※ 引述《changeup (克蕾兒狂想曲)》之銘言：
: 差不多看完了。感想是：本paper跟媒體的標題幾乎一點關係也沒有。至少不是重點
: 。
http://image.thelancet.com/extras/03art4347web.pdf
剛剛翻了一下，覺得這篇更值得看(至少我覺得啦)
這篇在討論六個死亡病例，把摘要貼出來好了
(重點是一個pdf檔要3MB，開超慢.........)
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Lung pathology of fatal severe acute respiratory syndrome
John M Nicholls, Leo L M Poon, Kam C Lee, Wai F Ng, Sik T Lai, Chung Y Leung,
Chung M Chu, Pak K Hui, Kong L Mak, Wilina Lim, Kin W Yan, Kwok H Chan,
Ngai C Tsang, Yi Guan, Kwok Y Yuen, J S Malik Peiris
Summary
Background
Severe acute respiratory syndrome (SARS) is a novel infectious disease
with global impact. A virus from the family Coronaviridae has been identified
as the cause, but the pathogenesis is still unclear.
Methods
Post-mortem tissue samples from six patients who died from SARS in
February and March, 2003, and an open lung biopsy from one of these patients
were studied by histology and virology. Only one full autopsy was done.
Evidence of infection with the SARS-associated coronavirus (SARS-CoV) and
human metapneumovirus was sought by reverse-transcriptase PCR and serology.
Pathological samples were examined by light and electron microscopy and
immunohistochemistry.
Findings
All six patients had serological evidence of recent infection with
SARS-CoV. Diffuse alveolar damage was common but not universal. Morphological
changes identified were bronchial epithelial denudation, loss of cilia, and
squamous metaplasia. Secondary bacterial pneumonia was present in one case. A
giant-cell infiltrate was seen in four patients, with a pronounced increase
in macrophages in the alveoli and the interstitium of the lung.
Haemophagocytosis was present in two patients. The alveolar pneumocytes also
showed cytomegaly with granular amphophilic cytoplasm. The patient for whom
full autopsy was done had atrophy of the white pulp of the spleen. Electron
microscopy revealed viral particles in the cytoplasm of epithelial cells
corresponding to coronavirus.
Interpretation
SARS is associated with epithelial-cell proliferation and an increase in
macrophages in the lung. The presence of haemophagocytosis supports the
contention that cytokine dysregulation may account, at least partly, for the
severity of the clinical disease. The case definition of SARS should
acknowledge the range of lung pathology associated with this disease.
Published online May 16, 2003
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從現在起 流浪是我的名字
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