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癩性皮膚의 조직비반세포(mast cell)에 關한 硏究

The Study on Tissue Mast Cells in Leprous Skin Lesion

중앙의학 1963년 5권 2호 p.117 ~ 136
김도일,
소속 상세정보
김도일 (  ) - 서울대학교 의과대학 피부과학교실

Abstract


Surgically biopsied 351 skin tissues of leprous change under the diagnosis of leprosy ,,from 243 cases of male and 108 cases of female were collected. They were divided into 4 types of leprosy, healing stage and reactional stage by the histological and clinical findings. On the basis of these 4 types of leprosy observed on slides stained with hematoxylin-eosin and Ziel-Nelsen, and then tissue mast cells were counted from the 5 micron section stained with toluidin blue.
Tissue mast cells are disclosed more numbers in the cases of tuberculoid type than other type of leprosy and decrease gradually in the cases of lepromatous type, indeterminate group and borderline group in order.
The normal type of mast cells were appeared in small numbers in each type and decrease gradually in order of the borderline group, tuberculoid type, lepromatous. type and indeterminate group.
It is difficult to recognize the remarkable difference among each type in the degree of metachromasia, but in the cases of tuberculoid type and lepromatous type, the small mast cells which is deeply stained relatively to be recognized as new fromed cells increase in number than the cases of indeterminate group and borderline group.
Through the each type, each of mast cells varies considerably in their size and . shape. Specially such variation is adore marked and the metachromatic granules in the cells tend to be more deeply stained.
Leprosy is the disease proceeding to a chronic inflamed change, but according to the point of appearance of the tissue mast cell, the unstable type such as indeterminate group and borderline group tend to proceed more acutely than the stable type such as tuberculoid type and lepromatous type.
Decrease in number of the cells appears to be mainly due to destruction of the cells. Cause of cell destruction is not clearly understood and it is considered that inflammatory stimuli and products are responsible to swelling of cell bodies and cytoplasmic granules, to argumented staining property of metachromatic granules and to folination of intra-cytoplasmic vacuoles. These changes are followed by dispersion of the granules into surrounding tissue which is then turned into being stained metachromatically, and at the same nuclei of the cells are disintegrated.
The tissue mast cells which appears in the skin of leprous change are usually observed more numerously in middle layer of skin(mainly stratum reticulare) than any other layers. Tela subcutanea and superficial layer(mainly stratum papillare) of skin are less in order. The tissue mast cells are not observed among foamy cell infiltrations.
In the leprous reaction stage, the number of mast cells decreases remarkably but it is considered that shows acute inflammatory change temporarily. In the healing stage the number of mast cells also decreases remarkably, and the normal type of mast cells are observed more numerously in this stage than the reaction stage. Cause of increase in number of normal type of mast cells in the healing stage is presumed that the inflammation is ceased and when the tissue goes into repair processes there is observed increase in number of well outlined preserved mast cells which appear to be new-formed or regenerated. The mast cells are decreasing gradually according to increase of age in adult, and are observed more numerously in the legs than the forearms.
The mast cells are observed more numerously at the positive eases than negative cases bacteriologically and by lepromin test.
From above findings it can be concluded that there is a mutual relation between the attitude of mast cells(their number, appearing morphology) and each type of leprosy and inflammatory changes(in quality and in quantity) as well as its course.

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