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

使用有或没有主动脉瘤的老年标本进行脊髓循环的组织学和形态测量研究

• 批准号: 12671317
• 负责人: MORISHITA Kiyofumi
• 金额: $ 1.28万
• 依托单位: Sapporo Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12671317/
• 关键词: aneurysm; Adamkiewicz artery; anterior spinal artery; histological study; Adamkiewicz artery; aortic aneurysm; adaptive intimal hyperplasia; electron microscopy; 胸腰部肋間動脈; 病理学的研究; 抗α-smooth muscle actin; 免疫染色

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

介绍。 Adamkiewicz 动脉起源于下肋间/腰动脉，沿着脊神经的椎根走行并与脊前动脉相通。在主动脉瘤移植置换手术中，应重建下肋间/腰动脉，以维持经 Adam 向腰脊髓的动脉血供。目前，关于从主动脉经 Adam 到 ASA 的动脉通路的组织学特征的报道很少，甚至在 Adam 本身也是如此。此外，该动脉通路也有可能因主动脉瘤而退化。在这项研究中，我们尝试使用有或没有未破裂胸腹主动脉瘤的老年标本来揭示动脉通路的组织学特征。材料和方法。标本取自 190 具捐赠尸体（固定 10% 福尔马林）。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（范围为49-97岁），尸体的性别比例为8：7。我们拾取了肋间/腰动脉、其背支、亚当和脊髓前动脉的碎片。常规组织学操作后，用醛-品红、苏木精-伊红、平滑肌肌动蛋白免疫组织化学和甲苯胺蓝阶梯对每个切片进行多次染色。此外，还通过 TEM 观察揭示了弹性纤维和胶原纤维的结构。借助 Photoshop 和 NIH 图像程序在光显微水平上进行形态测量研究。结果。 1．Adamkiewicz动脉形成较厚的内膜，内膜含有多层较厚的弹力纤维层，可能还含有大量的内膜平滑肌细胞。2．肋间/腰动脉和Adamkiewicz动脉内膜厚度个体间差异显着。3．与其他动脉相比，Adamkiewicz 动脉的内膜厚度趋于恒定，与管腔扩张无关。4．内膜增厚通常局限于沿着通往腰脊髓的动脉路线的肋间/腰动脉。5．有或没有未破裂主动脉瘤的标本在所有测量参数上均未发现显着差异。讨论和结论。 Adamkiewicz动脉由于其厚厚的内膜含有大量的平滑肌和弹性纤维，似乎能够适应随着衰老而引起的全身循环状态的急性和慢性变化。针对高血压等全身循环功能障碍的各种事件，其独特的形态表明，该动脉可能发挥调节器甚至屏障的关键作用，沿着动脉路线插入腰髓。较少的

项目成果

Kiyofumi Morishita: "Anatomical study of blood supply to the spinal cord"The Annals of Thoracic Surgery. (in press).

Kiyofumi Morishita：“脊髓血液供应的解剖学研究”胸外科年鉴。

藤澤康聡: "通常解剖体及び胸部・腹部大動脈瘤を有する解剖体を用いたアダムキービッツ動脈の組織・計量形態学的検討"札幌医学雑誌. 72(1-2). T1-T18 (2003)

Yasutoshi Fujisawa：“使用正常解剖和胸腹主动脉瘤解剖对 Adamkiewicz 动脉进行组织学和测量形态学研究”Sapporo Medical Journal 72(1-2) (2003)。

Koshino T, Murakami G, Morishita K, Mawatari T, Abe T: "Does the Adomkiewicz artery originate from the larger segmental arteries ?"J Thorac Cardiovasc Surg. 117・5. 898-905 (1999)

Koshino T、Murakami G、Morishita K、Mawatari T、Abe T：“Adomkiewicz 动脉起源于较大的节段动脉吗？”J Thorac Cardiovasc Surg. 117・5 (1999)。

Yasuaki Fujisawa: "Histological and morphometrical study of the arterial route from the intercostals/lumbar artery via Adamkiewicz artery to the anterior spinal artery using elderly specimens with or without unruptured thoracoabdominal aortic aneurysm"The

Yasuaki Fujisawa：“使用有或没有未破裂胸腹主动脉瘤的老年标本，对从肋间/腰动脉经 Adamkiewicz 动脉到脊髓前动脉的动脉路线进行组织学和形态测量研究”