여러물질의 cuff를 이용한 미세혈관 문합술의 실험적 비교연구

근자에 미세혈관 문합술은 수지 재접합 및 유리피판술등에 통상 슬기로 널리 사용되고 있으나, 그 결과는 아직 완벽하지 못한 상태이며, 수술실패의 가장 큰 원인은 혈전으로써 이의 방지와 시술시간 단축에 끊임없는 노력이 기울여져 왔다. 혈전 형성의 원인은 혈관벽의 손상, 혈류 변화, 혈액 성분의 변화 등 여러가지 요인이 있으나, 가장 중요한 요인은 봉합 술기로서, 봉합으로 인한 혈관벽의 손상은 물론 봉합사 자체가 혈전 형상을 유발하며, 문합 시간을 단축하기 위해 봉합 수를 가능한 한 줄여야 함은 주지의 사실이나, 봉합 수가 적을수록 봉합간 간격이 넓어지면서 그 간격을 통해 출혈이 발생, 결과적으로 혈종이 혈관을 압박하여 혈관을 폐쇄케 하므로 봉합수를 줄이면서도 혈종을 방지할 수 있는 문합법들이 시도되어왔다. 이러한 시도로서 봉합수를 줄이고 문합부 주위에 여러 종류의 cuff를 하는 방법이 간구되어 왔는데, 본 실험에서는 200마리의 백서를 대상으로 대퇴동맥을 절단하고 8개의 단순봉합으로 문합한 대조군 40마리와, 3개의 단순봉합을 한 후 각각 정맥cuff, gelatin cuff, 양막cuff 및 fibrin glue를 사용한 실험군을 각각 40마리로 나누어 실험한 개존율, 시술시간, Hematoxylin과 Eosin 염색을 하여 광학현미경으로 본 소견과 주사전자현미경 소견을 비교한 결과 다음과 같은 결과를 얻었다. 1. 개존율은 대조군이 94.9%, 정맥 cuff군이 84.6%, gelatin cuff군이 94.5%, 양막 cuff군이 94.7%, fibrin glue군이 69.2%였다. 2. 시술시간은 대조군은 17.5±7.1분, 정맥cuff군이 16.7±6.4분, gelatin cuff군이 9.2±4.0분, 양막cuff군이 13.3±4.2분, fibrin glue도포군이 16.1±6.5분으로 gelatin cuff군과 양막cuff군은 단순봉합을 시행한 대조군에 비해 통계학적으로 의의있는 시간단축을 보였다(p<0.01). 3. 조직학적소견(Hematoxylin과 Eosin 염색)상 모든군에서 1주후 내피재생이 시작되어 3주 후에는 완성되어 있었으며, 정맥cuff군과 양막cuff군에서는 3주후 cuff와 동맥외벽이 완전히 유착되어 있었고 gelatin cuff와 fibrin glue는 1주후부터 탐식되기 시작하여 3주 후에는 거의 섬유조직으로 대치되어 있었다. 4. 주사전자현미경소견은 대조군보다 cuff를 시행한 실험군에서 내막의 손상이 모두 적었다. ; End-to-end anastomosis of arteries less than 1 mm in diameter has been successfully accomplished for several years. However, good result have not been obtained consistently. The complication of excessive bleeding and thrombosis at the site of repair have not infrequently resulted in failure. Even though it is desirable to minimize both number of sutures in a microvascular anastomosis and bleeding at the anastomsis site. One solution could be to cuff around the anastomosal site and various material have been used as cuff. In this study, we divided 200 rats into five groups. In one group, 8 sutures were done for control. In the other four groups, 3 sutures were done and autologous vein, gelatin sponge, amniotic membrane and fibrin glue were applied as a Cuff for each group. The results obtained from the study were as follows: 1. The parency rate was 94.9% in control group, 84.6% in venous cuff group, 94.5% in gelatin cuff group, 94.7% in amniotic membrane cuff group, and 69.2% in fibrin glue group. 2. Operative time was 17.5±7.1 minute in control group, 16.7±6.45 minutes in venous cuff group, 9.2±4.0 minutes in gelatin cuff group, 13±4.2 minutes in amniotic membrane cuff group, and 16.1±6.5 minutes in fibrin glue group. There was statistically significant shortening of operative time in gelatin cuff and amniotic membrane cuff group compared with classic control group. 3. Microscopic study showed that endothelial regeneration was started at 1 week and completed at 3 weeks postoperatively in all groups. Gelatin cuff and fibrin glue were started to absorbe by phagocytosis within 1 week, and almostly replaced by fibrous tissue at 3 weeks. 4. Scanning electron microscopic changes were showed that intimal damage was less extensive in experimental groups than in control group.논문개요 ------------------------------------------------------------- ⅶ Ⅰ. 서론 ------------------------------------------------------------- 1 Ⅱ. 실험재료 및 방법 ------------------------------------------------- 2 Ⅲ. 실험결과 --------------------------------------------------------- 4 A. 개존율 ----------------------------------------------------------- 4 B. 시술시간 --------------------------------------------------------- 4 C. 조직학적 소견 ---------------------------------------------------- 5 D. 주사현미경 소견 -------------------------------------------------- 6 Ⅳ. 고찰 ------------------------------------------------------------- 7 Ⅴ. 결론 ------------------------------------------------------------- 12 참고문헌 ------------------------------------------------------------- 13 사진부도 및 사진설명 ------------------------------------------------- 17 영문초록 ------------------------------------------------------------- 2

Seismic reflection survey for the investigation of basement in tidal flat zone

2

Feasibility of Sparker Profiling for Investigation of the Rubble Mound Foundation in a Coastal Area

22Nkc

Water bottom seismic refraction survey for engineering applications

Accurate mapping of the basement is one of the most crucial factors to the construction of harbour facilities and bridges in the coastal areas. In shallow waters, the seismic reflection method employing acoustic profiling technology often fails to image the basement geometry beneath the sediment cover in many cases. We present the result of a shallow marine seismic refraction survey using two ships, 12-channel hydrophone arrays deployed on the bottom and a borehole sparker or percussion powder as sources. Velocity structure was computed by tomography since data from more than 6 different source points had been collected for one spread. A comparison of the results of the refraction survey with drilling logs demonstrates remarkable consistency in basement ge-ometry. It thus appears that the refraction method in this study is an efficient and cost-effective way to investigate the basement structure in coastal area, river, and lake.1

Localized mirror functor constructed from a Lagrangian torus

Fixing a weakly unobstructed Lagrangian torus in a symplectic manifold X, we define a holomorphic function W known as the Floer potential. We construct a canonical A(infinity)-functor from the Fukaya category of X to the category of matrix factorizations of W. It provides a unified way to construct matrix factorizations from Lagrangian Floer theory. The technique is applied to toric Fano manifolds to transform Lagrangian branes to matrix factorizations and prove homological mirror symmetry. Using the method, we also obtain an explicit expression of the matrix factorization mirror to the real locus of the complex projective space. (C) 2018 Elsevier B.V. All rights reserved.OAIID:RECH_ACHV_DSTSH_NO:T201907735RECH_ACHV_FG:RR00200001ADJUST_YN:EMP_ID:A077276CITE_RATE:.806FILENAME:1-s2.0-S0393044018304443-main.pdfDEPT_NM:수리과학부EMAIL:[email protected]_YN:YFILEURL:https://srnd.snu.ac.kr/eXrepEIR/fws/file/af8dc926-61a5-404d-afa8-a12c37e0ac90/linkY