• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.29-38
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• 1997

A peripheral nerve when approximation of the ends imparts tension at the anastomosis and with a relatively long segment defect after excision of neuroma and neurofibroma cannnot be repaired by early primary suture. The one of the optimistic reconstruction method of severed peripheral nerves is to restore tension-free continuity at the repair site putting an autogenous nerve graft into the neural gap despite of ancipating motor or sensory deficit of the donor nerve area. To overcome the deficit of the autogenous nerve graft, several other conduits supplying a metabolically active environment which is able to support axon regeneration and progression, providing protection against scar invasion, and guiding the regrowing axons to the distal stump of the nerve have been studied. An author have used ipsilateral femoral vein, ipsilateral femoral vein filled with fresh thigh muscle, and autogenous sciatic nerve for the sciatic nerve defect of around 10 mm in length to observe the regeneration pattern in rat by light and electron microscopy. The results were as follows. 1. Light microscopically regeneration pattern of nerve fibers in the autogenous graft group was more abundant than vein graft and vein filled with muscle group. 2. On ultrastructural findings, the proxial end of the graft in various groups showed similar regenerating features of the axons, myelin sheaths, and Schwann cells. The fascicular arrangement of the myelinated and unmyelinated fibers was same regardless of the type of conduits. There were more or less increasing tendency in the number and the diameter of myelinated fibers correlated with the regeneration time. 3. In the middle of the graft, myelinated nerve fibers of vein filled with muscle group were more in number and myelin sheath was thinner than in the venous graft, but the number of regenerating axons in autogenous nerve graft was superior to that in both groups of the graft. The amount of collagen fibrils and amorphous materials in the endoneurial space was increased to elapsed time. 4. There was no difference in regenerating patterns of the nerve fibers of distal end of the graft. The size and shape of the myelinated nerve fbers were more different than that of proximal and middle portion of the graft. From the above results, the degree of myelination and regenerating activity in autogenous nerve is more effective and active in other types of the graft and there were no morphological differences in either ends of the graft regardless of regeneration time.

• Journal of Pharmaceutical Investigation
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• 제29권1호
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• pp.47-53
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• 1999

Gastrodia elata (GE) is an oriental medicinal herb which has been used traditionally for the treatment of various brain diseases including convulsion and epilepsy. The purpose of this study was to determine pharmacokinetic parameters of 4-hydroxy-3-methoxybenzaldehyde (HMBA) and p-hydroxybenzaldehyde (PHBA), constituents of GE, in rats. Male rats were cannulated in the femoral vein, femoral artery, bile duct and ureter. They received a single i.v. bolus dose of either HMBA or PHBA through the femoral vein. The concentration of HMBA or PHBA in plasma, bile and urine samples were analyzed by reversed-phase HPLC. HMBA and PHBA have very short half-lives, i.e. 4.03 and 2.26 minutes respectively. Most of HMBA and PHBA were thought to be eliminated through metabolism as the metabolized fraction approaches unity. Derivatives of HMBA or PHBA with longer biological half-lives should be designed to develop better anticonvulsants and more complete qualitative and quantitative understanding of the overall pharmacokinetic fate of these compounds awaits further investigation.

• Journal of Chest Surgery
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• 제37권10호
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• pp.880-883
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• 2004

복부 인조혈관 감염증은 매우 심각한 상태로서 문합부 파열로 심한 출혈이나 급성 말초 색전증으로 하지 허혈을 유발하여 사망률이 높고 치료하기 어려운 질환으로 치료에 대한 논란이 많은 질환이다. 저자는 복부대동맥류 수술 후 약 1년 후에 발생한 인조혈관 감염증례를 양 허벅지 심부정맥인 표제성 대퇴정맥을 사용하여 재치환하여 좋은 결과를 얻었기에 문헌과 함께 보고한다.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.441-446
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• 2023

