Reduction Of Elastic Fibers Research Articles

The Regulation of the Function of Fibroblasts in Patients with Chronic Obstructive Pulmonary Disease by Regulating Tenascin-C Protein Under Feedback Lung Training with Curcumin in Combination with Suzi Jiangqi Decoction

Chronic obstructive pulmonary disease (COPD) is characterized by reduction of elastic fibers in alveolar wall. This study explores the mechanism of curcumin combined with Suzi Jiangqi Decoction in lung fibroblasts. 50 COPD patients suspected of lung cancer were collected. Ten patients were assigned into control group, and the remaining 40 patients underwent feedback lung training and were divided into model group, curcumin group, Suzi Jiangqi decoction group, and curcumin combined with Suzi Jiangqi decoction group. 5 mL peripheral venous blood was collected and a percutaneous lung biopsy was performed to collect lung tissue and culture fibroblasts. Tenascin (TNC) level was detected by ELISA and pathological changes of lung tissue were detected by HE staining. CCK-8 assay detected cell proliferation and Transwell chamber detected cell migration. Cell apoptosis was assessed by flow cytometry and TGF-β1, MMP-9, and TNC expression were evaluated by Real Time Quantitative Polymerase Chain Reaction (RT-qPCR) and Western blot. TNC level in COPD patients decreased significantly and levels of various pulmonary function indexes showed an upward trend. The epithelial cells in lung tissue of control group were less and alveolar wall was obviously thinner. Epithelial cells gradually increased and alveolar walls gradually fused. TNC protein can improve the development of fibroblasts in COPD patients. Curcumin combined with Suzi Jiangqi Decoction inhibited TNC expression, and down-regulated TGF-β1 and MMP-9. Curcumin combined with Suzi Jiangqi decoction increased the proliferation ability and reduced apoptosis of lung fibroblasts by down-regulating the expression of Tenascin-C. This study provides a solid theoretical basis for curcumin combined with Suzi Jiangqi Decoction as a treatment for COPD.

Uso do eletrocautério no rejuvenescimento da região orbital – relato de caso

As skin ages, skin tissue undergoes changes in its structures. Genetic material modification and cell proliferation decrease, resulting in loss of elasticity and the ability to regulate metabolism. Collagen fibers become more rigid and there is reduction of elastic fibers, leading to the appearance of wrinkles, and tissue replication becomes less efficient. In a young skin, cells take about 28 days to reach the surface. In a more mature skin, this “turnover” happens in about 40 days. This means a skin with an accumulation of aged and dead cells, opaque and dull. Not only age, but other factors such as UV rays exposure, pollution, lack of sleep and nutrition contribute to a slower cell renewal rate. Taking proper care in relation to appearance is not just a matter of aesthetics, but a way to gain self-esteem and self-confidence. There are several techniques that can be used to reduce these aging signs. This work shows a clinical case of a single session using electrocautery in the orbital region rejuvenation. After fulguration, the Red Led 660nm 30-second phototherapy was used on the area worked. The result was promising, with reduction of skin sagging and rhytids in the region, probably due to skin retraction caused by tissue trauma in just one session.

Frequent hypotension during hemodialysis in a patient with cutis laxa

Abstract Rationale: Cutis laxa is a rare disorder characterized by redundant, loose, and inelastic skin. Its chief histological feature is the reduction of elastic fibers in the dermal layer. Hypotension on dialysis is defined as a decrease in systolic blood pressure of ≥20 mm Hg or a decrease in mean arterial pressure of 10 mm Hg, accompanied by a clinical event requiring therapeutic intervention. Patient concerns: A 49-year-old female patient with cutis laxa who had frequent episodes of hypotension during hemodialysis. Diagnoses: A skin biopsy revealed changes typical of cutis laxa. Physical examination of the patient revealed systemic skin laxity with a presenile appearance. Interventions: We replaced conventional hemodialysis with hemodiafiltration. Outcomes: The hypotension improved after the patient started hemodiafiltration. Lessons: Cutis laxa may be a risk factor for hypotension during hemodialysis. Hemodiafiltration increases systemic vascular resistance and norepinephrine plasma levels in patients with cutis laxa, thereby stabilizing blood pressure. In a patient with cutis laxa, replacing conventional hemodialysis with hemodiafiltration resulted in an improvement in hypotension.

