Degeneration Of Elastic Tissue Research Articles

Angioid streaks and generalized arterial disease.

Although histopathologic studies have shown that angioid streaks of the retina and pseudoxanthoma elasticum are only part of a generalized elastic tissue degeneration, which includes the arterial tree, the clinical relationship to arterial disease is less well known. This paper adds 10 patients to those previously reported in the literature, all of whom showed clinical evidence of arterial disease, especially marked in the lower extremities. Symptoms suggestive of vascular disease may be absent or extreme, depending upon the location of the vessel and the severity of the involvement. When the arteries of the extremities are affected, the patient may notice paresthesias, numbness, chilling, or intermittent claudication. Objective signs may be obvious or detectable only by careful examination. Pulses may be weak or absent. Pulse waves recorded on an oscillometer are ofter reduced or even absent. Vasodilatation tests may demonstrate reduced blood flow. Roentgen examination of the extremities often shows calcification

Elastica disease; case of Grönblad-Strandberg syndrome with gastrointestinal hemorrhage.

PSEUDOXANTHOMA elasticum is a well-known disease, described and named by Darier in 1896.* When associated with retinal alterations (angioid streaks, etc.), the complex is known as the Gronblad-Strandberg syndrome. The disease is presumed to be due, basically, to elastic tissue degeneration. Cutaneous lesions vary from pinhead- to pea-sized yellowish flat papules that often fuse to form plaques. The symmetrical distribution is in flexural folds (axillae, antecubital fossae, inguinal regions), the sides of the neck, upper and inner aspects of the thighs, and over the abdomen. In extreme cases there is obvious loss of cutaneous elasticity. The unilateral or bilateral retinal changes, accompanied by loss of visual acuity, appear to be due to degenerative changes of the elastica of Bruch's membrane. The disease may be found at any age in both sexes, but most commonly it begins in childhood or early adult life. A familial history, fairly regularly elicited, emphasizes the

Histogenesis of coronary arteriosclerosis.

The coronary arteries of 250 individuals dying suddenly from traumatic or natural causes were studied. Many different histopathologic processes were found to participate in the development of coronary arteriosclerosis. The earliest changes which occurred, even in infants, were increased fibroblastic activity, deposits of mucopolysaccharide and degeneration of elastic tissue. These changes were not related to lipid deposition. Moderately advanced lesions were characterized by regeneration of elastic tissue, formation of collagen and lipid deposition. The far-advanced lesions showed hyalinization, abundant lipid deposition, calcification, intramural hemorrhage and thrombosis. The possible mechanisms involved in the development of coronary arteriosclerosis are discussed.

PRECANCEROUS MELANOSIS AND DIFFUSE MALIGNANT MELANOMA OF THE CONJUNCTIVA

The fact that tissue may undergo certain changes prior to the development of a malignant growth is well known. A precancerous stage of varying duration has been observed in the experimental production of epithelioma in animals. In human beings such instances are afforded by the senile dystrophy of the skin which manifests itself by atrophy, degeneration of elastic tissue, flecks of pigment, telangiectasis and circumscribed keratosis. The same changes are seen in xeroderma pigmentosum. Other conditions in which such changes occur are leukoplakia, extramammary Paget's disease and Bowen's disease. Among these rarer manifestations can be mentioned also melanosis of the skin and of the conjunctiva. In dermatology this is recognized as a precancerous change, and considerable is known about its clinical and histologic characteristics. It may appear in the skin anywhere over the body but has a predilection for the face. It is a rather diffuse nonelevated pigmentation