Journal of Chest Surgery

  • 제41권5호
  • /
  • Pages.563-567
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  • 2008
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

관상동맥 및 이식편으로 사용 가능한 혈관들의 조직형태학적 비교

Histomorphological Comparison of the Coronary Artery and Available Graft Conduits

  • 김용호 (충남대학교 의과대학 충남대학교병원 흉부외과학교실) ;
  • 이석기 (충남대학교 의과대학 충남대학교병원 흉부외과학교실) ;
  • 유정환 (충남대학교 의과대학 충남대학교병원 흉부외과학교실) ;
  • 김시욱 (충북대학교 의과대학 충북대학교병원 흉부외과학교실) ;
  • 강신광 (충남대학교 의과대학 충남대학교병원 흉부외과학교실) ;
  • 임승평 (충남대학교 의과대학 충남대학교병원 흉부외과학교실) ;
  • 유재현 (충남대학교 의과대학 충남대학교병원 흉부외과학교실) ;
  • 이영 (충남대학교 의과대학 충남대학교병원 흉부외과학교실)
  • Kim, Yong-Ho (Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University, College of Medicine) ;
  • Lee, Seok-Ki (Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University, College of Medicine) ;
  • Yu, Jeong-Hwan (Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University, College of Medicine) ;
  • Kim, Si-Wook (Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Chungbuk National University, College of Medicine) ;
  • Kang, Shin-Kwang (Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University, College of Medicine) ;
  • Lim, Seung-Pyung (Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University, College of Medicine) ;
  • Yu, Jae-Hyeon (Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University, College of Medicine) ;
  • Lee, Young (Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University, College of Medicine)
  • 발행 : 2008.10.05
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초록

배경: 본 연구에서는 관상동맥 및 이식 가능한 도관들을 조직형태학적으로 비교하여 각 도관의 특성을 알아보고자 하였다. 대상 및 방법: 모든 표본은 해부학 실습용 사체 19구에서 얻었다 채취부위는 좌측 내흉동맥의 중앙부, 5번째 좌측 늑간동맥의 중앙부, 좌전하행지동맥의 중앙부, 좌측 요골동맥의 말단부였다. 표본은 Hematoxylin-Eosin (H&E) 염색과 Van Gieson's elastin 염색을 하여 광학현미경으로 관찰하였고, 동맥 각 층의 두께는 $Metamorpho^{(R)}$를 이용하여 측정하였으며, 동맥별로 내막(I)과 중간막(M)의 비율(I/M ratio)을 비교하였다. 통계는 SPSS 12.0을 사용하였으며, 각 동맥간의 통계적 유의성은 일원배치 분산분석을 이용하였다. 결과: 남자가 17예, 여자는 2예였으며, 평균 나이는 $61.5{\pm}9.6$세였다. 내흉동맥과 늑간동맥은 탄력형 동맥의 소견을 보였으며, 좌전하행지동맥과 요골동맥은 근육형 동맥의 소견을 보였다. 내막과 중간막의 비는 내흉동맥 $0.07{\pm}0.03$, 늑간동맥 $0.16{\pm}0.11$, 요골동맥 $0.45{\pm}0.29$, 좌전하행지동맥 $0.93{\pm}0.52$ 순으로 관찰되었다. 각 동맥간 내막증식 정도는 F=30.67, p=0.00으로 통계적 유의성이 있었다. 결론: 내흉동맥, 늑간동맥, 요골동맥, 좌전하행지동맥 순으로 내피의 과증식이 적었고, 근육형 동맥보다 탄력형 동맥에서 내피의 과증식이 적은 것을 확인할 수 있었다. 내흉동맥과 조직학적으로 유사한 늑간동맥을 이식 도관으로 사용할 수 있을 것으로 생각되며, 늑간동맥의 사용 방법에 대해서는 좀 더 연구가 필요하겠다.

Background: The histomorphological properties of the left anterior desecending artery (LAD), the left internal thoracic arteries (LITA), the radial arteries (RA) and the intercostal arteries (ICA) were studied for their use as a conduit for coronary artery bypass grafting (CABG), and we compared them with each other. Material and Method: All the vessels were harvested from nineteen cadavers (17 males and 2 females). The mid-portion of the LAD, the mid-portion of the LITA, the distal RA and the mid-portion of the 5th ICA were obtained. All of them were stained with hematoxylin-eosin and with Van Gieson's elastin stain. The morphological characteristics were examined and the thicknesses of the intima and media (I/M ratio: the intima to media ratio) were compared using one-way ANOVA tests. Result: The mean age of the cadavers was $61.5{\pm}9.6$ years. The LITA and ICA were elastic arteries, and the LAD and RA were muscular arteries. The I/M ratio showed statistically significant differences: $0.07{\pm}0.03$ in the LITA, $0.16{\pm}0.11$ in the ICA, $0.45{\pm}0.29$ in the RA and $0.93{\pm}0.52$ in the LAD, respectively. Conclusion: This study showed that the degrees of intimal hyperplasia of the CA and the various conduits for CABG were different significantly. The ICA was found to have relatively favorable characteristics as a coronary by pass conduit, but its suitability for clinical use is a challenging issue.

키워드

참고문헌

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