Thickened Blood Vessels Research Articles

Recurrent optic neuromyelitis with endocrinopathies: a new syndrome.

We report a new syndrome that we call "recurrent optic neuromyelitis with endocrinopathies" in eight Antillean women from Martinique and Guadeloupe Ocular involvement was either monocular or binocular, whereas myelopathy was acute or subacute. In seven patients, myelopathic symptoms recurred, and in six patients, visual problems recurred. Spinal cord involvement was a consistent band-like pseudo-syringomyelic dissociated sensory loss. All eight patients had endocrinopathies consisting of amenorrhea, galactorrhea, diabetes insipidus, hypothyroidism, or hyperphagia. Spinal cord MRI revealed cavitation-like images. Various immunosuppressant treatments had little effect on the uniformly deteriorating course, ending in blindness and paraplegia. Six patients died within 5 years of onset, and an autopsy in one patient showed multiple demyelinizing lesions of the spinal cord with thickened blood vessels walls without evidence of inflammation. These cases appear to constitute a syndrome distinct from MS and from classic Devic's syndrome, not only because of the association with endocrinopathies but because of the stereotypy of the recurrences, the absence of MRI lesions in the cerebral white matter, and the unusual image of cavitation of the spinal cord. The syndrome is also distinct from HTLV-I-associated paraparesis, which is endemic in the West Indies.

MRI-pathological correlate of brain lesions in a necropsy case of HTLV-I associated myelopathy.

A postmortem case of HTLV-I associated myelopathy (HAM)/tropical spastic paraparesis (TSP) with a history of remission and exacerbation of neurological signs and symptoms, resembling those of multiple sclerosis is reported. MRI analysis revealed lesions in the periventricular white matter in addition to atrophy of the thoracic spinal cord, characteristic of HAM/TSP. The cerebral periventricular areas consisted of ill-defined paucity of myelin sheaths with astrocytic gliosis and hyaline thickening of blood vessels. The poorly demarcated white matter lesions found in both brain and spinal cord were different from plaques found in multiple sclerosis. It is suggested that, in some cases of HAM/TSP, inflammatory lesions that destroy myelin can involve not only the spinal cord but also the cerebral periventricular white matter.

Systemic vasculitis: A temporal bone histopathologic study

Systemic vasculitis includes a broad spectrum of disorders that may involve blood vessels of any size in any organ system. Systemic vasculitis is associated with immunopathogenic mechanisms. Sixteen temporal bones from eight persons were studied to determine histopathologic changes that occur in systemic vasculitis. Three persons had Wegener's granulomatosis, two had polyarteritis nodosa, and three had systemic lupus erythematosus. Otitis media was seen in 15 ears, with ten ears showing chronic middle ear changes and two showing fibrotic inner ear changes. In Wegener's granulomatosis, granulation tissue was observed around the eustachian tube and protympanum, and in polyarteritis nodosa, inflammatory cell infiltrate and thickened blood vessels were observed around the facial nerve. Although sensorineural hearing loss has been described clinically in systemic lupus erythematosus, the present report describes findings in temporal bones, including severe fibrosis and new bone formation throughout the inner ear.

Unusual case of diffuse connective tissue disease with nodule formations in muscle, lung, kidney and brain

A 9-year-old boy had nodular masses in the left gastrocnemius muscle and lung, right kidney and right frontal area of the brain. Laboratory examinations, including positive anti-nuclear antibody, anti-RNP antibody, RA and CRP, hyper-gamma-globulinemia and accelerated ESR, showed characteristic of diffuse connective tissue disease (DCTD). Biopsy specimens were obtained from the thymus and from masses in the left lung and gastrocnemius muscle. The thymus showed hyperplasia, and a mass in the lung showed nonspecific inflammatory reactions such as connective tissue proliferation and cellular infiltration. Biopsied muscle also showed severe connective tissue proliferation, cellular infiltration, variation in fiber size and thickened blood vessel walls. In addition, abnormalities, including thickening of the basement membrane and an almost occluded narrow lumen of capillaries, were found on electron microscopy examination. Steroid administration led to remarkable improvement of the symptoms. These results suggested that DCTD is responsible for these symptoms.