Inferior vena cava (IVC) injuries, while accounting for fewer than 0.5% of blunt abdominal trauma cases, are among the most difficult to manage. Despite advancements in prehospital care, transportation, operative techniques, and perioperative management, the mortality rate for IVC injuries has remained at 20% to 66% for several decades. Furthermore, 30% to 50% of patients with IVC injuries succumb during the prehospital phase. A 65-year-old male patient, who had been struck in the back by a 500-kg excavator shovel at a construction site, was transported to a regional trauma center. Injuries to the right side of the infrarenal IVC and the right external iliac vein (EIV) were suspected, along with fractures to the right iliac bone and sacrum. The injury to the right side of the infrarenal IVC wall was repaired, and the right internal iliac artery was ligated. However, persistent bleeding around the right EIV was observed, and we were unable to achieve proximal and distal control of the right EIV. Attempts at prolonged manual compression were unsuccessful. To decrease venous return, we ligated the right superficial femoral vein. This reduced the amount of bleeding, enabling us to secure the surgical field. We ultimately controlled the bleeding, and approximately 5 L of blood products were infused intraoperatively. A second-look operation was performed 2 days later, by which time most of the bleeding sites had ceased. Orthopedic surgeons then took over the operation, performing closed reduction and external fixation. Five days later, the patient underwent definitive fixation and was transferred for rehabilitation on postoperative day 22.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권2호
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• pp.137-143
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• 2001

The effect of topical heparin application and vascular freezing on thrombosis was evaluated in the femoral vein of rabbits. The femoral veins were crushed, incised transversely and treated by 4 different ways; 1) group 1, heparin treated only, 2) group 2, frozen only, 3) group 3, heparin treated and frozen, 4) group 4, treated with saline as control. The patency was evaluated by empty-and-refill test and thrombus formation was judged by stereoscopic and SEM observation. The results obtained were as follows: 1. Thirty minutes after suture, the patency was more improved in the three groups than the control, but there was no significant difference among groups. 2. Three days after suture, the patency was more improved in the three groups than the control, and was prominent in group 1 and group 3 (P<0.05). 3. Significantly reduced thrombus could be seen in most case of group 3. These results suggest that topical application of heparin and vascular freezing is effective in reducing thrombus formation in microsurgery of vein.

• 한국임상수의학회지
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• 제32권3호
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• pp.243-246
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• 2015

9개월령 암컷 치와와(체중 1.5 kg)가 운동 불내성과 좌측 흉벽 심기저부의 큰 심잡음으로 의뢰되었다. 방사선 검사의 배복상에서 좌심실 종대 및 주폐동맥, 대동맥, 좌심방 확장의 전형적인 소견인 트리플범프(triple bump)가 확인 되었다. 심초음파 검사에서 동맥관이 확인되었으며 대동맥과 주폐동맥 사이에 좌우 방향의 연속적인 와류(최고 속도 5.73 m/s)가 측정되었다. 이 환자는 대퇴 정맥(정맥을 통한 접근)으로 접근하여 Amplatzer$^{(R)}$ vascular plug를 이용해 동맥관을 성공적으로 폐쇄하였다. 본 증례는 PDA를 대퇴 정맥으로 접근하여 vascular plug를 이용해 막은 국내 최초보고이다.

• 한국임상수의학회지
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• 제32권4호
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• pp.334-337
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• 2015

9개월령 프렌치불독(체중 13 kg)이 심한 심잡음과 운동불내성으로 내원하였다. 영상진단검사상, 폐동맥에서 5 m/s이상의 고속의 젯트와 우심실 비대가 확인되었다. 우심실과 유출로 사이의 압력구배가 100 mmHg이상이여서 풍선확장술로 치료하였다. 치료후 폐동맥에서 젯트속도는 2.1 m/s (PG = 18 mmHg)이하로 감속되었다. 환자는 그 이후에 별다른 진단검사상 악화소견이 관찰되지 않았다. 본 증례는 대퇴정맥으로 폐동맥 협착을 풍선확장술로 치료한 국내 첫 증례이다.