Elastic tissue disruption is a major pathogenic factor to human vascular disease.

Elastic fibers are essential components of the arterial extracellular matrix. They consist of the protein elastin and an array of microfibrils that support the protein and connect it to the surrounding matrix. The elastin gene encodes tropoelastin, a protein that requires extensive cross-linking to become elastin. Tropoelastin is expressed throughout human life, but its expression levels decrease with age, suggesting that the potential to synthesize elastin persists during lifetime although declines with aging. The initial abnormality documented in human atherosclerosis is fragmentation and loss of the elastic network in the medial layer of the arterial wall, suggesting an imbalance between elastic fiber injury and restoration. Damaged elastic structures are not adequately repaired by synthesis of new elastic elements. Progressive collagen accumulation follows medial elastic fiber disruption and fibrous plaques are formed, but advanced atherosclerosis lesions do not develop in the absence of prior elastic injury. Aging is associated with arterial extracellular matrix anomalies that evoke those present in early atherosclerosis. The reduction of elastic fibers with subsequent collagen accumulation leads to arterial stiffening and intima-media thickening, which are independent predictors of incident hypertension in prospective community-based studies. Arterial stiffening precedes the development of hypertension. The fundamental role of the vascular elastic network to arterial structure and function is emphasized by congenital disorders caused by mutations that disrupt normal elastic fiber production. Molecular changes in the genes coding tropoelastin, lysyl oxidase (tropoelastin cross-linking), and elastin-associated microfibrils, including fibrillin-1, fibulin-4, and fibulin-5 produce severe vascular injury due to absence of functional elastin.

Skin Aging & Modern Edge Anti-Aging Strategies

Skin Aging & Modern Edge Anti-Aging Strategies

Clinical and pathological features of 16 cases of childhood bullous pilomatricoma

Objective To analyze the clinical and pathological features of childhood bullous pilomatricoma. Methods The clinical and pathological features were analyzed in 16 patients with bullous pilomatricoma, who visited Department of Dermatology of Beijing Children′s Hospital from 2013 to 2017. Results Among the 16 patients, 5 were males, and 11 were females. Their age of onset ranged from 4 months to 11 years, and the median age of onset was 8.5 years. Their course of disease ranged from 2 months to 4 years, and the average course of disease was 10 months. The tumors were found predominantly on the upper limbs (10 cases, including 7 on the upper arm, 2 on the shoulder and 1 on the forearm) , followed by the face (4 cases) and the neck (2 cases) . These tumors manifested as limited pushable red lumps with blister-like appearance, and telangiectasia was observed on the surface of some lesions. The diameters of the lumps ranged from 0.5 cm to 3 cm, and hard nodules could be detected in the blisters by palpation. Under dermoscopy, uniform red background was observed in 16 cases, unstructured white area in 13, unstructured blue-grey area in 4, and liner or irregular branched vessels. Two or more dermoscopic features were observed in 15 patients. All the skin lesions were resected by surgery, and no recurrence was observed during the follow-up of 1 - 5 years. Histopathological examination showed that the tumors were located in the middle to deep dermis, and mainly consisted of basaloid cells and shadow cells, as well as transitional cells between the above two kinds of cells. Varying degrees of infiltration of inflammatory cells and hyperplasia and calcification of the fibrous connective tissue were observed in the tumor interstitium, with multinucleated giant cells in some areas. There were varying degrees of infiltration of inflammatory cells, lymphangiectasis, reduction or absence of elastic fibers in the dermis between the epidermis and tumors. Conclusions Childhood bullous pilomatricoma mostly occurs on the upper limbs, face and neck. Histopathologically, the tumor consists of basaloid cells and shadow cells with lymphangiectasis and reduction of elastic fibers in the dermis. The main dermoscopic features are red background and unstructured white areas. Its prognosis is good after surgical excision. Key words: Pilomatrixoma; Child; Dermoscopy; Skin manifestations; Pathologic processes; Bullous pilomatricoma

