한국수정란이식학회지 (Journal of Embryo Transfer)

  • 제22권1호
  • /
  • Pages.63-67
  • /
  • 2007
  • /
  • 2508-755X(pISSN)
  • /
  • 2288-0178(eISSN)
한국수정란이식학회 (The Korean Society of Embryo Transfer)
권호 표지

Sodium Carboxymethylcellulose가 개복 수술한 한국흑염소의 생식기 유착 방지에 미치는 영향 평가

Reduction of Postsurgical Adhesion Formation of Reproductive Tract with Sodium Carboxymethylcellulose in Korean Black Goats

  • 신현국 (충남대학교 수의과대학.동물의과학연구소) ;
  • 최윤석 (충남대학교 수의과대학.동물의과학연구소) ;
  • 이승재 (충남대학교 수의과대학.동물의과학연구소) ;
  • 이두수 (한미약품 연구센터) ;
  • 조종기 (충남대학교 수의과대학.동물의과학연구소) ;
  • 신상태 (충남대학교 수의과대학.동물의과학연구소)
  • Shin, H.G. (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Choi, Y.S. (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Lee, S.J. (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Lee, D.S. (Hanmi Research Center) ;
  • Cho, J.K. (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Shin, S.T. (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University)
  • 발행 : 2007.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Sodium carboxymethylcellulose(SCMC)와 Hyaluronic acid(HA)가 수정란 이식 및 채란을 위한 복강 수술 후 생식기의 유착 방지 효과 여부를 확인하기 위하여 본 실험을 수행하였다. 실험 동물로 성숙한 암컷 한국 흑염소 20두를 대조군, saline 투여군, SCMC 1%, SCMC 2% 및 HA 0.4% 투여군에 각각 4마리씩 배치하였다. 수정란 채취를 위한 통상적인 방법의 수술을 시행한 후 약물 주입용 카테터를 절개부를 통하여 복강에 정착시킨 후 앞쪽에 끼운 채로 복막과 피부를 봉합한 후 약물을 처치하였다. 각 군의 흑염소들에 각각 체중 10 kg 당 50ml의 용액을 복강내로 투여하였으며, 대조군은 무처치하였다. 각 군은 3주 후에 상기와 동일한 방법으로 개복 수술하여 좌 우측의 자궁 및 난관채에서부터 난소까지의 2 부분으로 구분하여 각 부분의 유착 정도를 유착 범위, 피막의 상태 및 유착부의 분리 여부에 대해 각각의 등급을 정하여 판정하였고, 실험 동물의 반복 이용 가능성에 대해 알아보고자 똑같은 처치 방법으로 수술과 등급 판정을 반복하였다. 1차 실험에서는 자궁과 난소쪽 모두에서 SCMC 2%군의 점수$(mean{\pm}SD)$가 각각 $0.8{\pm}1.4$ 및 $1.5{\pm}2.8$로서 다른 군에 비해 유의적으로 낮았으며(P<0.05), 반복된 2차 실험에서도 SCMC 2% 군의 자궁과 난소에서의 점수가 각각 $4.1{\pm}1.6$ 및 $1.9{\pm}2.1$로서 다른 군에 비해 유의적으로 낮았다(p<0.05). 3차 실험에서 자궁의 판정 점수는 SCMC 1%가 $6.0{\pm}2.0$, 난소 점수는 SCMC 2% 가 $4.0{\pm}1.1$,로 다른 군에 비해 낮았고, 4차 실험에서는 자궁과 난소 모두에서 SCMC 2%가 각각 $7.0{\pm}2.1$, 및 $3.2{\pm}1.9$,로 다른 군에 비해 낮았으나 유의성은 없었다. 반복되는 실험 결과에 따른 비교시 모든 군에서 실험횟수가 반복될수록 유착점수가 높게 나타났다. 결론적으로 한국흑염소에서 수정란의 채취 및 이식을 위한 개복 수술 후 SCMC 2% 용액을 복강 내로 주입하는 것이 다른 처치에 비해 생식기의 유착 방지에 효과가 있으며, 반복 수술에 따른 생식기 유착 정도를 완화시켜줄 것으로 생각된다.

