Histological and morphometrical study of spinal cord circulation using elderly specimens with or without aortic aneurysm

导论. Adamkiewicz动脉起源于下肋间/腰动脉，沿着脊神经的椎根走行，与脊前动脉相通。在主动脉瘤人工血管置换术中，应重建下海岸间/腰动脉，以维持动脉经Adam向腰髓的血供。目前，关于从主动脉经Adam到阿萨的动脉通路的组织学特征的报道很少，甚至在Adam本身也很少。此外，该动脉通路可能因主动脉瘤而退化。在本研究中，我们试图用有或没有未破裂的胸腹主动脉瘤的老年标本来显示动脉通路的组织学特征。从190具捐献的尸体（固定10%福尔马林）中获得标本。这些尸体包括16例主动脉瘤病例。这些尸体的平均年龄为78.5岁（49-97岁 关于我们 尸体性别比为8：7。我们找到肋间/腰动脉的碎片，它的背分支，亚当和脊髓前动脉。常规组织学检查后，分别用碱性复红、苏木精-伊红、平滑肌肌动蛋白免疫组化和甲苯胺蓝染色。此外，通过透射电镜观察，揭示了弹性纤维和胶原纤维的结构。应用Photoshop和NIH图像分析软件，在光镜水平上进行形态计量学研究。1. Adamkiewicz动脉内膜较厚，内膜内含有多层较厚的弹性纤维层，可能含有大量的内膜平滑肌细胞.肋间/腰动脉和Adamkiewicz动脉的内膜厚度个体间差异显著.与其他动脉相比，Adamkiewicz动脉的内膜厚度在管腔扩张的情况下趋于恒定.内膜增厚通常局限于肋间/腰动脉沿着动脉途径至腰索。未破裂主动脉瘤标本与未破裂主动脉瘤标本之间的所有测量参数均无显著差异。Adamkiewicz动脉内膜增厚，含有大量的平滑肌和弹性纤维，能适应循环系统状态随年龄的急、慢性变化。针对各种全身循环功能障碍事件，如高血压，其独特的形态学表明，该动脉可能发挥调节剂甚至屏障的关键作用，其沿着动脉途径插入腰髓。少

Introduction. Adamkiewicz aretery originate from the lower intercostals/lumber artery, run along vertebral roots of the spinal nerve and communicate with the anterior spinal artery. In the operation of graft replacement for aortic aneurysm, the lower intercoastal/lumbar artery should be reconstructed to maintain arterial blood supply to the lumbar spinal cord via the Adam. At present there are few reports of histological characters of the arterial pathway from the aorta to the ASA via Adam, even in Adam itself. In addition, there is a possibility that this arterial pathway was degenerated by the aortic aneurysm. In this study, we attempt to bring out the histological characters of the arterial pathway using elderly specimens with or without unruptured thoracoabdominal aortic aneurysm.Materials and methods. Specimens were obtained from the 190 donated cadavers (fixed 10 % formalin). These cadavers included 16 aortic aneurysm cases. The average age of these cadavers is 78.5 (ranged 49-97 … More ), and sex ratio of the cadavers is 8 : 7. We picked up fragments of the intercostals/lumbar artery, its dorsal branch, the Adam and the anterior spinal artery. After routine histological procedures, several staining were performed for each of sections with aldehyde-fuchsin, hematoxylin-eosin, smooth muscle actin immunohistochemistry and toluidine-blue stairing. In addition, TEM observation were conducted to reveal configurations of elastic and collagen fibers. Morphometrical study was conducted in the light microscopic level with aids of Photoshop and NIH image program.Result. 1. Adamkiewicz artery camied the thick intima containing multiple thick elastic fiber layers and, perhaps, numerous intimal smooth muscle cells.2. Intimal thickness varied significantly between individuals in the intercostals/lumbar artery and Adamkiewicz artery.3. Intimal thickness tended to be constant irrespective of luminal dilatation in Adamkiewicz artery in contrast to other arteries.4. Intimal thickening was often restricted in the intercostals/lumbar artery along the arterial route to the lumbar cord.5. No significant difference was found between specimens with or without unruptured aortic aneurysm in all parameters measured.Discussion and conclusion. Adamkiewicz artery seemed to be able to adapt to acute and chronic changes of systemic status in circulation with aging because of its thick intima containing numerous smooth muscles and elastic fibers. Against various events of systemic circulatory dysfunction such as hypertension, its unique morphology suggested, this artery may play a critical role of a modulator, or even a barrier, that is intercalated along the arterial route to the lumbar cord. Less