• 한국임상수의학회지
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• 제17권2호
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• pp.381-387
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• 2000

Efficacy of a 1% solution of sodium carboxymethylcellulose (SCMC) infu7ed into the peritoneal cavity of dogs was evaluated for prevention of intraperitoneal adhesion, resulting from operations of the reproductive tract. Saline-treated deles (n = 5) were controls that underwent ventral midline celiotomy, and adhesions were cleated by incision and scraping about 5 cm segment of each uterine horn. Saline (7 ml/kg of body weight) was then infused into the peritoneal cavity. Others (n = 5) were treaded similarly to the saline-treated dogs. except that 1% SCMC :solution (7mH/kg of body weight) was infused into the peritoneal cavity. This group was studied to determine whether SCHC would prevent the adhesions in the peritoneal cavity, especially in the uterine horn model. Abdominal adhesions were evaluated and an adhesion severity score was assigned to each dog on the basis of severity of adhesions. At the time of necropsy. the mean adhesion score in the saline treated group was $2.65{\pm}0.22.$ In contrast, adhesion formation in the SCMC treated group was less ($mean score =1.70{\pm}0.26$). Statistic71 analysis was performed using the grouped t-test and paired t-test. A significanlty lower adhesion score was observed in dogs given SCMC than in the saline treated group (P<0.01). In summary, SCMC significantly reduced adhesion formation in the dog uterine horn model. The results of this study suggest that application of 1% SCMC solution, following various reproductive pelvic surgery, will present the adhesions.

• 한국임상수의학회지
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• 제25권6호
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• pp.494-500
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• 2008

The aim of this study was to determine the effectiveness of hyaluronic acid-carboxymethylcellulose membrane (GUARDIX-$MB^{(R)}$) barriers on prevention against post-operative peritoneal adhesions. In this study, fourteen mongrel dogs were divided into two experimental groups: 0.1 % hyaluronic acid (0.1HA) group and hyaluronic acidcarboxymethylcellulose membrane (HA-CMC) group. In order to induce adhesions, the anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogenous petechial hemorrhagic surface over a $1\;{\times}\;1cm$ area. Solution of 0.1HA were simply coated over the abraded tissues, $1.5\;{\times}\;1.5cm$ HA-CMC membrane was placed over the abraded tissues, allowed to spread across the intra-abdominal organs before closure of the abdomen. On day 1 before and day 1, 4, 7, 14, and 21 after operation, venous blood specimens were collected for measurement of fibrinogen and total WBC. The adhesions were blindly assessed 3 weeks later by using a computerized tensiometer. The fibrinogen and total WBC values of two groups showed no statistical significances. The mean tensile strength (gram force, gf) of formed adhesions day 21 after surgery was $88.1\;{\pm}\;55.70gf$ in the 0.1 % HA group and $24.8\;{\pm}\;22.69gf$ in the HA-CMC group. The tensile strength values of adhesion separation HA-CMC membrane group was significantly lower than the 0.1HA group (p<0.05). Therefore, we suggest that HACMC membrane reduce peritoneal adhesions may be applicable to preventing post-operative intraperitoneal adhesions in dogs.

• 대한수의학회지
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• 제45권3호
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• pp.417-421
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• 2005

Adhesions are the most common postoperative complication in intestinal surgery in dogs. This study was aimed at verify to the efficacy of sodium carboxymethylcellulose (SCMC) in the adhesion prevention during healing of intestinal anastomosis. Twenty three healthy dogs were taken with average 4.17 years and weight was 5.68 kg and divided into 4 groups. The dogs of group III and IV, a pedicle of greater omentum was wrapped around the suture line. In the animals of group II and IV, 1% SCMC was infused (5 ml/kg, IP) at just before closure of the abdominal cavity. Two weeks after surgery, animals were reoperated and the adhesions were evaluated and graded. We found various degrees of intraabdominal adhesions in animals of all the groups. The significantly (P<0.05) lower adhesion score was observed in group IV than that of other groups. Nevertheless, varying intra-peritoneal adhesions, healing of anastomotic site was normal in all groups. It could be concluded that intra-peritoneal administration of SCMC solution reduces postoperative adhesions without any adverse effects on healing, and a synergistic beneficial effect can be obtained by supplementation with omental graft for intestinal anastomosis.

• 대한수의학회지
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• 제43권1호
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• pp.151-156
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• 2003

The objective of this study was to determine the effective concentration of carboxymethyl chitoaan(CMC) solution on preventing intraperitoneal adhesions. In this study, 60 rats were divided into four groups : an untreated control group and three experimental groups that were treated with 3 ml of 3, 5, and 7% CMC solution. Adhesions were induced by suturing both the ileal serosa and peritoneum scraped until petechial bleeding occurred. CMC solutions were instilled intraperitoneally immediately before closure of the peritoneomuscular layer. The tensile strength of formed adhesions was measured by using a computerized tensiometer. Histopathological changes of adhesions were evaluated by hematoxylin-eosin for light microscopic examination and Massons's trichrom staining for collagen fibers. All of CMC solutions reduced significantly the tensile strength of the adhesions. CMC inhibited the increase of inflammatory cell infiltration and damage of adhesion spot, and accelerated the collagen synthesis and neovascuiarization. No significant differences were observed among all of CMC concentration at inhibiting adhesion formation. Therefore, we could conclude that 3% CMC, the lowest concentration adopted in this study, was appropriate to prevent the formation of peritoneal adhesion.