This study was performed to evaluate the efficacy of sodium carboxymethylcellulose (SCMC) for the prevention of postoperative uterus and ovary adhesion formation in the Korean black goats. Twenty adult female Korean black goats randomly were divided into five groups with four animals in each group. After the routine laparotomy, catheter for injection was inserted into the abdomen. Before abdominal closure, saline, 1% SCMC, 2% SCMC or 0.4% HA solution (50ml/10kg of body weight/head) were injected in the abdominal cavity in each group. Three weeks after surgery, second laparotomy was performed and the adhesions were scored on a scale of 0 to 10 according to their vascularity and adhesion size in uterus and ovary. This trial was repeated the four times with the interval of three weeks. In the first and second trial, the group treated with 2% SCMC significantly reduced the adhesion formation than other treatment groups (P<0.05). In the third trial, the adhesion formation was significantly reduced in 2% SCMC and 1% SCMC (P<0.05). In the fourth trial, 2% SCMC reduced the adhesion formation. However, there was no significant difference among other groups. This study showed that the 2% SCMC administered at the end of the surgery reduced the adhesion formation in the Korean black goats.

키워드

참고문헌

  1. Buckenmaier CC, Summers MA and Hetz SP. 2000. Effect of the antiadhesive treatments, carboxymethylcellulose combined with recombinant tissue plasminogen activator and Seprafilm, on bowel anastomosis in the rat. Am. Surg., 66: 1041-1045
  2. Burns JW, Skinner K, Colt MJ, Burgess L, Rose R and Diamond MP. 1996. A hyaluronate based gel for the: prevention of postsurgical adhesions: evaluation in two animal species. Fertil. Steril., 66:814-821 https://doi.org/10.1016/S0015-0282(16)58642-7
  3. Corfman RS and Badran O. 1994. Effect of pelvic adhesions on pelvic pain and fertility. In: Leach RE, guest ed. Infertility and reproductive clinics of North America: adhesions. Philadelphia: WB Saunders, pp. 400-421
  4. Diamond MP, DeCherney AH, Linsky CB, Cunningham T and Constantine B. 1988. Assessment of carboxymethylcellulose and 32% dextran 70 for prevention of adhesions in a rabbit uterine horn model. Int. J. Fertil., 33:278-282
  5. Diamond MP. 1996. Reduction of adhesions after uterine myomectomy by Seprafi1m membrane (HAL-F): a blinded, prospective, randomized, multicenter clinical study. Seprafilm Adhesion Study Group. Fertil. Steril., 66:904-910 https://doi.org/10.1016/S0015-0282(16)58716-0
  6. diZerega GS. 1994. Contemporary adhesion prevention. Fertil. Steril., 61:219-235 https://doi.org/10.1016/S0015-0282(16)56507-8
  7. Elkins TE, Bury RJ and Ritter JL. 1984a. Adhesion prevention by solutions of sodium carboxymethylcellulose in the rat. Part I. Fertil. Steril., 41 :926-928 https://doi.org/10.1016/S0015-0282(16)47909-4
  8. Elkins TE, Ling FW and Ahokas RA. 1984b. Adhesion prevention by solutions of sodium carboxymethylcellulose in the rat. Part II. Fertil. Steril., 41 :929-932 https://doi.org/10.1016/S0015-0282(16)47910-0
  9. Elkins TE, Warren J and Portz DM. 1991. Oxygen free radicals and pelvic adhesion formation II. The interaction of oxygen free radicals and adhesion-preventing substances. Int. J. Infert., 36:231-237
  10. Grainger DA, Meyer WR, DeChemey AH and Diamond MP. 1991. The use of hyaluronic acid polymers to reduce postoperative adhesions. J. Gynecol. Surg., 7:97-101 https://doi.org/10.1089/gyn.1991.7.97
