Alloxan 투여 가토(家兎)에 대한 골절치유 실험

Abstract

[영문]

[한글]

Studies on the Fracture Healing in the Alloxan treated Rabbits

Sung Joon Kim

Department of Medical Science The Graduate School, Yonsei University

(Directed by Professors: 5.5. Hong and K. H. Choi)

It is well known that diabetes mellitus is associated with metabolic

derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread

alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is

also recognized that healing of skin wound is delayed in diabetic3.In bone,

according to Aegerter, ost대penia develops in diabetes mellitus and it is chiefly

ascribed to overutilization of protein. Shim claims that total blood flow to the

entire skeletal system is approximately 4 to 8 percent of resting cardiac output

and blood supply to the skeletal system would be decreased on account of secondary

arteriosclerotic changes in the diabetics.

An adequate blood supply is an essential factor in the healing process of

fracture, and disturbed blood flow, either local or systemic, will invariably delay

minion of the fragments or the fragments from being fused.

As the author has encountered several cases of diabetics in whom healing of

fracture was delayed or incomplete, this experimental study was undertaken to

elucidate the effects of hyperglycemia and diabetes mellitus on the healing process

of fracture.

In this experiment adult albino rabbits, weighing about 2 kg. were used and

divided int? 6 groups. The femur of earth animal was fractured surgioally, and then

the healing process of fracture was periodically checked by radiography at an

interval of one week for a period of 6 weeks. Thereafter, all the rabbits were

killed t? obtain tissue preparation of the femur. The experimental groups were as

follows;

1) Control group: Six rabbits sustained a surgical fracture to the femur, without

being given any other treatment or drug.

2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously

to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80

mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively.

3) Insulin-treated grouts: Protamine-zinc insulin was injected subcutaneously to

each of 6 rabbits in a daily dote of 1 unit Per kilogram of body weight.

4) Group treated with insulin after alfoxan: Four rabbits were given 80 mg of

alloxan once and then 1 unit of insulin per kilogram of body weight daily. Another

5 rabbits were injected 1 unit of insulin per kg of body weight daily following

administration of alloxan in a dose of 120 mg/kg.

5) Homotransplantation group: Following intravenous injection of alloxan in a

dome of 120 mg/kg,10 rabbits underwent homotransplantation of a short bone segment

t? the femur. Five of them were subsequently given 1 unit/kg of insulin daily.

6) Sugar-treated group: six rabbits were fed 15∼20 gm of sugar daily throughout

the period of experiment.

The results obtained are summarized as follows;

1. Blood sugar level and damage to the pancreatic islet increased proportionately

when alloxan was given to the rabbits in various doses. No appreciable change could

be observed in the islets when the blood sugar level was altered by either oral

administration of sugar or suboutaneous injection of insulin.

2. Comparing with the control group, healing of fracture was delayed in the

alloxan-treated group, while callus formation and periosteal reaction were shown to

be more prominent in this group and subsequently, the ultimate osseous tissue

formed at the fracture site was significantly smaller in amount and less compact.

These findings were more marked as the amount of alloxan increased.

3. Administration of insulin prevented the delay in hearting process of fracture

in the rabbits with alloxan-induced hyperglycemia. In this case, the course and

progression of fracture healing were almost similar to those of control group.

4. Union between the host bone and the fragment transplanted from other rabbit of

the same species was more delayed in the group treated with alloxan alone than in

the group to which insulin was administered after development of alloxan-induoed

diabetes. In both groups periosteal new bone developed from the ends of the holt

bone, above and below the transplanted fragment, and directly fused with failure of

periosteal callus to bridge the adjacent ends of the host bone and the transplanted

fragment.

5. The healing process of fracture was not inhibited by alteration in blood sugar

level when the blood sugar was abnormally increased by excessive sugar intake or

lowered by administration of insulin alone. The healing of fracture in these groups

progressed similarly as in the control group.

In brief summary, it appears that the healing process of fracture would be

definitely disturbed in diabetic state brought about by damage to the pancreatic

islet. as such an inhibition could be overcome with insulin, it seems that insulin

plays an important role in healing of fracture, but alteration in blood sugar level

alone does not modify healing process of fracture to significant degree.