Cutis laxa associated with monoclonal gammopathy: 14 new cases and review of the literature

Cutis laxa associated with monoclonal gammopathy: 14 new cases and review of the literature

The Histopathological Findings of Patients Who Underwent Blepharoplasty Due to Dermatochalasis

ABSTRACTPurpose: To assess changes in lymphatic vessels, collagen, and elastic fiber structure in excised tissues with dermatochalasis (DC). Methods: In this prospective histopathological study, 70 upper eyelid skins of 35 patients operated on for dermatochalasis were compared with 10 eyelid skins of 10 patients operated on for other diagnoses. In histopathological examination, the two groups of patients were compared with respect to number of lymphatic vessels, largest lymphatic vessel diameter, number of elastic fibers, number of macrophages, edema between collagen fibers, and depth of stromal collagen bed. Results: As compared to the control group, the study group had a significantly greater number of dilated lymphatic vessels (p = 0.0001), largest lymphatic vessel diameter (p = 0.02), depth of stromal collagen bed (p = 0.0001), edema space between collagen fibers (p = 0.0001), elastic fiber density (p = 0.0001), and number of macrophages (p = 0.001). Conclusion: According to the results of the present study, in addition to an increase in the diameter and number of lymphatic vessels, a reduction in elastic fibers that are essential for the structure and function of lymphatic system, disarrangement in collagen fibers, stromal edema, and increased number of macrophages play a role in the development of dermatochalasis.

Reduction and fragmentation of elastic fibers in the skin of obese mice is associated with altered mRNA expression levels of fibrillin-1 and neprilysin

ABSTRACTAim of the study: Our previous research suggested that obesity induces structural fragility in the skin. Elastic fibers impart strength and elasticity. In this study, we determined whether elastic fibers decrease in the skin of obese mice. Materials and Methods: To confirm alterations in elastic fiber content due to obesity, we used spontaneously obese model mice (TSOD) and control mice (TSNO). Furthermore, to evaluate the elastin structure and gene expression dependent on the severity of obesity, an obesity-enhanced mouse model was developed by feeding a high fat diet to TSOD (TSOD-HF). Back skin samples were stained with hematoxylin and eosin and Elastica van Gieson for microscopic examination, and the samples were stained for immunohistochemical analysis of neprilysin. Gene expression levels were determined using a real-time PCR system. Results: The abundance of elastic fibers beneath the epidermis was remarkably reduced and fragmented in TSOD as compared with TSNO. Fibrillin-1 mRNA levels in TSOD were significantly suppressed compared with those in TSNO, whereas neprilysin mRNA levels and immunohistochemical expression in TSOD were significantly increased, as compared with those in TSNO. The reduction of elastic fibers was enhanced and the expression levels of elastic fiber formed factors were significantly suppressed in TSOD-HF, as compared with those in the TSOD. Conclusions: The abundance of elastic fibers was reduced and fragmented in obesity, suggesting that the reduction in elastic fibers is initially caused by increased neprilysin and decreased fibrillin-1 expression, which may inhibit formation and stabilization of elastic fibers, resulting in skin fragility in obesity.

Histologic and sonographic features of holmium laser in the treatment of chronic venous disease.

A new holmium laser (HOL) has been introduced to the market. The device is able to reduce the great saphenous vein (GSV) caliber in a tumescence-free procedure, favoring an effective sclerotherapy of large vessels. Aim of the present investigation is to provide the first in vivo data about the effect of HOL on GSV histology. Six chronic venous disease (C2-5, Ep, As, Pr) patients (M:F ratio 1:1; age: 57±8, BMI 24±2 kg/m2) underwent HOL-assisted caliber reduction of the GSV, high-ligation and flush ligation of the incompetent tributaries. Three cm of proximal great saphenous vein not treated by laser and 3 cm of a contiguous segment that was just previously treated by HOL were harvested. Histological assessments were performed. Patent GSV lumen caliber was assessed at the mid-thigh right before, and after the procedure. Periprocedural pain was graded by Visual Analogue Scale. GSV samples after holmium laser therapy showed thickening of the vascular wall with a decreased, yet patent lumen. Immunostaining demonstrated intact endothelial lining in both the treated and not treated segments. Expansion of collagen fibers was observed in the laser-treated segments. Collagen appeared more homogeneous than in controls, with an amorphous appearance. Laser treated veins showed a reduction in elastic fibers with greater fragmentation. Smooth muscle cells appeared swollen. The caliber of the mid-thigh great saphenous vein lumen decreased from 8.1±0.8 mm to 3.9±0.2 mm (P<0.0001). The average periprocedural pain was 1±0.6. HOL significantly reduces the caliber of the GSV. The endothelial lining is spared, while the remaining wall is thickened by a hyalinization-like process.

