BACKGROUND: Bioprosthetic devices for treating cardiovascular diseases and defects may provide alternatives to autologous and homograft tissue. We evaluated the mechanical and physical conditions of a porcine pericardial bioprosthesis treated with Glutaraldehyde (GA), Ethanol, or Sodium dodecylsulfate (SDS) before implantation. MATERIAL AND METHOD: 1) Thirty square-shaped pieces of porcine pericardium were fixed in 0.625%, 1.5% or 3% GA solution. 2) The tensile strength and thickness of these and other bioprosthesis, including fresh porcine pericardium, fresh human pericardium, and commercially produced heterografts, were measured. 3) The tensile strength and thickness of the six treated groups (GA-Ethanol, Ethanol-GA, SDS only, SDS-GA, Ethanol-SDS-GA and SDS-Ethanol-GA) were measured. RESULT: 1) Porcine pericardium fixed in 0.625% GA the thinnest and had the lowest tensile strength, with thickness and tensile strength increasing with the concentration of GA solution. The relationship between tensile strength and thickness of porcine pericardium increased at thicknesses greater than 0.1 mm (correlation-coefficient 0.514, 0<0.001). 2) There were no differences in tensile strength or thickness between commercially-produced heterografts. 3) Treatment of GA, ethanol, or SDS minimally influenced thickness and tensile strength of porcine pericardium, except for SDS alone. CONCLUSION: Porcine pericardial bioprosthesis greater than 0.1 mm thick provide better handling and advantageous tensile strength. GA fixation did not cause physical or mechanical damage during anticalcification or decellularization treatment, but combining SDS-ethanol pre-treatment and GA fixation provided the best tensile strength and thickness.
Bioprosthesis ; Cardiovascular Diseases ; Ethanol ; Glutaral ; Handling (Psychology) ; Humans ; Pericardium ; Sodium ; Tensile Strength ; Transplantation, Heterologous ; Transplantation, Homologous

Reconstruction of the middle hepatic vein (MHV) tributaries, in modified right lobe grafts, appears to be effective for solving the congestion problem of the right paramedian sector (segment V, VIII). Various methods have been proposed to maintain efficient graft outflow for right lobe grafts without the middle MHV by centers with a high volume of procedures. Since December 2005, we adopted the bench procedure for reconstruction of a modified right lobe graft into the shape of an extended right lobe graft with a venous pouch to form a common trunk between the MHV (or newly reconstructed MVH) and right hepatic vein (RHV) using a cryoperserved aortic patch or bovine pericardium. Before December 2005, the graft RHV and MVH were anastomosed to the recipients' RHV and MHV/left hepatic vein. In this study, we compared the results of these two different methods (23 recipients of the direct and separate anastomosis, group A; 40 recipients of formation of a common outflow trunk, group B). The two groups were comparable in terms of preoperative parameters. Compared with group A, the middle hepatic vein patency length in group B was much better (p = 0.000). The necessity of metallic stenting due to early occlusion of the hepatic vein was significantly decreased in Group B (Group A; 5/21 vs. Group B; 2/40, p = 0.042). However, 1-year patient and graft survival was not different between the two groups (p = 1.000). Our procedure for constructing a modified right lobe graft into an anatomical figure with the extension of the right lobe graft and reconstruction of a wider outflow tract might provide an effective functioning liver mass and help to improve the outcomes in these patients.
Estrogens, Conjugated (USP) ; Graft Survival ; Hepatic Veins* ; Humans ; Liver Transplantation* ; Liver* ; Living Donors* ; Pericardium ; Stents ; Transplants

pericardium.METHODS: From January 2007 to June 2009, among the patients who received an implant at Chosun University Dental Hospital, patients were selected if they were treated with guided bone regeneration (GBR) with simultaneous implant placement or GBR prior to implant placement. The selected patients were sorted according to the materials and membranes used in GBR, and the implant survival rate was recorded by clinical examination and reviewing the medical records and the radiographs. Each study list was analyzed by SPSS (version 12.0, SPSS Inc., USA) software and the survival rate was verified by Chi-square tests. P values less than 0.05% were deemed significant.RESULTS: 278 implants were placed on a total of 101 patients and 8 implants resulted in failure. Three implants failed among 15 implants with only a mineralized bone allograft. No failure was shown among the 74 implants placed with mineralized bone allograft and a barrier membrane derived from ox pericardium. One group of 4 implant placements showed failure among the 102 implants placed with a mineralized bone allograft and another bone graft material. The group that had a barrier membrane derived from ox pericardium with a mineralized bone allograft or other bone materials showed no implant failure. Three failures were shown among the 21 implants placed with only bone graft and not using a membrane. The group with membranes other than a barrier membrane derived from ox pericardium showed 5 failures among 170 implants.CONCLUSION: The implant survival rate of the group with GBR using a mineralized bone allograft was 96.3%, which meant there was little difference compared to the groups of another bone graft materials (98.9%). The implant survival rate of the group without a membrane-was 85.7% and it showed a significant difference compared to the group using a barrier membrane derived from ox pericardium (100%) and the group using another membrane (97.1%).]]>
Bone Regeneration ; Dental Implants ; Humans ; Medical Records ; Membranes ; Pericardium ; Survival Rate ; Transplantation, Homologous ; Transplants

