인체 공수병의 병리 - 병독학적으로 확인된 인체공수병 일증례의 병리학적 검색- : Pathology of Human Rabies

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이성수; 지제근

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서울대학교 의과대학
Seoul J Med, Vol.1 No.1, pp. 101-105
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
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
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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. 01 No.1 (1960)
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