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Updated: May 26, 2025
The virus of syphilis exerts a special influence upon the Blood Vessels, exciting a proliferation of the endothelial lining which results in narrowing of their lumen, endarteritis, and a perivascular infiltration in the form of accumulations of plasma cells around the vessels and in the lymphatics that accompany them.
The negative results of tuberculin tests may assist in the differentiation from tuberculous disease, but the more certain means of excising one of the suspected glands and submitting it to microscopical examination should be had recourse to. The sections show proliferation of endothelial cells, the formation of numerous giant cells quite unlike those of tuberculosis and a progressive fibrosis.
The affection readily subsides under treatment, but is liable to relapse on a repetition of the exciting cause. Gouty Teno-synovitis. A deposit of urate of soda beneath the endothelial covering of tendons or of that lining their sheaths is commonly met with in gouty subjects.
The internal clot plays the most important part in the process; it becomes invaded by leucocytes and proliferating endothelial and connective-tissue cells, and new blood vessels permeate the mass, which is thus converted into granulation tissue. This is ultimately replaced by fibrous tissue, which permanently occludes the end of the vessel.
There is no endothelial lining, and the fibrous tissue of the wall is in immediate contact with the colloid material in the interior, which appears to be derived by a process of degeneration from the surrounding connective tissue. In the region of the knee the ganglion is usually multilocular, and consists of a meshwork of fibrous tissue, the meshes of which are occupied by colloid material.
To this process Metchnikoff gave the name of phagocytosis, and he recognised two forms of phagocytes: the microphages, which are the polymorpho-nuclear leucocytes of the blood; and the macrophages, which include the larger hyaline leucocytes, endothelial cells, and connective-tissue corpuscles.
#Surgical Anatomy.# An artery has three coats: an internal coat the tunica intima made up of a single layer of endothelial cells lining the lumen; outside of this a layer of delicate connective tissue; and still farther out a dense tissue composed of longitudinally arranged elastic fibres the internal elastic lamina. The tunica intima is easily ruptured.
The wall of capillaries consists of a single layer of endothelial cells. Various terms are employed in relation to hæmorrhage, according to its seat, its origin, the time at which it occurs, and other circumstances. The term external hæmorrhage is employed when the blood escapes on the surface; when the bleeding takes place into the tissues or into a cavity it is spoken of as internal.
However, if synovial discharge persists too long because of tardy closure of an open joint, there is great danger of infection gaining entrance into the synovial cavity, or in some instances, desiccation of endothelial cells of the articulation occurs, in areas, and the reactionary inflammation eventually results in ankylosis.
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