Resin and Silicone Tracheobronchial Cast
Transcription
Resin and Silicone Tracheobronchial Cast
Kasetsart J. (Nat. Sci.) 33 : 363 - 367 (1999) «. ‡°…µ√»“ µ√å («‘∑¬.) ªï∑’Ë 33 : 363 - 367 (2542) Resin Cast ·≈– Silicone Cast ¢Õß·¢πß∑àÕ≈¡„πªÕ¥ Resin and Silicone Tracheobronchial Cast ¡“≈’«√√≥ ‡À≈’ˬ¡»‘√‘‡®√‘≠ °¡≈ ‡ √’°ÿ≈ Õÿ‰√ æß»å™—¬ƒ°…å ÿ√æß…å Õ“∑‘µ¬å«ß»å ·≈– Õ¿—πµ√’ ¥â«ß‡ß‘π Maleewan Liumsiricharoen, Kamol Serikul, Urai Pongchairerk, Surapong Arthitvong and Apantree Duangnjern ABSTRACT From previous work the proper anatomical configuration of tracheobronchial cast can be made from numerous kinds of resin and silicone in both unfixed and formalin fixed tissue of lungs. In this report an apply material and method for creating a tracheobronchial cast by using industrial resin (Alpolit UP 240 BS) and household silicone sealant (Sony chemical silicone sealant L 6301) in unfixed lung is described. Both resin cast and silicone cast can give a good three dimensional structure of tracheobronchial tree of whole lung. Key words : resin cast, silicone cast, tracheobronchial cast ∫∑§—¥¬àÕ ‰¥â¡’°“√‡µ√’¬¡ cast ∑’Ë· ¥ß≈—°…≥–°“¬«‘¿“§ ∑’Ë∂Ÿ°µâÕß ¢Õß∑àÕ∑“߇¥‘π≈¡ªÕ¥ ¥â«¬°“√„™â resin ·≈– silicone ™π‘¥µà“ß Ê ‚¥¬„™â°—∫ªÕ¥ ¥ ·≈– ªÕ¥∑’Ë¥Õߥ⫬ formalin °“√»÷°…“„π§√—Èßπ’È ‡ªìπ°“√ ¥—¥·ª≈ß™π‘¥¢Õß “√·≈–«‘∏’°“√‡µ√’¬¡∑àÕ∑“߇¥‘π≈¡ ªÕ¥ ‚¥¬„™â resin À≈àÕ„ ∑’Ë„™â„πß“πÕÿµ “À°√√¡ (Alpolit UP 240 BS) ·≈– silicone (Sony chemical silicone sealant L 6301) ∑’Ë„™âÕÿ¥ ¡“πÕÿª°√≥åµà“ß Ê ¡“‡µ√’¬¡ resin cast ·≈– silicone cast ¢Õߪե ¥ æ∫«à“‰¥â cast ∑’Ë “¡“√∂· ¥ß°“¬«‘¿“§¢Õß∑àÕ∑“ß ‡¥‘π≈¡ªÕ¥ ∑—Èߪե‰¥â‡ªìπÕ¬à“ߥ’ §”π” ‰¥â ¡’ ° “√‡µ√’ ¬ ¡Õÿ ª °√≥å ™à « ¬ Õπ ∑“ß °“¬«‘ ¿ “§»“ µ√å ¢ Õߪե ∑’Ë “¡“√∂· ¥ß à « π ª√–°Õ∫¢Õߪե„π≈—°…≥– “¡¡‘µ‘ ‚¥¬°“√æ—≤π“ „™â “√À≈“¬™π‘¥ ·≈–«‘∏·’ µ°µà“ß°—π‰ª‡æ◊ÕË „À≥â speci- ¿“§«‘™“°“¬«‘¿“§»“ µ√å §≥– —µ«·æ∑¬»“ µ√å ¡À“«‘∑¬“≈—¬‡°…µ√»“ µ√å °√ÿ߇∑æ 10900 Department of Anatomy, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand. 364 «. ‡°…µ√»“ µ√å («‘∑¬.) ªï∑’Ë 33 ©∫—∫∑’Ë 3 men ∑’Ë¥’·≈–‡À¡“– ¡∑’Ë®–„™â»÷°…“∑“ß°“¬«‘¿“§ »“ µ√å¢Õߪե ‡™àπ°“√‡µ√’¬¡ cast ¢ÕßÕ«—¬«–µà“ß Ê ¥â«¬ resin ´÷Ëß¡’«‘∏’°“√∑’Ë´—∫´âÕπÀ≈“¬¢—ÈπµÕ𠵓¡ ™π‘¥¢Õß resin ∑’Ë„™â (Tomsett,1956; Tucker and Krementz, 1957) resin cast ∑’ˉ¥â ¡’√Ÿª∑√ß∑’˧ß∑’Ë ·µà‡ª√“– ·µ°À—° ßà“¬ ®÷߉¥â¡’°“√æ—≤π“„™â “√µ—«Õ◊Ëπ ‚¥¬∑¥≈Õß„™â silicone À≈“¬™π‘¥ ¥â«¬«‘∏’µà“ß Ê ‡™àπ°“√‡µ√’¬¡ªÕ¥ ÿπ—¢¥â«¬«‘∏’ forced air impregnation ‚¥¬„™â Silicone S10 ·≈– S3 º ¡ xylene „π ªÕ¥∑’ˇªÉ“·Àâß (Henry and Butler, 1990) «‘∏’π’È∑”‰¥â –¥«°°«à“«‘∏’ vacuum impregnation ¥â«¬ silicone (Hagens et al., 1987) µàÕ¡“‰¥â¡’°“√æ—≤𓇵√’¬¡ cast ¢Õß∑àÕ∑“߇¥‘π≈¡„πªÕ¥ ·≈– cast ∑àÕ∑“߇¥‘π≈¡ ¢Õߪե§Ÿ°à ∫— ‡ âπ‡≈◊Õ¥∑’ Ë ¡— æ—π∏å°∫— ∑àÕ≈¡ ‚¥¬„™â silicone À≈“¬™π‘ ¥ ‡™à π Biodur S10/S3/S2 mixture(Bioduproduct) ·≈– Silastic E RTV ¢Õß Dow corning corp (Henry, 1992) √«¡∑—Èß°“√‡µ√’¬¡ cast ¢Õß∑àÕ∑“߇¥‘π≈¡„πªÕ¥§Ÿà°—∫‡ âπ‡≈◊Õ¥ ‚¥¬ ∑¥≈Õß„™âªÕ¥∑’ºË “à π°“√¥Õߥ⫬ formalin ·≈–„™â silicone §«“¡Àπ◊¥µË” cast ∑’ˉ¥â¡’§«“¡≈–‡Õ’¬¥ “¡“√∂ »÷°…“ √–¥—∫®ÿ≈∑√√»πåÕ‘‡≈Á°µ√Õ𠉥â (Nettum, 1995) ®ÿ¥ª√– ß§å¢Õß°“√»÷°…“„π§√—Èßπ’È ‡æ◊ËÕÀ“ “√ ∑’ˇÀ¡“– ¡„π°“√‡µ√’¬¡ cast ¢Õß∑àÕ∑“߇¥‘π≈¡„π ªÕ¥ ‚¥¬∑¥≈Õß„™â resin À≈à Õ „ ∑’Ë „ ™â „ πß“π Õÿµ “À°√√¡ (Alpolit UP 240 BS) ·≈– silicone §«“¡Àπ◊¥ Ÿß (Sony chemical silicone sealant L 6301) ∑’Ë„™â‡ªìπ “√Õÿ¥ ¡“πÕÿª°√≥åµà“ß Ê ´÷ËßÀ“´◊ÈÕ ßà“¬ ¡’√“§“‰¡à·æß √«¡∑—Èß«‘∏’°“√‡µ√’¬¡‰¡à¬ÿà߬“°·≈– ‡æ◊ËÕ„À≥â cast ∑’Ë “¡“√∂· ¥ß≈—°…≥– “¡¡‘µ‘ ∑“ß °“¬«‘¿“§¢Õß·¢πß∑àÕ≈¡„πªÕ¥‰¥â®π∂÷ß·¢π߬àÕ¬ ∑’Ë¡’¢π“¥‡≈Á° √«¡∑—Èß “¡“√∂¥—¥·ª≈߉ª„™â„π°“√ ‡µ√’¬¡ cast ¢ÕßÕ«—¬«–Õ◊Ëπ Ê ‰¥â Õÿª°√≥å ·≈–«‘∏’°“√ π”ªÕ¥ ÿπ—¢ 3 ªÕ¥ ªÕ¥·æ– 1 ªÕ¥ ·≈–ªÕ¥ ·¡« 1 ªÕ¥ ®“°ÀâÕßºà“´“° ¿“§«‘™“欓∏‘«‘∑¬“ ·≈–®“°‚√ß¶à “ — µ «å π”ªÕ¥¡“≈â “ ßπÈ” „Àâ –Õ“¥ ™”·À≈– à«πÀ—«„® ‡ âπ‡≈◊Õ¥ mediastinal tissue ·≈–‰¢¡—π ∑’ˉ¡àµâÕß°“√ÕÕ° ¬°‡«âπªÕ¥ ÿπ—¢ 1 ªÕ¥ ∑’˵âÕß°“√©’¥ resin ‡¢â“‡ âπ‡≈◊Õ¥À—«„® ·∫àߪե‡ªìπ 2 °≈ÿà¡ °≈ÿà¡∑’Ë 1 ‡ªÉ“„Àâ·Àâ߇æ◊ËÕÕ—¥ silicone °≈ÿà¡∑’Ë 2 ©’¥ resin ªÕ¥Õ—¥ silicone π”ªÕ¥·æ– 1 ªÕ¥ ªÕ¥·¡« 1 ªÕ¥ ·≈–ªÕ¥ ÿπ—¢ 1 ªÕ¥ ¡“‡ªÉ“≈¡‚¥¬°“√µàÕ∑àÕ‡¢â“∑“ßÀ≈Õ¥≈¡ „™â ‡ §√◊Ë Õ ßªíö ¡ ≈¡Õ— µ ‚π¡— µ‘ ‚ ¥¬§«∫§ÿ ¡ ª√‘ ¡ “µ√≈¡∑’Ë ∑”„ÀâªÕ¥¢¬“¬µ“¡√Ÿª√à“ß·≈–¢π“¥¢Õß°“¬«‘¿“§ ¢Õߪե —µ«å·µà≈–™π‘¥ ‚¥¬ªÕ¥‰¡à·µ° ª≈àÕ¬„Àâ ªÕ¥·Àâß —߇°µ«à“ªÕ¥®–‰¡à·ø∫≈߇¡◊ÕË ∂Õ¥∑àÕ≈¡ÕÕ° Õ—¥ silicone (Sony chemical silicone sealant L6301) ‡¢â“ªÕ¥∑“ßÀ≈Õ¥≈¡¥â«¬ªóπ¬‘ß silicon ªÕ¥ ÿπ—¢„™â silicone 1 À≈Õ¥ (¢π“¥ 330 ´’.´’.) ªÕ¥·æ–„™â silicone 2 À≈Õ¥ ºŸ°À≈Õ¥≈¡·¢«πªÕ¥§â“ß§◊π 1 §◊π‡æ◊ËÕ„Àâsilicone ·¢Áßµ—« π”ªÕ¥∑’Ë©’¥ silicone ·™à „ππÈ”¬“ Potassium hydroxide §«“¡‡¢â¡¢âπ 25% ª√–¡“≥ 1- 2 —ª¥“Àå À¡—Ëπ°≈—∫ specimen ‡æ◊ËÕ„Àâ °—¥‡π◊ÈÕªÕ¥ÕÕ°„ÀâÀ¡¥ π” cast ¢Õߪե≈â“ßπÈ”„Àâ –Õ“¥ ªÕ¥©’¥ resin π”∑àÕ plastic Õ¥„π∑àÕ≈¡ªÕ¥ ÿπ—¢ ©’¥¥â«¬ resin À≈àÕ„ ‡∫Õ√å 240 BS (Alpolit Up 240 BS) º ¡µ—«∑”·¢Áß 1-1.5% (Liumsiricharoen et al., 1995) ´÷ßË º ¡ ’‡À≈◊Õß ©’¥‡¢â“∑àÕ≈¡ º ¡ ’·¥ß©’¥‡¢â“‡ âπ‡≈◊Õ¥ aorta ´÷ßË ®–‰À≈¬âÕπ∑“߇¥‘π¢Õ߇≈◊Õ¥ª°µ‘‚¥¬ºà“π®“° «. ‡°…µ√»“ µ√å («‘∑¬.) ªï∑’Ë 33 ©∫—∫∑’Ë 3 left ventricle ‰ª¬—ß left atrium ·≈–ºà“π pulmonary vein ‡¢â“ ŸàªÕ¥ ‚¥¬„™â resin ª√–¡“≥ 100-120 ´’.