自己血栓の静脈内1回注入を受けたウサギの肺血栓塞栓症特に初期病変の発生病理について
新鮮人工自己血栓 (50～100mg) を細切して耳静脈へ1回静注したウサギ55羽について, 24時間以内の初期肺病変を検索した. 塞栓血栓は外径70～800μmの肺小動脈に存在し, 30分後すでに血栓中のフィブリンは密に集簇し, また血小板が血管壁内皮細胞傷害部に粘着している. 小動脈内白血球集積は2時間後より認められ, 10時間後に極期に達したが, 24時間後には減少した. また血管周囲結合織における浮腫と炎症性細胞浸潤が認められた. 一方メチルプレドニゾロン40mg/kg 1回静注40分後, またはインドメタシン5mg/kg 1回静注15分後の自己血栓注入群では, 肺血管内白血球集積は抑...
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| Published in | 日本胸部疾患学会雑誌 Vol. 23; no. 10; pp. 1144 - 1157 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | English Japanese |
| Published |
社団法人 日本呼吸器学会
25.10.1985
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0301-1542 1883-471X |
| DOI | 10.11389/jjrs1963.23.1144 |
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| Abstract | 新鮮人工自己血栓 (50～100mg) を細切して耳静脈へ1回静注したウサギ55羽について, 24時間以内の初期肺病変を検索した. 塞栓血栓は外径70～800μmの肺小動脈に存在し, 30分後すでに血栓中のフィブリンは密に集簇し, また血小板が血管壁内皮細胞傷害部に粘着している. 小動脈内白血球集積は2時間後より認められ, 10時間後に極期に達したが, 24時間後には減少した. また血管周囲結合織における浮腫と炎症性細胞浸潤が認められた. 一方メチルプレドニゾロン40mg/kg 1回静注40分後, またはインドメタシン5mg/kg 1回静注15分後の自己血栓注入群では, 肺血管内白血球集積は抑制されたが, 間質浮腫の減少は極めて少ない. したがって肺血栓塞栓症の初期病変における間質浮腫発生の主役は, 注入血栓による血管内皮細胞の機械的傷害と, 塞栓血栓中のフィブリンおよび血小板から放出された血管透過性因子で, 白血球の役割は付加的なものであろうと推論した. |
|---|---|
| AbstractList | 新鮮人工自己血栓 (50～100mg) を細切して耳静脈へ1回静注したウサギ55羽について, 24時間以内の初期肺病変を検索した. 塞栓血栓は外径70～800μmの肺小動脈に存在し, 30分後すでに血栓中のフィブリンは密に集簇し, また血小板が血管壁内皮細胞傷害部に粘着している. 小動脈内白血球集積は2時間後より認められ, 10時間後に極期に達したが, 24時間後には減少した. また血管周囲結合織における浮腫と炎症性細胞浸潤が認められた. 一方メチルプレドニゾロン40mg/kg 1回静注40分後, またはインドメタシン5mg/kg 1回静注15分後の自己血栓注入群では, 肺血管内白血球集積は抑制されたが, 間質浮腫の減少は極めて少ない. したがって肺血栓塞栓症の初期病変における間質浮腫発生の主役は, 注入血栓による血管内皮細胞の機械的傷害と, 塞栓血栓中のフィブリンおよび血小板から放出された血管透過性因子で, 白血球の役割は付加的なものであろうと推論した. |
| Author | 坂田, 一美 |
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| Copyright | 日本呼吸器学会 |
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| References | 34) Pingleton, W. W., Coalson, J. J., Hinshaw, L. B. & Guenter, C. A.: Effects of steroid pretreatment on development of shock lung. —Hemodynamic, respiratory and morphologic studies. Lab. Invest., 27: 445, 1972. 7) Tahamont, M. V. & Malik, A. B.: Granulocytes mediates the increase in pulmonary vascular permeability after thrombin embolism. J. Appl Physiol: Respirat Environ. Exercise Physiol., 54: 1489, 1983. 33) Sun, C. -H., Phalla, N. S. & Olson, R. E.: Formation of gigantic mitochondria in hypoxic isolated perfused rat hearts. Experimentia, 25: 763, 1969. 26) Johnson, A. & Malik, A. B.: Effect of graunlocytopenia on extravascular lung water content after microembolization. Am. Rev. Respir. Dis., 122: 561, 1980. 29) Henson, P. M.: Pathologic mechanism in neutrophil-mediated injury. Am. J. Pathol., 68: 593, 1972. 21) Majno, G., Shen, S. M. & Leventhal, M.: Endothelial contraction induced by histamine type mediators: An electron microscopic study. J. Cell Biol., 42: 642, 1969. 10) Hellstrom, H. R. & Fisher, E. R.: Comparison of pathologic effects of experimental thromboembolism. Effects in peripheral and pulmonary arteries of the rabbit. Arch. Pathol. Biol. Med., 80: 521, 1965. 27) Flick, M. R., Perel, A. & Staub, N. C.: Leukocytes are required for increased lung microvascular permeability after microembolization in sheep. Circ. Res., 48: 344, 1981. 