창자 가로절단-재문합 실험모델에서 창자신경계통의 형태계측학적 변화
The Morphometric Changes of the Enteric Nervous System in the Intestinal Transection- reanastomosis Model
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작은창자의 손상 후 시간경과에 따른 재생과정에서 근육층신경얼기와 제1형 카할사이질세포가 각각 어 떻게 변화하는지를 살펴보고자 돌창자 가로절단-재문합 실험모델을 제작하여 형태계측학적 방법으로 비교분석 하 였다. 형태계측학적 분석을 하기위해 Sprague Dawley계 성숙흰쥐의 돌창자를 가로절단한 후 재문합시킨 실험군과 가 로절단을 하지 않고 개복 후 봉합수술만을 시행한 대조군에서 수술 후 3일, 7일, 15일, 30일군의 근육층신경얼기와 제1형 카할사이질세포의 변화를 영상분석기를 이용하여 계수하고 통계처리 하였다. 작은창자의 가로절단으로 인한 손상효과는 근육층신경얼기와 제1형 카할사이질세포에서 동시에 일어났으며 손 상부위를 중심으로 앞쪽과 뒤쪽(구강쪽과 항문쪽) 양 방향으로 고르게 나타났다. 손상효과는 수술 후 3일군과 7일 군에서 가장 심하게 나타나 근육층신경얼기의 경우 신경세포의 형태적 변성과 아울러 세포수가 약 40% 감소하였 다. 제1형 카할사이질세포는 세포수가 20~37% 감소하였으며 대부분 세포의 세포질에는 많은 공포가 형성되어 있었다. 수술 후 15일 이후부터는 재생이 일어나기 시작하여 근육층신경얼기에서 신경세포의 감소정도는 20~25%로 줄어들었으며 세포의 염색정도나 형태가 정상으로 회복되는 양상을 보였다. 제1형 카할사이질세포 수 의 감소정도도 13~20%로 줄어들었으며 세포질 내 공포가 형성된 세포의 수도 감소하였다. 수술 후 30일군에서 근육층신경얼기를 이루는 신경세포의 형태는 대조군과 유사하였으며 신경세포의 수는 수술 면을 기준으로 구강 쪽과 항문쪽에서 각각 12.3%, 15.6% 씩 감소하여 (p⁄0.01) 정상으로의 완전한 회복은 이루어지지 않았다. 제1형 카할사이질세포 수는 구강쪽과 항문쪽에서 각각 7.5%, 4.2%씩 감소하였으나 유의한 차이는 없었으며(p¤0.01) 세 포 형태도 정상이었다. 이로서 작은창자의 가로절단으로 인한 손상효과는 근육층신경얼기에서 좀 더 심하게 나타나며 정상으로의 회 복도 제1형 카할사이질세포에 비해 더디게 나타남을 알 수 있었다.
Abstract
This study was performed to investigate the morphometric changes of myenteric plexus and type 1 interstitial cells of Cajal (ICC-I) in regeneration process of small intestine transection. Sprague Dawley rats (200~250 g) were anesthetized with ether; then the full thickness of ileal wall were semitransected; and subsequent end-to-end anastomosis were performed by using 6-0 silk suture thread. Sham-operated rats, which only underwent the laparotomy, were used for control group. Experimental animals were sacrificed at 3 days, 7 days, 15 days, and 30 days after the operation. In each group myenteric plexus and ICC-Is were prepared by histochemical method (NADH-TR stain for myenteric plexus, ZIO stain for ICC-Is) and cell numbers were counted by image analyzer (Image plus pro-5.0, Media Cybermedics, USA). Degeneration of myenteric neurons and ICC-Is occurred simultaneously and it was similar in oral and anal to the site of transection. Degeneration effects were most prominent at 3 days and 7 days after intestinal transection. In myenteric plexus, many neurons had degenerated appearances and about 40% of them were lost. Most of ICC-Is had cytoplasmic vacuoles and 20~37% of the cells were lost. At 15 days after transection, there were no more degeneration in myenteric neurons (20~25% cell loss) and ICC-Is (20~13% cell loss). At 30 days after transection, numbers of myenteric neurons were not recovered as that of the control group. However numbers of ICC-Is were as similar as that of the control group. In conclusion, we confirmed that degeneration effects of intestinal transection are more severe in myenteric plexus than in ICC-Is, and recovery of cell loss occurs more slowly in myenteric plexus.
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