´’. π”ªÕ¥ ÿπ—¢∑’Ë©’¥ resin ·≈â« ·¢«π≈Õ¬„ππÈ” 1 §◊π ‡æ◊ËÕ„Àâ§ß ¿“æ√Ÿª√à“ߢÕߪե·≈–‡æ◊ËÕ√Õ„Àâ resin ·¢Áßµ—« ®“°π—Èππ”ªÕ¥·™à„ππÈ”¬“ potassium hydroxide 50% π“πª√–¡“≥ 2 —ª¥“Àå ®π‡À≈◊Õ·µà cast ¢Õß resin π” cast ∑’ˉ¥â¡“≈â“ßπÈ”„Àâ –Õ“¥ ·≈–‡Õ“ resin à«π‡°‘π∑’ËÕ¬Ÿà√–À«à“ß·¢πß∑àÕ≈¡ÕÕ° π” resin cast ·≈– silicone cast ¢Õߪե ¡“»÷ ° …“ °“¬«‘¿“§»“ µ√å¢Õß·¢πß∑àÕ∑“߇¥‘π≈¡¢Õߪե “¡“√∂ºà“π‡¢â“‰ª„π∑àÕ≈¡¢π“¥‡≈Á°‰¥âßà“¬ (Henry, 1992 ; Nettum 1995) à«π cast ∑àÕ∑“߇¥‘π≈¡¢Õß ªÕ¥∑’‡Ë µ√’¬¡¥â«¬ silicone „πªÕ¥∑’∑Ë ”„Àâ·Àâߪ√–¡“≥ 1 «—π ®–‰¥â cast ∑’Ë silicone “¡“√∂ºà“π‡¢â“‰ª∂÷ß ∑àÕ≈¡µÕπª≈“¬∑’Ë¡’¢π“¥‡≈Á°‰¥â (Figure 3 ·≈– 4) ‡æ√“–ªÕ¥·≈–∑àÕ≈¡ ¬—ß¡’§«“¡‡À𒬫 ¢≥–Õ—¥ silicone ‡π◊ÈÕ‡¬◊ËÕªÕ¥ ·≈–∑àÕ≈¡®–‰¡à·µ° ¥—ßπ—Èπ cast ∑’Ë ‰ ¥â ®÷ ß „Àâ √ “¬≈–‡Õ’ ¬ ¥‰¥â ¥’ ‡¡◊Ë Õ »÷ ° …“¥â « ¬ °≈âÕß®ÿ≈∑√√»πåæ∫«à“ silicone “¡“√∂ºà“π‡¢â“‰ª∂÷ß terminal bronchiole ·≈– respiratory bronchiole (Figure 5) º≈ cast ∑àÕ∑“߇¥‘π≈¡¢Õߪե ∑’ˇµ√’¬¡¥â«¬ resin ¡’≈—°…≥–·¢Áß · ¥ß≈—°…≥– 3 ¡‘µ‘ µ“¡√Ÿª√à“ߢÕß ªÕ¥·≈–·¢π߬àÕ¬¢Õß∑àÕ≈¡∑’Ë¡’¢π“¥‡≈Á°‰¥â (Figure 1) ªÕ¥∑’Ë©’¥ resin ‡¢â“∑àÕ≈¡·≈–‡ âπ‡≈◊Õ¥ “¡“√∂ · ¥ß§«“¡ —¡æ—π∏å√–À«à“ß·¢πß∑àÕ≈¡°—∫‡ âπ‡≈◊Õ¥ ‚¥¬æ∫«à“‡ âπ‡≈◊Õ¥®–·µ°·¢πß —¡æ—π∏å°∫— ·¢πß∑àÕ≈¡ (Figure 2) resin cast ¢Õߪե¡’¢âÕ‡ ’¬§◊Õ ‡ª√“– ·µ°À—°‰¥âßà“¬ µâÕß∫√√®ÿ„π°≈àÕß plastic ¢≥–π”¡“ »÷°…“ «‘∏’‡µ√’¬¡ resin cast «‘∏’π’È„™â resin ∑’Ë¡’ à«π º ¡¢Õßµ—«‡√àߪؑ°‘√‘¬“„π resin Õ¬Ÿà·≈â« ¥—ßπ—Èπ¢—Èπ µÕπ®÷ßßà“¬°«à“°“√„™â crystic resin ™π‘¥∑’˵âÕß„ à∑—Èß µ—«‡√àߪؑ°‘√‘¬“ ·≈– hardener √«¡∑—ÈßµâÕß§«∫§ÿ¡ Õÿ≥À¿Ÿ¡¢‘ Õß resin „Àâ‡À¡“–∑’ÕË ≥ ÿ ¿Ÿ¡‘ 20°C-24°C ¢≥– ‡µ√’¬¡ cast (Cook and Tompsett, 1968; Tompsett, 1956) cast ¢Õß∑àÕ∑“߇¥‘π≈¡¢Õߪե∑’ˇµ√’¬¡¥â«¬ silicone æ∫«à“∂⓪≈àÕ¬„ÀâªÕ¥·Àâß®π‡°‘π‰ª¢≥–Õ—¥ silicone ªÕ¥·≈–∑àÕ≈¡®–·µ° ∑”„Àâ silicone ‰¡à “¡“√∂ºà“π‡¢â“‰ª„π∑àÕ≈¡∑’¡Ë ¢’ 𓥇≈Á°‰¥â ∑—ßÈ π’‡È æ√“– silicone ∑’Ë„™â„π§√—Èßπ’È ‡ªìπ silicone ∑’Ë¡’§«“¡Àπ◊¥ Ÿß‰¡à‡À¡◊Õπ°“√„™â silicone ∑’Ë¡’§«“¡Àπ◊¥µË”´÷Ëß 365 Figure 1 Resin cast of dog’s lung. A. Trachea B. Primary bronchi C. Secondary bronchi D. Bronchial tree 366 «. ‡°…µ√»“ µ√å («‘∑¬.) ªï∑’Ë 33 ©∫—∫∑’Ë 3 Figure 2 Resin cast of dog’s lung. A. Aorta B. Left auricle C. Coronary artery D. Left ventricle E. Pulmonary vein (carry oxygenated blood from the lung) F. Trachea G. Brochial tree Figure 3 Silicone cast of dog’s lung. A. Trachea B. Primary bronchi C. Secondary bronchi D. Bronchial tree «‘®“√≥å °“√‡µ√’¬¡ cast ∑àÕ∑“߇¥‘π≈¡¢Õߪե¥â«¬ resin À≈àÕ„ ∑’Ë„™â„πß“πÕÿµ “À°√√¡ ·≈– silicone ∑’Ë¡’ §«“¡Àπ◊¥ Ÿß∑’Ë„™â„π°“√Õÿ¥ ¡“πÕÿª°√≥å “¡“√∂ „Àâµ—«Õ¬à“ß ∑’Ë¡’§«“¡≈–‡Õ’¬¥‰¥â¥’‡∑à“°—∫ resin ·≈– silicone ™π‘¥µà“ß Ê ∑’ˉ¥â‡§¬∑¥≈Õß„™â¡“°àÕπ resin ∑’Ë„™â„π°“√∑¥≈Õß§√—Èßπ’È ¡’√“§“∂Ÿ° ∑”‰¥âßà“¬‡æ√“– ‰¡àµÕâ ߺ ¡µ—«‡√àߪؑ°√‘ ¬‘ “ ·≈–‰¡àµÕâ ß§«∫§ÿ¡Õÿ≥À¿Ÿ¡‘ à«π silicone ∑’Ë„™â„π§√—Èßπ’È·¡â®–„™â silicone ∑’Ë¡’ §«“¡Àπ◊¥ Ÿß °Á “¡“√∂º≈‘µ cast ∑’Ë¡’§«“¡≈–‡Õ’¬¥ ‰¥â‡∑à“ silicone ∑’Ë¡’§«“¡Àπ◊¥µË” ∑’Ë¡’√“§“ Ÿß°«à“ ·≈–µâ Õ ßº ¡µ— « ∑”·¢Á ß „Àâ ‰ ¥â — ¥ à « π∑’Ë ∂Ÿ ° µâ Õ ß πÕ°®“°π’Ȭ—ß “¡“√∂π” resin ·≈– silicone ∑—Èß 2 ™π‘¥∑’Ë„™â„π°“√∑¥≈Õßπ’È𔉪‡µ√’¬¡ cast ¢Õß Õ«—¬«–Õ◊Ëπ Ê ‰¥â cast ∑’ˇµ√’¬¡¥â«¬ resin ¡’≈—°…≥– ·¢Áß·≈–‡ª√“– ‚¥¬ª≈“¬∑àÕ∑’¡Ë ¢’ 𓥇≈Á°¡—°®–À—° à«π cast ∑’ˇµ√’¬¡¥â«¬ silicone ¡’§«“¡ÕàÕπ·≈–¬◊¥À¬ÿàπ‚¥¬ silicone “¡“√∂ºà“π‡¢â“‰ª∂÷ß√–¥—∫ terminal brochiole ·≈– respiratory bronchiole ¥—ßπ—Èπ°“√‡µ√’¬¡ cast “À√—∫»÷°…“·≈– “¡“√∂®—∫µâÕ߉¥â §«√„™â silicone cast «. ‡°…µ√»“ µ√å («‘∑¬.) ªï∑’Ë 33 ©∫—∫∑’Ë 3 Figure 4 Silicone