  11. Hay WP, Mueller PO, Harmon B and Amoroso L. 2001. One percent sodium carboxymethylcellulose prevents experimentally induced abdominal adhesions in horses. Vet. Surg., 30:223-227 https://doi.org/10.1053/jvet.2001.17849
  12. Hill-West J, Chowhury S and Sawhney A. 1994. Prevention of postoperative adhesions in the rat by in situ photopolyrnerization of bioresorbab1e hydrogel barriers. Obstet. Gynecol., 83:59-64
  13. INTERCEED(TC7) Adhesion Barrier Study Group. 1989. Prevention of postsurgical adhesions by INTERCEED(TC7), an absorbable adhesion barrier: a prospective randomized multicenter clinical study. Fertil. Steril., 51:933-938 https://doi.org/10.1016/S0015-0282(16)60721-5
  14. Leach RE and Henry RL. 1990. Reduction of postoperative adhesions in the rat uterine horn model with poloxamer 407. Am. J. Obstet. Gynecol., 162: 1317-1319 https://doi.org/10.1016/0002-9378(90)90044-8
  15. Leach RE, Burns JW, Dawe EJ, SmithBarbour MD and Diamond MP. 1998. Reduction of postsurgical adhesion formation in the rabbit uterine horn model with use of hyaluronate/carboxymethylcellulose gel. Fertil. Steril., 69:415-418 https://doi.org/10.1016/S0015-0282(97)00573-6
  16. Mueller PO, Hay WP, Harmon B and Amoroso L. 2000. Evaluation of a bioresorbab1e hyaluronate-carboxymethylcellulose membrane for prevention of experimentally induced abdominal adhesions in horses. Vet. Surg., 29:48-53 https://doi.org/10.1111/j.1532-950X.2000.00048.x
  17. Mueller PO, Hunt RJ, Allen D, Parks AH and Hay WP. 1995. Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy. Vet. Surg., 24: 112-117 https://doi.org/10.1111/j.1532-950X.1995.tb01304.x
  18. Raftery AT. 1979. Regeneration of peritoneum: a fibrinolytic study. J. Anat., 129:659-664
  19. Rice VM, Shanti A, Moghissi KS and Leach RE. 1993. A comparative evaluation of Poloxamer 407 and oxidized regenerated cellulose (Interceed [TC7]) to reduce postoperative adhesion formation in the rat uterine horn model. Fertil. Steril., 59:901-906 https://doi.org/10.1016/S0015-0282(16)55879-8
  20. Steinleitner A, Lambert H, Kazensky C and Cantor B. 1991. Po1oxamer 407 as an intraperitoneal barrier material for the prevention of postsurgical adhesion formation and reformation in rodent models for reproductive surgery. Obstet. Gynecol., 77:48-52
  21. Thomas SC, Jones LC and Hungerford DS. 1982. Hyaluronic acid and its effects on postoperative adhesions in the rabbit flexor tendon. Clin. Orthop. Relat. Res., 206:281-289
  22. Thornton M and diZerega GS. 1996. Using barriers to prevent adhesions. Contmep. Ob. Gyn., 41:107-124
  23. Toole B, Jackson G and Gross J. 1972. Hyaluronate in morphogenesis: inhibition of chondrogenesis in vitro. Proc. Natl. Acad. Sci. USA., 69:1384-1389
  24. Toole BP. 1982. Developmental role of hyaluronate. Connect. Tissue Res., 10:93-101 https://doi.org/10.3109/03008208209034409
  25. Urman B, Gomel V and Jetha N. 1991. Effect of hyaluronic acid on postoperative intraperitoneal adhesion formation in the rat model. Fertil. Steril., 56:563-567 https://doi.org/10.1016/S0015-0282(16)54558-0
  26. Weiss C, Balazs EA, St. Onge R and Denlinger JL. 1981. Clinical studies of the intra-articular injection of Healon (sodium hyaluronate) in the treatment of osteoarthritis of human knees. Semin. Arthritis Rheum., 11:143-147
  27. Weiss C, Levy HJ, Delinger J, Suros JM and Weiss HE. 1986. The role of Na-hylan in reducing postsurgical tendon adhesions. Bull Hos. Jt. Dis. Orthorop. Inst., 45:9-15
  28. Weiss C, Suros JM, Michalow A, Denlinger J, Moore M and Tejero W. 1987. The role of Na-hylan in reducing postsurgical tendon adhesions: Part 2. Bull Hosp, It. Dis. Orthop. Inst., 47:31-39