Distribution of wall shear stress of vascular anastomosis and Irnmuno-hlstologicai study of anastomotic Intimal hyperplasia

本研究的目的是通过测量端侧吻合口的局部壁切变和免疫组织化学染色来确定吻合口内膜增生的病理生理学。通过注入塑料铸造物，由吻合的动脉制成血管铸型，由此建立起紫外线透明的流动模具。光致变色示踪技术测量吻合口周围不同部位的壁切应力：近端为-1~-3dyne/cm~2，远端为16~2ddyne/cm~2。端侧吻合后2周给予BrdU。制备吻合口纵切切片，免疫组织化学染色，测量不同部位细胞分裂率。BrdU阳性细胞率以吻合口趾对面远端最高(16%)，其他部位为4%~10%。制作吻合口轴位切片，MIB免疫组织化学染色。然而，在本系列手术中，许多手术兔死亡或吻合口闭塞，由于采集的标本不足，没有得到任何结果。上述结果分别发表在2002年第37届欧洲外科学会和2003年国际血管学会亚洲分会上。

The purpose of this research was to determine the pathophyslology of anastomotic intimal hyperplasia by measuring the local wall shear in an end-to-side anastomosis and by immunohistological staining of the anastomotic intimal hyperplasia.An end-to-side anastomosis was produced in rabbit common carotid arteries. A vascular cast of the anastomosis was made from the anastomosed arteries by infusing a plastic casting compound, from which an ultraviolet-transparent flow mold was constructed. The wall shear stress was measured at various sites around the anastomosis using the photochromic tracer technique : it was -1 to -3dyne/cm^2 the proximal floor and 16 to 2gdyne/cm^2 the distal floor. BrdU was administered 2 weeks after the end-to-side anastomosis. Longitudinal sections of the anastomosis were prepared and then stained immunohistologically to measure the rate of cell division at different positions. The rate of BrdU-positive-cells was highest (16%) at the distal floor opposite the toe of the anastomosis ; at other portions it was 4 to 10%. Axial sections of the anastomosis were then prepared and stained immunohistologically by MIB. However, in this series many of the operated rabbits died or suffered occlusion of the anastomoses, and no results were obtained due to the shortage of harvested specimens.The above results were presented at the 37^<th> European Society for Surgical Research in 2002 and at the Asian Chapter Congress of the International Union of Angiology in 2003.