인체 공수병의 병리 - 병독학적으로 확인된 인체공수병 일증례의 병리학적 검색-

Abstract

Pathologic-anatomic and pathologic-histologic studies were made on one autopsy case of human rabies which was virologicallyexamined and confirmed at the U.S: 406 Medical General Laboratory. The following observation and conclusion were made. The heart showed marked capillary congestion and minimal interstitial infiltration of lymphocytes and large mononuclears along with cloudy swelling of heart muscle cells. The lungs showed moderate interstial pneumonitis that probably was superimposed by secondary :bacterial infection. The liver showed marked sinusoidal and capillary congestion accompanied by cloudy swelling of liver cells .. The spleen showed acute splenitis with diffuse proliferation of reticulo-endothelial cells in the red and white pulp. The adrenal glands showed degenerative changes in cortical cells especially in cells of zona glomerulosa and in those of outer layer of zona fasciculata, along with capillary and sinusoidal congestion. The kidneys showed slight interstitial cellular infiltration and cloudy swelling of tubular epithelial cells , particularly of convoluted tubules. Lymph nodes showed non-suppurative inflammatory reaction with marked proliferation of reticulo'endothelial cells. Lymphatic tissues in the intestinal wall revealed Very similar histological changes to those of the lymph nodes and splenic lymphoid follicles. Neuropathological changes were characterized by diffuse exudative, non-suppurative inflammation of the cerebrum, cerebellum, brain stem , spinal cord and leptomeninges, in pan-encephalo-myelic pattern with different degree of severity. Vascular congestion, edema, petechial hemorrhages and perivascular cuffing by lymphocytes and large monouclears were observed. Degenerative changes in nerve cells , including cytoplasmic and nuclear swelling, shrinkage of cytoplasm and nucleus.· chromatolysis of varying severity. karyorrhexis etc. were observed. Large or focal areas of necrosis or demyelinization were observed, that were usually characterized by localized infiltration of inflammatory cells including microglias, large mononuclears and Iymphocytes , and by some increase of astrocytes and 이igodendrog l ia s . Aside from these glial nodes in the grey and white matter. there were also observed diffuse but slight increase of glia cells and infiltration of [lymphocyte. and large mononuclears. In relativelyless damaged nerve cells , Negri bodies or Negri body-like structures were observed. These intracellular inclusions were spherical or ovoid. eosinophilic. homogeneous and amorphous, . usually intracytoplasmic, counted one or more in one nerve cell , and were prominently observed in the temporal lobes (or hippocampal gyri) . Minimal but definite exudative cerebro-spinal leptomeningitis was characterized by infiltration of lymphocytes and large mononuclears. Neuropathological changes in this case of human rabies appeared to have included almost identical neuropathological changes previously described. Authors assume anatomical changes in the viscera including the central nervous system in human rabies appear to be very similar qualitatively to those of other types of viral encephalomyelitides including that of Japanese type B. although they were quantitatively less severe as compared to those of the Japanese type B encephalitis. Neuropathological changes observed in brains of albino mice, inoculated with 10% saline suspension of brain tissue of this patient and then:successively for 14 generations, were very similar qualitatively to those in the patient