Is to apply the clamp at a point distal of these areas, if possible, while

Is to apply the clamp at a point distal of these areas, if possible, while observing both the anterior spinal artery and arteria radicularis magna, in order to maintain a short clamping period and keep the distance between the clamping and reimplantation of intercostals as much as possible [24?6]. Kouchoukos [27] reported a correlation to exist between paraplegia and the time of clamping and the length of harvested aorta. However, the reimplantation of the intercostals to the graft as far as possible is one of the best MS023 site methods of protection, and especially all possible intercostals and lumber arteries between T6 and L1 should be reimplanted to the graft as far as possible. Svensson et al [24] identified theseFig. 2 Hematoxylin and Eosin x 200 staining of the medulla spinalis tissue. Results of histopathological analysis of all experimental groups. A spinal cord region at 60 min postischemia shows widespread hemorhage, edema, cell degeneration, and inflammation (H E, ?00)Erkut and Onk Journal of Cardiothoracic Surgery (2015) 10:Page 6 ofTable 3 Histopathologic results of the medulla spinalis tissueGrade Control group Experimental group P value Number ( ) Cell Degeneration 0 1 2 3 4 Edema 0 1 2 3 4 Hemorrhage 0 1 2 3 4 Inflammation 0 1 2 3 4 0 (0) 0 (0) 1 (11.1) 2 (22.2) 6 PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26024392 (66.7) 0 (0) 0 (0) 0 (0) 4 (44.4) 5 (55.6) 0 (0) 1 (11.1) 1 (11.1) 2 (22.2) 5 (55.6) 0 (0) 2 (22.2) 1 (11.1) 2 (22.2) 4 (44.4) Number 7 (77.8) 1 (11.1) 1 (11.1) 0 (0) 0 (0) 6 (66.7) 1 (11.1) 1 (11.1) 1 (11.1) 0 (0) 5 (55.6) 2 (22.2) 2 (22.2) 0 (0) 0 (0) 8 (88.9) 1 (11.1) 0 (0) 0 (0) 0 (0) 0.0001 0.0009 0.0003 0.arteries by a special method perioperatively by which the incidence of paraplegia after their operations decreased. Yamada et al [28] preoperatively revealed the ASA, ARM, and critical intercostal arteries by magnetic resonance angiography. They obtained notable results in the protection of the cord by reimplanting the determined critical arteries to the int erposed aortic graft. In literature there are several studies that evaluating the protective effects of the different pharmacological agents and their combination (simvastatin, pentoxifylline, dantrolen Na, vitamins, ilioprost and N-acetylcysteine combination, etc.) on the spinal cord I/R injury [29, 30]. All researchers agree that many agents may partially prevent reperfusion injury, but none have been found to be sufficient by itself; it must be combined with other agents and protective surgical methods [28, 31, 32]. We examined that the NAC and allopurinol combinations decreased I/R damage, both histopathological and biochemical. Our literature search did not produce any study showing the efficacy of NAC and allopurinol in a spinal cord ischemia/ reperfusion model. Free radicals (FRs) are normal by-products of cellular metabolic processes. The human body has a complex antioxidant defense system that includes the antioxidant enzymes (SOD and CAT) and nonenzymatic antioxidantcomponents such as glutathione, a-tocopherol, ascorbic acide, and b-carotene. These prevent the initiation or propogantation of free radical chain reactions. Postischemic reperfusion injury is associated with the generation of FRs which damage cellular components and initiate the lipid peroxidation process. In many studies, antioxidant activity was tried to be shown through biochemical enzyme studies in addition to histopathological studies. SOD can scavenge the superoxide radicals and can play an important role in preventing oxidative.