스테로이드성 괴사에 있어서 혈관 및 지방변화에 관한 실험적 연구

초록

To elucidate the pathogenesis of steroid-induced necrosis of the bone, the author performed a histologic study on femoral head, lung, kidney, and liver in the rabbits. Of twenty two rabbits, twelve were administered a weekly dose of five milligrams of methylprednisolone (group Ⅰ), eight were administered a weekly dose of eight milligrams of methylprednisolone (group Ⅱ) and two were employed as a control. Each, two rabbits were sacrificed at one, three, four, eight, ten and twelve weeks after administration in group Ⅰ and another two rabbits were sacrificed at one, three four and eight weeks in group Ⅱ. Those histologic changes mainly observed on hemorrhage, vascular and fatty change, osteoporosis, and necrosis of bone were studied. The results obtained are as follows. 1. Fatty changes of the femoral head showed increasing the size of fat cell at one week after initial administration and were progressively increased until four weeks, but size of fat-cell began to decrease at eight weeks. Vascular changes of the femoral head were noted at three weeks and necrosis of vascular wall at eight weeks. Finally avasrular necrosis of the femoral head were found at ten and twelve weeks in group Ⅰ. 2. Fatty changes of the liver reavealed at one week and the changes were progressively aggravated with portal and central venous congestion and dilatation until eight weeks in group Ⅱ. Necrosis with hepatitis were noted at ten and twelve weeks in group Ⅰ and at eight weeks in group Ⅱ. 3. Fatty changes of the lung were not noted in group 1 and 2 through experimental periods. Vascular changes of the lung showed subintimal edema, endothelial hyperplasia, medial hypertrophy and vacuolar degeration at three weeks, subintimal edema and fibrosis at ten weeks and twelve weeks in group Ⅰ and endateritis at four and eight weeks in group Ⅱ. 4. Fatty changes of the kidney showed fat vacuoles in the proximal tubules at four and twelve weeks in group Ⅰ, one and four weeks in group Ⅱ. Vascular changes of the kidney showed mucinous degeration and edema of medial layer in arterioles and small artery at four weeks, erdateritis and subintimal fibrosis at eight weeks in group Ⅰ and hydrophic dgeneration at four weeks in group Ⅱ. With the above results it is suggested that vascular changes proceed or associated with fatty change in steroid induced necrosis.