백서에서의 세균내독소에 의한 전체적 SHWARTZMAN 반응의 병리조직학적 연구

Abstract

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 hon. 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