Histopathology of leech parasitism on Capoeta capoeta gracilis, Squalius cephalus and Carassius auratus

asl, Adel Haghighi Khiabanian,Salimi, Behnam The Korean Society of Fish Pathology 2017 한국어병학회지 Vol.30 No.2

Parasitic leeches could directly (through causing poor growth, anemia and wound in the fish) and indirectly (by predisposition of the fish to secondary bacterial and fungal infections) affects their hosts. In the present study, fishes that were attacked by leeches in natural and experimental environment were studied. Pathologic samples were obtained from damages at the site of leech bite, as well as kidney and liver of the fish. Histopathological examination revealed numerous lesions at the site of leech bite including tissue demolition, detachment at the site of leech bite in the epidermis of epithelial tissue in the skin, destructed nucleus in epithelial cells of the skin plus necrosis in the damaged skin and weak inflammatory penetration to acute necrotic damages along with piercing dermis layer. Pathologic lesions in the kidney included some changes such as proliferation by increasing glomerular cells and membrane cells in capillary vein of the kidney, blood cell necrosis in kidney with infiltration of white blood cells mainly mononuclear and less polymorphonuclear which are the symptoms of anemia due to blood feeding and sucking by leeches. There was also a chronic kidney infection probably originated from another part of body such as skin. Moreover, leeches caused hemorrhagic anemia due to blood consumption of the hosts, which led to observation of immature red blood cells. Also results showed that diseases induced by leeched in fish could be acute or chronic, which depends on size of fish, species of leech and severity of infection.

The Relationship between Explanation and Patient Compliance in Hirudotherapy

김광석,심호섭,신준호,황재하,이삼용 대한두개안면성형외과학회 2017 Archives of Craniofacial Surgery Vol.18 No.3

Background: The use of leeches can effectively increase the salvage rate of flap congestion. However, the first reaction from patients and carers in using leeches in clinical fields is strong aversion. This can be due to the fact that development of our culture from agriculture to industrial society, coming across leeches became fairly rare. Also because of the biological traits that leeches carry; staying attached to a leg or other body parts of the host, sucking blood, and leaving wounds. Methods: This study was conducted through questionnaires, divided into many subgroups. We scaled the compliance of the two therapies, with or without leech. Maximum scale of 10 showing no rejective response to the therapy and minimum scale of 0 showing the greatest rejective response. Results: Overall subjects’ compliance was improved after explaining the benefits of hirudotherapy. Irrelevant to the explanation, there was no significant difference in general compliance between male and female. Young-aged group and medical personnel or people studying medicine showed higher compliance over older-aged group and the general public. Conclusion: In the terms of general social cognition, recognizing leech as a therapeutic material may not be welcomed at first, but provided with proper information and explanations, overall compliance of patients and carers can be improved and consequently result in superior outcomes in flap salvage.

Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage

박수한,최우영,손경민,천지선,양정열 대한두개안면성형외과학회 2015 Archives of Craniofacial Surgery Vol.16 No.3

In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this 8×6 cm defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches.

Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap

Kim, Jin Hyung,Kim, Jeong Min,Park, Jang Wan,Hwang, Jae Ha,Kim, Kwang Seog,Lee, Sam Yong Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.6

Background The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. Methods This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. Results All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. Conclusions Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches.

Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap

Jin Hyung Kim,Jeong Min Kim,Jang Wan Park,황재하,김광석,이삼용 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.6

Background The medial canthus is an important area in determining the impression of a person’s facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. Methods This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. Results All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. Conclusions Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches.

거머리 사용후 발생할수 있는 Aeromonas hydrophila 감염을 줄이기 위한 대책

윤효헌,정두성,최준 大韓微細手術學會 2002 Archives of reconstructive microsurgery Vol.11 No.1

소아에서의 수지재접합술후 의료용 거머리의 이용

윤인대,김용규,김진오,박재현,백롱민,최준,Yoon, In-Dae,Kim, Yong-Kyu,Kim, Jin-O,Park, Jae-Hyun,Baek, Rong-Min,Choe, Jun 대한미세수술학회 1999 Archives of reconstructive microsurgery Vol.8 No.1

Digit that were formerly assessed as non replantable may now be replanted with the help of salvage procedure. In case that, venous repair is either marginal or technically impossible and postoperative venous congestion developed following replantation, are treated with the application of medical leeches. From July 1997 to April 1998, the authors performed arterial anastomosis and venous drainage using medical leeches in 3 children(The age of the patients ranged from 13 months to 6 years.) to have a result of aesthetic and functional success with minimizing the complications. Leech therapy has many advantages, to avoid injuring of finger tip, to decrease focal capillary coagulation, to prevent severe bleeding, and to prevent thromboembolism. The authors conclude that the use of medical leeches shows promise as a safe and effective method of providing temporary venous drainage in replanted digits.

