Comparison Between Ligation Through Thoractomy and Video-assisted Clipping / 대한흉부외과학회지

BACKGROUND: This study was aimed at analyzing the preoperative conditions post-operative results indication and methods of surgical closure of patent ducturs arteriosus in prematures low birth weight infants and neonates. PATIENTS AND METHODS: We retro-spectively studied two groups of patients (prematures group and neonates group) who underwent surgical closure of the patent ductus arteriosus between March 1995 and June 1998. RESULTS: The premature group consisted of 9 patients(3 males and 6 females) Their mean gestational period was 30.7 weeks(ranging from 26 weeks to 33 weeks) mean age 27.8 days(11 days to 55 days) and mean body weight 1.56 kg. Prominent preoperative symptoms were dependency on mechanical ventilation generalized edema and hepatomegaly. We performed PDA ligation via thoracotomy in all premature patients. The neonate group consisted of 16 patients and their mean body weight was 3.75 kg. Major symptoms of this group was tachypnea and intercostal retraction resistant to medical treatment. We performed video-assisted PDA clipping to them all. There were no postoperative complications or operation-related mortality in both groups. Comparing the ratio of size of PDA(mm)/body weight(kg) the ratio of premature group (ligation through thoracotomy) was higher than that of neonate group ( video-assisted clipping) that is 3,89:1.21(p=0.03) CONCLUSION: We conclude that the surgical closure of PDA can be a safe method of treatment for prematures low birth weight infants and neonates with compromised general conditions. Choice of surgical technique depends on the surgeon's preference but there was a tendency to choose the ligation method through thoracotomy for patients with small body weight and large PDA.

Prevention of Calcification in Glutaraldehyde Treated Bovine Pericardium with Combined Treatment of Sodium Dodecyl Sulfate ( SDS ) and Glutamate / 대한흉부외과학회지

BACKGROUND: Bovine pericardium treated with glutaraldehyde(GA) is one of the most popular prosthetic materials. However, its late calcific degeneration after implantation results in early failure of the prosthesis. Therefore, we investigated the effects of combined treatment with sodium dodecyl sulfate(SDS) and glutamate on calcific degeneration of GA treated bovine pericardium. MATERIAL AND METHOD: Sixty square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4g/L MgCl2 6H2O as a control group (group 1). Sixty pieces pretreated with 1% SDS (group 2) and sixty pieces posttreated with 8% glutamate (group 3) were also fixed in the same GA solution. Sixty pieces pretreated with 1% SDS and posttrated with 8% glutamate were also fixed in the same GA solution (group 4). After 1 month of fixation, the pieces were implanted into the belly of sixty Sprague-Dawley rat subdermally and were extracted 1 month, 2 months and 3 months after the implantation. With an atomic absorption spectrophotometry, we measured the calcium amount deposited. RESULT: The calcium deposition in 1 month was 2.01+/-0.13 mg/g in group 1, 1.45+/-0.31 mg/g in group 2, 2.49+/-0.15 mg/g in group 3 and 0.75+/-0.27 mg/g in group 4. In 2 months, it was 3.57+/-0.15 mg/g in group 1, 0.98+/-0.30 mg/g in group 2, 3.46+/-0.12 mg/g in group 3, and 1.48+/-0.39 mg/g in group 4, and 5.45+/-0.42 mg/g in group 1, 2.43+/-0.53 mg/g in group 2, 4.20+/-0.55 mg/g in group 3, and 1.02+/-0.27 mg/g in group 4 in 3 months. The calcium depositions in group 2 and 4 were less than those of group 1 and 3 in 1 month 2, months, and 3 months(p<0.01). The calcium depositions in group 1, 2 and 3 increased with time. However, they remained unchanged in group 4, which was statistically significant(p<0.01). CONCLUSION: Pretreatment with SDS is effective in reducing calcification of GA treated bovine pericardium, and the combined method of pretreatment with SDS and posttreatment with glutamate was more effective than the other methods.

