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The granulovesicular bodies of the arterial wall.

Small, round, membrane-bound electron-dense bodies were observed in the smooth muscle cells and the intimal and medial intercellular spaces of arteries in the dog, rat, and pig under normal and various experimental conditions. These structures, referred to as granulovesicular bodies (GVB), measured from 0.2 to 0.5 mum. in diameter and contained an inner core of granular and vesicular subunits. The intercellular and extracellular forms of the GVB were structurally similar, and in the interstitial spaces they appeared to have a definite spatial relation to the elements of elastic tissue. The GVB were more numerous under experimental than under normal conditions. It is speculated that the GVB are secretory in nature, originating from the smooth muscle cells, and may play a role in the remodeling of arterial elastic fibers.

Animals↗

[Vitronectin in normal human skin and in skin lesions].

Vitronectin (S-protein of complement, serum spreading factor) is a multifunctional glycoprotein present in human plasma and in the elastic tissue of various organs. It belongs to the group of adhesion proteins and is of importance in the terminal stages of both the coagulation and complement system and in fibrinolysis. In human skin it is localized on dermal elastic fibers and on pathologically altered elastic material (solar elastosis, pseudoxanthoma elasticum) as well as on keratin filament material such as keratin bodies in lichen planus or amyloid deposits in localized cutaneous amyloid. It is also found in the abnormally thickened cutaneous blood vessels in erythropoietic protoporphyria and porphyria cutanea tarda. Late-stage inhibition of the complement cascade in bullous disorders in which activation of the complement system is of pathogenetic significance may be an additional important function of vitronectin in skin diseases.

Blood Coagulation↗

Pseudoexfoliative fibrillopathy in visceral organs of a patient with pseudoexfoliation syndrome.

Evidence is increasing that pseudoexfoliative material develops in widespread areas of skin and parabulbar tissues as well as intraocularly. To determine whether this process is even more diffusely distributed, ultrastructural examination was performed on visceral and ocular tissues of a patient with long-standing glaucoma found to have bilateral ocular pseudoexfoliation at autopsy. Aggregates consistent with pseudoexfoliative material were present in the lung, heart, liver, and gallbladder, in addition to the classic intraocular sites. The aggregates were in the fibrovascular septa and stroma of these organs, most frequently adjacent to elastic and oxytalan fibers. They stained positively for elastin and human amyloid P protein, like the ocular sites, in preliminary immunologic testing. Rare atypical aggregates were seen in one of the four control patients. These findings suggest that pseudoexfoliation is a systemic process involving abnormal matrix synthesis, particularly as related to elastic tissue components.

Aged↗

D-penicillamine-induced elastosis perforans serpiginosa in a child with juvenile rheumatoid arthritis. Report of a case and review of the literature.

Elastosis perforans serpiginosa is a rare complication of D-penicillamine therapy. It has been reported to occur in Wilson's disease and cystinuria, usually after many years of high-dose therapy. We report a case of D-penicillamine-induced elastosis perforans serpiginosa with unique clinical features occurring in a 10-year-old child with juvenile rheumatoid arthritis who received only 71 gm of the drug over 9 months. The case is also unusual because of the short course and low cumulative dose of drug received and because of the calcification of elastic fibers. The calcification of elastic fibers suggests that this case may represent an unusual variant of elastosis perforans serpiginosa or an overlap with pseudoxanthoma elasticum. All reported cases of D-penicillamine-induced elastosis perforans serpiginosa are reviewed, and histopathologic and electron microscopic findings are presented. The theoretic mechanisms of action of D-penicillamine on elastic tissue synthesis and morphology are discussed.

Arthritis, Juvenile↗

Histologic features of lichen sclerosus et atrophicus in a surgical scar.

A 76-year-old woman presented with a 7-mm, hard, pink nodule at the site of an appendectomy scar of more than 70 years' duration. The clinical impression at the time of biopsy was that of a keloid. Surprisingly, light microscopic examination revealed classic histologic features of late-stage lichen sclerosus et atrophicus (LSA) overlying a scar. Elastic tissue stain highlighted the unusual presence of abundant nodules of elastin in the reticular dermis only.

Aged↗

[Changes in the wall of the rabbit vertebral artery following hypokinesia].

Limitations in general mobility produces a number of changes in the vertebral artery wall: distony of the vascular wall, degeneration and atrophy of its tissue elements. The morphological changes have a certain dynamics corresponding to differnt time of hypokinesia (2, 4, 8 weeks). The most intensive changes appear by the end of the first month and are located mainly in the internal and median tunica of the artery. The most active elements of the vascular wall are destroyed, namely, endothelium, smooth muscle cells, elastic tissue. As a result, on the 2d month of hypokinesia some parts in the vertebral artery wall grow thin, areas of the media poor in nuclei and disorders in elastic stroma appear. The changes mentioned above reach their greatest intensity in the initial, extracanal parts of the vertebral artery, and the least changes are seen in the wall of the intracranial part of the artery.

Animals↗

Preservation of microelastic properties of dentin and tooth enamel in vitro--a scanning acoustic microscopy study.

