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방사선 조사가 백서 구강점막에 미치는 영향에 관한 실험적 연구

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[한글] 방사선 치료는 악성종양 치료법으로 광범위하게 사용되고 있는데, 저자는 두경부 악성 종양 치료를 위한 방사선조사가 정상 구강점막에 미치는 영향을 관찰하기 위하여, 생후 3 ∼4개월된 체중 180gm 내외의 백서(Sprague-Dawley strain) 64마리를 대조군, 실험군 제 Ⅰ,Ⅱ,Ⅲ군으로 각각 16마리씩 나누어, 1.25 MeVRAC-120 Cobalt 60치료기를 사용하여 조 사거리 100cm에서 매분당 62.1rads로, 제Ⅰ군에서는 총조사량 4800rads로써 매수 1200rad s 씩 분할조사 시켰고, 제Ⅱ군은 단회조사로 1500rads, 제Ⅲ군 역시 단회조사로 2000rads 을 조사시킨후 조사완료후 1일, 3일, 5일, 7일, 10일, 14일, 21일, 28일에 백서를 희생시 켜, 적출한 점막조직을 10% Formalin 용액에 고정후, Paraffin에 포매한 후, 6μ 두께로 연속절편하여 Hematoxylin-Eosin에 중염색한후 광학현미경으로 검경한 결과 다음과 같은 조직학적인 결론을 얻었다. 1. 전 실험군에서 상피층의 변화로서 각화증(Hyperkeratosis), 극세포증(acantthosis), 이형성(Dysplasia) 등의 소견을 보였다. 2. 상피층의 변화는 조사완료후 3일째 가장 심했으며 이형성의 심한 정도로 보아 전암 병소 간주되었다. 3. 고유층(Lamina Propria)의 변화로는 부종(Edema), 혈관충혈(Congestion), 염증세포 침윤(Infiltration of inflammatory cells) 등을 볼 수 있었고, 5일 이후에는 현저히 감 소하였으며, 대신 섬유화(fibrosis)로 대치되었다. 4. 실험군 제Ⅰ군의 1일, 3일째와 제Ⅱ군, Ⅲ군의 5일째에서 Rete 걍ㅎㄷ의위축(Flatte ning of Rete ridge)을 보였고 이 경우에는 표면에 괴사(Necrosis)를 동반하였으며 중등 도의 이형성이 관찰되었다. 5. 상피층과 고유층의 변화는 제Ⅰ군에서 가장 미약했으며 Ⅱ군, Ⅲ군은 유사하였으나 특히Ⅲ군에서 이형성의 회복이 지연되는 소견을 얻었다.
[영문] This study was undertaken to observe the histologic changes in oral mucosa of the albino rats when exposed to single and fractionated dose of Cobalt 60 irradiation. Sixty four albino rats of a Sprague-Dawley strain, weighing approximately 180 gm, about 3 to 4 months old, were divided into the control group and 3 experimental groups. Irradiation was carried out using 1.25 MeV RAC-120 Cobalt 60 Teletherapy Unit with exposure dose rate 62.1 rads/min., in TSD 100 cm. In experimental groups, group I was irradiated 1200 rads weekly of total dose 4800 rads for a period of 4 weeks, Group Ⅱ was irradiated 1500 rads with single dose and Group Ⅲ was irradiated 2000 rads with single dose. The animals were sacrificed at 1st, 3rd, 5th, 7th, 10th, 14th, 21th and 28th days after each irradiations. Each specimens were fixed with 10% Formalin solution. The specimen was embedded in paraffin and sectioned serially 6μ in thickness. All slides were stained with Hematoxylin-Eosin and examined in the usual methods. The result were as follows, 1. The histologic changes of hyperkeratosis, acanthosis and epithelial dysplasia were seen in the superficial epithelical layer of all ecperimental groups. 2. The most severe changes of superficial epithelial layer showed in the 3rd day of Group Ⅰ,Ⅱ,Ⅲ and the findings of these severe epithelial changes thoutht to be precancerous lesion. 3. The hystologic changes of edema, congestion and infiltration of inflammatory cells were particularly seen in the lamina propria. However, there was a less changing tendency to decrease in the following 5th day and replaced with fibrosis in this layer. 4. Flattening of Rate ridge was seen in the 1st, 3rd day of Group Ⅰ, 5th day of Group Ⅱ, Ⅲ, in this case, necrosis on superficial surface and moderate degree of dysplasia were observed. 5. Group Ⅰ was mildest in the changes of epitheial layer and lamina propria layer and Group Ⅱ, Ⅲ showed histopathologically very similar findings, but Group Ⅲ showed delayed recovery of epithelial changes to normal tissue than that of Group Ⅰ and Ⅱ.
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