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M Wanke

Publications and source records attributed to M Wanke.

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[Is there a special ulcer of old age? A contribution on the significance of vascular factors as integrating components in the pathogenesis of stomach ulcer].

After stating and evaluating the different ulcer theories in reference to the morphological, physiological and biochemical premises, the integrating components of vascular factors for the ulcer genesis were generally exposed. Apart from the magical 50th birthday after which the old age ulcer in terms of Spang should develop, the clinical appearance of the ulcer in old age can correspond with the following morphological equivalents: 1. with increasing age the reduction of the turnover rate of gastric mucosa epithelium 2. with increasing age a general reduction of the lymphatic reticulum tissue and consequently of the immunological defense reaction in the stomach 3. atrophic mucosa in old age with/without gastritis 4. increase of intestinal metaplasia with age 5. as a result of 1-4 increased qualitative and quantitative faulty composition of the mucus barrier 6. changes in the intramural stomach arteries a) secondary sclerosing proliferating arteries b) loss of elasticity of the elastic muscle accompanying apparatus of the stomach arteries c) primary sclerosis of the preterminal vascular system by diabetes mellitus as well as hypertension d) due to the vascular sclerosis as well as elastosis with obliteration of the perivascular shifting layer increased danger of bleeding and the impossibility of vessel invagination as a method of spontaneous blood clotting after erosion.

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