3) Yamamoto, M.: Pathology of experimental pulmonary bone marrow embolism I. Initial lesions of the rabbit lung after intravenous infusion of allogeneic bone marrow with special reference to its pathogenesis. Acta Path. Jpn., 35: 45, 1985. 40) Nakano, J. & McCloy, R. B. Jr.: Effects of indomethacin on the pulmonary vascular and air way resistance responses to microembolization. Proc. Soc. Exp. Biol. Med., 143: 218, 1973. 37) Skubitz, K. M., Craddock, P. R., Hammerschmidt, D. E. & August, J. T.: Corticosteroids block binding of chemotactic peptide to its receptor on granulocytes and cause disaggregation of granulocyte aggregates in vitro. J. Clin. Invest., 68: 13, 1981. 28) Staub, N. C.: Pulmonary edema due to increased microvascular permeability to fluid and protein. Circ. Res., 43: 143,, 1978. 4) Geer, J. C., Glass, B. A. & Albert, H. M.: Pulmonary vascular lesions in the dog produced by autogenous clot embolism. Exp. Mol. Pathol. 4: 391 1965. 1) Lindquist, O., Rammer, L. & Saldeen, T.: Pulmonary insufficiency, microembolism and fibrinolysis inhibition in a post-traumatic autopsy material. Acta Chir. Scand., 138: 545, 1972. 8) Chandler, A. B.: In vitro thrombotic coagulation of the blood. A method for producing a thrombus. Lab. Invest., 7: 110, 1958. 35) Hammerschmidt, D. E., Haris, P. M., Wayland, J. H. & Jacob, H. S.: Intravascular granulocyte (PMN) aggregation in live animals: A complement (C)-mediated mechanism of ischemia. Blood. 52 (Suppl): 125, 1978. 32) Albring, M., Radsak, K. & Thoenes, W.: Giant mitochondria II. Induction of matrix enriched megamitochondria in mouse liver parenchymal cells by ethidium bromide. Virchows. Arch. Abt. B. Zellpath. 14: 373, 1973. 24) 坂田一美, 山本雅博, 永原貞郎: 肺微小塞栓症の病理. 第9報, ザイモザン静注によるウサギ肺の変化―特にメチルプレドニゾロン前投与の影響について―. 日胸疾会誌, 22 (増): 173, 1984. 15) 長田博: 組織トロンボプラスチン静注後にみられる血栓塞栓性肺疾患に関する研究―成人呼吸促迫症候群 (ARDS) との関連性について―. 日胸疾会誌, 19: 605, 1981. 17) Ohkuda, K., Nakahara, K., Weidner, W. J., Binder, A. & Staub, N. C.: Lung fluid exchange after uneven pulmonary obstruction in sheep. Circ. Res.,43: 152, 1978. 18) Saldeen, T.: The microembolism syndrome. Microvasc. Res., 11: 227, 1976. 25) Müller-Berghaus, G.: Übersichten Beziehungen zwishen Komplement und Blutgerinnung. Klin. Wochenschr, 55: 663, 1977. 31) 坂田一美, 山本雅博, 永原貞郎: 出血性ショックにおける肺の病理―出血で死亡した29剖検例の肺病変の観察と実験的出血性ショック肺―. 日胸疾会誌, 20: 214, 1982. 6) Horie, A., Kurozumi, T., Morimatsu, M. & Tanaka, K.: Ultrastructural study of experimental thrombosis in pulmonary muscular arteries of rabbits. Acta Path. Jpn.,24: 169, 1974. 9) Hand, R. A. & Chandler, A. B.: Atherosclerotic metamorphosis of autologous pulmonary thromboemboli in the rabbit. Am. J. Pathol., 40: 469, 1962. 23) 山本雅博, 永原貞郎, 豊田博: 肺微小塞栓症の病理. 第5報, ウサギの実験的骨髄塞栓症の初期肺病変としての血管内白血球集積―特に塩酸ジフェンヒドラミン (抗ヒスタミン剤) 前投与の影響―. 日病会誌, 71: 239, 1982. 14) Heard, B. E.: An experimental study of thickening of the pulmonary arteries of rabbits produced by the organization of fibrin. J. Path. Bact, 64: 13, 1952. 