A case of lipoatrophic panniculitis in a 2-year-old boy.

Lipoatrophic panniculitis is generally a rare condition affecting mainly children, sometimes associated with connective tissue diseases [1, 2]. There are also reports about this condition occurring in adults [3]. This idiopathic, rarely reported panniculitis is presumed to have an autoimmune pathogenesis. A histopathological analysis reveals lobular panniculitis with fat necrosis and an associated inflammatory infiltration. Other histological findings are a focally increased number of lymphocytes rimming the adipocytes and infiltration of vascular walls by mildly atypical lymphoid cells [4]. Clinical and histopathological features lead to diverse diagnostic considerations like subcutaneous panniculitis-like T-cell lymphoma, Weber-Christian disease or Rothman-Makai syndrome [5]. We present a 2-year-old boy with no clinical or laboratory features of connective tissue disease who presented a progressive appearance of annular atrophic plaques with erythema on the right ankle. Skin lesions were about 2–3 cm in diameter with palpable loss of subcutaneous tissue (Figure 1). The patient was referred to the Chair and Clinical Department of Internal Diseases, Dermatology and Allergology in Zabrze after several consultations in other dermatology and rheumatology departments, with a suspicion of morphea, granuloma annulare orlipodystrophy. All blood tests like blood count, biochemical analysis, antinuclear antibodies and inflammatory markers were normal. Also X-ray of the lower limb was correct. There was no anamnesis of arthritis, thyroid gland abnormalities or fever. The first histopathological examination revealed acanthotic epidermis, collagen fiber protrusion, reduction of elastic fibers and in subcutaneous tissue – panniculitis. On the basis of the histological image, morphea profunda was suspected. However, the clinical picture with no immunological markers of connective tissue disease was still thought-provoking. The boy was treated with topical and systemic steroids for 6 months, and also with pentoxifylline and naproxen with no significant improvement. The second histopathological examination showed lymphocytes and histiocytes infiltration in the deep layers of dermis and subcutaneous tissue, in fatty tissue atrophy and inflammatory infiltration with histiocytes, lipofages similar to Touton cells and lymphocytes (Figure 2). On the basis of analyzed data, clinical and histopathological examination we identified lipoatrophic panniculitis. The appearance of new disease outbreaks required different treatment. Methotrexate (MTX) in an oral dose of 6.125 mg once a week (10 mg/m2/week) was administered for 10 weeks. A good tolerance of medication, on the basis of clinical condition and biochemical parameters monitoring, was noticed. We observed total suppression of the process with no further progression of skin lesions during 2 years of observation. Figure 1 Skin lesions before the treatment Figure 2 Histopathological examination – lipoatrophic panniculitis We present the case to describe clinical and diagnostic difficulties in our young patient with good clinical response to methotrexate (MTX) treatment. Although lipoatrophic panniculitis is a rare condition it should be considered particularly in the case of children. Panniculitis in children is a heterogeneous group of diseases, and so is in adults; it is characterized by inflammation of the subcutaneous and fatty tissue. Only a few types of panniculitis are found in childhood only, such as fat sclerosis of the newborn, while the vast majority of other types may be found both in the pediatric age and in adults [6, 7]. Lupus panniculitis, cold panniculitis, panniculitis in Behcet's disease, and post-steroid panniculitis are mainly observed in adults [8]. There are also few rare forms of panniculitis, such as eosinophilic panniculitis or subcutaneous panniculitis T-cell lymphoma, which often give diagnostic difficulties but also mainly occur in adults [9]. Lipoatrophic panniculitis is most frequently observed in infants and children. Its clinical features are erythematous nodules and plaques followed by circumferential atrophy of the distal lower extremities, sometimes connected with fever, juvenile arthritis, or Hashimoto disease. In the diagnostic process it should be differentiated with all forms of panniculitis. Immunological, endocrine abnormalities and morphea or lupus profundus should be excluded. In our case, the patient was previously diagnosed with morphea, probably because of lack of experience in recognizing lipoatrophic panniculitis, which is rare. As described by some authors, it may be difficult to distinguish between lipoatrophic panniculitis and panniculitis of Weber-Christian or its variant – Rothmann-Makai panniculitis [10]. Histopathological examination of the deep skin biopsy seems to be crucial for differentiation. Also treatment of lipoatrophic panniculitis may be challenging. There are few reports concerning therapy with steroids, hydroxychloroquine or methotrexate (MTX) [11]. However, there are no clear indications for children's therapy. Lipoatrophic panniculitis should be considered in infants and young children with clinical features of panniculitis and fat atrophy without clinical or serologic evidence of connective tissue disease. Methotrexate may be considered as a good treatment when systemic therapy is essential.

