• Title/Summary/Keyword: Pericardium

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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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Primary Fibromyxoma of the Pericardium (심낭의 원발성 양성 섬유 점액종: 1례 보고)

  • 이세순
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.69-74
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    • 1968
  • Primary neoplasms of the pericardium are rarer than those originating within the myocardium or endocardium and, moreover, primary benign tumors of the pericardium are of much rare occurence. Mahaim[1945] was able to collect 84 cases of pericardial tumors, the majority of which were malignant. A case of primary benign fibromyxoma of the pericardium is presented. This tumor arouse in the right anterior aspect of the pericardium, through which the phrenic nerve was penetrated. The tumor was measured 10X6X6 cm in size and 120 gm in weight. Total excision of the mass was accomplished by antero-lateral thotacotomy incision, resulting complete cure. This is the first case of primary benign fibromyxoma of the pericardium on literatures in our knowledge.

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Tracheal augmentation with Bovine pericardium (Bovine pericardium을 이용한 기관협착의 치험예)

  • 김부연;이교준;신화균;이응석
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.320-323
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    • 2000
  • This case describes a tracheal stenosis complicated by endobronchial truberculosis. A 50-year-old female with progressive dyspnea was referred to us for the management of long segmental tracheal stenosis. Treatment modalities for tracheal stenosis include open surgical resectin and reconstruction, mechanical dilation, laser resection, and placement of an airway prosthesis. The following is a report of a successful treatment of a long segmental tracheal stenosis through a tracheal augmentation and the use of al Bovine pericardium. This technique may provide a relief from tracheal stenosis.

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Noninvasive Imaging of Pericardium (심막의 영상 소견)

  • Bae Young Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.337-350
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    • 2020
  • The clinical manifestation of pericardial disease is similar to that of coronary artery disease and aortic disease. Therefore, a timely and accurate diagnosis is necessary. The pericardium is a 2-layered membrane that envelops the heart and great vessels, and there are numerous anatomic variations and pathologic conditions. Large or unusually located pericardial recesses can be easily mistaken for abnormal findings. Additionally, primary pericardial diseases resulting from infections, tumors, and injuries are possible; further, diseases can quickly spread along the pericardium. Echocardiography is generally the first imaging tool used to evaluate the pericardium. However, it has limited windows and poor resolution. Besides, the evaluation of postoperative echocardiography is sometimes limited. Currently, CT and MR imaging are useful for evaluating pericardial diseases. Detailed knowledge of the pericardium is important for interpreting the images and clinical results.

Changes of the Structural and Biomechanical Properties of the Bovine Pericardium after the Removal of ${\alpha}$-Gal Epitopes by Decellularization and ${\alpha}$-Galactosidase Treatment

  • Nam, Jinhae;Choi, Sun-Young;Sung, Si-Chan;Lim, Hong-Gook;Park, Seong-Sik;Kim, Soo-Hwan;Kim, Yong Jin
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.380-389
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    • 2012
  • Background: Bovine pericardium is one of the most widely used materials in bioprosthetic heart valves. Immunologic responses have been implicated as potential causes of limited durability of xenogenic valves. This study aimed to determine the effectiveness of decellularization and ${\alpha}$-galactosidase (${\alpha}$-gal) to remove major xenoreactive antigens from xenogenic tissues. Materials and Methods: Recombinant Bacteroides thetaiotaomicron (B. thetaiotaomicron) ${\alpha}$-gal or decellularization, or both were used to remove ${\alpha}$-gal from bovine pericardium. It was confirmed by ${\alpha}$-gal-bovine serum albumin-based enzyme-linked immunosorbent assay (ELISA), high-performance anion exchange chromatography, flow cytometry, 3,3'-diaminobenzidine-staining, and lectin-based ELISA. The mechanical properties of bovine pericardium after decellularization or ${\alpha}$-gal treatment were investigated by tests of tensile-strength, permeability, and compliance. Collagen fiber rearrangement was also evaluated by a 20,000${\times}$ transmission electron microscope (TEM). Results: Recombinant B. thetaiotaomicron ${\alpha}$-gal could effectively remove ${\alpha}$-gal from bovine pericardium B. thetaiotaomicron (0.1 U/mL, pH 7.2) while recombinant human ${\alpha}$-gal removed it recombinant human ${\alpha}$-gal (10 U/mL, pH 5.0). There was no difference in the mechanical properties of fresh and recombinant ${\alpha}$-gal-treated bovine pericardium. Furthermore, the TEM findings demonstrated that recombinant ${\alpha}$-gal made no difference in the arrangement of collagen fiber bundles with decellularization. Conclusion: Recombinant B. thetaiotaomicron ${\alpha}$-gal effectively removed ${\alpha}$-gal from bovine pericardium with a small amount under physiological conditions compared to human recombinant ${\alpha}$-gal, which may alleviate the harmful xenoreactive immunologic responses of ${\alpha}$-gal. Recombinant ${\alpha}$-gal treatment had no adverse effects on the mechanical properties of bovine pericardium.

