(The) experimental studies on the influence of testicles upon allergic changes in the stomach
성인 특발성 혈소판감소성 자반증에 대한 치료는 일반적으로 부신피질호르몬제를 사용하며, 이에 반응이 없거나 생리적 요구량 이상의 용량이 장기간 필요한 경우 또는 재발이 빈번한 경우에는 비절제술을 시행한다. 비절제수술에도 불구하고 호전이 되지 않는 경우에는 다시 부신피질호르몬을 투여하거나, 면역억제제, 면역글로블린 및 기타의 방법으로 치료를 하게 된다.
저자는 성인 특발성 혈소판감소성 자반증 환자에 대한 비절제술의 효과를 검토하고자 1970년 1월부터 1984년 1월까지 본 병원 내과에 내원하여 비절제술을 받았던 15예의 성인 특발성 혈소판감소성 자반증 환자에 관한 임상적 고찰을 하여 다음과 같은 결과를 얻었다.
초진시 연령분포는 14∼49세로 평균 25,5세였고 남녀비는 1:2.8로서 여성에서 많았다.
초진시 혈소판수는 4,500∼91,000/㎣로 평균 35,OOO/㎣(중앙치 28,000/㎣)이었고, 주소는 피하출혈, 비출혈, 치주출혈. 혈뇨 그리고 발치후 지속된 치주출혈의 순이였다.
비절제술을 시행하게된 적응증으로는 부신피질호르몬에 반응이 없었던 경우가 8예, 그리고 생리적 요구량이상의 부신피질호르몬이 장기간 요구되었던 경우와 재발이 빈번하였던 경우가 7예였다.
증세 출현으로부터 비절제술을 시행하기까지의 기간은 1개월에서 7년까지로 평균 22개월(중앙치 7개월)이었다.
수술직전의 혈소판치는 5,000∼96,000/㎣로 평균 41,200/㎣(중앙치 28,000/㎣)이었고, 수술직후 18,000∼206,O000/㎣으로 평균 147,000/㎣(중앙치 120,000/㎣)이었으며 수술후 150,000/㎣이상으로 되는데 소요된 기간은 0∼9일로 평균 2.6일이었다.
수술후 반응으로서는 완전관해가 9예(60%)이었고, 나머지 6예중 부신피질호르몬 및 면역억제제의 사용으로 2예는 완전관해가 되었으며, 3예는 호반응을 보였으나, 1예에서는 모든 치료에 반응하지 않았다.
이상의 결과로 성인 특발성 혈소판감소성 자반증의 치료로 비절제술의 효과는 외국의 결과와 비교하여 차이를 찾아볼 수 없었으며, 수술후 반응이 없었던 예에서도 부신피질호르몬 및 면역억제제로 대부분에서 좋은 효과가 있었기에 앞으로 성인특발성 혈소판감소성 자반증의 치료에 좋은 성적을 기대할 수 있을 것이다.
There have been numbers of experimental and clinical investigation upon the influence of various endocrine organs to a production of allergic changes. Although opinions vary among workers as to the effects of various hormones on allergic phenomenon,neverthless,it is generally agreed that there is a significant influence of endocrine organs on the production of allergic changes.
The present study is to investigate various effects and influences of testis; the main source of androgenic hormone,upon experimental allergic inflammation of stomach,since there have been no such previous reports on this particular subject.
Materials and Methods
1.Normal healthy rabbits weighing.1.6kg.to 2.0kg.were used for the experiment.
They were fed with ordinary rabbit diet in addition to an occasional fresh vegetable feedigns.
2.Normal horse serum produced by R.O.K.A. central laboratory was used as the antigen.
3.The testicles used for transplantation were taken from normal healthy rabbits weighing around 2.0kg.The removed testicles were rised in normal saline.
They were prepared immediately before transplantation
For the production of allergic inflammation in the stomach,normal horse serum 1.Oc.c.per kg.body weight of rabbit was injected subcutaneously in the abdomen, once a day for four consecutive days.On the 15th day from the initial sensitization,
reinjection of horse serum 0.1c.c. per kg.body weight was made into the stomach wall. This procedure was carried out identically on four different group of rabbits prepared as follows.
1.The first group of rabbits represents the control.Production of allergic inflammation is carride out without any previous treatment.
2.The second group represents castrated rabbits.Allergic inflammation is produced as in the control group immediately after the castration.
3.The third group of rabbits were also castrated but waited for 90 days before the production of allergic inflammation.
4.The fourth group of rabbits were prepared similarly as the third group but on the 90th after castration,transplantation of fresh and intact testicle was made.Three weeks after the transplantation,allergic inflammation was similarly produced.
Each of these four different groups of rabbits was sacrificed on following intervals; 3 hours,6 hours,12 hours,24 hours,48 hours,72 hours,one weekx and 2 weeks.Stomach was removed and sectioned.Hematoxylin and Eosin stain,Van Gieson stain,Weigert's stain,Sudan III stains were carried out on each specimen.
1. Comparing the inflammatory changes between the first and second group,the allergic changes of stomach were more intense and prolonged in the second group than in the first group.
2. Among the four groups,the most severe and prolonged gross and microscopic changes of allergic inflammation in the stomach were noted in the third group.
3. The fourth group showed changes more than in the first and second group but less than the third group.
4 .From the data obtained above,it is evident that the removal of testicular hormone produced more intense and prolonge allergic inflammation than in the non-castrated animals.
5.In view of the fact that third group showed the most intense and prolonged allergic inflammatory changes,it is felt that the testicular hormone definitely restrained the allergic inflammatory changes in the stomach.
6.It is also felt that the behaviour of the fourth group can be interpreted as the phenomenon of reactivation of testicular hormone after transplantation and that prolonged absence of testicular hormone produced more severe inflammatory changes than in the second group.
7. From the results of these experiments,it is concluded that the testicular hormone definitely restrains the allergic changes in the stomach.