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        흰쥐 하지근육의 허혈-재관류 손상에 Mannitol이 미치는 억제효과

        이경현,박장상,고용복,최홍식 대한혈관외과학회 1995 Vascular Specialist International Vol.11 No.1

        Revascularization and normal blood reperfusion after the period of ischemia are still associated with systemic complications and severe local damage. In the literature, there are reports about mortality rates between 15% and 52% and amputation rates between 12%∼22%. Moreover, after successful revascularization, in only 60%∼70% of the survivors does a good functional recovery occur, and one third of patients show a viable, but nonfunctioning extremity. This is due to a reperfusion syndrome, originally described by Haimovici in 1960. The important role of free radical mediated damage following reperfusion after a period of ischemia has been documented in the kidney, heart, intestine, and brain. However, the role of oxygen free radical in reperfusion injury of the skeletal muscle has not been well defined partly because skeletal muscle is relatively resistant to ischemia. The goal of this envestigation is to evaluate the role of free radical and the role of mannitol as well as radical scavengers in reperfusion injury of the skeletal muscle in male Wistar rats. The blood levels of thiobarbituric acid(TBA) reactants, serum CPK, and the water content of calf muscles, were measured in the experimental model, where infrarenal abdominal aorta was occluded for 2 hours and 30 minutes followed by reperfusion with and without intraperitonial administration of radical scavenger, superoxide dismutase(SOD) and intravenous administration of mannitol although the exact mechanism of the injury remains unclear. These rats were divided into four groups: group A; single laparatomy, group B(ischemia- reperfusion group 2 hour and 30 minutes occlusion, group C(SOD group+2 hour and 30 minutes occlusion with SOD, group D(mannitol group);2 hour and 30 minutes occlusion with mannitol. The results were as follows: 1) The level of serum CPK and MDA in group B increased steeply immediately after the abdominal aortic clamp was released. 2) The level of serum CPK and MDA following reperfusion were not increased significantly in SOD-treated group and mannitol-treated group as compared with those in ische- mia-reperfusion group. 3) The water contents of calf muscles showed a significant increase after reperfusion in ischemia-reperfusion group whereas it did nit change significantly in superoxide dismutase-treated group and mannitol-treated group. Mannitol-treated group had less water than did SOD-treated group. Our studies suggested that oxygen-derived free radicals may play an important role in the reperfusion injury in the lower extremity and that hypertonic mannitol seems to play an important role in reducing lipid peroxidation.

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