Simultaneous treatment of pterygium complicated with conjunctivochalasis: analysis of pterygium excision and conjunctival autotransplantation combined with sclera fixation.

BackgroundThis prospective study investigated the safety and efficacy of a therapeutic method of treating pterygium complicated with conjunctivochalasis, using pterygium excision and conjunctival autotransplantation combined with sclera fixation, followed by therapeutic contact lens application.MethodsFifty-seven patients (83 eyes) diagnosed as pterygium complicated with conjunctivochalasis, at our hospital from July 2011 to June 2012, were selected. Patients were treated with pterygium excision and conjunctival autotransplantation combined with sclera fixation surgery, then therapeutic bandage contact lenses were applied. The efficacy of simultaneous surgery was evaluated based on vision changes, tear dynamics, and other complications. Histopathological changes were investigated on removed bulbar conjunctival tissue, using hematoxylin eosin (HE) and Masson’s trichrome staining.Results(1) Three months after the operation, the success of simultaneous surgery in the treatment of pterygium was 97.6 %, and the recurrence was 2.4 %. Based on subjective evaluation, the success of the simultaneous treatment of conjunctivochalasis was 95.2 %, and failure was 4.8 %. Based on objective evaluation, the success rate was 94.0 % and the recurrence rate was 6.0 %. (2) Visual acuity of the 83 eyes was significantly improved after surgery, and was statistically significant (X2 = 10.29, P < 0.05). (3) Three months after surgery, the height and integrity of the tear meniscus, tear film break-up time, and chloramphenicol test results of the 83 eyes were significantly improved and there was a statistically significant difference (X2 the height and integrity of tear meniscus = 147.24, X2 tear film break-up time = 81.17, X2 chloramphenicol test = 17.41, P < 0.01). (4) Complications after the operation such as granulation hyperplasia, constrictive fornix, oculomotor defect, and other complications were not observed. (5) Pathological observations, using HE and Masson’s trichrome staining of removed bulbar conjunctival tissue, showed several pathological changes, including obvious squamous epithelial hyperplasia, parakeratosis, basal cell pigmentation, lamina propria hemorrhage, infiltration of lymphocytes, and reduction of elastic fibers and collagen fibers.ConclusionPterygium excision and conjunctival autotransplantation, combined with sclera fixation followed by therapeutic contact lens use was safe, effective, and suitable for simultaneous treatment of pterygium complicated with conjunctivochalasis.

Oral lichen sclerosus expressing extracellular matrix proteins and IgG4-positive plasma cells

Lichen sclerosus (LS) is a mucocutaneous disease with uncommon oral involvement. The etiology is not yet well understood, but LS has been associated with autoimmune, genetic, and immunological factors. We report a 47-year-old man with LS that exhibited an asymptomatic white plaque with red patches on the maxillary alveolar mucosa extending to the labial mucosa. He had no other skin disease. Positive immunostaining for tenascin and scarcity of fibronectin suggested extracellular matrix reorganization. Elastin immunostaining indicated a reduction of elastic fibers. Immunoexpression of collagen IV in blood vessels and its absence in the epithelial basement membrane, together with diffuse MMP-9 immunoexpression, suggested altered proteolytic activity. Mast cell staining bordering areas of sclerosis indicated a possible role in the synthesis of collagen. IgG4 positivity in plasma cells suggested a role in the fibrogenesis. This is an unusual presentation of oral LS and we discuss immunohistochemical findings regarding cellular and extracellular matrix components.

