이종골 이식시 Fibrin adhesive의 사용이 골 재생에 미치는 영향에 관한 조직병리학적 연구

고영우,임성빈,정진형,이종헌,Ko, Young-Woo,Lim, Sung-Bin,Chung, Chin-Hyung,Lee, Chong-Heon 대한치주과학회 2003 Journal of Periodontal & Implant Science Vol.33 No.1

Several effective treatment methods and materials have been developed for the treatment of furcation involvement. Currently, the combination of guided tissue regeneration (GTR) and bone grafts is the most commonly prescribed method of treating furcation involved defects. But because these cases often present with poor accessibility, placement of the membrane may be difficult and consequently, clinically impractical. In this study, the alveolar bone healing patterns of adult beagle dogs presenting with alveolar bone destruction treated by one of two methods - treatment using solely bone allografts (BBP(R)), or treatment using bone allografts (BBP(R)) stabilized by a fibrin adhesive - were comp ared. The effects of the fibrin adhesive on the initial stabilization of the newly formed bone, subsequent regeneration of bone, and the feasibility of the clinical application of the fibrin adhesive were analyzed. The results of the study were as follows: 1. Clinical signs of inflammation at the 4-8 week interval were not observed: but signs of mild inflammation were histologically observed at the 4-week interval. 2. Allografts stabilized by fibrin adhesive showed good bone formation, whereas defects treated with only the allograft material showed incomplete alveolar bone regeneration. 3. Allografts stabilized by fibrin adhesive showed a decrease in the amount old bone with a concurrent increase in the formation of new lamellar bone four weeks post-op, whereas defects treated with only the allograft material showed no new lamellar bone formation at the same interval. 4. In detects treated with only the allograft material, the defective area was filled with connective tissue 8-weeks post-op, whereas fibrin adhesive stabilized allografts showed viable connections between the original bone and the newly formed bone, in addition to neovascularization 8-weeks post-op. The results of this study show that concurrent use of fibrin adhesive materials can stabilize the allograft material and aid in new bone formation Although the stability of fibrin adhesives fall short of the results achievable by GTR membranes, in cases presenting with poor accessibility that contraindicate the use of membranes, fibrin adhesive materials provide a viable and effective alternative to graft stabilization and new bone formation.

조직접착제를 이용한 익상편의 상하결막전위술 3례

김지홍,이지은,이종수.Ji Hong Kim. M.D.. Ji Eun Lee. M.D.. Jong Soo Lee. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.12

Purpose: To report the clinical effect of a superior-inferior sliding conjunctival flap for pterygium using fibrin tissue adhesives (Tisseel?; Baxter Healthcare Corporation, Glendale, CA) instead of sutures. Methods: After the primary pterygial tissue was removed from the sclera, a superior-inferior sliding conjunctival flap was created. The fibrin tissue adhesive (Tisseel?) was composed of two solution types: fibrinogen containing aprotinin solution and a CaCl solution containing thrombin. The two solutions with 27 G needle were applied on the bare sclera in sequence, and the conjunctival flap was attached into the bare sclera within 5 seconds. We performed this procedure with a fibrin tissue adhesive instead of sutures in three patients, and follow-up for recurrence of pterygium and postoperative complications. Results: The superior-inferior sliding conjunctival flaps were attached into the bare sclera in all patients using fibrin tissue adhesives. We didn`t find any significant postoperative complications such as ocular pain, epiphora, foreign body sensation, wound defect, or dehiscence. Conclusions: A superior-inferior sliding conjunctival flap constructed with fibrin tissue adhesives should be a useful management tool for the inhibition of the recurrence of pterygial.