Tracheaoplasty with autologous pericardium for tracheal invasion in lung cancer (폐암에 의한 기관침범 환자에서 자가심막을 이용한 기관 성형술)

  • 조현민;이두연;정은규
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.66-70
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    • 2002
  • In patient with lung cancer, the resection margin of right main bronchus was invaded by tumor intraoperatively. So we performed tracheal reconstruction with autologous pericardium after resection of lower trachea including carina. Postoperatively, the patient discharged well and followed up for 5 months without any evidence of tumor recurrence or restenosis.

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Indentation in the Right Ventricle by an Incomplete Pericardium on 3-Dimensional Reconstructed Computed Tomography

  • Kim, Hak Ju;Kwak, Jae Gun
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.298-299
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    • 2017
  • We report the case of a 17-year-old girl who presented with an indentation in the right ventricle caused by an incomplete pericardium on preoperative 3-dimensional reconstructed computed tomography. She was to undergo surgery for a partial atrioventricular septal defect and secundum atrial septal defect. Preoperative electrocardiography revealed occasional premature ventricular beats. We found the absence of the left side of the pericardium intraoperatively, and this absence caused strangulation of the diaphragmatic surface of the right ventricle. After correcting the lesion, the patient's rhythm disturbances improved.

Meridian Study on Dianxian(癲癎, Epilepsy) (전간(癲癎)의 병기(病機)에 대한 경락적(經絡的) 연구 (황제내경(黃帝內經)을 중심으로))

  • Cho, Hyun-Seok
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.27-34
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    • 2003
  • I studied connection between meridians and Dianxian(癲癎, Epilepsy). Dianxian is caused by Feun(風) based on the Blood-Deficiency(血虛) which is induced by Heart-deficiency(心虛). Therefore, when Heart and blood are in deficient condition(心血虛), Heart meridian(心經) and Pericardium meridian(心包經) can be easily affected by Feng(風), which is main cause of Dianxian. Furthermore, Liver heat(肝熱) is another main cause of Dianxian. It shows along Liver meridian(肝經) and affects Pericardium Meridian(心包經). Heart, Pericardium and Liver are main organs of human psychoconscious activities, and also are main pathological organs of Dianxian. Dianxian progresses in several ways and simtoms of Dianxian are variant according to the deficiency-exess state(虛實) of Stomach and Spleen meridians(脾胃經). So, I concluded that controling Heart, Pericardium, Liver, Stomach and Spleen meridians can make therapeutical effects on Dianxian. So I report it for the better treatment, and it shoud need further study.

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Detoxification of Glutaraldehyde Treated Porcine Pericardium Using L-arginine & $NABH_4$