The zoapatle VIII. Ultrastructural changes in endometrium of rats

Intrauterine administration of Zoapatle aqueous crude extract (ZACE) prepared from Montanoa tomentosa s.s.p. tomentosa , on day 4 of pregnancy, did not alter the normal uterine morphological changes by days 5 and 8 of pregnancy in the rat. On the other hand, ZACE made from Montanoa frutescens caused profound alterations on the uterine structures, such as: focal loss of epithelial lining, thickened blood vessels and alterations in stroma cells in rat endometrium. Morphological alterations correlate well with the antiimplantation effect associated with the intrauterine administration of these plant extracts. Scanning electron micrographs of leaves from Montanoa tomentosa and Montanoa frutescens revealed striking differences in glandular secretion and trichomes.

1522 EVIDENCE OF CHRONIC RENAL DAMAGE IN PATIENTS WITH STEROID DEPENDENT MINIMAL CHANGE DISEASE (MCD) NEPHROTIC SYNDROME

Renal biopsies of 11 patients with frequently relapsing, steroid-dependent but responsive nephrotic syndrome were evaluated prior to therapy with chlorambucil. There were 7 males and 4 females. Age at onset ranged from 2 to 10 yrs. (mean 4.5) and the duration of disease from 5 mos. to 12 yrs. (mean 3.6 yrs.). Glomerular histology was consistent with MCD and no deposits were seen on immunofluorescence and electron microscopy. However, histological changes of chronic damage were seen in 7/11 patients and included: focal tubular atrophy and thickened tubular basement membrane in 4/11, periglomerular fibrosis 2/11, interstitial fibrosis 4/11, interstitial inflammation 4/11, focal interstitial calcinosis 2/11 and thickened blood vessel wall in 3/11. All patients achieved complete, prolonged remissions with chlorambucil. Three subsequently relapsed but remained steroid responsive. Histological changes of chronicity showed no correlation to age at onset, sex, duration of disease, frequency and/or number of relapses, serum lipid levels, the selectivity of proteinuria and the in-vitro lymphoblast inhibitory factor in plasma. These results show that in some patients with steroid dependent MCD prominent histological evidence of chronic renal damage can occur. Whether these changes induce steroid dependency, are due to prolonged proteinuria, and would progress without therapy to chronic renal failure remains a possibility.

Histopathological and biochemical changes in guinea pigs after repeated dermal exposure to benzene hexachloride.

Dermal application of benzene hexachloride in daily doses of 100, 200 and 500 mg/kg for a total period of 30 days caused significant changes in male guinea pigs. The animals exposed to high doses of benzene hexachloride (1,2,3,4,5,6-hexachlorocyclohexane) (BHC) (BHC) died within 5--12 days. There was no mortality in 100 mg/kg/day but significant pathologic and biochemical changes were observed in the vital organs of the experimental animals. Massive congestion and thickened blood vessels were seen in liver of the BHC treated animals in comparison to the normal picture of the controls. Similarly, testicular changes included mild to severe pathologic lesions. There was no change in the epididymis, kidney, spleen, brain and lungs. The changes in the skin were mild and no signs of dermatitis were observed in the BHC painted areas. The activity of glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT) and alkaline phosphatase in liver and serum revealed significant changes from that of the controls. The significance of biochemical changes with the tissue damage of the insecticide exposed animals are discussed.

Proliferative Optic Neuropathy in Horses.

An asymptomatic, ophthalmoscopically visible proliferation affected the optic disc and nerve of two aged horses. The lesion consisted of an accumulation of foamy cells, histologically akin to fat cells, which contained an unidentified lipid-like material. The affected area and its environs were permeated by tortuous, thickened blood vessels with heavy deposits of collagen in their walls. The neuropathy is considered to be a storage disease, and although the product stored is unidentified, the lesion is similar to that of human xanthelasma. The neuropathy seems distinct from the exudative optic neuritis of horses that has been known since 1890.