중이수술에 인체에서 추출한 Fibrin 접착제의 이용 : Ammonium Sulfate fibrin 접착제와 ??의 비교

이형철,양미경,박문흠 영남대학교 의과대학 1991 Yeungnam University Journal of Medicine Vol.8 No.1

성공적인 종이수술을 위하여 안전하고 효과적인 접착제가 필요하며, 합성 접착제의 독성작용 때문에 인체에서 추출한 접착제를 사용하게 되었다. Fibrin 접착제가 저장 혈액에서 체취되면 감염성 질환의 전염 위험성이 있지만 자가 Fibrin접착제를 사용하면 전염위험성이 없다. 저자들은 ammonium sulfate fibrin 접착제와 상품화된 fibrin 접착제의 접착력을 비교한 결과 ammonium sulfate fibrin 접착제의 접착력이 상품화된 fibrin 접착제의 반 정도의 접착력을 가지지만 그 정도의 접착력이면 고막재생술, 안면신경 봉합술, 이소골 재건술, 외이도 후벽재건술, 뼈가루를 이용한 전두동 및 유양동폐쇄술등 이비인후과 수술에 사용하기엔 충분한 접착력이다. Successful middle ear surgery requires the availability of al safe, effective bonding material. Side effect caused by synthetic materials have led to the use of biologic adhesive, However, they carry the risk of transmission of infectious diseases if they are prepared from pooled human blood. The adhesive strength of ammonium sulfate fibrin adhesive produce an adhesive strength that is half that of the homologous commercial product. It is, however, good enough for use in several otolaryngological operations, tympanoplasty, facial nerve repair, reconstruction of ossicles. reconstruction of posterior wall of ear canal and obliteration of frontal sinus and mastoid antrum using bone dust.

CASE REPORT : Fibrin Glue Fixation for Suction Blister Epidermal Grafting in Two Patients with Stable Vitiligo

( Hyo Jin Kim ),( Jeong Nan Kang ),( Sung Hwan Hwang ),( Jong Keun Seo ),( Ho Suk Sung ) 대한피부과학회 2014 Annals of Dermatology Vol.26 No.6

Vitiligo is a chronic disorder characterized by depigmented macules which can slowly enlarge with the concurrent development of new lesions. Although autologous suction blister epidermal grafting is an established technique for the treatment of recalcitrant, stable vitiligo, the donor tissue graft is not easy to fix at the recipient site, especially in areas such as the joints, face, cutaneous folds, hands, feet, and hair- bearing areas. Therefore, various methods of donor tissue fixation have been attempted. We report two cases of vitiligo treated with suction blister epidermal grafting, with fibrin tissue adhesion. The first case is that of 16-year-old female patient presented with hypopigmented patches on the forehead and frontal scalp area. The other case is that of 32-year-old female patient presented with hypopigmented patches on the chin. We treated them with phototherapy for 1∼4 years; however, the lesions were recalcitrant. Therefore, we tried treatment with a suction blister epidermal graft. Because graft fixation is difficult at the recipient sites, fibrin glue was sprayed on the grafts. Thereafter, we applied a porous silicone wound contact layer over the graft area and applied sterile gauze dressing that was left for a week. One week after the procedure, firm fixation of the donor tissue was observed in both cases. Fibrin glue seemed to improve the graft fixation, providng protection against infection and an optimal environment for wound healing. This report suggests that the application of an epidermal graft with fibrin glufixation, can provide the best result in the surgical treatment of stable vitiligo. (Ann Dermatol 26(6) 751∼754, 2014)

Scalded Skin of Rat Treated by Using Fibrin Glue Combined with Allogeneic Bone Marrow Mesenchymal Stem Cells

( Yadong Yang ),( Wenyuan Zhang ),( Ying Li ),( Guojian Fang ),( Keji Zhang ) 대한피부과학회 2014 Annals of Dermatology Vol.26 No.3

Background: It is difficult to achieve satisfactory results with the traditional treatment of large-area skin defects and deep burns. Objective: To test the treatment effect of an active dressing film made of a mixture of fibrin glue and bone marrow mesenchymal stem cells (BMSCs) for repairing burn wounds on the skin of rats. Methods: Two scald wounds were made on the back of each rat. A total of 30 scald wounds were randomly divided into 3 groups, with 10 wounds in each group. In the experimental treatment group, the scald wounds were covered with the fibrin glue and BMSC mixture. The wounds of the experimental control group were covered with fibrin glue only. No intervention was administered to the blank control group. Thirty days after treatment, pathological sections were cut from the scalded local tissues of all rats from the 3 groups and observed with a microscope. Results: The speed of scald wound healing in the experimental treatment group was faster than the other 2 groups. In the experimental treatment group, histopathological analysis revealed that the sebaceous glands showed obviously proliferous at the edge of the new tissue and gradually extended to the deep dermal layer of the new tissue. Conclusion: BMSCs may have an active role in promoting skin tissue repair and generating skin appendages. Allogeneic BMSCs mixed with fibrin glue can contribute to the quick formation of a film-like gel over the scald wounds, which might be of significance for emergency treatment and skin-grafting operations. (Ann Dermatol 26(3) 289∼295, 2014)