OBJECTIVES: The aim of this study was to examine the influence of storage media on the elastic properties of dentin and tooth enamel with respect to the storage period. Several reports suggest that saline and other aqueous solutions may induce chemical reactions and the dissolution of minerals, which in turn may cause alterations of elastic tissue properties. METHODS: Three non-erupted human wisdom teeth were extracted and divided in three slices. Sections were stored in three different media for a maximum period of 21 days. During this time all sections were inspected by time-resolved 50-MHz scanning acoustic microscopy. RESULTS: Storage in saline solution resulted in a progressive decrease of the acoustic impedance up to 70% in dentin but not in enamel tissue. Hank's balanced salts solution and artificial saliva appeared to maintain the elastic properties of dentin and enamel during the entire time of storage. The measurements of surface wave velocities did not show significant differences. High resolution (900 MHz) inspection of sections cut perpendicular to the surface exposed to the storage media for 21 days revealed a progressive increase of impedance in dentin up to the initial values at a depth of approximately 300 microm. SIGNIFICANCE: These findings suggest that quantitative SAM is a suitable tool for assessing surface and sub-superficial elastic properties of tooth tissue.

Dental Enamel↗

[Relapsing polychondritis and cartilage].

Atrophic polychondritis (APC) results from elective lesions of the components of elastic cartilage. Clinical criteria have been established in terms of the incidence of auricular, nasal, ocular, tracheobronchial or cochlear involvement. However, recent clinical and pathological reviews have shown the frequency and severity of vascular lesions, aortic as well as peripheral. Several pathological mechanisms probably participate together in the destruction of elastic cartilage. A direct enzyme abnormality of glycoaminoglycanes and of elastic tissue are believed to be interlinked with an auto-immune process bringing type II anticollagen antibodies into play.

Cartilage↗

Generalized acquired cutis laxa associated with coeliac disease: evidence of immunoglobulin A deposits on the dermal elastic fibres.

Acquired cutis laxa (ACL) is an uncommon elastolytic disorder of unknown aetiology. In rare instances, ACL has been reported in association with autoimmune diseases and dermal deposit of immunoglobulins, suggesting that destruction of elastic tissue may be immunologically mediated. We report a 35-year-old man with generalized acquired cutis laxa (GACL) associated with a persistent papular erythematous eruption that histopathologically showed some resemblance to dermatitis herpetiformis. A marked reduction and degeneration of dermal elastic fibres was noted in biopsies from loose-hanging skin. Direct immunofluorescence from non-inflammatory loose skin revealed granular immunoglobulin A (IgA) deposits at the basement membrane zone and fibrillar IgA deposits in the dermal papillae. IgA deposits were also observed on the elastic fibres of the reticular dermis. Electron microscopy of skin from the submammary fold revealed fragmented elastic fibres, partial absence of peripheral microfibrils and abundant neutrophils, some of which were degranulated and adjacent to elastic fibres. Immunoelectron microscopy of an erythematous papule revealed IgA deposits around dermal elastic fibres. Antigliadin, antireticulin and antiendomysium antibodies were present. Jejunal biopsies showed a gluten-sensitive enteropathy. A possible IgA-mediated immune mechanism for the development of GACL in our patient is suggested.

Adult↗

Penicillamine-induced elastosis perforans serpiginosa. Tip of the iceberg?

Elastosis perforans serpiginosa (EPS) is now a well-recognized potential complication of long-term penicillamine therapy. By itself, EPS appears to be a relatively innocuous cutaneous side effect of penicillamine. However, suspicion has been raised in recent literature that EPS may represent only a superficial manifestation of more serious penicillamine-induced systemic elastic tissue damage, particularly involving blood vessels. This is a report of a patient with Wilson's disease who was treated with penicillamine for 14 years. She developed EPS, and histologic examination of the skin revealed the characteristic penicillamine-induced "lumpy-bumpy" elastic fibers in the dermis. More important, nonlesional skin showed the same elastic fiber changes. Of greatest significance was the finding of identical elastic fiber alterations in an artery.

Adult↗

Current applications of orcein in histochemistry. A brief review with some new observations concerning influence of dye batch variation and aging of dye solutions on staining.

Current uses of orcein to demonstrate elastic fibers and, following permanganate oxidation (Shikata's modification), hepatitis B surface antigen, copper associated protein, and sulfated mucins, are reviewed. Variations in staining performance with batch of dye and age of dye solution is also discussed. Additional experimental findings support the view that the orcein stain for elastic tissue and Shikata's modification produces consistent, high quality results as long as appropriate controls and suitable dye batches, e.g., Biological Stain Commission certified dyes, are used.

Elastic Tissue↗

Comparison of quantitative shear wave MR-elastography with mechanical compression tests.

The mechanical properties of in vivo soft tissue are generally determined by palpation, ultrasound measurements (US), and magnetic resonance elastography (MRE). While it has been shown that US and MRE are capable of quantitatively measuring soft tissue elasticity, there is still some uncertainty about the reliability of quantitative MRE measurements. For this reason it was decided to determine in vitro how MRE measurements correspond with other quantitative methods of measuring characteristic elasticity values. This article presents the results of experiments with tissue-like agar-agar gel phantoms in which the wavelength of strain waves was measured by shear wave MR elastography and the resultant shear modulus was compared with results from mechanical compression tests with small gel specimens. The shear moduli of nine homogeneous gels with various agar-agar concentrations were investigated. The elasticity range of the gels covered the elasticity range of typical soft tissues. The systematic comparison between shear wave MRE and compression tests showed good agreement between the two measurement techniques.

