The Validity of a Combined High Saphenous Division and Sclerotherapy for Varicose Vein / 대한흉부외과학회지

BACKGROUND: The purpose of this study is to evaluate the validity of a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein. MATERIAL AND METHOD: Between August 2004 and October 2005, 70 limbs in 50 patients were treated by a combined high saphenous vein division and sclerotherapy. The operative indication is valvular incompetence of femoral-saphenous or popliteal-saphenous junction. Patients received local anesthesia and were treated by a combined high saphenous vein division, ligation of incompetent perforating vein and 1~3% sclerosant. Patients received 1 day hospitalization and applied in compression stocking for 6 weeks. Patients followed after 1 week, 1 and 3 months. RESULT: Mean age of patients was 50+/-11. The female was more common. 8 patients was no symptom, another 42 patients complained of pain, heaviness and fatigue of limbs. The symptoms of varicose vein disappeared 1 month after the procedure in all symptomatic patients. 8 patients needed a adjuvant sclerotherapy for residual varicose vein on 1 week after the procedure. There were only minor complications such as hematoma (1), wound infection (1), thrombophlebitis (20), skin blister (10), hyper-pigmentation (1), and skin ulcer (1). CONCLUSION: We concluded that a combined high saphenous vein division and sclerotherapy without sacrificing saphenous vein for varicose vein is simple, less invasive, economical, and effective treatment for primary varicose vein, and it has a special advantage that saphenous vein can be used as a bypass conduit later. The method was selective in old aged patients.

Mitigation of Calcification of Heterograft Tissue / 대한흉부외과학회지

BACKGROUND: With the development of cardiac surgical technique, we need more prosthetic materials for repairing the intra- and extracardiac defects. Although bovine pericardial bioprosthesis treated with glutaraldehyde (GA) solution is one of the most popular materials, it has a drawback of later calcific degeneration. The purpose of this study is to investigate the effectiveness of several materials and methods in reducing the calcific degeneration of bovine pericardium. MATERIAL AND METHOD: Forty square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4 g/L MgCl2.6H2O as a control group (group 1). Other 40 pieces pre-treated with 1% SDS (group 2) and 40 pieces post-treated with 8% glutamate (group 3) and 2% chitosan (group 4) were also fixed in the same GA solution. Other 40 pieces pre-treated with 1% SDS and post-treated with 8% glutamate and 40 pieces post-treated with 2% chitosan were also fixed in the same GA solution (group 5, 6). The pericardial pieces were implanted into the belly of 40 Fisher 344 rats subdermally and were extracted 1 month, 2 months, 3 months, and 6 months after the implantation. With an atomic absorption spectrophotometry, we measured the calcium amount deposited and examined the tissue with microscope. RESULT: The calcium deposition in 1 month was less in group 2, 5, 6 than that in group 1 (p<0.05). It was most prominent in group 5 (p<0.01). This finding continued in 2 month. In 3 month, the calcium deposition was less in group 3 and 4 as well as group 2, 5, and 6 than in group 1. In 6 month, the calcium deposition in group 2, 3, 4, 5, and 6 was less than that in group 1 and the difference was more than that of 1, 2, and 6 month. The microscopic calcium deposition was also less in group 2 and 5. Calcium deposition developed in the whole layer of pericardium, beginning with the surrounding the collagen fiber and progressing inwardly. CONCLUSION: Pre-treatment with SDS, post-treatment with glutamate or chitosan, and SDS pre-treatment and post-treatment with glutamate or chitosan were effective in reducing the calcium deposition in bovine pericardium. Moreover, the combined method of SDS pre-treatment and glutamate post-treatment was more effective than other methods.

A Giant Bronchial Artery Aneurysm in Brochiectatic Patient: One case report / 대한흉부외과학회지

Bronchial artery aneurysm is a rare but life-threatening disease when it ruptures, and it requires prompt treatment to prevent from catastrophic ruptures.A 78-year-old woman was referred to our hospital to evaluate mediastinal massfound on chest computed tomography. We did a selective bronchial artery angiography and diagnosed as bronchial artery aneurysm. Aneurysmectomy with division of afferent and efferent arteries was performed through standard thoracotomy without cardiopulmonary bypass. The patient recovered uneventfully and was discharged on postoperative 8th day without any complications.