Involution of placental site and corpus luteum in the monkey

Fibrous and often calcified myometrial nodules up to 0.4 cm. in diameter were observed in the majority of parous monkeys at necropsy. Histologically, these areas consisted of large pale cells surrounding thickened blood vessels. Frequently, the cells were seen inside thrombosed blood vessels. Fibrosis was common. These nodules are considered to be involuting placental sites which, in monkeys, may persist for more than one year post partum while in human beings they have disappeared by 7 weeks post partum. The origin of the large cells is disputed, but they may be decidual. In the ovaries, histiocytic corpora lutea predominated rather than the corpora albicantia usually seen in human beings. The histocytic coropora contained a ceroid pigment. It is concluded that the development of corpora albicantia from corpora lutea via corpora histiocytica takes longer in monkeys than in man.

Ankylosing Spondylitis and Osteitis Condensans ILII: A Histological, Microradiographical and Tetracycline Fluorescence Study of the Iliac Bone Adjacent to the Sacro-Iliac Joint

SummaryBiopsy material from the iliac bone adjacent to the sacroiliac joint was studied by histological, microradiographical and tetracycline fluorescence methods in three male cases of ankylosing spondylitis and in three female cases of osteitis condensans ilii. Microradiography was also performed in two control cases. Histological examination revealed bone areas indicating osteonecrosis in one case each of spondylitis and osteitis condensans and also regenerative areas in one case of both groups. Thickened blood vessels were found in the bone in one case of spondylitis and in the outer part of bone in osteitis condensans. Microradiography revealed both thick and narrow trabeculae in roentgenologically sclerotic areas in both groups. In two cases of either group there were regenerative areas. Tetracycline fluorescence was found in both groups, but was somewhat more marked in the osteitis condensans cases.

METABOLISM OF MONOAMINES IN SPONTANEOUSLY HYPERTENSIVE RAT

A number of reports (1) have been appeared in attempt to explain the pathogenesis of essential hypertension from the pathological, pharmacological and epidemiological points of view. It has recently been demonstrated that norepinephrine (NE) and serotonin (5HT) are important transmitters of the nervous system. In addition, metabolic pathway of these amines has recently been clarified (2-4). The present study is primarily concerned with a comparison between normotensive Wistar strain rats and spontaneously hypertensive rats separated from the same strain through the selective inbreedings by Okamoto and his colaborators (5). They mated Wistar strain rats which showed slightly higher blood pressure than the average under normal conditions. Continuously hypertensive first generation rats were selected and mated again in brother-sister breedings, until by serial reperation of this method, a spontaneously hypertensive colony of Wistar rats was obtained. This hypertensive colony is useful for these experiments, because it is not so difficult to obtain numerous offsprings and they keep an average span of life, and it is not necessary to turn to any particular agent like DOCA or surgical operation to obtain hypertension. They show an almost 100% occurrence of over 150 mmHg of blood pressure after 25 weeks of age. Pathological changes (6) such as heart hypertrophy, thickening of blood vessels, and nephrosclerosis after the maintenance of hypertension being satisfactory for experimental hypertension, and it may be comparable with human essential hypertension. The purpose of this study is to ascertain whether the metabolism of monoamines is consistently associated with hypertension or not, by means of comparison, on 5HT and NE metabolism has been made between normotensive and hypertensive rats.

Clinical bacteriological and histo-pathological studies on bacteria within the maxillary sinus mucosa with special regard to bacterial allergy

Attempts were made of the clinical, bacteriological and histo-pathological studies on bacteria within the maxillary sinus mucosa to clarify their etiological significance in the causes of maxillary sinusitis. Results obtained were as follows:1. Gram-negative bacilli which were predominant in the pus (Table 1) were hardly found in the mucous membrane, while cocci and diplococci were equally present both in the pus and mucous membrane (Table 2 and 4).2. In general, the bacteria were observed more in the middle or deeper layer of the mucous membrane than in the superficial layer. Few bacteria were found in the area associated with marked cellular infiltration and most of them were within phagocytes. They were numerous in the edematous areas with slight cellular infiltration and around thickened blood vessels.3. No statistically significant relationship was present between the number of the bacteria in-the mucous membrane and the duration of symptoms of the individual patients examined (Table 5).4. It was ascertained that macroscopically edematous hypertrophic membrane contained numerous bacteria and the membrane appearing almost normal was contaminated with few bacteria (Table 6).5. The number of bacteria within the mucous membrane of a sinus was in proportion to the quantity and the foul smell of the pus in the sinus, and not to the stickiness of the pus (Table 7).6. The relationship between eosinophilic infiltration in the mucous membrane and bacterial allergy was not evident as shown in Table 9.7. According to histological types of the affected mucous membrane, the bacteria were found less in the infiltrative or normal type, and more in the edematous or fibrotic type (Table 8).8. The origin of respective histological type following bacterial infection was assumed from above observations. Infiltrative type with numerous plasma cells and lymphocytes may be formed as chronic allergic productive inflammation due to bacterial allergy.