• 한국임상수의학회지
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• 제26권4호
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• pp.324-330
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• 2009

이 실험의 목적은 개에서 poloxamer/sodium alginate 혼합물(PX/SA)의 수술 후 복강 유착 방지 효과를 알아보는 것이다. 잡종견 15마리를 무처치군, 2% Sodium carboxymethylcellulose(SCMC)처치군, PX/SA 처치군으로 각각 5마리씩 배치하였다. 유착은 돌창자의 창자간막 대측에 1 ${\times}$ 1 cm 크기로 미세 점상 출혈 찰과상을 일으켜 유도하였다. SCMC 용액은 카테터를 통하여 복강내 주입하였고, PX/SA는 찰과상 부위에 단순히 도포하였다. 수술 전 1일과 수술 후 1일, 4일, 7일, 14일에 정맥에서 혈액을 채취하여 적혈구수, 총백혈구수, 섬유소원농도를 분석하고, 수술 후 21일에 유착정도를 computerized tensiometer를 이용하여 분석하였다. 적혈구수, 총백혈구수, 섬유소원농도는 각 군간에 유의성은 없다. 유착부 분리에 필요한 평균 장력은 무처치군에서 173.05 ${\pm}$ 113.48 gf, SCMC 처치군에서 111.42 ${\pm}$ 38.25 gf, PX/SA 처치군에서 69.00 ${\pm}$ 45.07 gf였다. PX/SA 처치군의 평균 분리 장력이 다른 두 군에 비하여 유의성 있게 낮았다 (p < 0.05). 본 실험 결과로 PX/SA는 SCMC용액과 비교하여 복강유착을 감소시키는 것으로 보아 PX/SA를 개에서 복강 수술 후 유착 방지에 적용 가능한 것으로 생각한다.

• 한국임상수의학회지
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• 제33권1호
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• pp.58-61
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• 2016

An 11-year-old, intact male Cocker Spaniel dog was presented with history of abdominal distension, dyspnea for 10 days and lethargy for 1 day. Abdominal radiographs showed decreased serosal detail with abdominal distension. Abdominal ultrasounds revealed gallbladder mucocele with generalized peritonitis showing stellate-like sludge in the gallbladder with echogenic fat degeneration of cranial abdomen and abdominal free fluid containing echogenic materials. Loss of gallbladder wall integrity was shown clearly on computed tomography but ambiguously on ultrasound. Ultrasound-guided abdominocentesis was performed and showed amount of yellowish-bloody peritoneal fluid with vegetable matter and mucoid substance. On peritoneal fluid analysis, bilirubin level was elevated over three times than those of the serum. On exploratory laparotomy, gallbladder rupture and generalized bile peritonitis with intestinal adhesions were confirmed and cholecystectomy with peritoneal lavage was performed. One day after operation, patient died. This report describes delayed clinical symptoms of gallbladder rupture by gallbladder mucocele. In addition, this is the first case report using computed tomography made a diagnosis gallbladder rupture in a dog. Computed tomography might be helpful to diagnose gallbladder rupture.

• Clinical and Experimental Reproductive Medicine
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• 제27권1호
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• pp.111-116
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• 2000

IVF-ET therapy was originally developed as a method for treating patients with absolute mechanical infertility for whom spontaneous conception is almost impossible. Objective: To report that the recent IVF-ET is now applied to couples not only untreatable tubal infertility but also peritubal periovarial adhesions, endometriosis, male-related or unexplained infertility. Material and Method: Case report. Result: We experienced 5 Pregnancies after unsuccessful IVF-ET attempt with additional non IVF-ET therapy or without therapy. Conclusions: The follicular puncture and ovarian enlargement may result in restoration of pituitary-ovarian axis and peritoneal environment in infertility patients.

• Korean Chemical Engineering Research
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• 제55권1호
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• pp.34-39
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• 2017

본 실험은 방사선을 이용하여 유착방지용 Carboxymethyl cellulose sodium salt (CMC)/Porcine Cartilage Acellular Matrix (PCAM) 수화젤 필름에 대해 연구하였다. 방사선 조사시 CMC/PCAM의 농도 및 혼합비율에 따른 필름의 형태학적 구조, 젤화율, 젤강도, 팽윤도 등을 분석하였다. 방사선에 의해 가교된 CMC/PCAM 필름은 CMC 필름보다 물리적인 특성인 젤화율이 낮게 측정되었다. 또한, 가교된 CMC 필름보다는 CMC/PCAM 필름에서 인간 혈관내피세포의 부착 및 증식율이 감소하였다. 우리는 PCAM에 함유한 세포의 항부착 성분이 도입된 CMC/PCAM 필름과 CMC 필름은 세포의 접착 및 증식율을 낮추는 것을 확인하였다. 결론적으로, 본 연구에서는 방사선 가교된 CMC/PCAM 수화젤 필름은 유착방지 향상을 위한 유착방지제로서 응용이 기대된다.