BACKGROUND: Various studies and experimental trials have been done to develop bioprosthetic devices to treat complex congenital heart disease due to the limited usage of homograft tissue. The purpose of the present study was to evaluate the effect of diamine bridges with using L-lysine, as compared with using ethanol. MATERIAL AND METHOD: Porcine pericardium was fixed at 0.625% GA (commercial fixation). An interim step of ethanol (80%; 1 day at room temperature) or L-lysine (0.1 M; 2 days at 37degrees C) was followed by completion of the GA fixation (2 days at 4degrees C and 7 days at room temperature). The tensile strength and thickness of the porcine percardium were measured, respectively. The treated pericardiums were implanted subcutaneously into three-week old Long-Evans rats for 8 weeks. The calcium content of the implants was assessed by atomic absorption spectroscopy and the histology. RESULT: Ethanol pretreatment (13.6+/-10.0 ug/mg, p=0.008), L-lysine pretreatment (15.3+/-1.0 ug/mg, p=0.002), and both treatment (16.1+/-11.1 ug/mg, p=0.012) significantly inhibited calcification, as compared with the controls (51.2+/-8.5 ug/mg). L-lysine pretreatment (0.18+/-0.02 mm, 1.20+/-0.30 kg f/5 mm) significantly increased the thickness and tensile strength, as compared with ethanol pretreatment (0.13+/-0.03 mm, 0.85+/-0.36 1.0 kg f/5 mm) (p<0.01, p=0.035). CONCLUSION: The diamine bridges using L-lysine seemed to decrease the calcification of porcine pericardium fixed with glutaraldehyde, and this was comparable with Ethanol. Additionally, it seemed to enhance the thickness and tensile strength.
Absorption ; Bioprosthesis ; Calcium ; Ethanol ; Glutaral ; Heart Diseases ; Lysine ; Pericardium ; Rats, Long-Evans ; Spectrum Analysis ; Tensile Strength ; Transplantation, Heterologous ; Transplantation, Homologous

BACKGROUND: We attempted to reproduce a previously reported method that is known to be effective for decellularization, and we sought to find the optimal condition for decellularization by introducing some modificationsto this method. MATERIAL AND METHOD: Porcine semilunar valves, arterial walls and pericardium were processed for decellularization with using a variety of combinations and concentrations of decellularizing agents under different conditions of temperature, osmolarity and incubation time. The degree of decellularization and the preservation of the extracellular matrix wereevaluated by staining with hematoxylin and eosin and with alpha-Gal and DAPI in some of the decellularized tissues. RESULT: Decellularization was achieved in the specimens that were treated with sodium deoxycholate, sodium dodesyl sulfate, Triton X-100 and sodium dodesyl sulfate with Triton X-100 as single-step methods, and this was also achieved in the specimens that were treated with hypotonic solution --> Triton X-100 --> sodium dodesyl sulfate, sodium deoxycholate --> hypotonic solution --> sodium dodesyl sulfate, and hypotonic solution sodium dodesyl sulfate as multi-step methods. CONCLUSION: Considering the number and the amount of the chemicals that were used, the incubation time and the degree of damage to the extracellular matrix, a single-step method with sodium dodesyl sulfate and Triton X-100 and a multi-step method with hypotonic solution followed by sodium dodesyl sulfate were both relatively optimal methods for decellularization in this study.
Deoxycholic Acid ; Eosine Yellowish-(YS) ; Extracellular Matrix ; Heart Valves ; Hematoxylin ; Indoles ; Octoxynol ; Osmolar Concentration ; Pericardium ; Sodium ; Tissue Engineering ; Transplantation, Heterologous