22) Craddock, P. R., Fehr, J., Dalmasso, A. P., Brigham, K. L. azd Jacob, H. S.: Hemodyalisis leukopenia: Pulmonary vascular leukostasis resulting from complement activation by dialyzer cellophane membrane. J. Clin. Invest., 59: 879, 1977. 12) Shen, T. -Y. & Winter, C. A.: Chemical and biological studies of indomethacin sulindac and their analogs.In Happer, N. J. and Simmones, A. B. (Editors): Adv. in Drug Res. 12: 216, Academic Press, New York, 1977. 16) 井口千春, 河口幸博, 永原貞郎: 実験的羊水塞栓症における肺病変の形態学的観察, 日病会誌, 72: 233, 1983. 5) Barnard, P. J.: Experimental fibrin thromboembolism of the lungs. J. Path. Bact. 65: 129, 1953. 19) Malik, A. B.: Pulmonary microembolism. Physiol. Rev., 63: 1115, 1983. 11) Ardlie, N. G. & Schwartz, C. J.: Acomparison of the organisation and fate of autologous pulmonary emboli and of artificial plasma thrombi in the anterior chamber of the eye, in normocholesterolaemic rabbits. J. Path. Bact, 95: 1, 1968. 13) 竹内正: 腎内血管攣縮の形態学と腎内血行動態. 日病会誌, 63: 63, 1974. 36) Weiler, J. M. & Packard, B. D.: Methylprednisolone inhibits the alternative and amplification pathways of complement. Infect. Immun., 38: 122, 1982. 38) Lindsey, H. E. & Wyllie, J. H.: Release of prostaglandins from embolized lungs. Br. J. Surg., 57: 738, 1970. 2) Sandritter, W., Mittermayer, C., Riede, U. N., Freudenberg, N. azd Grimm, H.: Shock lung syndrome (A general review). Pathol. Res. Pract. 162: 7, 1978. 30) Sacks, T., Moldow, C. F., Craddock, P. R., Bowers, T. K. & Jacob, H. S.: Oxygen radicals mediate endothelial cell damage by complement-stimulated granulocytes. An in vitro model of immune vascular damage. J. Clin. Invest., 61: 1161, 1978. 20) Levy, S. E., Shapiro, B. J. & Simmons, D. H.: Pulmonary hemodynamics after autologous in vivo pulmonary thromboembolism. J. Appl. Physiol., 27: 53, 1969. 39) Oropeza-Rendon, R. L., Ernst, M., Schade, U., Rietschel, E. Th. & Fischer, H.: Activation of bone marrow-derived macrophages by repeated zymosan phagocytosis leads to enhanced prostaglandin synthesis. Immunobiol., 160: 208, 1981. |
| References_xml | – reference: 5) Barnard, P. J.: Experimental fibrin thromboembolism of the lungs. J. Path. Bact. 65: 129, 1953. – reference: 30) Sacks, T., Moldow, C. F., Craddock, P. R., Bowers, T. K. & Jacob, H. S.: Oxygen radicals mediate endothelial cell damage by complement-stimulated granulocytes. An in vitro model of immune vascular damage. J. Clin. Invest., 61: 1161, 1978. – reference: 18) Saldeen, T.: The microembolism syndrome. Microvasc. Res., 11: 227, 1976. – reference: 20) Levy, S. E., Shapiro, B. J. & Simmons, D. H.: Pulmonary hemodynamics after autologous in vivo pulmonary thromboembolism. J. Appl. Physiol., 27: 53, 1969. – reference: 12) Shen, T. -Y. & Winter, C. A.: Chemical and biological studies of indomethacin sulindac and their analogs.In Happer, N. J. and Simmones, A. B. (Editors): Adv. in Drug Res. 12: 216, Academic Press, New York, 1977. – reference: 17) Ohkuda, K., Nakahara, K., Weidner, W. J., Binder, A. & Staub, N. C.: Lung fluid exchange after uneven pulmonary obstruction in sheep. Circ. Res.,43: 152, 1978. – reference: 22) Craddock, P. R., Fehr, J., Dalmasso, A. P., Brigham, K. L. azd Jacob, H. S.: Hemodyalisis leukopenia: Pulmonary vascular