いわゆる増殖性動脈内膜炎の病理形態学的研究

とくに慢性消化性胃潰瘍底にみる動脈病変の成り立ちについて

抄録

In order to elucidate the nature and morphogenesis of the so-called productive endarteritis, arteries in chronic peptic gastric ulcers, various inflammatory foci and tumor tissues of autopsy and biopsy materials were histologically investigated, and at the same time, arterial changes produced in experimental animals by ligation, cavitary opening, transplantation and tissue culture were compared with the above mentioned.
1) In the base of chronic peptic ulcer of the stomach was often observed the so-called productive endarteritis, which was characterized by the proliferation of intimal smooth muscle cells. A similar lesion was experimentally produced by ligation, cavitary opening, transplantation and tissue culture of the artery. The nature of this lesion is, therefore, neither organization of thrombus nor inflammatory change, but unspecific proliferative reaction of the arterial intimal tissue.
2) As for the morphogenesis of this lesion found in the base of gastric ulcer, it is considered to be ascribed to occlusion due to thrombosis at a distal portion of the artery, resulting from ulcer; and it seems to have the same morphogenesis with the intimal thickening which is produced on the proximal side of the ligated artery. And the most important cause of this intimal thickening is considered to be hemodynamic disturbances acting upon arterial wall.
3) Endarteritis productiva in the base of gastric ulcer and in experimentally ligated artery of the animal is histologically and cytologically different in a few points from thromboangitis obliterans resulting from organization of thrombus and inflammation. This difference can principally be arcribed to hemodynamic difference. Hemodynamic effect on arterial wall has significant bearing on development of elastic fibers and differetiation of intimal cells into smooth muscle cells in the productive endarteritis.
4) Intimal cells in this arterial lesion are considered to be derived from endothelial cells. The results of tissue culture in tubes, made of cellophane or Millipore Filter, completely denied their derivation from blood cells.
5) Stratified structure was often observed in thickened intima of arteries in the base of gastric ulcer and of ligated arteries.
6) Severe fatty deposition and atherosclerotic change were not visible in the proliferative intima in the base of gastric ulcer.
7) In arteries lying in various inflammatory and tumorous foci, the so-called productive endarteritis was found besides endarteritis obliterans.
8) Intimal thickening observed in productive endarteritis is considered to be derived from regenerative and reparative proliferation of endothelial cells, resulting from their injuries, which are caused by hemodynamic alteration.