BACKGROUND: Calcification is the most frequent cause of clinical failure of bioprosthetic tissues that are fabricated from Glutaraldehyde (GA)-fixed porcine valve or bovine pericardium. We recently used a multi-factorial approach of employing different mechanisms to investigate how to reduce the calcification of bioprosthetic tissues. The purpose of the present study was to evaluate the synchronized synergism using ethanol, L-lysine and NaBH4 in glutaraldehyde treated porcine pericardium from the standpoint of calcification and tissue elasticity. MATERIAL AND METHOD: Porcine pericardium was fixed with 0.625% GA (commercial fixation). An interim step of ethanol (80%; 1 day at room temperature) or L-lysine (0.1 M; 2 days at 37degrees C) or NaBH4 (0.1 M; 2 days at room temperature) was followed by completion of the GA fixation (2 days at 4degrees C and 7 days at room temperature). The tensile strength and thickness of the samples were measured. The treated pericardiums were implanted subcutaneously into three-week old Sprague-Dawley rats for 8 weeks. The calcium content was assessed by atomic absorption spectroscopy and the histology of the samples. RESULT: The amount of calcium in the pericardium pretreated with ethanol (13.6+/-10.0 ug/mg, p=0.008), L-lysine (15.3+/-1.0 ug/mg, p=0.002) and both (16.1+/-11.1 ug/mg, p=0.012) was significantly reduced compared with the control (51.2+/-8.5 ug/mg). However, NaBH4 pretreatment (65.7+/-61.8 ug/mg, p=0.653) and combined pretreatment that including ethanol, L-lysine and NaBH4 (92.9+/-58.3 ug/mg, p=0.288) were not significantly different from the controls (51.2+/-8.5 ug/mg). Both the combined pretreatment using ethanol and L-lysine (7.60+/-1.55, p=0.76) and the combined pretreatment that included ethanol, L-lysine and NaBH4 (7.47+/-1.85, p=0.33) increased the tensile strength/thickness ratio compared with that of the controls (4.75+/-1.88). CONCLUSION: The combined pretreatment using ethanol and L-lysine seemed to decrease the calcification of porcine pericardium fixed with glutaraldehyde, as compared to single pretreatment, and it increase the tissue elasticity, but to the degree that showed synchronized synergism. NaBH4 pretreatment seemed to increase the calcification of porcine pericardium, irrespective of whether single or combined pretreatment was used.
Absorption ; Bioprosthesis ; Calcium ; Elasticity ; Ethanol ; Glutaral ; Lysine ; Pericardium ; Rats, Sprague-Dawley ; Spectrum Analysis ; Tensile Strength ; Transplantation, Heterologous

BACKGROUND: Bovine pericardium fixed in glutaraldehyde solution (GA) has been one of the most popular surgical bioprosthesis, however, late calcific degeneration after implantation remains to be solved. To mitigate calcific degeneration, we posttreated the bovine pericardium with amino acids after GA fixation. MATERIAL AND METHOD: 40 small pieces of bovine pericardia were fixed in 0.625% GA solution with 4 g/L MgCl2 6H2O as a control group (group 1). 40 pieces fixed in the same GA solution were posttreated with 2% chitosan solution (group 2) and the other 40 pieces posttreated with 8% glutamate (group 3). These were implanted into the belly of forty Fisher 344 rats subdermally and extracted at 1 month, 2 months, 3 months and 4 months after implantation. RESULT: With atomic absorption spectrophotometry we measured the deposited calcium amount and the results were as follows; 2.01+/-0.13 mg/g in group 1, 2.34+/-0.73 mg/g in group 2, 2.49+/-0.15 mg/g in group 3 at 1 month after implantation, and 3.57+/-0.15 mg/g in group 1, 3.52+/-0.92 mg/g in group 2, 3.46+/-0.12 mg/g in group 3 at the second month. But 5.45+/-0.42 mg/g in group 1, 3.22+/-1.31 mg/g in group 2 and 4.20+/-0.55 mg/g in group 3 at the 3rd month, which have statistical significance in group 2 (p<0.05). Finally at 4th month, 6.01+/-1.21 mg/g in group 1, 3.78+/-1.82 mg/g in group 2, 3.92+/-0.92 mg/g in group 3, which also have statistical significance (p<0.05). CONCLUSION: This means posttreatment with 2% chitosan shows meaningful calcium mitigation effects after 3rd month on subcutaneously implanted bovine pericardium in the rat models but 8% glutamate shows mitigation effect after 4months in this experiment.
Amino Acids* ; Animals ; Bioprosthesis* ; Calcium ; Chitosan ; Glutamic Acid ; Glutaral ; Magnesium Chloride ; Models, Animal ; Pericardium ; Rats ; Spectrophotometry, Atomic ; Transplantation