cast of lungs. A. Cat’s lung B. Dog’s lung C. Goat’s lung §”¢Õ∫§ÿ≥ ¢Õ¢Õ∫§ÿ≥ Dr. Cathy Schaap ¿“§«‘™“ °“¬«‘¿“§»“ µ√å §≥– —µ«·æ∑¬»“ µ√å University of Prince Edward Island, Canada ∑’Ë„Àâ§”·π–π” °“√∑” silicone cast ·≈–¢Õ¢Õ∫§ÿ≥ §ÿ≥¥‘‡√° √ÿ®√‘ µ— π«√“°√ ∑’˙૬∂à“¬¿“æª√–°Õ∫ ‡Õ° “√Õâ“ßÕ‘ß Cook, W. R. and D. H. Tompsett. 1968 . Anatomical models prepared by corrosion casting. Med. Biol. III. 18 : 183-188. Hagens, GV., K. Tiedemann, and W. Kriz. 1987. Current potential of plastination. Anat. Embryol. 175 : 411-421. Henry, R.W. 1992. Silicone Pulmonary vascular casts with atlached tracheobronchial casts. J. Int. Soc. Plastination 6 : 41-44. Henry, R.W. 1992 . Silicone tracheobronchial casts. 367 Figure 5 Light micrograph of silicone cast (goat’s lung) showing bronchiole (X 40) A. Terminal bronchiole B. Respiratory bronchiole C. Alveoli J. Int. Soc. Plastination 6 : 38-40. Henry, R.W. and J. Butler. 1990 . Room-temperature çForced airé impregnation of dried lungs with S10/S3-xylene mix. J. Int. Soc. Plastination 4 : 14-24. Liumsiricharoen, M., S. Kamol, and C. Apuntree.1995. Comparative anatomical study of kidney using corrosion cast technique and latex injection technique. Kasetsart J. (Nat. Sci.) 29 : 339-344. Nettum, J.A. 1995. Combined vascular-bronchoalveolar casting using formalin - fixed canine lungs and a low viscosity silicone rubber. Anat. Rec. 243 : 479-482. Tompsett, D.H. 1956. Anatomical Techniques. E. and S. Livingstone, Ltd. London. 240 p. Tucker, Jr. J.L. and E.T. Krementz. 1957. Anatomical corrosion specimens. Anat. Rec. 127 : 655-676. «—π√—∫‡√◊ËÕß : 15 ¡’.§. 42 «—π√—∫µ’æ‘¡æå : 24 .§. 42