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RT-PA(Recombinant Tissue Plasminogen Activator)가 굴근건 유착에 미치는 영향에 관한 연구
안상태,Bruce A, Kraemer,Margie Mohler,Margie Mohler,M.S. 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3
Formation of peritendinous adhesions often impairs the outcome of flexor tendon repairs. Peritendinous blood collections which form around injured tendons may act as a scaffold for later adhesion formation. Modification of the peritendinous wound by recombinant tissue plasminogen activator(rt-PA) could possibily lyse the peritendinous blood clot and decrease tendon adhesions. After evaluating the activity of rt-PA in chickens, a new flexor tendon adhesion model was developed to study its effect on the tendon adhesions. Adult chicken long toe flexor profundus tendons were uniformly injured and then treated with either rt-PA in sodium hyaluronate vehicle, sodium hyaluronate vehicle alone or nothing(controls). After 2 weeks of immobilization, the tendons were pulled to full flexion using a tensometer to generate a stress-strain curve. Rt-PA showed an in vitro effect in chickens at doses 25 times the dose needed in rabbits and 100 times the dose needed in humans. However, in vivo plasminogen studies suggested a 5 fold increased dose was needed in chickens as compared to rabbits. The total energy required for full DIP joint flexion in the operated control toes was 6 times that of the unoperated controls. There was no significant difference between any of the treatment groups. Use of a model which induces less adhesions, a repetitive drug dosing regimen or study of another species with greater rt-PA response is needed to determine the effectiveness of rt-PA in reducing peritendinous adhesions.
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