최근 10년간의 水蛭(수질) 연구 동향: 비만 및 대사증후군에의 응용 가능성 제고

이진원 ( Jin Won Lee ),박원형 ( Won Hyung Park ),차윤엽 ( Yun Yeop Cha ),송윤경 ( Yun Kyung Song ) 한방비만학회 2014 한방비만학회지 Vol.14 No.1

The purpose of this study is to analyse research trends about medical leech in the last 10 years. Methods: We searched the papers with key words of ‘medical leech’, ‘水蛭’ in China Knowledge Resource Integrated Database (CNKI), Korean traditional knowledge portal, DBPIA, KISS. We classified the papers by year and content. Results: 1. Result of the classification on the basis of the research methods, 50 studies are clinical case reports, 301 studies are experimental paper, 599 studies are clinical trial study, 219 studies are literature review. 2. Result of the classification on the basis of the research topics, 454 studies are the effect of anticoagulant research, 84 studies are diabetes and renal disease research, 194 studies are pharmacological properties research, and 43 studies are effect of allergic and anti-inflammatory research. 3. The proportion of the coagulation effect study tends to decrease every year since 2006. 4. Leech research tends to decrease in last 3 years. 5. Recently, there are many research in psychiatry, orthopedic diseases and beauty. 6. There are 10 studies related to leech in Korean. Conclusions: The researches of medical leech are actively done. The diversity of subjects is getting wider and richer.

도서형 동맥피판의 생존에 대한 Chemical Leech의 효과

최태엽,심영기,이세일,홍인표 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.1

A good circulatory balance between arterial inflow and venous outflow is vital in the success of replantation of amputated digits or free flap transfers. However, under some circumstances, it is not easy to anastomose the vein after arterial sutures. Several methods have been tried to enhance the survival of the replanted finger when veins were difficult to anastomose. In 1989 Barnett et al experienced three successful cases of digital replantation without venous anastomosis by injecting the calcium heparin subcutaneously into the replasnts at intervals over 9 days, and they called it 'chemical leech'. The objective of this study is to identify the effect of chemical leech in the rabbit. 14 rabbits were used as the experimental animals in the present study and were divided into 2 surgical groups. Each animal was anesthetized with intramuscular ketamine. Arterialized island flaps where vascular pedicles were composed of a central auricular artery and denuded ear cartilage were elevated. The chemical leech applied the rt. ear and It. ear was the control. The results were obtained after observation of 14 rabbits for 7 days. 1. The period from postoperative 3rd to 5th was the most critical to the survival of the flap 2. The survival rate of the chemical leech group (57.14%) was higher than that of the control group (21.42%) So we recommend this method in such various clinical situations as a replanted digits without venorrhaphy or flaps with venous insufficiency.

천사군자탕(喘四君子湯)과 수질(水蛭)(마황초(麻黃炒))가 인간 기관지상피세포의 IL-6, IL-16, GM-CSF 발현에 미치는 영향

정희재,정승기,이형구,한동하,Jung, Hee-Jae,Jung, Sung-Ki,Rhee, Hyung-Koo,Han, Dong-Ha 대한한방내과학회 2001 大韓韓方內科學會誌 Vol.22 No.4

Objectives : We aimed to identify the dose-dependent inhibitory effects of Cheonsagunja-tang(喘四君子湯), leech(Hirudo medicinalis/水蛭) roasted with Ephedrae Herba(麻黃) on the mRNA expression of IL-6, IL-16, GM-CSF involved in the asthma model. Methods : In the study BEAS-2B cell lines, human epithelial cells were used. These cells were stimulated with tumor necrosis factor(TNF)-${\alpha}$ for artificial inflammatory expression. ${\beta}$-actin messenger RNA(mRNA) was used by internal standard. After 24 hours of the Cheonsagunja-tang, leech-treatment, total cellular RNAs were collected treating RNA zol directly on the living cells. Then the transcriptional activities of IL-6, 16 and GM-CSF were measured by RT-PCR with electrophoresis. Results: In the Cheonsagunja-tang study, the mRNA expression of IL-6 showed 30% transcriptional inhibitory effect compared to the control group in the $100{\mu}l/ml$ category(p<0.005). In the IL-16, there was 26%, 31% and 31% transcriptional inhibitory effect compared to the control groups in the $4{\mu}l/ml$, $20{\mu}l/ml$ and $100{\mu}l/ml$ categories, respectively(p<0.05). In the GM-CSF, the experimental group had 56% transcriptional inhibitory effect compared to the control group in the $100{\mu}l/ml$ category(p<0.001). In other concentrations, there was no inhibitory effect. In the leech study, the mRNA expression of IL-6 showed 37% transcriptional inhibitory effect compared to the control group in the $100{\mu}l/ml$ category(p<0.001). In the IL-16, there was 63% and 67% transcriptional inhibitory effect compared to the control groups in the $20{\mu}/ml$ and $100{\mu}/ml$ categories, respectively(p<0.001). In the GM-CSF, there was 64% and 68% transcriptional inhibitory effect compared to the control groups in the $20{\mu}l/ml$ and $100{\mu}l/ml$ categories, respectively(p<0.001). In other concentrations, there was no inhibitory effect. Conclusions : This study shows that Cheonsagunja-tang and leech roasted with Ephedrae Herba have dose-dependent inhibitory effects on the mRNA expression of IL-6, IL-16 and GM-CSF in BEAS-2B cell lines, human epithelial cells.