家兎頸動脈球剔出及び交感神経上節剔出の諸臓器に及ぼす影響に就いて

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Excision of the carotid body has been performed on many cases of bronchial asthma and spontaneous gangrene in this clinic. With a view of contributing to the fundamental study of the influence excision of carotid body might have on the bodily conditions of patients, the author undertook histological examination as well as weighing of various organs of the rabbit after performing excision of the carotid body. At the same time, excision of the cervical upper ganglion has been performed on several rabbits and they were used as control. The rabbits used in the experiments were grown-up ones, weighing about 2 kg., and numbered 41 in total. Of this number, 4 were used as control, 22 underwent excision of the carotid body and 15 underwent excision of the sympathetic upper ganglion. Excision of the carotid body was carried out with utmost carelest unnecessary side injuries should be caused; and presence or absence of respiratory reflexes were tested by injecting cyan natrium into the cervical artery in order to establish that the carotid body. had been excised without fail. The rabbits were killed by injecting air into the heart. Immediately after having been killed, various organs were weighed and subjected to investigations histologically as well as by naked eyes. No marked changes were detected in various organs by naked eyes. It was observed in both methods of operation that body weight and behavior had returned to normal by the first week after the operation and any noteworthy symptoms such as loss of weight, falling-out of hairs, etc. had not taken place. No appreciable variations in leukocyte count occurred but erythrocyte count temporarily increased (about 500,000 on the average), returning to normal in about three weeks. No large variations in erythrocyte count were observed in control. The results of histological investigations of the chief organs, such as the liver, adrenal glands, spleen, lymph glands, lungs and kidneys are as follows:Influence on the Liver: The number of those that manifested deposit of fat in the kidney (in the periphery of lobes), though in small degree, was larger in the cases which had undergone excision of the carotid body of both sides than in the cases which had undergone excision of the carotid body of one side. As this change in the kidney was too slight to be described as morbid, however, it would not be justified to claim that excision of the carotid body was responsible. In this connection, it is interesting to note that Betke and Fischer, who claimed that changes of large degree had been manifested, reported that no marked change had been observed in the liver. The results of the present experiments also revealed that there existed no morbid change in the liver morphologically. With regard to the deposit of hemosiderin, no definite chronological relations were established. Influence on the Adrenal Glands: It was disclosed that the cortex was less fatty and the fat drops were smaller in cases which had undergone excision of the carotid body than in cases which had undergone excision of the sympathetic upper ganglion. Of those which had undergone excision of the carotid body, it was observed in 5 cases that the zona glomerulosa was least fatty and fat drops were small, and in 4 other cases similar observations were made in the zona reticularis. It is presumed that this would be attributed to the exacerbation of cortical function. Hypertrophy and hyperplasia of small degree were observed in the medulla of those which had undergone excision of the carotid body However, no definite observations were made so far as the changes in the chromaphin system were concerned. The circulatory system manifested no appreciable changes which deserve description. Werner and Fischer have also reported that excision of the carotid body had resulted in hypertrophy of the medulla of adrenal glands. It is presumed that this represents a sort of compensatory hypertrophy of the chromaphin system caused by excision of the carotid body.Influence on the Spleen: Neither atrophy nor the decrease of lymph follicles was observed although Betke and Fischer had reported about them. The cases which had undergone excision of the carotid body of both sides manifested congestion of small degree in the first week after the operation, showing the tendency to become normal gradually after that period. The number of those that manifested congestion of large degree were greater in the cases which had undergone excision of the sympathetic upper ganglion than in the cases which had undergone excision of carotid body.Hyperplasia of the reticuloendothelial system was observed in majority of the cases under investigation. This would offer some suggestions in view of the results of the physiological experiment which indicate that excision of the carotid body results in enhanced activities of various phagocytes. Influence on the Lymph Glands: Neither atrophy nor hypertrophy was observed in the lymph glands but hyperplasia of the reticulo-endothelial system was observed even in the first week after the operation. Influence on the Lungs: No observations directly attributable to excision of the carotid body were made in the lungs. However, the cases which had undergone excision of the carotid body of both sides manifested progressive increase of blood which lasted until the second week after the operation, becoming normal in the third week. The cases which had undergone excision of the sympathetic upper ganglion manifested irregular and continuous increase in the amount of blood. This corresponded to the conditions of circulatory system in the spleen. Since the lungs are liable to congestion as the result of sudden death, efforts were made to ensure that identical conditions prevailed when the rabbits were killed.It behooves the author to refrain from drawing any hasty conclusion concerning the results, but those of the present investigation would be dependable to a certain extent in view of the fact that the observations made in the lungs corresponded to those made in the spleen. The cases which had undergone excision of the carotid body of one side did not manifest any change of similar nature in the circulatory system of the spleen and lungs, although investigations were undertaken in chronological sequence. This will be due to the compensatory activity of the carotid body of other side. Influence of the Kidneys Scarcely any morbid changes were observed in Bowmann's capsule and the renal tubule in all the cases under investigation. The cases which had undergone excision of the carotid body manifested increase in the amount of blood which lasted until the second week, becoming normal in the third week. The increase in the amount of blood did not take place in the cases which had undergone excision of the sympathetic upper ganglion. On the contrary, the latter was characterized by anemia from the first till the third week. The following are the conclusions: 1. The cases which had undergone excision of the carotid body of both sides manifested an increase in the amount of the blood in the spleen, lungs and kidney which lasted until the second week becoming more or less normal in the third week. There existed interrelations among leukocyte count, erythrocyte count and the amount of hemoglobin. 2. Hyperplasia of the reticulo-endothelial system was observed in the spleen and lymph glands. 3. There was a tendency to hypertrophy in the medulla of adrenal glands which constitute the chromaphin system. 4. A profound and marked state of constitutional disorder, falling-out of hairs, loss of appetite, infirmity, emaciation and decrease in bodily movements nonexistent. The various changes as described above were slight and temporary causing no serious trouble.It will be seen, therefore, that excision of the carotid body, when performed on patients with a certain ailment, entails no appreciable trouble.
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