Agar↗

Effect of smoking on skin elastic fibres: morphometric and immunohistochemical analysis.

BACKGROUND: It has been established during recent years that smoking is an independent risk factor for the development of premature facial wrinkling. The underlying mechanism is not well known, but elastic fibres of the dermis seem to be the major target of smoke components. OBJECTIVES: To determine quantitative and qualitative changes of the dermal elastic tissue of non-sun-exposed skin induced by smoking, as well as the possible mechanisms responsible for them. METHODS: Sixty-nine patients were recruited (20 nonsmokers, 19 former smokers and 30 smokers). Using static morphometry and immunohistochemistry and lectin staining we analysed elastic fibres of the dermis and their major components, elastin and microfibrillar component. RESULTS: Significantly higher values for the number of elastic fibres mm(-2) and the percentage of the area filled by them in the reticular dermis were found in smokers. Cumulative tobacco dose showed statistically significant correlations with both morphological parameters (Spearman's rank correlation coefficient). Immunohistochemistry demonstrated that the two main components of elastic fibres were altered in smokers. Plasma protease inhibitors and lectin staining were negative in all the samples. CONCLUSIONS: Smoking is an independent risk factor for the increase of elastic fibres in the reticular dermis of nonexposed skin, and it acts on their two main structural components, elastin and microfibrillar component. This increase in the area of elastic fibres in smokers is not due to newly synthesized elastic material, but to their degradation, as occurs in solar elastosis and which acts in an additive manner.

Adult↗

Stress urinary incontinence, a new concept.

OBJECTIVE: A new concept is put forward to explain stress urinary incontinence (SUI). Urine continence depends on an intact strong internal sphincter and a reactive sympathetic activity. STUDY DESIGN: Thirty patients suffering from SUI were evaluated clinically and by urodynamic studies. During surgical repair of SUI, minute tissues were taken from the bladder neck and were examined microscopically after preparation and staining. Furthermore, examination of 15 postmortem specimens was done. Also a clinical trial was done to demonstrate the effects of sympathomimetics and alpha-blockers on the internal sphincter. RESULTS: There is paucity and dispersion of collagenous and elastic tissues constituents of the internal sphincter in patients suffering SUI. alpha-Blockers lower the urethral pressure, while sympathomimetics increases it. CONCLUSION: Sudden increase of intravesical pressure overcomes a weak internal sphincter leading to leakage of urine. This initiates a reactive sympathetic quick response that increases the internal sphincter tone preventing further leakage.

Adrenergic alpha-Antagonists↗

The anatomy and pathogenesis of wrinkles.

The anatomy of linear wrinkles ("crow's feet' and temporal frown lines), fine criss-cross wrinkles of the face and wrinkling of the general body surface of elderly persons, was studied by light and scanning electron microscopy. No histological features distinguished the various wrinkles from surrounding skin. It was concluded that the wrinkle is a configuration change, like the grooves worn into an old glove, without specific structural alterations at the histological level. As regards pathogenesis, the common setting was found to be deterioration of the elastic tissue network. The skin becomes looser, excessive, and loses the ability to snap back to its original state after being deformed.

Aged↗

Elastin and mechanoreceptor mechanisms with special reference to the mammalian carotid sinus.

Light microscopic studies reveal that the carotid baroreceptor region in mammals, located at the origin of the internal carotid artery, has a preponderantly elastic structure and a thick tunica adventitia. Electron microscopy discloses the presence of sensory nerve endings within the parts of the tunica adventitia adjoining the preponderantly elastic zone of the internal carotid artery. Bundles of collagen fibres in the tunica adventitia form convolutions or whorls around the nerve terminals and often terminate on the surface of the elastic fibres or into the basement membranes of the neuronal profiles. It is concluded that the large content of elastic tissue in the tunica media of the baroreceptor region renders the vessel wall highly distensible to intraluminal pressure changes, and thereby facilitates transmission of the stimulus intensity to sensory nerve terminals. However, a change in the geometrical configuration of the bundles of collagen under the influence of elastic fibres may provide a better insight into the mechanisms of distortion of the baroreceptors related to and/or in contact with collagen fibres. In support of this is the demonstration of contact sites between collagen and elastic fibres.

Animals↗

Skin elastic fiber pathology and idiopathic scoliosis.

An antomic study of skin elastic fibers coupled with a histochemical and ultrastructural study of one peripheral muscle sample was performed in 34 patients with idiopathic scoliosis. Twenty-eight of them had an elastopathy resulting in rupture or disparity between the dermis elastic fibers. The muscle histoenzymologic study showed that 17 of the patients also had an abnormal predominance of type I muscle fibers. These data led to our discussion of the role of elastic tissue abnormalities in the genesis of early or severe idiopathic scolioses.

Adolescent↗