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감마선의 국소외부조사가 백서의 피부 창상치유에 미치는 영향

Other Titles
 Effect of local irradiation of gamma ray on healing skin wound on rat 
Issue Date
1983
Description
의학과/박사
Abstract
[한글] 피부에 창상이 초래되면 피하조직이나 창상주위의 결체조직이 섬유모세포로 분화증식하고 섬유모세포는 교원섬유의 교원분자를 합성하여 창상이 치유된다고 하였다(Ross 및 Benditt, 1961; Grillo 1963; Levenson 등, 1965). 대부분의 학자들은 창상피부장력 (breaking strength)은 섬유모세포의 수 및 교원질의 양과 서로 비례한다고 하였으며 (Howes, 1929) 백서에서 창상피부장력은 hydroxyproline의 양과 밀접한 관계가 있음을 보아 교원질이 창상피부장력의 기본이 됨을 시사하였다(Le venson등, 1965). 창상치유과정에 있어서 방사선 조사가 창상치유를 지연시키는 중요한 역활을 함은 널리 알려져 있으나 방사선의 성질, 조사량과 조사시기에 따라 반응이 달라 창상치유 촉진이나 지연등 일정치 않은 결과를 보고하였으며 (Nathanson, 1934; Pohle등, 1949; Grillo 및 Potsaid, 1961) 또한 창상치유 촉진 및 지연의 기전도 완전히 규명되어 있지 못하다. 이에 저자는 276마리의 백서의 대퇴부에 피부를 절개후 봉합하고 Co-60 Therapy Unit를 이용하여 감마선(gamma ray)을 조사하고 창상피부장력을 측정하며 광학 및 전자현미경을 이용 그 조직의 변화를 관찰함으로써 창상치유과정을 생리학적 및 형태학적으로 규명하고자 본 실험을 시도하였다. 실험동물로는 체중 150내지 200그람의 백서 76마리를 약 2주간 예비사육한 후 대조군으로 피부절개후 봉합하여 방사선 조사를 하지 않은 군과 실험군으로 감마선 600rad를 조사한 군과 1800rad를 조사한 군으로 구분하고 각 실험군은 수술직후 조사받은 군, 수술 48시간에 조사받은군, 수술후 4일에 조사받은군, 수술후 7일에 조사받은 네군으로 각각 나누었다. 방사선 조사는 Co-60 Therapy Unit를 사용하여 0.5cm의 조직등가물질을 대퇴부에 얹고 방광과 골반을 차폐후 실험에 따라 600r.와 1800r.를 각각 일회씩만 조사하였다. 모든 대조군 및 실험군은 수술후 1, 3, 7, 14, 21, 28일에 회생시켜 창상피부장력은 창상을 중심으로 한 1×2cm의 조직절편을 얻어 Polygraph Grass Model No.7을 이용 측정하였으며 조직 관찰은 10% 포르마린에 고정 후 파라핀에 포매하여 hematoxylin-eosin염색을 하였으며 전자현미경검사는 2% paraformaldehyde, 2.5% gluaraldehyde혼합고정액으로 관류 고정 후 osmium tetraoxide로 2시간 재고정하였다. 이를 alcohol로 탈수하여 Epon 812에 포매한 후 초박절편을 만들어 초산우라늄과 구연산연으로 이중 염색후 전자현미경 hitachi H-500형으로 관찰하였다. 관찰결과를 종합하면 1. 600r.의 감마선이 창상후 48시간 내에 조사되었을 때 창상후 3주까지는 창상피부장력이 감소하였으며 창상후 4주의 창상 피부장력은 대조군에서 보다 다소 높았다. 2. 600r.의 감마선이 창상후 4일후에 조사되었을 때 창상후 4주까지의 창상피부장력은 대조군과 차이가 없었다. 3. 1800r.의 감마선이 창상후 48시간내에 조사되었을 때 창상후 4주까지는 창상피부장력이 계속 감소하였으나 창상후 4일에 조사되었을 때는 창상후 3주까지는 감소하였고 창상후 4주에는 대조군의 장력으로 회복되었다. 또한 창상후 7일에 조사되었을 때는 창상후 4주까지 창상피부장력은 대조군과 차이가 없었다. 4. 창상후 감마선이 48시간내에 600r.가 조사되었을 때는 창상치유과정의 염증반응이 다소 억제되었으며 1800r.가 조사되었을 때는 창상치유과정의 염증반응, 육아조직형성 및 교뭔질형성에 모두 뚜렷한 억제를 보였다. 5. 600r.나 1800r.의 감마선이 창상후 48시간내에 조사되었을 때 창상후 7일의 섬유 모세포는 심한 변화를 보였다. 이상의 소견으로 미루어 창상후 48시간내에 600r.와 1800r.의 감마선의 국소외부조사는 백서의 피부창상치유를 억제함을 관찰하였다.