폐수술 후 지속적 공기누출에 희석한 Fibrin Glue의 효과

이석열,최창우,이승진,이철세,이길노 대한흉부외과학회 2006 Journal of Chest Surgery (J Chest Surg) Vol.39 No.10

배경: 폐수술 후 흉관을 통한 지속적 공기누출은 환자의 입원기간을 증가시킬 뿐 아니라 농흉 등의 많은 합병증을 초래할 수 있다. 이러한 공기누출을 막고자 화학적 흉막 유착술을 흔히 사용하게 된다. 본 연구는 폐수술 후 흉관을 통한 지속적 공기누출이 있는 환자들에게 희석한 Fibrin Glue를 이용한 흉막유착술을 시행하여 치료의 유용성과 합병증을 관찰하였다. 대상 및 방법: 2001년 9월부터 2005년 8월까지 순천향대학교 천안병원 흉부외과에서 폐수술을 시행 받고 흉관을 통한 공기누출이 7일 이상 지속되었던 환자 16명을 대상으로 하였다. 먼저 용해시킨 fibrinogen 1.0 g과 aprotinin 50만 KIU를 50 cc 주사기 한 곳에 모았다(혼합액 A). 그리고 용해시킨 thrombin 5,000 IU와 calcium chloride 600 mg을 50 cc 주사기에 하나로 모았다(혼합액 B). 세 번째로는 cefazolin 1.0 g을 50 cc 생리식염수에 희석시켜서 50 cc 주사기에 모았다(혼합액 C). 환자의 흉관과 배액병 사이에 고무줄을 삽입하여 삽입된 고무관이 환자보다 상방으로 약 60 cm 올라가서 아래로 향하도록 loop형태의 모양이 되도록 하였다. 그리고는 가장 높은 고무관에 혼합액 A, B, C를 환자측 방향으로 순서대로 주입을 하였다. 결과: 16명 모두에서 다음날 공기누출이 사라졌다. 그리고 3일 후에 흉관을 모두 제거하였다. 부작용으로는 흉통이 12명(75%), 혈액검사상 백혈구 증가가 14명(88%), 고열과 한기가 14명(88%)에서 나타났다. 이러한 부작용들은 모두 일시적이었으며 특별한 치료를 하지 않아도 시간경과와 함께 사라졌다. 결론: 저자들은 폐수술 후 흉관을 통한 7일 이상의 지속적 공기누출이 있던 16명의 환자들을 대상으로 희석한 Fibrin Glue를 흉관을 통해 주입하는 화학적 흉막유착술을 시행하여 모든 환자에서 공기누출이 멈추는 좋은 효과를 보았다. 희석한 Fibrin Glue를 이용한 화학적 흉막유착술은 별다른 합병증 없이 비교적 손쉽게 지속적 공기누출을 치료하는 데 효과적인 방법이라고 생각한다. 그러나 더 많은 환자를 대상으로 장기적인 추적관찰이 필요하다고 생각한다.

Limited eye movement caused by clumping of fibrin glue used in blowout fracture surgery: a care report

신진용,이내호,Min-Seok Kim,노시균,Yoon Kyu Chung 대한두개안면성형외과학회 2022 Archives of Craniofacial Surgery Vol.23 No.5

Fibrin glue is a topical agent widely used for hemostasis, wound healing, and surgical adhesion. Complications of fibrin glue itself are extremely rare because it is absorbed over time, but can occur as a result of inappropriate application. We report a case of a postoperative complication caused by inappropriate application of fibrin glue in blow-out fracture surgery. A 65-year-old male patient presented with periorbital swelling and an open wound on the right infraorbital area. Computed tomography showed a right orbital floor fracture. After reduction of the herniated tissue into the orbit, an implant was inserted and fibrin glue was applied to stabilize the implant. This procedure was performed without difficulty, but the patient complained of persistent diplopia and limited eyeball movement after surgery. An imaging study showed a mass-like lesion, which was not a hematoma, in the orbital cavity. In a second operation, the mass was identified as clotted fibrin glue that had not been applied properly. After removal, the patient’s symptoms were relieved without further complications. Appropriate and careful application of fibrin glue is necessary to avoid unnecessary complications.

