백서에서의 세균내독소에 의한 전체적 SHWARTZMAN 반응의 병리조직학적 연구 : A histopathologic study on the generalized Shwartzman reaction induced by bacterial endotoxin in rats

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서울대학교 의과대학
Seoul J Med, Vol.19 No.3, pp. 112-128
To study the generalized Shwartzman reaction induced
by endotoxin injection in the rats. 48 Fisher and
35 Sprague-Dawley strain rats were observed for
their histopathologic findings of the tissues. 12~24
hours later the i. v. E. coli lipopolysaccharide 0127:
B, (0. 3~3. Omg single or twice 24 hours apart) bollus
injection. In the Sprague·Dawley rats , prothrombin
time. partial thromboplastin time and plasma fibrinogen
levels were determined after endotoxin injections in
the blood obtained by the cardiac puncture.
Following were the results:
1. Main histopathologic findings observed in this
particular study were those of adrenal cortical
infarction/necrosis. focal necrosis and/or diffuse or
focal hemorrhage of the liver and lungs.
2. Shwartzman reaction of the rats was more enhaneed
in the pregnant rats than the nonpregnant rats.
and estrogen pretreatment failed to enhance the reac
3. There were no differences between the Fisher
and Sprague-Dawley rats in their generalized Shwartzman
reactions induced by endotoxin
4. It was unable to detect the charachteristic findings
of the generalized Shwartzman reaction , bilateral
cortical necrosis of the kindeys and the βbrin thrombi
in these rats, although substantial evidence suggested
the presence of the generalized Shwartzman reaction.
5. In two pregnant Sprague-Dawley rats. trealed
with endotoxin. focal pituitary necrosis was observed.
6. 2~3 hours later the endotoxin injection. prothrombin
time , partial thromboplastin time and plasma
fibrinogen levels were prolonged or decreased markedly
in the pregnant Sprague-Dawley rats , suggesting
the picture of diffuse intravascular coagulation , but
the prothrombin time and partialthromboplastin time
were moderately prolonged in the nonpregnant rats
and the plasma fibrinogen levels were not altered in
these rats.
These results suggest that the main feature of the
generalized Shwartzman reaction in the rats, especially
in the susceptible pregnant rats , were adrenal
cortical infarction, focal or diffuse hemorrhagic neerosis
of the liver and the lungs , sparing the kidneys ,
where characteristic findings usually occur in other
animals. Associated coagulation abnormalities in this
reaction suggest the presence of disseminated intra
vascular coagulation.
Adrenal cortical necrosis and the alterations of the
pituitary gland observed in this experiment suggest
the possible implication of the generalized Shwartzman
reaction in the Waterhouse-Friderichsen syndrorne
in man and probably in the Sheehans syndrome
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 19 No.3 (1978)
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