Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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A Study of the Effect of a Mixture of Hyaluronic Acid and Sodium Carboxymethyl Cellulose ($Guardix-sol^{(R)}$) on the Prevention of Pericardial Adhesion

Hyaluronic Acid와 Sodium Carboxymethyl Cellulose 혼합용액($Guardix-sol^{(R)}$)의 섬유막유착 방지 효과에 관한 연구

  • Lee, Song-Am (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Kim, Jin-Sik (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Kim, Jun-Seok (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Hwang, Jae-Joon (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, School of Medicine, Konkuk University) ;
  • Lee, Woo-Surng (Department of Thoracic and Cardiovascular Surgery, Konkuk University Chungju Hospital, School of Medicine, Konkuk University) ;
  • Kim, Yo-Han (Department of Thoracic and Cardiovascular Surgery, Konkuk University Chungju Hospital, School of Medicine, Konkuk University) ;
  • Cho, Yang-Kyu (College of Veterinary Medicine, Konkuk University) ;
  • Chee, Hyun-Keun (Department of Thoracic and Cardiovascular Surgery, Konkuk University Hospital, School of Medicine, Konkuk University)
  • 이송암 (건국대학교 의학전문대학원 건국대학교병원 흉부외과학교실) ;
  • 김진식 (건국대학교 의학전문대학원 건국대학교병원 흉부외과학교실) ;
  • 김준석 (건국대학교 의학전문대학원 건국대학교병원 흉부외과학교실) ;
  • 황재준 (건국대학교 의학전문대학원 건국대학교병원 흉부외과학교실) ;
  • 이우성 (건국대학교 의학전문대학원 충주병원 흉부외과학교실) ;
  • 김요한 (건국대학교 의학전문대학원 충주병원 흉부외과학교실) ;
  • 최양규 (건국대학교 수의학과) ;
  • 지현근 (건국대학교 의학전문대학원 건국대학교병원 흉부외과학교실)
  • Received : 2010.06.28
  • Accepted : 2010.08.17
  • Published : 2010.12.05
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Abstract

Background: This study was designed to evaluate the efficacy of a mixture of hyaluronic acid and sodium carboxymethyl cellulose ($Guardix-sol^{(R)}$) on experimental pericardial adhesion. Material and Method: Thirty rats were divided into 2 groups of 15 rats each and pericardial mesothelial injury was induced during surgery by abrasion. In the control group, blood and normal saline were administered into pericardium; in the test group, blood and HA-CMC solution were administered. Pericardial adhesions were evaluated at 2 weeks (n=5), 4 weeks (n=5), and 6 weeks (n=5) after surgery. The severity of adhesions was graded by macroscopic examination, and the adhesion tissue thickness was analyzed microscopically with Masson trichrome stain and an image processing program. Result: The test group had significantly lower macroscopic adhesion scores ($2.9{\pm}0.6$ : $3.9{\pm}0.4$, p<0.000) compared with the control group. For microscopic adhesion tissue thickness, the test group had lower scores compared with the control group, but this difference was not statistically significant ($91.73{\pm}49.91$ : $117.67{\pm}46.4$, p=0.106). Conclusion: We conclude that an HA-CMC solution ($Guardix-sol^{(R)}$) reduces the formation of pericardial adhesions in this animal model.

배경: 심장막유착에 hyaluronic acid와 sodium carboxymethyl cellulose 혼합용액 (HA-CMC solution, $Guardix-sol^{(R)}$)의 유착방지 효과를 평가하기 위해 본 연구를 시행하였다. 대상 및 방법: 30마리의 흰쥐를 각각 15마리씩 2그룹으로 나누었으며 기계적 마찰을 통해 심장막 중피 손상을 유발시켰다. 대조군은 혈액과 생리식염수를, 실험군은 혈액과 HA-CMC 혼합용액을 심장막공간에 주입하였다. 수술후 2주, 4주, 6주에 5마리씩 심장막유착의 정도를 평가하였다. 유착의 정도를 육안으로 평가하였으며, 유착조직의 두께는 Masson trichrome염색과 영상처리프로그램을 통해 현미경적 분석을 시행하였다. 결과: 육안적검사상 실험군에서 유착점수가 대조군에 비해 유의하게 낮았다($2.9{\pm}0.6$ : $3.9{\pm}0.4$, p < 0.000). 실험군에서 유착조직두께는 대조군에 비해 낮았으나 통계적으로 유의하지는 않았다($91.73{\pm}49.91$ : $117.67{\pm}46.4$, p=0.106). 결론: 실험동물 모델에서 HA-CMC용액 ($Guardix-sol^{(R)}$)의 유착형성을 감소시키는 것을 관찰하였다.

Keywords

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