BACKGROUND: Various experimental trials for the development of bioprosthetic devices are actively underway, secondary to the limited supply of autologous and homograft tissue to treat cardiac diseases. In this study, porcine bioprostheses that were treated with glutaraldehyde (GA), ethanol, or sodium dodecylsulfate (SDS) were examined with light microscopy and transmission electron microscopy for mechanical and physical imperfections before implantation. MATERIAL AND METHOD: 1) Porcine pericardium, aortic valve, and pulmonary valve were examined using light microscopy and JEM-100CX II transmission electron microscopy, then compared with human pericardium and commercially produced heterografts. 2) Sections from six treated groups (GA-Ethanol, Ethanol-GA, SDS only, SDS-GA, Ethanol-SDS-GA and SDS-Ethanol-GA) were observed using the same methods. RESULT: 1) Porcine pericardium was composed of a serosal layer, fibrosa, and epicardial connective tissue. Treatment with GA, ethanol, or SDS had little influence on the collagen skeleton of porcine pericardium, except in the case of SDS pre-treatment. There was no alteration in the collagen skeleton of the porcine pericardium compared to commercially produced heterografts. 2) Porcine aortic valve was composed of lamina fibrosa, lamina spongiosa, and lamina ventricularis. Treatment with GA, ethanol, or SDS had little influence on these three layers and the collagen skeleton of porcine aortic valve, except in the case of SDS pre-treatment. There were no alterations in the three layers or the collagen skeleton of porcine aortic valve compared to commercially produced heterografts. CONCLUSION: There was little physical and mechanical damage incurred in porcine bioprosthesis structures during various glutaraldehyde fixation processes combined with anti-calcification or decellularization treatments. However, SDS treatment preceding GA fixation changed the collagen fibers into a slightly condensed form, which degraded during transmission electron micrograph. The optimal methods and conditions for sodium dodecylsulfate (SDS) treatment need to be modified.
Aortic Valve ; Bioprosthesis ; Collagen ; Connective Tissue ; Electrons ; Ethanol ; Glutaral ; Heart Diseases ; Humans ; Light ; Microscopy ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Pericardium ; Pulmonary Valve ; Skeleton ; Sodium ; Transplantation, Heterologous ; Transplantation, Homologous

PURPOSE: Most of grafts used as interposition conduits for middle hepatic vein (MHV) in living donor liver transplantation (LDLT) have been allografts and autografts. Recently, polytetrafluoroethylene (PTFE) and bovine pericardium patch have also been used. Thus, we performed large-animal lab tests to assess the feasibility of interposition vessel graft substitutes for MHV. METHODS: The inferior vena cava was replaced in 9 dogs with allograft (3), PTFE (3), and bovine pericardium patch (3). After 28 days, patency rate, outer and inner diameter, intimal thickness, histology, and immunohistochemistry were evaluated according to interposition grafts. RESULTS: The allograft and PTFE groups were all patent at post-operative week 4, but the bovine group was not patent in all dogs. Outer diameter of anastomotic site at 4 weeks was 8.41+/-0.37, 10.83+/-0.51, and 7.41+/-0.86 mm in allograft, PTFE, and bovine group, respectively. Inner diameter of interposition graft at 4 weeks was 7.90+/-0.23, 6.33+/-0.68, and 0 mm in allograft, PTFE, and bovine groups, respectively. Intimal thickness was 48.0+/-8.6, 113.8+/-45.3, and 218.3+/-59.9microm in allograft, PTFE, and bovine groups, respectively. In histologic findings, inflammation was most severe in the bovine group. Intima of anastomotic site in the bovine group was thickest in all groups. Proliferation of smooth muscle cells was most severe in anti-alpha-actin antibody test in bovine group. CONCLUSION: Our data implicate that the use of allografts and PTFE grafts is more feasible than bovine pericardium for MHV reconstruction in LDLT.
Animals ; Dogs ; Glycosaminoglycans ; Hepatic Veins ; Humans ; Immunohistochemistry ; Inflammation ; Liver ; Liver Transplantation ; Living Donors ; Myocytes, Smooth Muscle ; Pericardium ; Polytetrafluoroethylene ; Pyridines ; Thiazoles ; Transplantation, Homologous ; Transplants ; Vena Cava, Inferior

Aortoesophageal fistula (AEF) is a rare but fatal complication caused by foreign body ingestion. Aortic replacement and endovascular stent graft are the common repair surgeries. The materials to repair an aortic defect in AEF are typically homograft or allograft, but the use of an autologous pericardium patch is rarely reported. Here we reported a patient with AEF and severe mediastinal infection induced by chicken bone ingestion. In this case, the autologous pericardium patch was used as the repair material.
Aorta ; injuries ; surgery ; Aortic Diseases ; etiology ; surgery ; Autografts ; transplantation ; Esophageal Fistula ; etiology ; surgery ; Foreign Bodies ; complications ; Gastrointestinal Hemorrhage ; etiology ; surgery ; Humans ; Mediastinal Diseases ; surgery ; Pericardium ; transplantation ; Stents ; Transplantation, Autologous ; methods ; Vascular Fistula ; etiology ; surgery ; Vascular Grafting ; methods