Morphologic and Biomechanical Changes of Thoracic and Abdominal Aorta in a Rat Model of Cigarette Smoke Exposure

Smoking is the most relevant environmental factor that affects the development of aortic aneurysm. Smokers have elevated levels of elastase activity in the arterial wall, which leads to weakening of the aorta. The aim of this study was to verify whether cigarette smoke exposure itself is capable of altering the aortic wall. Forty-eight Wistar rats were divided into 2-, 4-, and 6-month experimental periods and into 2 groups: smokers (submitted to smoke exposure at a rate of 40 cigarettes/day) and nonsmokers. At the end of the experimental periods, the aortas were removed and cross-sectioned to obtain histologic specimens for light microscopic and morphometric analyses. The remaining longitudinal segments were stretched to rupture and mechanical parameters were determined. A degenerative process (i.e., a reduction in elastic fibers, the loss of lamellar arrangement, and a reduction of smooth muscle cells) was observed, and this effect was proportional in intensity to the period of tobacco exposure. We observed a progressive reduction in the yield point of the thoracic aorta over time (P < 0.05). There was a decrease in stiffness (P < 0.05) and in failure load (P < 0.05) at 6 months in the abdominal aorta of rats in the smoking group. Chronic exposure to tobacco smoke can affect the mechanical properties of the aorta and can also provoke substantial structural changes of the arterial wall.

Chronic stress-induced oxidative damage and hyperlipidemia are accompanied by atherosclerotic development in rats

Although stress-induced hyperlipidemia and increased oxidative stress have been reported and implicated in etiology of atherosclerosis, experimental evidence for stress-induced atherosclerotic development concomitant with these alterations is lacking. In this study, exposure of adult male albino Wistar rats (Rattus norvegicus) to restraint for 1 h and after a gap of 4 h to forced swimming for 15 min every day for 2, 4, or 24 weeks resulted in a duration of exposure-dependent hyperlipidemia as shown by significant increases in concentrations of blood cholesterol, low-density lipoproteins, and triglycerides and decrease in high-density lipoprotein concomitant with increased oxidative stress as indicated by decrease in hepatic antioxidant enzyme activities and increase in lipid peroxidation in the liver, kidney, and heart. These alterations were accompanied by development of fibrous layer, formation of foam cells, reduction in elastic fibers, and accumulation of Oil-Red-O-positive lipid droplets in the intima of thoracic aorta following 24 weeks of stress exposure, but not after 4 weeks. The study demonstrates for the first time that (i) chronic stress-induced hyperlipidemia and oxidative damage are coupled with atherosclerotic development in rats fed with normal diet and (ii) chronic stress effects prevail even after the cessation of stress exposure as indicated by high concentration of blood cholesterol and reduced hepatic superoxide dismutase activity 20 weeks after 2 or 4 weeks of stress. This study exemplifies long-term allostatic regulation leading to a pathological state, with long-term hyperlipidemia and oxidative damage from chronic stress resulting in atherosclerosis.

Effects of corticosteroid, montelukast and iNOS inhibition on distal lung with chronic inflammation

