• Title/Summary/Keyword: 이식혈관

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Investigation of Bovine Pericardial Heterograft (I) - Concentration of fixatives and tensile strength - (소의 심낭을 이용한 이종이식 보철편의 개발 (I)고정액의 농도와 장력)

  • An, Jae-Ho;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.373-383
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    • 1989
  • Glutaraldehyde is known as an ideal preservatives for pericardial heterograft, and many laboratories used this chemicals for preparing tissue valves, pericardial patches and MVOP [monocusp ventricular outflow patch] so we tried to find out the appropriate concentration and ingredients of the Glutaraldehyde for the preparing bovine pericardium. We selected 50 calves, aged about 2 years, and procured their pericardia. These were divided 6 groups such as fresh group, treated with only antibiotics, treated with Glutaraldehyde 0,5%, 0.625 %, 0.75 %, and 0.875 %, and our experiments included microbial culture test, tensile strength measurement and microscopic examination. On microbial culture, there were no growth on 1 week and 4 weeks after preparation with all kind of Glutaraldehyde, but on 4 weeks after only antibiotics treatment [Penicillin, Streptomycin, Kanamycin, Amphotericin -B] E.coli and candida albicans were observed. On tensile strength test, 0.625 % and 0.75 % Glutaraldehyde were revealed as the best preservatives for bovine pericardium and compared to other commercial products they kept more desirable tensile strength. On light and electron microscopic examinations, Glutaraldehyde treated pericardia had much regular and compact collagen fibers and preserved more normal structures, but there were no difference between the different concentration of the Glutaraldehyde. We concluded that 0.625% and 0.75 % Glutaraldehyde were the best concentration for preservation of bovine pericardium in our experiment.

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Investigation of Bovine Pericardial Heterograft (II0) : Clinical applications of glutaraldehyde-preserved bovine pericardium (우심낭을 이용한 이종이식 보철편의 개발 (II) - 0.625% Glutaraldehyde 에 보존한 우심낭의 임상 적용 -)

  • 김기봉
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.465-473
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    • 1990
  • Glutaraldehyde have been used as the most effective cross-linking agent for stabilizing collagen fibers and preventing biodegradation. We processed bovine pericardium in a solution containing 0.625% glutaraldehyde,0.05M HEPES buffer and 0.26% magnesium chloride in saline. The glutaraldehyde-preserved bovine pericardium was implanted in 36 patients at Seoul National University Hospital during a 11-month period between May 1989 and March 1990. 24 were males and 12 females, with ages ranging from 6 months to 168 months [mean age of 43 months]. In 12 patients, the glutaraldehyde-preserved bovine pericardium was used for orthotopic reconstruction of the pericardial sac. In 24 patients. the glutaraldehyde-preserved bovine pericardium was heterotopically implanted.; pulmonary monocusp implant and RVQT [right ventricular outflow tract] patch widening were performed in 10 patients, pulmonary monocusp implant in 6, RVOT patch widening in 4, valved conduit in 2, conduit and pulmonary angioplasty in 1, and ventricular septation in l. With vascular suture techniques, the anastomoses were immediately tight. There was no bleeding from the needle holes and no oozing through bovine pericardium itself. During the follow-up period of up to 10 months, no infections of the glutaraldehyde-preserved bovine pericardium occurred and no bovine pericardium-related complications were observed in this series.

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Surgical Treatment of Plummer - Vinson Syndrome with Carcinoma in Situ - One case report - (상피내암종으로 발전한 Plummer - Vinson 증후군의 수술적 치험 - 1례 -)

  • 최주원;장운하;박찬필;오태윤
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.495-499
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    • 2002
  • Plummer-Vinson syndrome(Paterson-Kelly syndrome) is characterized by dysphagia due to upper esophageal or hypopharyngeal web, iron deficiency anemia, and atropic oral and glossal mucosa. This syndrome is usually known as precancerous lesion that develops into postcricoid carcinoma. Universally, the clinical manifestations of this syndrome were markedly improved after oral iron replacement therapy or endoscopic balloon or electrocautery treatment. 63 year-old woman was received a short segment, free jejunal transfer to be released from esophageal stricture. After the operation, the stenotic lesion proved to be Plummer-vinson syndrome with carcinoma in situ by pathologic study.

Desmoplastic Small Round Cell Tumor of the Mediastinum -A case report - (종격동에 발생한 결합조직형성 소원형세포 종양 - 1예 보고-)

  • Kim, Jeong-Won;Cha, Hee-Jeong;Park, Sang-Kyu;Jung, Jong-Pil;Shin, Je-Kyoun;Park, Chang-Ryul
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.147-150
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    • 2007
  • Desmoplastic small round cell tumor (DSRCT) is rare and a recently described, poorly differentiated malignant tumor and it usually presents with widespread intra-abdominal involvement. We report a case of DSRCT arising form the mediastinum which was treated with multimodality anticancer therapy in 15 year-old girl.