leukostasis resulting from complement activation by dialyzer cellophane membrane. J. Clin. Invest., 59: 879, 1977. – reference: 36) Weiler, J. M. & Packard, B. D.: Methylprednisolone inhibits the alternative and amplification pathways of complement. Infect. Immun., 38: 122, 1982. – reference: 6) Horie, A., Kurozumi, T., Morimatsu, M. & Tanaka, K.: Ultrastructural study of experimental thrombosis in pulmonary muscular arteries of rabbits. Acta Path. Jpn.,24: 169, 1974. – reference: 2) Sandritter, W., Mittermayer, C., Riede, U. N., Freudenberg, N. azd Grimm, H.: Shock lung syndrome (A general review). Pathol. Res. Pract. 162: 7, 1978. – reference: 28) Staub, N. C.: Pulmonary edema due to increased microvascular permeability to fluid and protein. Circ. Res., 43: 143,, 1978. – reference: 35) Hammerschmidt, D. E., Haris, P. M., Wayland, J. H. & Jacob, H. S.: Intravascular granulocyte (PMN) aggregation in live animals: A complement (C)-mediated mechanism of ischemia. Blood. 52 (Suppl): 125, 1978. – reference: 26) Johnson, A. & Malik, A. B.: Effect of graunlocytopenia on extravascular lung water content after microembolization. Am. Rev. Respir. Dis., 122: 561, 1980. – reference: 37) Skubitz, K. M., Craddock, P. R., Hammerschmidt, D. E. & August, J. T.: Corticosteroids block binding of chemotactic peptide to its receptor on granulocytes and cause disaggregation of granulocyte aggregates in vitro. J. Clin. Invest., 68: 13, 1981. – reference: 21) Majno, G., Shen, S. M. & Leventhal, M.: Endothelial contraction induced by histamine type mediators: An electron microscopic study. J. Cell Biol., 42: 642, 1969. – reference: 13) 竹内正: 腎内血管攣縮の形態学と腎内血行動態. 日病会誌, 63: 63, 1974. – reference: 24) 坂田一美, 山本雅博, 永原貞郎: 肺微小塞栓症の病理. 第9報, ザイモザン静注によるウサギ肺の変化―特にメチルプレドニゾロン前投与の影響について―. 日胸疾会誌, 22 (増): 173, 1984. – reference: 25) Müller-Berghaus, G.: Übersichten Beziehungen zwishen Komplement und Blutgerinnung. Klin. Wochenschr, 55: 663, 1977. – reference: 14) Heard, B. E.: An experimental study of thickening of the pulmonary arteries of rabbits produced by the organization of fibrin. J. Path. Bact, 64: 13, 1952. – reference: 15) 長田博: 組織トロンボプラスチン静注後にみられる血栓塞栓性肺疾患に関する研究―成人呼吸促迫症候群 (ARDS) との関連性について―. 日胸疾会誌, 19: 605, 1981. – reference: 34) Pingleton, W. W., Coalson, J. J., Hinshaw, L. B. & Guenter, C. A.: Effects of steroid pretreatment on development of shock lung. —Hemodynamic, respiratory and morphologic studies. Lab. Invest., 27: 445, 1972. – reference: 39) Oropeza-Rendon, R. L., Ernst, M., Schade, U., Rietschel, E. Th. & Fischer, H.: Activation of bone marrow-derived macrophages by repeated zymosan phagocytosis leads to enhanced prostaglandin synthesis. Immunobiol., 160: 208, 1981. – reference: 1) Lindquist, O., Rammer, L. & Saldeen, T.: Pulmonary insufficiency, microembolism and fibrinolysis inhibition in a post-traumatic autopsy material. Acta Chir. Scand., 138: 545, 1972. – reference: 10) Hellstrom, H. R. & Fisher, E. R.: Comparison of pathologic effects of experimental thromboembolism. Effects in peripheral and pulmonary arteries of the rabbit. Arch. Pathol. Biol. Med., 80: 521, 1965. – reference: 31) 坂田一美, 山本雅博, 永原貞郎: 出血性ショックにおける肺の病理―出血で死亡した29剖検例の肺病変の観察と実験的出血性ショック肺―. 