; Female ; Gastrointestinal Tract ; Humans ; Infant ; Thoracic Cavity

BACKGROUNG: Continuous air leakage through chest tube after lung surgery may increase pt's hospital stay and lead to many complications including empyema etc. Chemical pleurodesis has frequently been used for prevention of air leakage. Therefore, we performed chemical pleurodesis using diluted fibrin glue in patients with continuous air leakage and observed the effects and efficiency of treatment. MATERIAL AND METHOD: From September, 2001 to August, 2005, 16 patients whose continuous air leakage lasted more than 7 days underwent chemical pleurodesis with diluted fibrin glue. The effects of treatment, complications and recurrences were reviewed. Dissolved fibrinogen 1.0 g and aprotinin 500,000 KIU were mixed in a 50 cc syringe (Mixed solution A). And dissolved thrombin 5,000 IU and Calcium chloride 600 mg were mixed in a 50 cc syringe (Mixed solution B). Cefazolin 1.0 g was mixed in a 50 cc syringe (Mixed solution C). Rubber tube was inserted between the chest tube and the collecting bottle. An inserted rubber tube was positioned 60cm above the patient and forming a loop appearance was done. Mixed solutions A, B and C were injected into the highest rubber tube. RESULTS Continuous air leakages disappeared in all 16 patients at next day. Chest tubes were removed after 3 days in all patients. Complications were chest pain in 12 patients (75%), leukocytosis in 14 patients (88%), fever and chill in 14 patients (88%). All complicaitons were transient and disappeared without specific treatment. CONCLUSION: Our findings demonstrated that diluted fibrin glue chemical pleurodesis was effective in patients with continuous air leakage lasting more than 7 days. Diluted fibrin glue chemical pleurodesis had good results with acceptable complications. Long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence in a large number of patients.
Aprotinin ; Calcium Chloride ; Cefazolin ; Chest Pain ; Chest Tubes ; Empyema ; Fever ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrinogen ; Humans ; Length of Stay ; Leukocytosis ; Lung* ; Pleurodesis ; Recurrence ; Rubber ; Syringes ; Thrombin ; Tissue Adhesives

An 1-month old female newborn was admitted to our hospital because of jaundice which occurred at 2 days after birth. Plain chest X-ray and chest CT revealed a collapsed right middle lobe and lobar emphysema was suspected. Right upper lobectomy of the lung was done and pathologic findings showed an infantile lobar emphysema. After the operation, the newborn was discharged without complication and was followed up through the out patient clinic. Infantile lobar emphysema is rare and male dominant. Left upper lobe of the lung is the most prevalent site. Patients with infantile lobar emphysema complain of respiratory symptoms. We report one case of infantile lobar emphysema on right upper lobe of lung, in a female with no respiratory symptoms.
Emphysema* ; Female ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Lung ; Male ; Parturition ; Thorax ; Tomography, X-Ray Computed

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

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*