Inhibitory Effects of Citaowan on Metastatic Cancer Growth and Agiogenesis in an Orthotopic Model of Breast Cancer (생쥐의 동소이식 유방암에서 자도환(慈桃丸)의 in vivo 전이암 성장 억제 및 혈관신생 억제 효과)

  • Myung, Eu-Gene;Kang, Hee;Shim, Bum-Sang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.6
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    • pp.1502-1506
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    • 2006
  • To investigate the inhibitory effects of Citaowan (CTW) on the growth and angiogenesis of breast cancer in vivo. Orthotopic breast cancer model was established by injection of MDA-MB-231 cells into mammary fat pad of nude mice. Seven weeks after injection, CTW was orally administered at dose of 50, 100 mg/mouse every day for 40 days. Body weight, tumor volume, tumor apoptosis, microvessel density and tumor proliferation were evaluated, after the mice were sacrificed. The body weight and tumor volume were not significantly changed in CTW group compared with the control group. Tumor apoptosis, proliferation and microvessel density were significantly reduced in CTW group (100 mg/mouse) compared with the control group. These data indicate that CTW has anti-angiogenic and proapoptotic effects on breast cancer.

Angiographic and CT Scan Follow-up of the Omental Free Graft in the Mediastinum - A Case Report - (종격에 자유이식된 대공막의 혈관조영 및 전산화 단층촬영 추적결과 - 1례 보고 -)

  • Sun, Kyung;Kim, Jung-Taek;Kim, Kwang-Ho;Lee, Choong-Jae;Kim, Young-Mo;Lim, Hyun-Kyoung
    • Korean Journal of Bronchoesophagology
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    • v.4 no.1
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    • pp.101-104
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    • 1998
  • Partial splitting of the upper sternum provides an excellent surgical view in reconstruction of the intrathoracic trachea. However, when deep-seated mediastinitis develops postoperatively, it is difficult to manage especially when combined with sternal osteomyelitis. It also needs an additional consideration compared to the usual treatment modality applied to mediastinitis following a standard median stemotomy because the lower part of the stemum remains intact. We treated a 50 year old female patient with deep-seated mediastinitis and sternal osteomyelitis following resection and end-to-end anastomosis of the trachea through an upper midline sternotomy. The patient underwent extensive stemectomy, omental free grafting, and pectoral myocutaneous flap. Postoperative viability of the free-grafted omentum was evaluated by angiography and CT scan.

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Comparison of Different Thawing Methods on Cryopreserved Aorta (냉동 보존된 대동맥의 해동방법)

  • 오영민;심성보;사영조;박재길;곽문섭;이선희
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.113-118
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    • 2004
  • The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. Material and Method: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37$^{\circ}C$ (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. Result: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. Conclusion: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopresewed arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.

The Potential Therapeutic Effects of Endothelial Progenitor Cells in Ischemic Cardiovascular Disease (허혈성 심혈관 질환의 치료제로서 혈관내피전구세포(EPC)의 가능성에 대한 고찰)

  • Kim, Da Yeon;Kim, Bo Min;Kim, So Jung;Choi, Jin Hee;Kwon, Sang-Mo
    • Journal of Life Science
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    • v.30 no.7
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    • pp.651-659
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    • 2020
  • Cardiovascular disease is one of the leading causes of death across the world, and gold-standard treatments such as percutaneous coronary intervention and artery bypass grafting have various limitations including myocardial damage and subsequent maladaptive cardiac remodeling. To overcome this, stem-cell therapies are emerging as a promising strategy for cardiovascular regeneration. Endothelial progenitor cells (EPCs) have high potential to proliferate and differentiate into endothelial cells for vascularization and tissue regeneration, and several clinical trials have explored EPC function in tissue repair in relation to clinical safety and improving cardiac function. Consequently, EPC has been suggested as a feasible stem-cell therapy. However, autologous EPC transplantation in cardiovascular disease patients is restricted by risk factors such as age, smoking status, and hypertension that lead to reduced bioactivity in the EPCs. New approaches for improving EPC function and stem-cell efficacy have therefore been suggested, including cell priming, organoid culture systems, and enhancing transplantation efficiency through 3D bioprinting methods. In this review, we provide a comprehensive understanding of EPC characteristics, therapeutic approaches, and the current state of clinical research into EPCs as stem-cell therapy for cardiovascular disease.

