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yxfbbiedtj · Wysłany: Pią 15:55, 11 Mar 2011

SARS pathology of multiple organ puncture and Ultrastructure of

Injuries caused by the leakage of inflammatory changes mainly metamorphic, including more extensive pulmonary edema associated with hyaline membrane formation, alveolar capillary dilatation and congestion and focal alveolar hemorrhage, relatively few inflammatory cells, mainly small lymphocytes; also showed desquamative alveolitis and desquamative bronchitis change. Immune organ damage, mainly in the spleen and lymph nodes, mainly hemorrhagic necrosis, lymphocytes decreased significantly. The main clinical manifestations of virus viremia: fever, fatigue, headache, cough, shortness of breath, lung 哕 sound, X ray appeared patchy or cloudy shadow of the lungs, respiratory distress syndrome can occur (RI) S) _ 】 q. Course in accordance with this Section 3 to 5 weeks of SARS patients died of multiple organ observations of late that the pathology of SARS is in the alveolar interstitial fibrosis and early alveolar fibrosis, and changes were glomeruloid BOOP The main features of pneumonia-like changes, accompanied by diffuse alveolar epithelium and terminal bronchioles epithelial cell injury and desquamation of alveolar inflammation, and squamous metaplasia occur, alveolar polymorphonuclear easier to fit kind of big and small to see * 883 * cell, many of these large cells expressed Cytokeratin. 1 patient with infection seen in patients with large amounts of alveolar neutrophils, the lung tissue is generally only see a small number of CD3 positive lymphocytes. Spleen lymphocytes CD3 and CD20-positive spleen than normal although significantly reduced, but with the course 1 to 2 weeks a slight increase in SARS patients compared. CD68 positive cells was significantly increased, S-100 positive dendritic cells also increased. Decreased proliferation of bone marrow granulocyte system. With the development of clinical disease, chest tightness, increased breath, difficulty breathing, X line appears rapid progress in the shadow of a large pulmonary consolidation, some patients were significantly elevated myocardial enzymes, cardiac arrhythmia, viral myocarditis, the symptoms appear. Pulmonary disease patients in this group except the immune organ damage, and individual patients had focal myocardial degeneration, myocardial interstitial edema, and to see a few CDa positive CD68-positive lymphocytes and macrophage infiltration. In addition, moderate fatty degeneration of liver cells were like change, can be seen mainly in small vacuoles of varying sizes mixed vacuoles. Kuffer within the CD68-positive sinusoidal cells was proliferation. The electron microscope results showed that: In addition to viruses target organ damage and fiber cell ultrastructure of cell proliferation changes, in alveolar type Ⅱ cells, vascular epithelial cells and spleen cells can be seen within the cytoplasm of two types of corona virus like particles, and both were 60 ~ 220nm, a capsule, the surface seems to be spike-like structure. A to A-type virus particles, with concentric outer membrane, the core of low electron density; another way for the C-type virus particles with high electron density core l4J. Electron microscopy studies and confirm the coronavirus particles and other pathogens and disease organ ultrastructure changes are of great value, can be applied directly to the negative staining method in the rapid detection of pathogens or tracheal lavage and tracheal puncture biopsy of the organization ultrastructure. Immune electron microscopy for determining the pathogen a greater help. Confirmation of the new coronavirus also depends on the application of traditional tissue culture amplification of isolated pathogens, followed by electron microscopy studies to confirm the virus type. The largest selection of models derived 14Gage needle biopsy, the patient bedside after the death of the multiple organ puncture, drawn full, fresh, fixed in a timely manner, the cell ultrastructure preservation is superior than the autopsy material. In the absence of bio-safety level three or more conditions of pathological dissection room, multi-organ puncture drawn both to reduce pollution of the environment and human pathogens, the risk, but also to meet the needs of pathology and etiology research, is recommended lesions derived methods.