We evaluated the effects of anti-iNOS (1400W – W) associated with leukotriene antagonist (montelukast – M) or corticosteroid (dexamethasone – D) on distal lung of guinea pigs (GP) with chronic pulmonary inflammation. MethodsGP were inhaled with ovalbumin (OVA-2×/week/4weeks), treated with M (OVAM), D (OVAD) and/or W (OVAW, OVADW, OVAMW) and distal lungs were evaluated by morphometry. ResultsIsolated treatments were not sufficient to reduce all parameters. In OVADW, all parameters were reduced with greater reduction in elastic fibers, TIMP-1, IL-4, IL-5, IFN-gamma and PGF2-alpha compared with OVAD (p<0.05). OVAMW potentiated the reduction of actin, elastic fibers, TIMP-1, IL-4, IL-5, TGF-beta, IFN-gamma, iNOS, and PGF2-alpha to a greater extent than OVAM (p<0.05). A reduction of TIMP-1, IL-4, IL-5, TGF-beta, IFN-gamma and iNOS was observed in OVADW compared with OVAMW (p<0.05). ConclusionsAlthough anti-iNOS paired with montelukast or dexamethasone yields better results than isolated treatments, the most effective pairing for controlling inflammation, oxidative stress and remodeling in this asthma model was found to be corticosteroids and anti-iNOS.

Therapeutic effect of phosphodiesterase-5 inhibitor on pathological changes of tunica albuginea in erectile dysfunction: experiment with rats

To investigate the pathological changes of tunica albuginea in erectile dysfunction (ED), the role of tunica albuginea in penis erection, and the therapeutic effect of phosphodiesterase-5 inhibitor (PDE5I) on ED. Thirty 8-week-old male Sprague-Dawley rats were randomly divided into 3 equal groups: (1) control group fed with normal diet for 16 weeks, (2) high-fat group fed with the diet containing 2% cholesterol and 10% pork fat, and (3) Tadalafil group fed with high-fat diet for 16 weeks and undergoing gastric perfusion of Tadalafil 2 mg/kg daily since the 13th week for 4 weeks. Sixteen weeks later, intracavernous pressure and mean arterial pressure were measured, and the ratio of maximal intracavernous pressure to mean arterial pressure (ICP/MAP) was calculated blood samples were collected. Blood samples were collected from the abdominal aorta to undergo lipid profile test. Then penis was cut. Victoria blue/ponceau red staining and color image analysis were used to observe the content of elastic fibers in the tunica albuginea. The ICP/MAP of the high-fat group was 0.49 +/- 0.05, significantly lower than that of the control group (0.82 +/- 0.06, P < 0.01). The ICP/MAP of the Tadalafil group was 0.60 +/- 0.02, significantly higher than that of the high-fat group (P < 0.05). The content of elastic fibers in tunica albuginea of the high-fat group was 468 +/- 152, significantly lower than that of the the control group (3292 +/- 1123, P < 0.01). The content of elastic fibers in tunica albuginea of the Tadalafil group was 2062 +/- 560, significantly higher than that of the high-fat group (P < 0.05). High fat diet may lead to ED and reduction of elastic fibers in tunica albuginea, and PDE-5I reverses such pathological changes.

Calcium pyrophosphate crystal deposition in the ligamentum flavum of degenerated lumbar spine: histopathological and immunohistological findings

We investigated the histological and immunohistochemical features of degenerative changes in the ligamentum flavum of the lumbar spine with calcium crystal deposition. We investigated degenerative changes in 270 ligamentum flavum specimens harvested from 198 patients who underwent decompressive surgeries for lumbar spinal canal stenosis. En bloc sections of the ligamentum flavum were examined histologically. We also examined immunoreactivity for transforming growth factor (TGF)-beta, vascular endothelial growth factor (VEGF), CD34, and CD68; immunoblot analysis for VEGF; and terminal deoxynucleotidyl transferase-mediated deoxyuridine 5-triphosphate nick end-labeling (TUNEL) method. The ligamentum flavum showed fragmented and disorganized elastic fiber bundles with increased collagen fibrils in the matrix. Calcium deposition, which was identified as calcium pyrophosphate dihydrate crystals, was evident in 72 of 198 patients and in 99 of 270 samples, and was associated with appearance of hypertrophic chondrocytes and new blood vessel formation. Areas of calcium deposits were surrounded by abundant hypertrophic chondrocytes (with marked immunoreactivity to TGF-beta and VEGF) and a significant number of TUNEL-positive chondrocytes. Calcium crystal deposition in the lumbar ligamentum flavum progresses with reduction in elastic fibers and accumulation of collagen fibrils in the matrix as well as expansion of chondrometaplastic areas.