Calcium Mitigation in the Bovine Pericardial Tissue in the Rat Subcutaneous Implantation model-MgCl2 Effect / 대한흉부외과학회지

Bovine pericardial bioprosthesis treated with glutaraldehyde is one of the most popular prosthetic materials, but late calcific degeneration must be solved. According to the alleged hypothesis of this calcification mechanism the free aldehyde groups on the surface of the tissue treated with glutaraldehyde bind to the circulating free calcium and induce mineralization. For mitigating the calcific degeneration, I added MgCl2 into the 0.625% glutaraldehyde solution to compete with calcium for binding to free aldehyde from the glutaraldehyde. I prepared 60 pieces of square shaped bovine pericardia and fixed in the 0.625% glutaraldehyde solution as control group (group 1), and the other 60 pieces in the same glutaraldehyde solution with 4g/L MgCl2 6H2O as the other group (group 2). After fixation for 1 month these were implanted into the bellies of 60 Sprague-Dawley rats subdermally and extracted on 1 month, 2 months, 3 months and 6 months later. With atomic absorption spectophotometry I measured the deposited calcium amount with the following results; 1 month and 2 months after implantation I could not find any differences between two groups, but in the 3rd month calcium was 1.738 mg/g in group 1 and 0.786 mg/g in group 2 and in the 6th month calcium had risen to 3.102 mg/g in group 1 and 1.623 mg/g in group 2, which has statistical significance (p<0.05). This means magnesium shows meaningful calcium mitigation effects on subcutaneously implanted bovine pericardium in the rat models.

Malignant Thrombi of Inferior Vena Cava from Renal Cell Carcinoma: 4 cases reports / 대한흉부외과학회지

Renal cell carcinoma involves the inferior vena cava (IVC) in approximately 5-10% of the patients. Presently surgical extirpation is the only form of therapy that can result in cure. Circulatory arrest with cardiopulmonary bypass is an operative technique that recently has been used to assist in resection of tumors that extend into the vena cava above the level of hepatic veins. We performed removal of tumor thrombi of IVC in 4 patients. All of them who had the renal cell carcinormas with infrahepatic vena caval extension were performed by standard surgical technique without cardiopulmonary bypass. But in one patient, inferior vena caval thrombectomy was done using circulatory arrest because of the recurred extension of the tumor thrombi within the vena cava above the insertion of the hepatic vein. All patients were recovered without any significant problems.

Prevention of calcification in bovine pericardial bioprosthesis cyxretreatment with surfactants / 대한흉부외과학회지

BACKGROUND: Bovine pericardial bioprosthesis treated with glutaraldehyde (GA) is one of the most popular prosthetic materials, but late calcific degeneration after implantation is a problem that remains unsolved. For the purpose of mitigating the calcific degeneration, we added MgCl2 into the 0.625% GA solution to compete with calcium for binding to the free aldehyde from GA and pretreated with the surfactants like sodium dodecyl sulfate (SDS) and Triton X-100 before GA fixation for preventing the phospholipid infiltration into the pericardial tissue, the first step of the calcific degeneration. MATERIAL AND METHOD: 40 square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4g/L MgCl2 6H2O as a control group (group 1). 40 pieces pretreated with 1% SDS were also fixed in the same GA solution (group 2) and other 40 pieces pretreated with 1% Triton X-100 were prepared with the same method (group 3). After 1 month of fixation these were implanted into the belly of 40 Sprague-Dawley subdermally and extracted 1 month, 2 months, 3 months and 6 months after implantation. With atomic absorption spectrophotometry we measured the deposited calcium amount. RESULT: 1 month after implantation we could not find any differences between the three groups, but by the 2nd month calcium deposition was 0.921+/-0.121 mg/g in group 1, 0.481+/-0.037 mg/g in group 2 and 1.369+/-0.200 mg/g in group 3. By the 3rd month it was 0.786+/-0.080 mg/g in group 1, 0.584+/-0.054 mg/g in group 2 and 1.139+/-0.188 mg/g in group 3, and on the 6th month 1.623+/-0.601 mg/g in group 1,0.501+/-0.043 mg/g in group 2 and 1.625+/-0.382 mg/g in group 3, with statistical significance in group 2 (p<0.05). CONCLUSION: Pretreatment with SDS showed meaningful calcium mitigation effects on subcutaneously implanted bovine pericardium in the rat models but the neutral type surfactant, Triton X-100, had no positive mitigation effect in this experiment.

Modulation of calcium current by cyclic GMP in the single ventricular myocytes of the rabbit / 대한흉부외과학회지

No abstract available.