Stent Implantation for Effective Treatment of Refractory Chylothorax due to Superior Vena Cava Obstruction as a Complication of Congenital Cardiac Surgery

Chylothorax is a serious complication of congenital cardiac surgery and is significantly associated with increased morbidity and mortality. Central venous obstruction, which is often related to the insertion of central venous catheters for postoperative management, is known to be an important risk factor for treatment failure and mortality associated with this condition. We present the case of a 6-month-old girl with refractory chylothorax after surgical repair of tetralogy of Fallot. The chylous drainage continued for more than 2 months despite maximal conservative therapy (water restriction, total parenteral nutrition, and infusion of somatostatin and steroid) and surgical ligation of the thoracic duct. Subsequently, we observed stenosis of the superior vena cava (SVC) caused by large thrombi possibly associated with the prolonged use of central venous catheter placed in the internal jugular vein. Because transcatheter balloon dilation failed to relieve the stenosis, we performed stent implantation for the SVC and innominate vein. After the procedure, chylous drainage dramatically reduced, and the patient was discharged from the hospital. In conclusion, central venous obstruction due to thrombosis should be routinely examined when chylothorax is diagnosed and is resistant to conservative therapy after congenital heart surgery. Stent implantation can effectively relieve the venous obstruction and thus be a life-saving treatment option for this difficult condition

Effect of Arbuscular Mycorrhizal Colonization on Early Growth and Nutrient Content of Two Peat­ Swamp Forest Tree Species Seedlings, Calophyllum Hosei and Ploiarium Alternifolium

Tropical peat-swamp forests are one of the largest near-surface reserves of terrestrial organic carbon, but rnany peat-swamp forest tree species decreased due over-exploitation, forest fire and conversion of natural forests into agricultural lands. Among those species are slow-growing Calophyllum hoseiand Ploiarium alternifolium, two species are good for construction of boats, furniture, house building and considerable attention from pharmacological viewpoint for human healthly. This study was aimed at understanding the effects of arbuscular mycorrhizal (AM) fungi on early growth of C. hosei and P.alternifoliumunder greenhouse condition. Seedlings of C. hosei and P.alternifoliumwere inoculated with AM fungi: Glomus clarum and Glomus aggregatum ,or uninoculated under greenhouse condition during 6 months. AM colonization, plant growth, survival rate and nutrient content (P, Zn and B) were measured. The percentage of C. hoseiand P.alternifolium ranged from 27-32% and 18-19%, respectively. Both inoculated seedling species had greater plant height, diameter, leaf number, shoot and root dry weight than control seedlings. Nutrient content of inoculated plants were increased with AM colonization- Survival rates of inoculated plants were higher (100%) than those of control plants (67%). The results suggested that inoculation of AM fungi could improve the early growth of C. hoseiand P.alternifolium grown in tropical peat-swamp forest therefore this finding has greater potential impact if this innovative technology applied in field scales which are socially acceptable, commercially profitable and environmentally friendly