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

本课题的研究成果如下：通过对人胎儿肺淋巴系统的研究，我们认识到肺内淋巴管的分布和系统与Okada（1959）的报道相同。淋巴管的下降路线和上升路线同样重要。腹部淋巴结捕获碳并通过此途径被肺癌转移。对大鼠支气管相关淋巴组织（BALT）的免疫组化研究显示了BALT中t细胞亚群的分布和动态。BALT的超微结构研究表明，高内皮小静脉（HEV）作为巨噬细胞和淋巴细胞进出的通道起着非常重要的作用。我们提出并实施了通过胸骨正中切开术对侧纵隔淋巴结的积极清扫和腹内淋巴结的超延伸清扫。选择性淋巴注射治疗阿霉素，经胸膜下淋巴管及开胸后立即经隆突下淋巴结注射，可有效控制微转移。我们生产了含有阿克拉霉素的PLA（聚乳酸）微球，作为一种长效药物。大鼠肺移植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。供肺外周血淋巴细胞亚群和支气管肺泡灌洗液（BALF）的变化与细胞反应相关。总之，早期诊断排斥是可能的通过监测血液和BALF。

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.