FUNDAMENTAL AND CLINICAL RESEARCH ON THE RELATIONSHIP BETWEEN PULMONARY LYMPHATIC SYSTEMS AND THE PATHOGENESIS OF VARIOUS LUNG DISEASES

本课题研究成果如下：1.研究成果。对人胎肺淋巴系统的研究发现，肺内淋巴管的分布和系统与Okada(1959)的报道一致。淋巴管的下行路径与上行路径同样重要。腹部淋巴结会捕获碳，并通过这一途径被肺癌转移。通过对大鼠支气管相关淋巴组织(BALT)的免疫组织化学研究，揭示了BALT中T细胞亚群的分布和动态变化。BALT的超微结构研究表明，高内皮微静脉(HEV)作为巨噬细胞和淋巴细胞进出的大门起着非常重要的作用。提出并积极实施经胸骨正中切开和腹内淋巴结超广泛性清扫对侧纵隔淋巴结。开胸术后即刻经胸膜下淋巴管和隆突下淋巴结注射阿霉素是控制微转移的有效方法。我们发现含有阿克拉霉素的聚乳酸微球是一种长效滞留型药物。大鼠肺移植的研究清楚地显示了肺和免疫系统器官中淋巴细胞亚群的动态变化。外周血和支气管肺泡灌洗液(BALF)中淋巴细胞亚群的变化与供体肺的细胞反应有关。综上所述，通过监测血液和BALF可以早期诊断排斥反应。

The results of this research project are as the followings.1. The study on the pulmonary lymphatic system of human fetus recognized us that the distribution and system of intrapulmonary lymphatic vessels were the same as Okada's report (1959). The descending route of lymphatics is as important as the ascending one. Abdominal lymphnodes capture the carbon and are metastasized by lung cancer through this route.2. Immunohistochemical study on the bronchus-associated lymphoid tissue(BALT) of rats shows the distribution and dynamics of T-cell subpopulation in BALT. The ultrastructural study on BALT demonstrated high endothelial venule(HEV) plays the very important role as a gate through which macrophages and lymphocytes go in and out.3. We proposed and performed agressively the dissecting of the contralateral mediastinal lymph nodes through the median sternotomy and the ultra-extended dissecting of intraabdominal lymph nodes.4. Selective lymphogenous injection therapy by adriamycin, which was injected via the subpleural lymphatic vessels and via the subcarinal lymph nodes immediately after thoracotomy, is useful for controlling the micrometastasis. We proudced PLA(poly-lactic acid) microsphere containing aclacinomycin as a long retention type of drug.5. The study on lung transplantation in rats shows clearly the dynamics of lymphocyte subsets in the lung and immune system organs. The lymphocyte subsets of peripheral blood and bronchoalveolar lavage fluid (BALF) change in correlation with the cell reaction in donor lung. In conclusion, the early diagnosis of rejection is possible by monitoring the blood and BALF.