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出血性 Shockd에서 Steroid가 血液 pH, 血淸 Acid Phophastase 및 肝細胞의 微細形態學的 構造에 미치는 影響에 關하여

Effect of Steroid on the Blood pH, Serum Acid Phosphatase and Hepatocellular Ultrastructure in Dogs with Hemorrhagic Shock

경북의대잡지 1974년 15권 2호 p.61 ~ 76
장수일, 洪善熹,
소속 상세정보
장수일 (  ) - 慶北大學校 醫科大學 外科學敎室
洪善熹 (  ) - 慶北大學校 醫科大學 外科學敎室

Abstract


A convenient quantitative monitor of the extent of cellular damage is the amount of intracellular lysosomal enzyme released through the single-unit lysosomal membrane during a stress period.
A lysosomal membrane-stabilizing action of glucocorticoids in shock eliminates the deleterious effect of the lysosomal hydrolase per se, that is, splanchnic vasoconstriction, capillary leakage, and sensitizing the heart to toxic factors, as well as their participation in the elaboration of a myocardial depressant factor.
Attention has teen directed previously to the ultrastructural changes produced by hypoxia, but a few investigators have described alterations in various organs at some phase of shock produced by different methods.
In the present study, the effect of corticosteroids on hepatocellular ultrastructure in shock was observed with serial measurement cf the blood pH and serum concentration of the lysosomal enzyme acid phosphtase in untreated and steroid treated dogs subjected to hemorrhagic shock and the following results were obtained.
The elevation in serum acid phosphatase was considerably less in steroid treated dogs as compared to untreated animals showing progressive increase in enzyme values.
In steroid treated dogs, the blood pH levels showed less tendency to be reduced as compared to untreated ones.
The ultrastructure of hepatocyte after hemorrhgic shock in untreated group revealed degenerative changes characterized by primarily an apparent increase in the number of primary and secondary lysosomes with vesiculation, vacuolation, fragmentation and ribosomal shedding of rER. And also observed that degenerative changes showing swelling of mitochondria with the decrease of cristae.
In steroid treated group, mostly ultrastructural alterations of intracellular organelles were not severe as compared to untreated one.
These findings suggested that steroids are efficacious in the treatment of shock by improving tissue perfusion related to the decrease of hepatocellular lysosomes electron microscopically as well as the inhibition of acid phosphatase biochemically.

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