Fibrin glue increases the cell survival and the transduced gene product secretion of the ceiling culture-derived adipocytes transplanted in mice

Yasuyuki Aoyagi,Yasushi Saito,Masayuki Kuroda,Sakiyo Asada,Hideaki Bujo,Shigeaki Tanaka,Shunichi Konno,Masami Tanio,Itsuko Ishii,Masayuki Aso 생화학분자생물학회 2011 Experimental and molecular medicine Vol.43 No.3

The development of clinically applicable scaffolds is important for the application of cell transplantation in various human diseases. The aims of this study are to evaluate fibrin glue in a novel protein replacement therapy using proliferative adipocytes and to develop a mouse model system to monitor the delivery of the transgene product into the blood and the fate of the transduced cells after transplantation. Proliferative adipocytes from mouse adipose tissue were transduced by a retroviral vector harboring the human lecithin-cholesterol acyltransferase (lcat) gene, and were subcutaneously transplanted into mice combined with fibrin glue. The lcat gene transduction efficiency and the subsequent secretion of the product in mouse adipocytes were enhanced using a protamine concentration of 500 μg/ml. Adipogenesis induction did not significantly affect the lcat gene-transduced cell survival after transplantation. Immunohistochemistry showed the ectopic enzyme production to persist for 28 days in the subcutaneously transplanted genetransduced adipocytes. The increased viability of transplanted cells with fibrin glue was accompanied with the decrease in apoptotic cell death. The immunodetectable serum LCAT levels in mice implanted with the fibrin glue were comparable with those observed in mice implanted with Matrigel, indicating that the transplanted lcat gene-transduced adipocytes survived and functioned in the transplanted spaces with fibrin glue as well as with Matrigel for 28 days. Thus,this in vivo system using fibrin is expected to serve as a good model to further improve the transplanted cell/scaffold conditions for the stable and durable cell-based replacement of defective proteins in patients with LCAT deficiency.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive

Erdinc Aydin,Erdem Eris,Levent Kazanci,Osman Murat Uyar 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.3

Purpose: To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. Methods: Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. Results: The median age of patients was 64 (range, 46–82) years, and the median duration of symptoms was 15 (range, 7–60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the followıng 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. Conclusions: Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

Fibrin glue increases the cell survival and the transduced gene product secretion of the ceiling culture-derived adipocytes transplanted in mice

Aoyagi, Yasuyuki,Kuroda, Masayuki,Asada, Sakiyo,Bujo, Hideaki,Tanaka, Shigeaki,Konno, Shunichi,Tanio, Masami,Ishii, Itsuko,Aso, Masayuki,Saito, Yasushi Korean Society for Biochemistry and Molecular Bion 2011 Experimental and molecular medicine Vol.43 No.3

The development of clinically applicable scaffolds is important for the application of cell transplantation in various human diseases. The aims of this study are to evaluate fibrin glue in a novel protein replacement therapy using proliferative adipocytes and to develop a mouse model system to monitor the delivery of the transgene product into the blood and the fate of the transduced cells after transplantation. Proliferative adipocytes from mouse adipose tissue were transduced by a retroviral vector harboring the human lecithin- cholesterol acyltransferase ($lcat$) gene, and were subcutaneously transplanted into mice combined with fibrin glue. The $lcat$ gene transduction efficiency and the subsequent secretion of the product in mouse adipocytes were enhanced using a protamine concentration of $500{\mu}g/ml$. Adipogenesis induction did not significantly affect the $lcat$ gene-transduced cell survival after transplantation. Immunohistochemistry showed the ectopic enzyme production to persist for 28 days in the subcutaneously transplanted genetransduced adipocytes. The increased viability of transplanted cells with fibrin glue was accompanied with the decrease in apoptotic cell death. The immunodetectable serum LCAT levels in mice implanted with the fibrin glue were comparable with those observed in mice implanted with Matrigel, indicating that the transplanted $lcat$ gene-transduced adipocytes survived and functioned in the transplanted spaces with fibrin glue as well as with Matrigel for 28 days. Thus, this $in$ $vivo$ system using fibrin is expected to serve as a good model to further improve the transplanted cell/scaffold conditions for the stable and durable cell-based replacement of defective proteins in patients with LCAT deficiency.