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  1. C100 医学部/医学系研究科
  2. C100b 紀要
  3. Nagoya journal of medical science
  4. 29(1)

Studies on the Pathogenesis of Pulseless Disease Especially On Experimental Angitis By Elastase

https://doi.org/10.18999/nagjms.29.1.59
https://doi.org/10.18999/nagjms.29.1.59
83e5d301-d7e0-47b2-952f-43bd207e1941
名前 / ファイル ライセンス アクション
v29n1p59_84.pdf v29n1p59_84.pdf (6.7 MB)
Item type 紀要論文 / Departmental Bulletin Paper(1)
公開日 2016-09-27
タイトル
タイトル Studies on the Pathogenesis of Pulseless Disease Especially On Experimental Angitis By Elastase
著者 TSUNEKAWA, SUSUMU

× TSUNEKAWA, SUSUMU

WEKO 93876

TSUNEKAWA, SUSUMU

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抄録
内容記述 Twenty-three patients of pulseless disease were described with clinical and histopathological findings. Twenty-two cases whose ages range 16 to 41 were female and one was male. In nineteen of twenty-three cases surgical treatments were performed: removal of carotid body in 7, excision with Tetron graft in 4, by-pass prosthesis with Tetron in 5 and autogenous vein graft in 2 cases. Biopsies were taken in 13 cases, and the histological features were classified into 4 types: adventitis type in 8 cases. tuberculoid granuloma type in one case, giant cell arteritis type and diffuse productive inflammation type in two cases. The main lesions were limitted to the media and the adventitia, and the intimal changes seemed to be secondary reaction, and the vasa vasorum may be primary sites of involvement of pulseless disease. The lesion of the elastic fibres seems to play an important role in the pathogenesis. In order to clarify the exact etiologic relationship of primary elasticopathy to granulomatous reaction with elasticophagic giant cell, elastase suspension was infused in the common carotid artery of the rabbits intravascularly (37 cases) and extravascularly (21 cases), and elastolysis of the arterial wall was made, thereby, the elastogranulomous reaction and multinucleare giant cells phagocytosing the fragments of disintegrated internal elastic lamina were recognized in 2 cases (Figs. 15 and 16 ). From the results of these experiments, it is clear that a causal relation exists between degenerating elastic fibres and granulomatous tissue reaction accompany· ing giant cell formation in vivo, and elastase has an elastolytic activity in vivo, and the fragments of the elastic fibres act as foreign bodies. The following conditions are necessary for the occurrence of elasticophagic giant cells: a specific destruction of the elastic fibres to provoke giant cells, for example, hard and slightly soluble fragments of the internal elastic lamina, and a mesenchymal activation brought about by some factors, one of which was typhoid-paratyphoid vaccination in this experiment. The change in early stage of the elastic fibre by elastase was not observed in vivo, but at the incubation before elastolysis, metachromasia of the elastica became negative and no initial increase of the metachromatic reaction was observed. A newly formed elastic fibre was presented in early stage in the intimal thickening, but the regeneration of disintegrated elastic fibre was not seen in the media. The effect of estrogen intensified metachromatic reaction of A.M.P. in the arterial walls, but it could not prevent the elastolytic action by elastase.For the present, although exact etiology of pulseless disease is still unexplained, from clinical and experimental results, the elasticopathy associated with anti-elastin auto-immune mechanism or allergy following infection may be important in the pathogenesis of pulseless disease.
内容記述タイプ Abstract
出版者
出版者 Nagoya University School of Medicine
言語
言語 eng
資源タイプ
資源 http://purl.org/coar/resource_type/c_6501
タイプ departmental bulletin paper
ID登録
ID登録 10.18999/nagjms.29.1.59
ID登録タイプ JaLC
関連情報
関連タイプ isVersionOf
識別子タイプ URI
関連識別子 http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/291/291.html
ISSN(print)
収録物識別子タイプ ISSN
収録物識別子 0027-7622
ISSN(Online)
収録物識別子タイプ ISSN
収録物識別子 2186-3326
書誌情報 Nagoya Journal of Medical Science

巻 29, 号 1, p. 59-84, 発行日 1966-11
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