• 감성과학
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• 제11권4호
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• pp.565-574
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• 2008

감성을 비롯한 인간의 뇌 기능은 혈-뇌 장벽을 매개로 약물의 작용에 의해 직접적인 영향을 받을 수 있다. 이 연구는 mannitol의 투여경로와 양, 농도에 의한 혈-뇌 장벽(blood-brain barrier, BBB)의 변화를 알아보고자 수행되었다. 실험동물로서 흰쥐에 20%의 mannitol을 오른쪽 뇌경동맥(internal carotid artery, ICA)을 통하여 주입하였고, 다른 그룹에서는 femoral vein을 통하여 주입하였다. 또한 각기 다른 경로를 이용하여 Evans blue(EB) 염색 시료를 투여한 후 BBB의 변성 정도를 확인하였다. 실험결과 ICA를 통해서 mannitol이 주입된 동물은 동측(ipsilateral side)이 대측(contralateral side)에 비해 EB 염색시료에 의해 영향을 많이 받았으나, femoral vein을 통해서 주입한 경우에는 mannitol의 양과 농도를 증가시켜도 EB 염색시료에 의한 영향이 거의 나타나지 않았다. 이러한 결과는 비록 EB 염색시료의 주입이 ICA를 통해서 또는 정맥경로를 따라서 이루어지더라도, BBB의 변성은 ICA를 통해서 이루어진다고 볼 수 있으며, 이러한 결과는 BBB의 제한적인 조절작용을 통해 인간의 뇌 기능을 이해하는데 좋은 방법을 제공할 수 있다는 것을 시사한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권5호
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• pp.284-293
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• 2013

Purpose: For reconstruction of craniomaxillofacial defects caused by tumor, trauma, infection etc, free flap transplantation with microvascular surgery is a very useful method. Thrombus formation at the anastomosis site is the major cause of graft failure. 4-Hexylresorcinol (4-HR) is generally known as an antiseptic and antiparasitic agent. This study was conducted in order to evaluate the effect of 4-HR on blood coagulation in vitro. In addition, we investigated thrombus formation and endothelial repair of an injured vessel in an animal model. Methods: In the in vitro experiment, we compared blood coagulation time between the 4-HR treated group and normal blood. Thirty rats were used for in vivo animal experiments. After exposure of the right femoral vein, a micro vessel clamp was placed and the femoral vein was intentionally cut. Microvascular anastomosis was performed on all rats using 10-0 nylon under microscopy. The animals were divided into two groups. In the experimental group (n=15), 4-HR (250 mg/kg) mixed with olive oil (10 mL/kg) was administered per os daily. Animals in the control group (n=15) were given olive oil only. The animals were sacrificed at three days, seven days, and fourteen days after surgery and rat femoral vein samples were taken. Vascular patency and thrombus formation were investigated just before sacrifice. Histologic analysis was performed under a microscope. Results: Results of an in vitro blood coagulation test showed that coagulation time was delayed in the 4-HR treated group. The results obtained from an in vivo 4-HR administered rat model showed that the patency of all experimental groups was better at thirty minutes, seven days, and fourteen days after microvascular anastomosis than that of the control group at seven and fourteen days after anastomosis, and the amount of thrombus in the experimental groups was much less than that of the control group. Endothelial repair was observed in the histologic analysis. Conclusion: Findings of this study demonstrated that blood coagulation was delayed in the vitro 4-HR treated group. In addition, good vascular patency, anti-thrombotic effect, and repair of venous endothelial cells were observed in the vivo 4-HR administered rat group.

• Journal of Chest Surgery
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• 제3권1호
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• pp.55-58
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• 1970

The problem of phlebothrombosis is an important one, not only because of its local effects, but because of the propensity for portions of the venous clot to berak off and travel back to the heart and into the pulmonary Artery. The result of pulmonary embolism, unfortunately is still as prominent a cause of death today as it was before the advant of modern advances in treatment and prevention. This paper reports a case of thrombosis of left common iliac vein left hypogastric vein and left common femoral vein, who had been bedmidden for two weeks because of left knee joint arthritis. Successfully treated with transabdominal direst venous thrombectomy and anticoagulant heparin. Authors also reviewed the references.