日胸疾会誌, 20: 214, 1982. – reference: 4) Geer, J. C., Glass, B. A. & Albert, H. M.: Pulmonary vascular lesions in the dog produced by autogenous clot embolism. Exp. Mol. Pathol. 4: 391 1965. – reference: 3) Yamamoto, M.: Pathology of experimental pulmonary bone marrow embolism I. Initial lesions of the rabbit lung after intravenous infusion of allogeneic bone marrow with special reference to its pathogenesis. Acta Path. Jpn., 35: 45, 1985. – reference: 7) Tahamont, M. V. & Malik, A. B.: Granulocytes mediates the increase in pulmonary vascular permeability after thrombin embolism. J. Appl Physiol: Respirat Environ. Exercise Physiol., 54: 1489, 1983. – reference: 40) Nakano, J. & McCloy, R. B. Jr.: Effects of indomethacin on the pulmonary vascular and air way resistance responses to microembolization. Proc. Soc. Exp. Biol. Med., 143: 218, 1973. – reference: 9) Hand, R. A. & Chandler, A. B.: Atherosclerotic metamorphosis of autologous pulmonary thromboemboli in the rabbit. Am. J. Pathol., 40: 469, 1962. – reference: 29) Henson, P. M.: Pathologic mechanism in neutrophil-mediated injury. Am. J. Pathol., 68: 593, 1972. – reference: 8) Chandler, A. B.: In vitro thrombotic coagulation of the blood. A method for producing a thrombus. Lab. Invest., 7: 110, 1958. – reference: 16) 井口千春, 河口幸博, 永原貞郎: 実験的羊水塞栓症における肺病変の形態学的観察, 日病会誌, 72: 233, 1983. – reference: 32) Albring, M., Radsak, K. & Thoenes, W.: Giant mitochondria II. Induction of matrix enriched megamitochondria in mouse liver parenchymal cells by ethidium bromide. Virchows. Arch. Abt. B. Zellpath. 14: 373, 1973. – reference: 23) 山本雅博, 永原貞郎, 豊田博: 肺微小塞栓症の病理. 第5報, ウサギの実験的骨髄塞栓症の初期肺病変としての血管内白血球集積―特に塩酸ジフェンヒドラミン (抗ヒスタミン剤) 前投与の影響―. 日病会誌, 71: 239, 1982. – reference: 11) Ardlie, N. G. & Schwartz, C. J.: Acomparison of the organisation and fate of autologous pulmonary emboli and of artificial plasma thrombi in the anterior chamber of the eye, in normocholesterolaemic rabbits. J. Path. Bact, 95: 1, 1968. – reference: 33) Sun, C. -H., Phalla, N. S. & Olson, R. E.: Formation of gigantic mitochondria in hypoxic isolated perfused rat hearts. Experimentia, 25: 763, 1969. – reference: 19) Malik, A. B.: Pulmonary microembolism. Physiol. Rev., 63: 1115, 1983. – reference: 38) Lindsey, H. E. & Wyllie, J. H.: Release of prostaglandins from embolized lungs. Br. J. Surg., 57: 738, 1970. – reference: 27) Flick, M. R., Perel, A. & Staub, N. C.: Leukocytes are required for increased lung microvascular permeability after microembolization in sheep. Circ. Res., 48: 344, 1981. |
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| Snippet | 新鮮人工自己血栓 (50～100mg) を細切して耳静脈へ1回静注したウサギ55羽について, 24時間以内の初期肺病変を検索した. 塞栓血栓は外径70～800μmの肺小動脈に存在し, 30分後すでに血栓中のフィブリンは密に集簇し, また血小板が血管壁内皮細胞傷害部に粘着している.... |
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| SubjectTerms | ウサギ肺 初期病変 発生病理 肺血栓塞栓症 自己血栓 |
| Title | 自己血栓の静脈内1回注入を受けたウサギの肺血栓塞栓症特に初期病変の発生病理について |
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| ispartofPNX | 日本胸部疾患学会雑誌, 1985/10/25, Vol.23(10), pp.1144-1157 |
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