[영문] Ultimate response to tissue injury is repair by either parenchymal or connective tissue regeneration, and the most important component of dermal injury is collagen formation which unfortunately reaults into scar formation. Many attempts to minimize scar formation during the process of wound repair have been made and several agents have been in general proved to inhibit collagen formation. Irradiation is known to delay wound healing but the response of the dermal wound depends upon the dose, the properties and the time of irradiation(Harberland, 1929; Fukase, 1929; Pohle et al, 1949; Grillo and Potsaid, 1961). For example the small dose of irradiation accelerate the wound healing and the large dose of irradiation delay the wound healing. If the wound is irradiated after 4th postoperative day the irradiation has no effect on the wound healing. However, the mechanism and causes in the change of wound healing is not yet known. Present study is aimed to elucidate the effects of gamma ray on the wound healing as to the different dose and time of irradiation by the ways of breaking strength measurement, light and electron microscepic obaervations. A total of 276 rats was divided into three experimental groups. All animals were sustained skin incisions on the dorsal aspects of both thighs and the wounds were immediately closed with 4-0 black silk. First group as a control was composed of 36 rats. The second and third group as a irradiated casea ware given a dose of 600r. and 1800r. respectively of gamma ray. The second and third experimental groups were subdivided into 4 groups respectively according to the time of irradiation. In the first subgroup the wounds were irradiated immediately after the operation. In the second subgroup they were irradiated on 48 hours after the operation. In the third subgroup they were irradiated on 4th day after the operation. In the 4th subgroup they were irradiated on 7 days after the operation. Gamma ray irradiation was performed by Co-60 Therapy Unit(Model; RCA-120, Toshiba, Activity; 60 R/min) after covering the lower extremities with 0.5 cm tissue equivalant material and shielding pelvis and bladder. Animals were sacrificed on 1, 3, 7, 14, 21, 28 days after the operation and the specimen of strips sized 1×2 cm including the incision scar were obtained for the measurement of the breaking strength as well as for the light and electron microscopic studies. The measurement of the breaking strength of the skin strip was carried out by the use of force transducer with the recording of polygraph for permitting continuous monitering of a progressive increasing until the breaking of the skin. For the light microscopic study, hematoxyline-eosin and Masson's trichrome stains were used and for electron microscopic examinations routine uranyl acetate and lead citrate stainings were made. Hitachi(H-500) model electron microscope was used for the ultrastructual observations. The results were summerized as follows; 1. When 600r. of local irradiation of gamma ray was done within postoperative 48 hours the breaking strength of the incised skin wound was weaker than that of control until postoperative 3rd weeks but its breaking strength became stronger than that of control on postopertive 4th week. 2. The 600r. local wound irradiation of gamma ray had no effeot on the breaking strength for four weeks postoperatively when irradiated after 4th postoperative day. 3. When 1800r. of local irradiation of gamma ray was done within postoperative 48 hours, the breaking strength of the incised skin wound for four weeks postoperatively was weaker than that of control. Also its breaking strength was weaker than that of control until postoperative 3rd week when 1800r. of local irradiation of gamma ray was done on postoperative 4th day but its breaking strength was reached to that of control on postoperative 4th week. And 1800r. local irradiation of gamma ray had no effect on the breaking strength for four weeks postoperatively when irradiated on 7th postoperative day. 4. The 600r. local wound irradiation of gamma ray slightly inhibited inflammaory reaction of the incised skin wound but the 1800r. local wound irradiation of gamma ray had definite inhibitory reactions on inflammatory, granulation and collagen formation of the incised skin wound when irradiated within 2nd postoperative day. 5. The 600r. and 1800r. local wound irradiation of gamma ray had damaged the fitroblasts of the incised skin wound on 7th postoperative day when irradiated within 2nd postoperative day. According to the summery, it can be concluded that 600r. and 1800r. local wound irradiation of gamma ray inhibited the healing of the incised skin wound in rats when irradiated externally within 48 hours after operation.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/115829
Appears in Collections:
2. 학위논문 > 1. College of Medicine > 박사
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