Acquired cutis laxa associated with cutaneous angiocentric T‐cell lymphoma

A 64‐year‐old man presenting with adenomegaly was diagnosed with stage IV A angiocentric cutaneous T‐cell lymphoma in 1988. Since he showed a poor response to psoralen plus UVA (PUVA) after 1 year of therapy, he was switched to systemic chemotherapy (COP), and was considered to be in remission after completion of 5 months of this regimen. In December 1989, the patient noted an asymptomatic lesion at the superior and internal aspect of his right thigh; on examination, there was a poorly circumscribed, noninflammatory, whitish, atrophic macula near the inguinal fold and a palpable adenopathy; its surface was irregular, showing small wrinkling, and could be depressed on palpation. There were no preceding inflammatory lesions and no cutaneous lymphoma lesions at this site. Slowly, the initial macule extended, and new similar lesions insidiously appeared symmetrically on the left thigh. In October 1990, the patient received electron beam therapy for a relapse that presented as troncular nodules and responded well to this therapy. In the months that followed, the skin of his whole body became progressively sagging and pendulous, without recoil. This was not preceded by an inflammatory phase or eruption. There was no family history of elastolytic disorder, and the patient was not taking any medication other than that described above. On questioning, there were no symptoms suggesting systemic involvement of this elastolytic disorder. On physical examination, the patient's whole body skin seemed redundant, nonresllient, and wrinkled, this being most obvious in the axillae, inguinal region, antecubital fossa, neck, and trunk, where loose and pendulous skin folds could be seen (Fig. 1). Also, the patient's face was excessively wrinkled and sagging and he had bilateral ectropion. At the superior and internal aspect of both thighs, large, poorly circumsoribed, but distinct, round patches of 1‐5 cm in diameter were observed; they were atrophic and whitish, with an uneven surface, and could be depressed on palpation. Apart from 1 cm, mobile, but firm, axillary and inguinal adenopathy and three subcutaneous nodules on the arm and trunk, the rest of the physical examination was unremarkable.Routine blood tests were normal, as was a chest X‐ray. Sezary cells were absent on blood smear, and borrelia and syphilis serology were negative. Thyroid function tests, angiotensin converting enzyme, and immunoelectrophoresis were within normal limits, and antinuclear antigen was negative. Two cutaneous biopsies were performed: one in an atrophic herniating lesion of the right thigh and the one on the abdomen. Both showed, on hematoxylin‐phloxin‐safran staining, a mild dermal perivascular inflammatory infiltrate with a predominance of mononuclear cells. On Weigert staining, both were marked by a net reduction in elastic fibers throughout the dermis.

Elastase-like protease and elastolytic activities expressed in cultured dermal fibroblasts derived from lesional skin of patients with pseudoxanthoma elasticum, actinic elastosis, and cutis laxa

Pseudoxanthoma elasticum (PXE), actinic elastosis, and cutis ‘laxa are three cutaneous disorders in which alterations in the structure of dermal elastic fibers are seen [1,2]. Elastic fibers in PXE are increased in number, appear clumped and become calcified. The acquired skin disorder, actinic elastosis, is described as a proliferation (elastosis) of abnormal elastic fibers that become thickened and tangled [3]. Cutis rhomboidalis nuchae represents an extensive form of actinic elastosis on the posterior aspect of the neck of individuals 60 years of age or older who have had chronic exposure to the sun. Cutis laxa is considered to be a more generalized elastolysis; the skin is abnormally lax and hangs in folds; histopathological changes include a reduction in elastic fibers. In addition, the remaining elastic fibers appear thin and fragmented. Therefore, these three distinct disorders are all characterized by abnormalities in elastic fibers. It has been suggested that proteolytic degradation by elastase(s) plays a role in the formation of the elastin abnormalities seen in disease states [4-61. These proteases have been found in extracts prepared from dermal fibroblasts [7-lo] and in sera from a patient with cutis laxa [ll]. In this investigation, fibroblast cultures were established from affected areas of patients with pseudoxanthoma elasticum, actinic elastosis (cutis rhomboidalis nuchae), and cutis laxa. Elastase-like protease and elastolytic activities were assayed using succinyl trialanine paranitroanilide (SANA) and radiolabeled insoluble skin elastin in extracts of these cells.