MORPHOLOGICAL STUDIES ON THE ARTERIES OF THE MUCOUS MEMBRANE OF THE HUMAN INFERIOR NASAL CONCHA

The author made the histological studies on the distributing arteries of the mucous membrane of the human inferior nasal concha. The specimens were obtained by means of the operation. After fixation with Zenker-formalin or Levi's solution, the trimmed pieces were embedded in paraffin, and cut into frontal, complete serial sections 7μ in thickness. Hematoxylineosin stain, Heidenhain's azan stain, Weigert's stain for elastic fibers, Heidenhain's iron-hematoxylin stain and periodic acid-Schiff stain were used. According to the author's observations, arteries of the mucous membrane of the inferior nasal concha are divided into two, that is, arterial plexus in the deep layer and that in the middle layer of the mucous membrane. Arterial plexus in the middle layer braches off subepit- helial arteries, arteries in the layer of glands, precapillary arterioles and capillaries. Author studied the morphological interrelationship of these arteries and their histological structures. Moreover, Pol- sterarterien. which are found in the deep and middle layer of the lamina propria mucosa and their specific structures, were mentioned. Author divided of Polsterarterien into two types, that is, the valve-shaped process type and the thickened intima type and then observed the histological structures in detail.In the valve-shaped process type, 1) the tunica media of blood vessels is convex into a lumen of blood vessel with the intima, and most parts of club-spaped process, is free from the blood vessel- wall, except its base. 2) Polster originates usually from the branching portion of the vessels and runs towards periphery. There are cases in which Polster enters into the both branches or only into the the main blood vessel. These Polster consist mainly of longitudial smooth muscle fibers with a small amount of collagen and fine elastic fibers. Longitudinal smooth muscle fibers in Polster connect with the smooth muscle layer of the tunica media in the blood vessel wall at the basal portion of the process. Tunica intima of Polster runs into the intima of the blood vessel wall itself. Therefore, the internal elastic lamina of both Polster and blood vessel wall are connected each other. 3) On the inner surface of the thickened blood vessel inculding Polster, remarkably waved plicae are not observed. The neighbouring portion of the blood vessel wall does not show any abnormalities.As regards the thickened intima type, 1) this type consists of the thickened intima, and longitudinal smooth muscle fibers in inner layer of internal elastic lamina. In this case, the lumen of bloodvessels become more narrower than that of the valve-shaped process type, but has never been compl-etely closed. 2) Polster in this type has usually a fairly small amount of elastic fibers and is not found in the capillaries which are lacking of a tunica media, like a valve-shaped process type. The neighbouring wall of blood vessels including Polster also does not show abnormalities.As results of above mentioned observations, the author considers that Polster, regulates arterial blood flow through capillary beds to the pseudo-erectile tissue, playing an important role incontrollin the physiological swelling of the inferior nasal concha. Also, in only one case the author found the direct arterio-venous anastomosis.

A CLINICAL AND NEUROPATHOLOGIC REPORT OF A CASE OF LEPRA MIXTA

Leprosy may so closely resemble syringomyelia that a differential diagnosis is not always possible.1Zambaco-Pacha2and others even consider these two morbid conditions one disease process, while Pestana and Bettencourt3claimed to have seen lepra bacilli in the syringomyelic cavities of the spinal cord. On the other hand, cases are on record in which cavities of the spinal cord were found in leprosy, as in the cases of Steudener,4Langhans,5and Gerber and Matzenauer.6In Steudener's case (lepra mutilans), a cavity extended from the medulla oblongata to the lumbar region, and was surrounded by greatly thickened blood vessels. Steudener thought that the cavity was not caused by leprosy but was the result of colloid degeneration. In contrast, Langhans considered the cavity in his case, in which it involved the gray matter of the lower cervical and all the thoracic segments, a product of leprosy.