  • Kim, Kwan-Chang;Kim, Soo-Hwan;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.99-107
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    • 2011
  • Background: Calcification is the most frequent cause of clinical failure of bioprosthetic tissues fabricated from GA-fixed porcine valves or bovine pericardium. A multi-factorial approach using different mechanisms was recently developed to reduce the calcification of bioprosthetic tissues. The purpose of the present study was to evaluate the synchronized synergism of using L-arginine and $NaBH_4$, compared with ethanol and L-lysine, in glutaraldehyde treated porcine pericardium from the standpoint of calcification and tissue elasticity. Materials and Methods: Porcine pericardium was fixed at 0.625% GA (7 days at room temperature after 2 days at $4^{\circ}C$). An interim step of ethanol (80%; 1 day at room temperature) or L-lysine (0.1 M; 2 days at $37^{\circ}C$) or L-arginine (0.1 M; 2 days at $37^{\circ}C$) was followed by completion of the GA fixation. A final step of NaBH4 (0.1 M; 2 days at room temperature) was followed. Their tensile strength, thickness, and thermal stability were measured. Treated pericardia were implanted subcutaneously into three-week-old Sprague-Dawley rats for 8 weeks. Calcium content was assessed by atomic absorption spectroscopy and histology. Results: L-arginine and $NaBH_4$ pretreatment ($1.81{\pm}0.39$ kgf/5 mm p=0.001, $0.30{\pm}0.08$ mm p<0.001) significantly increased tensile strength and thickness compared with the control ($0.53{\pm}0.34$ kgf/5 mm, $0.10{\pm}0.02$ mm). In a thermal stability test, L-arginine and $NaBH_4$ pretreatment ($84.25{\pm}1.12^{\circ}C$, p=0.023) caused a significant difference from the control ($86.25{\pm}0.00^{\circ}C$). L-lysine and $NaBH_4$ pretreatment ($183.8{\pm}42.6$ ug/mg, p=0.804), and L-arginine and $NaBH_4$ pretreatment ($163.3{\pm}27.5$ ug/mg, p=0.621) did not significantly inhibit calcification compared to the control ($175.5{\pm}45.3$ ug/mg), but ethanol and $NaBH_4$ pretreatment did ($38.5{\pm}37.3$ ug/mg, p=0.003). Conclusion: The combined pretreatment using L-arginine and $NaBH_4$ after GA fixation seemed to increase the tensile strength and thickness of porcine pericardium, fixed with GA. Additionally, it seemed to keep thermal stability. However it could not decrease the calcification of porcine pericardium fixed with GA. $NaBH_4$ pretreatment seemed to decrease the calcification of porcine pericardium fixed with GA, but only with ethanol.

Patch Graft of the Canine Esophagus (식도이식에 관한 실험적 연구)

  • Ha, Gye-Sik
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.167-167
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    • 1969
  • Two groups of esophagus graft were done in canine esophagus in 34 adult mongrel dogs. For the first group segmental replacement graft was done with fresh autologous pericardium tube, and for the second, patch graft was done utilizing fresh autologous pericardium, fresh homologous pericardium,and dacron piece. All eight dogs in the first segmental replacement graft group died 2 to 5 days after operation with severe empyema caused by anastomosis disruption. Among 26 patch graft dogs 2 died during operation and 7 died 13 to 18 days after operation. For the 17 long-term patch grafted survivors esophagography and postoperative weight check were done. Postoperative stool was collected and examined for dacron patch excretion. One, two, three, and four months postoperative long-term survivors were sacrificed to obtain specimens in each group respectively and the following observations were made.I. Survival; Autologous pericardium patch group showed no mortality but in homologous pericardium and dacron patch group only two thirds were long-term survivors. II. Postoperative swallowing; There was no case which demonstrated postoperative dysphagia. About half of the cases showed postoperative weight increase and in only 3 cases weight decrease followed operation. III. Dacron patch was excreted in the stool 8 to 23 days after operation. Animals which excreted dacron patch up to 9 days after operation all died of empyema due to anastomosis disruption.IV. Postoperative esophagogram; All esophagograms in each group showed no leakage of barium, no passage disturbances and no remarkable stenotic signs.V. Morphological findings; [A] Macroscopical findings; In one month group specimens of each group dense adhesion with surrounding structures was noted and luminal surface was smooth with contraction of the patched area. In two month groups anastomosis sutures were still exposed but patched area showed lesser abnormality. In three to four months groups sutures were covered completely and patched area showed only very slight signs of contraction. [B] Microscopic findings; In one month group luminal surface of the replaced tissue [transplanted tissue] showed almost complete epithelial covering that is composed of several layers of squamous cells with no evidence of keratinization. Basement membrane was also well distinct throughout. Slight to minimal inflammatory cells comprising of large mononuclears, lymphocytes and plasma cells were observed in the subepithelial fibrous stroma consisted entirely of loose fibrous tissue containing many newly formed capillaries and fibroblastic proliferation. Scattered suture granulomas were found, few of which became acutely inflamed. In two months group repairing process progressed with lesser degree of inflammatory cell infiltration and young capillary proliferation. Fibrous tissue was more matured showing even focal collagenization.Suture granuloma persisted but with lesser reactive changes. Epithelial covering was that of a mature non-keratinizing stratified squamous epithelium. In three and four months groups the replaced area showed essentially similar histological findings. However, subepithelial stroma still consisted entirely of connective tissue without evidence of smooth muscle regeneration. In this group, inflammatory cell infiltration was minimal or negligible. Among these patch materials autologous pericardium group showed the most satisfactory repairing process.The above mentioned results may signify the feasibility of autogenous pericardium patch graft in clinical esophageal surgery.