Pre-and Post-ishemic Changes of the Constituent Enzymes in Isolated Rabbit's Myocardium / 대한흉부외과학회지

BACKGROUND: Nucleoside transport inhibitor(NTI) Keeps AMP, ADP, ATP levels high in myocytes by inhibiting adenosine cataboilsm so that it may preserve the myocardial contractability during ischemia In this study we investigated the effects of cyclic AMP phosphodiesterase inhibor(C-AMP PDSI) and S-P-nitrobenzyl-6 -thioniosine(NBT; a sort of NIT) on myocadial preservation and changes of constituent enzyme. MATERIAL AND METHOD: Twenty-six isolated rabbit hearts were perfused with Krebs-Henseleit buffer solution for 20 minutes arrested for 20 minutes and ten reperfused for 30 minutes. The following four groups were prepared and hemodynamic changes coronary effluent lactate dehydrogenase (LDH) a-hydroxybutylic accid(a-HBD) levels and myocardial LDH creatine kinase-MB (CK-MB) adenosine deaminase(ADA) a-HBD levels and myocardial LDH creatine kinase-MB (CK-MB) adenosine deaminase(ADA) a-HBD levels were analysed before and after cardiac arest ; Group I(control) ; the heart was only perfused with K-H ; Group II ; the heart was perfused with K-H including C-AMP PDSI(Amrinone 25mg/L); Group III ; the heart was perfused with K-H including NBT(4.19mg/L) ; Group IV ; the heart was perfused with K-H including C-AMP PDSI + NBT. RESULT: Left venticular developed pressure(LVDP) at 10 minutes of the equilibrium was significantly higher in group III(72.1+/-5.3 mmHg p<0.01) and group III(72+/-5.6 mmHg P<0.025) as compared with group I (40.8+/-4.7mmHg) and LVDP at 20 minutes of the reperfusion was significantly higher in group II(74+/-5.3mmHg P<0.01) and group III(72+/-5.6mmHg p<0.025) as compared with group I (44.2+/-4.6mmHg). Percentage recovery of LVDP at the reperfusion was the highest in group II(123.3%) Percentage recovery of coronary flow at the equilibrium reperfusion were higher in group II(310%, 270%) group III(230%, 290%) group IV(310%, 280%) as compared with group I (100%) respectively. Myocadial LDH level was significant lower in group IV(33495+/-1802 IU/gm p<0.04) as compared with group I(48767+/-1421 IU/gm) Myocadial CK-MB level was significant higher in group II(74820+/-1421 IU/gm) compared with group I 45450+/-1737 IU/gm) Myocadial ADA level was significant higher group IV(1215+/-8 IU/gm p<0.05) compared with group I(125+/-15 IU/gm) but there was no significant difference between group I and group II ,III, IV in changes of coronary effluent LDH, a-HBD levels. CONCLUSIONS: C-AMP PDSI solely appears to have a better effect on myocardial preservation after ischemia than NBT but with no synergistic effect and it could keep CK-MB leve high in myocardial tissues.

Pulmonarg Nodular Amyloidosis / 대한흉부외과학회지

Amyloidosis is a rare disease which is characterized by the deposition of a histochemically specific substance called amyloid in many tissue bodies, and causes various symptoms according to the organs involved. Amyloid is usually recognized by its staining reaction with Congo red stain. Primary pulmonary amyloidosis is very rare. Nodular pulmonary amyloidosis is an uncommon entity that usually manifests itself as an asymptomatic incidental finding on the chest roentgenogram and is misdiagnosed as lung cancer or pulmonary tuberculosis.

Expression of bcl-2 , p53 Protein and Aggressiveness in Thymic Epithelial Tumor / 대한흉부외과학회지

BACKGROUND: The distinction between non-invasive and invasive or thymic carcinoma has been severely compromised by lack of objective morphological criteria. A reliable biological marker of tumor aggressiveness is, therefore, mandatory for predicting tumor behavior. MATERIAL AND METHOD: Thirty thymic epithelial tumors, including 7 non-invasive thymoma, 10 invasive thymoma, and 13 thymic carcinoma of the Rosai's classification; and 5 stage I, 7 stage II, 2 stage III, and 3 stage IVa of the Masaoka stage of thymoma were investigated for expression of bcl-2 and p53 proteins by immunohistochemistry. RESULT: The thymic epithelial cells showed positive immunostain for bcl-2 in 0 (0%), 3 (30%), 8 (61.5%) of categories in the Rosai's classification respectively and in 0 (0%), 1 (14.3%), 2 (100%), 0 (0%) of stage I, II, III, IVa of the Masaoka stage respectively. Thymic carcinoma, and high stage thymoma had significantly higher proportion of bcl-2 expression than thymoma (p=0.021) and low stage thymoma (p=0.011). However, p53 showed no correlation with the histological subtypes nor with clinical aggressiveness. Bcl-2 expression appeared to be positively correlated with p53 immunoactivity (p=0.007, kappa=0.525). CONCLUSION: These date indicate that bcl-2 expression correlates with aggressiveness in thymic epithelial tumors, but further studies on mutation of p53 protein is necessary because bcl-2 expression appeared to be positively correlated with p53 immunoactivity.

A Study of Anastomotic Stricture after EEA Stapled / 대한흉부외과학회지

BACKGROUND: The advent of EEA stapler has lowered the leakage rate of esophagogastric anastomoses and thereby contributed to a decrease in the operative mortality of the easophageal resection. Recent surgical reports, however, have documented 10% to 20% prevalence of benign anastomotic stricture formation after the use of EEA stapler to construct an esophagogastric anastomosis. We analyzed the cases of anastomotic strictures to reduce the incidence of anastomotic strictures with EEA stapled esophagogastrostomy. MATERIAL AND METHOD: EEA stapled esophagogastrostomy was performed in 195 parients during the period of over 11 years from Jan. 1986 to Dec. 1996 in Kosin Medical Center. Ten patients of them died in the early postoperative days. In the remaining 185 patients, we studied the incidence and the onset time of anastomotic strictures, relationship between the patients' ages, the anastomotic sites, and the size of the cartridges with incidence of anastomotic stricture. We also studied the method of treatment and its effect in the anastomotic strictures. RESULT: Benign anastomotic strictures occurred in 39 cases among 185 patients (21%), 25 cases (64.1%) of the 39 cases developed in one to three months postoperatively. The patients' ages and the anastomotic sites did not effect with the incidence of anastomotic stricture, but high incidence of anastomotic stricture in EEA stapled esophagogastrostomy (p=0.04)was observed in small cartridge sizes. One or two balloon dilatation (89%) relieved the anastomotic strictures. CONCLUSION: We conclude that a larger size cartridge is recommended in EEA stapled esophagogastrostomy to reduce the incidence of anastomotic stricture if possible, and one or two balloon dilatation would seem to be a safe and reliable method in treating anastomotic stricture when the anastomotic stricture was occurrs.