• Advances in pediatric surgery
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• 제10권2호
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• pp.123-126
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• 2004

Intestinal obstruction secondary to intraabdominal adhesion is a well-known postoperative complication occurring after appendectomy. The aim of this study was to measure the incidence and clinical manifestations of mechanical intestinal obstruction after appendectomy for perforated appendicitis. We reviewed all of the children (age <16 years) who had been treated for appendicitis at Asan Medical Center between January 1996 and December 2001. Inclusion criterion included either gross or microscopic evidence of appendiceal perforation. Exclusion criteria were interval appendectomy, and patients immune compromised by chemotherapy. Associations of intestinal obstruction with age, sex, operation time, and use of peritoneal drains were analyzed. Four hundred and sixty two open appendectomies for appendicitis were performed at our department. One hundred and seventeen children were treated for perforated appendicitis (78 boys, 39 girls). The mean age was 8.9 years (range 1.5 to 14.8 years). There were no deaths. Eight patients were readmitted due to intestinal obstruction, but there was no readmission due to intestinal obstruction in patients with non-perforated appendicitis. The interval between appendectomy and intestinal obstruction varied from 12 days to 2 year 7 months. Four patients needed laparotomies. In three of four, only adhesiolysis was performed. One child needed small bowel resection combined with adhesiolysis. There was no significant association between age or sex and the development of intestinal obstruction. This was no association with operative time or use of peritoneal drain. Patients who required appendectomy for perforated appendicitis have a higher incidence of postoperative intestinal obstruction than those with nonperforated appendicitis. For the patients with perforated appendicitis, careful operative procedures as well as pre and postoperative managements are required to reduce adhesions and subsequent bowel obstruction.

• Childhood Kidney Diseases
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• 제11권1호
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• pp.51-58
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• 2007

목적 : 복강경을 이용한 복막투석도관 삽입술은 직접 복강 내를 들여다보며 시술할 수 있어 위치 선정이 쉽고, 조직 손상이 적으며 합병증이 적다는 장점이 있으나, 소아에서의 경험은 많지 않다. 본 연구에서는 소아에서 복강경을 이용한 복막투석도관 삽입술의 유용성을 평가하고자 한다. 방법 : 2002년부터 2006년까지 삼성서울 병원에서 31명의 환아를 대상으로 복강경을 이용하여 복막투석도관 삽입술을 시행한 21례와 고식적 수술 방법으로 투석도관을 삽입한 16례의 의무기록을 바탕으로 복막투석관 삽입 후 첫 2개월간 투석도관의 누출, 폐쇄, 삽입 부위의 감염, 위치 이동 등 복막투석관 삽입과 관련된 합병증에 대해 후향적 분석을 시행하였다. 결과 : 고식적 수술을 받은 군(16례)에서 1례(6.3%)에서 수술 직후 심한 출혈로 재수술을 받았고, 복막액의 누출은 2례(12.5%) 있었으며, 보존적인 치료로 호전되었다. 삽입 부위 감염은 없었으나, 2례(12.5%)에서 복막염이 발생하였다. 투석도관의 이동으로 인한 기능부전이 3례 있었고 이중 2례에서 재수술을 받았으며, 1례는 보존적인 치료로 호전되었다. 복강경 수술을 받은 군(21례)에서 2례(9.5%)에서 투석액의 누출이 있었고, 보존적인 치료로 호전되었다. 삽입 부위의 감염은 없었고, 복막염이 2례(9.5%)에서 있었다. 1례에서 투석도관의 막힘이 있었고, 이 경우는 기존의 고식적 수술로 투석관 삽입 후 투석관 이동으로 재 삽입 후 불응성 복막염으로 투석관을 제거한 뒤 복강경 수술을 받은 증례였다. 투석도관의 이동은 없었다. 두 군의 합병증의 발생빈도는 통계적으로 유의한 차이는 없었다. 결론 : 본 연구에서 소아에서 복강경적 투석도관 삽입술을 시행한 경우, 1세 미만의 소아에서도 시술이 가능하였으며, 기존의 수술법에 비해 합병증이 증가하지 않았다. 또한 절개범위를 더 넓히지 않으면서도 장간막 절제 및 투석도관의 고정이 가능하여, 이를 통해 추후 투석도관의 이동이나 폐쇄의 위험요소를 줄일 수 있다는 장점이 있었다. 따라서 소아에서 복막투석도관 수술 시 복강경적 방법을 이용하는 것이 효율적인 복막 투석을 위해 유용하다고 생각된다.