Kebuladze I M, Bogdanova T I, Komissarenko I V, Dol'nitskiĭ Iu O
Probl Endokrinol (Mosk). 1990 Sep-Oct;36(5):34-40.
The paper is devoted to surgical treatment of patients with Itsenko-Cushing disease. Altogether 16 patients after adrenalectomy with subsequent autotransplantation of the gland on a vascular pedicle were investigated. The purpose was to study a morphological picture of the gland in ischemia and the determination of time required for blood flow recovery in the gland. Light and electron microscopy, radiological and clinical methods were employed. Emerging of the removed gland before autotransplantation into a nutrient medium for 30 min. (before blood flow recovery in a graft) was shown to damage neither secretory cells nor the components of the microcirculatory bed. The extracorporal condition of the gland for 1 h was accompanied by an increase in autolytic processes, especially in the medullary substance and deep layers of reticulated cortical zone, but most of the adrenocorticocytes preserved their viability and structural features of steroid activity, which became an indication for effective autotransplantation of the adrenal gland on a vascular pedicle in the treatment of Itsenko-Cushing disease.
本文致力于研究伊滕科 - 库欣病患者的外科治疗。共对16例肾上腺切除术后行带血管蒂肾上腺自体移植的患者进行了研究。目的是研究腺体缺血时的形态学表现,并确定腺体血流恢复所需的时间。采用了光镜和电镜检查、放射学及临床方法。结果显示,将切除的腺体在自体移植前放入营养培养基中30分钟(即在移植物血流恢复之前),既未损害分泌细胞,也未损害微循环床的成分。腺体在体外放置1小时会伴随着自溶过程的增加,尤其是在髓质和网状皮质深层区域,但大多数肾上腺皮质细胞仍保持其活力和类固醇活性的结构特征,这为带血管蒂肾上腺自体移植治疗伊滕科 - 库欣病的有效性提供了依据。