Off-Pump Total Arterial Revascularization Using the Skeletonized Right Gastroepiploic Artery as a Third Arterial Conduit; Early and Midterm Results (제3동맥 도관으로서의 골격화된 우위대망동맥을 사용하여 시행한 심폐바이패스를 사용하지 않는 관상동맥 우회술;초기 및 중기 결과)

  • 이현주;최재성;김기봉
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.659-665
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    • 2003
  • The aim of this study was to evaluate the early and midterm results of off-pump total arterial revascularization using the skeletonized right gastroepiploic artery (RGEA) as a third arterial conduit. Material and Method: We prospectively analyzed 103 patients who underwent off-pump total arterial revascularization using bilateral internal thoracic arteries (ITAS) and RGEA. The RGEA was used as in situ graft in 88 patients, composite graft in 10 patients, and free graft in 5 patients. Postoperative coronary angiographies were performed before discharge in 100 patients, and at postoperative one year in 88 patients. Result: The RGEA showed a significantly higher free flow (130$\pm$95 ml/min) than that of right ITA(113$\pm$57 ml/min) or left ITA (107$\pm$55 ml/min), which was measured before anastomosis (p < 0.05). The total number of distal anastomoses was 3.8$\pm$0.7. The number of distal anastomoses per bilateral ITAs was 2.8$\pm$0.7 and the number of distal anastomosis per RGEA was 1.0. There were two morialities including one operative mortality. The late mortality was not related to cardiac events. Early postoperative morbidities were atrial fibrillation in 15 patients, bleeding reoperation in 4 patients, mediastinitis in 1 patients, perioperative myocardial infarction in 2 patient, and transient ARF in 3 patients. Postoperative coronary angiographies showed the early patency rate of 98.6% (272/276) for ITAs and 97.0% (97/100) for RGEA, respectively (p=ns), and the one-year patency rate of 95.9% (234/244) for ITAs and 88.6% (78/88) for RGEA, respectively (p=0.07). Flow competition between the RGEA and NCA (native coronary artery) was seen in 5 of the 100 patients (5.0%) immediate postoperatively and 7 of the 88 patients (8.0%) 1 year after surgery. Since July, 2000, we measured transit time flow intraoperatively and could reduce flow competition significantly Conclusion: The skeletonized RGEA demonstrated excellent early and midterm patency rates and could be used as a third arterial graft following the bilateral ITAs.

Evaluation of the Potential of Retrograde Flow Competition in the Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting (우위대망동맥을 이용한 관상동맥우회술 후 역행성 혈류 발생가능성의 연구)

  • Chung, Bong-Kyu;Sun, Kyung;Kwon, Joon;Kim, Kwang-Ho;Jung, Jae-Seung;Son, Ho-Sung;Lee, Sung-Ho;Kim, Kwang-Taik;Kim, Hyung-Mook
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.20-26
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    • 2002
  • Background: Due to the concern of flow competition or retrograde steal, it has been generally suggested that the right gastroepiploic artery(RGEA) pedicled graft should be used in critical coronary stenosis lesion. The study was designed to evaluate the potential of retrograde flow competition in the RGEA pedicled graft by measuring the native pressure differences(PD) between the normal coronary artery and celiac arterial pressure, which would be compared with trans-stenosis pressure gradients(TSPG) in coronary artery occlusive disease. Material and Method: Between July, 1998 and February, 1999, pressures of the right coronary artery and the right gastroepiploic artery(or the celiac artery) were measured in patients with the patent right coronary artery(n=12). The PD between the arteries was compared with the TSPG in the occlusive coronary arteries(n=32). Result: The pressures of the normal right coronary artery and celiac artery were 143$\pm$23 vs. 134$\pm$17mmHg in systole(p<0.005), 74$\pm$13 vs. 73$\pm$14mmHg in diastole(p=NS), and 100$\pm$16 vs. 97$\pm$15mmHg in mean (p<0.05). The PD between the arteries were -8~25mmHg in systole, -4~7mmHg in diastole, and -1~10mmHg in mean. The TSPG measured in the occlusive coronary arteries were -4~19(7$\pm$5.8)mmHg in the lesion less than 75% stenosis vs. 7~74(27$\pm$18.3)mmHg in the 75% or over stenosis lesion(p<0.005). The normally existing pressure difference between the coronary arteries and RGEA(15~20mmHg) was significantlyless than the TSPG in .the occlusive coronary artery with 75% or over stenosis(p<0.001). Conclusion: If the pressure gradient between the RGEA and the coronary artery distal to the stenosis is the main determinant of development of retrograde flow competiton in the RGEA pedicled graft, the above data suggests that there will be little chance of competition when It is used in the coronary lesion with 75% or over stenosis.