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Ultrastructural features of epithelial cell degeneration in rectal crypts of patients with AIDS.

Focal crypt epithelial cell degeneration (apoptosis) of the rectum is a characteristic pathologic feature in AIDS. The presence of apoptosis usually implies cell-mediated cytolysis, which would be an unexpected finding in this disease. We investigated the ultrastructural features of apoptosis in rectal biopsies from five AIDS patients (three homosexual males and two females with i.v. drug abuse), three heterosexual controls, and two homosexual male controls. Apoptosis was found in all AIDS patients and, to a lesser extent, in one heterosexual control. Ultrastructurally, vacuolization of several adjacent cells, leading to extrusion of cellular debris through the basal lamina and phagocytosis by macrophages, was seen. No intracellular or extracellular viral particles were detected in the regions containing apoptotic bodies, in epithelial cells near the crypt bases, in intraepithelial lymphocytes, or in macrophages. In summary, apoptosis in the rectal crypts of patients with AIDS has the same ultrastructural features as in other conditions, which suggests that its pathogenesis is related to immune rather than infectious factors. If this process occurs on a chronic basis in multiple cell types, it would promote general tissue depletion, which has been demonstrated to occur in AIDS. The presence of apoptosis in AIDS is not explained by current concepts of disease pathogenesis.

Acquired Immunodeficiency Syndrome↗

Intranuclear inclusions correlate with the ultrastructural detection of herpes-type virions in oral hairy leukoplakia.

Hairy leukoplakia (HL) is an Epstein-Barr virus-associated lesion of the oral mucosa that occurs in persons infected with human immunodeficiency virus. Ultrastructural studies have demonstrated herpes-type virions in 63-100% of cases of HL. In this investigation, incisional biopsy specimens from 52 consecutive patients with oral lesions clinically suspicious for HL were analyzed by light and electron microscopy to determine which light microscopic features correlated best with the presence of herpes-type virions ultrastructurally. The predominant histopathologic features consisted of irregular hyperparakeratosis, acanthosis, koilocytoid cells, and an absence of significant inflammation. Candidal organisms and bacterial colonies were variable findings. Intranuclear inclusions, identical to Cowdry type A inclusions seen in other herpesvirus infections, were observed in 46 cases and demonstrated the best correlation with the presence of virions ultrastructurally (p less than 0.0001). Koilocytoid cells also had a statistically significant correlation with the presence of virions (p less than 0.001). We conclude that Cowdry type A inclusions are present in many cases of HL and that their presence, when combined with the other clinical and histologic findings in these lesions, is the most specific light microscopic feature of HL.

Cell Nucleus↗

Perineurial malignant peripheral nerve sheath tumor (MPNST): a clinicopathologic, immunohistochemical, and ultrastructural study of seven cases.

Most malignant peripheral nerve sheath tumors (MPNST) are schwannian in nature. The pathologic features of MPNST with perineurial cell differentiation remain to be characterized. To determine the clinicopathologic, immunohistochemical, and ultrastructural characteristics of perineurial MPNST, 121 MPNST from the Mayo Clinic Tissue Registry were examined. Of these 23 spindle cell tumors with long processes disposed in whorls or storiform patterns, features typical of perineurioma, were studied. On the basis of immunohistochemistry (epithelial membrane antigen+/S-100-), 5 perineurial MPNST were identified among 23 tumors selected. These and two previously characterized perineurial MPNST are the subject of this study. None of seven tumors was associated with NF-1. Patients included five males and two females ranging in age from 11 to 83 years (mean, 45.7 years). The tumors measured 1.5 to 30 cm (mean, 9.1 cm) and arose in the extremities (two), trunk (two), face (one), mediastinum (one), and retroperitoneum (one). Only one tumor was nerve associated (phrenic nerve). All tumors were surgically removed. No encapsulation or neurofibroma components were noted. Necrosis was seen in three lesions. Four tumors were classified as high-grade malignant and three as low grade. Mitotic indices varied from 1 to 85/10 high-power fields (median, 16). Immunoreactivities included epithelial membrane antigen (100%), vimentin (100%), Leu-7 (57%), and CD34 (14%). Stains for S-100 protein, muscle markers, and cytokeratin were nonreactive. Ultrastructurally, perineurial-like cells were noted in three tumors and cells intermediate between perineurial and Schwann cells in one. Four tumors recurred and two metastasized; no deaths of disease were noted at follow-ups of 28 to 98 months (mean, 66.9). In conclusion, 4% of MPNST show perineurial cell differentiation. An NF-1 association has yet to be described. Nerve involvement is infrequent. Their immunophenotype (epithelial membrane antigen+/S-100-) frequently indicates ultrastructural perineurial differentiation. The prognosis of perineural MPNST appears to be more favorable than that of conventional MPNST.

Adult↗

Changing of an isolated neurone ultrastructure during a prolonged impact of mediator.

We investigated the influence of prolonged excitation or combined excitation/inhibition on the ultrastructural changes in an isolated stretch receptor neurone from crayfish abdomen. Excitatory impulse activity was achieved by mechanical stimulation of a neurone for 10 or 120 min and inhibition of the activity was obtained by perfusion with gamma-aminobutyric acid (GABA, 2.5 x 10(-5) M) for the same periods. Changes in the ultrastructural components were observed following both excitatory and inhibitory stimulation for 120 min. Neuronal adaptation to excitatory or inhibitory stimuli after 120 min resulted in the appearance of an increased number of the giant mitochondria. Thus, the number of giant mitochondria may serve as an ultrastructural index of the degree of neuronal adaptation to external stimulation.

Abdomen↗

Clinical, histopathologic, and ultrastructural characteristics of BIGH3(TGFBI) amyloid corneal dystrophies are supportive of the existence of a new type of LCD: the LCDi.

PURPOSE: To assess the morphologic differences of three types of lattice corneal dystrophies (LCDs) from histologic, immunohistochemical, and ultrastructural studies. METHODS: Corneas from three patients, one LCD1, one His626Arg-LCD, and one LCD3A were processed for Congo red, betaig-h3(541-564) antibodies immunostaining, and electron transmission microscopy studies. Control tissues were submitted to identical analyses and consisted of one cornea from a patient not having LCD and one skin biopsy from the patient suffering from LCD1. RESULTS: The three corneas displayed birefringent congophilic deposits under polarized light, confirming their amyloid nature. The deposits differed regarding their shape and location in each of the corneas. A strong immunoreactivity for betaig-h3 was shown in the LCD1 and His626Arg-LCD deposits, which was faint for the LCD3A deposits. Ultrastructural analysis confirmed the dissimilarity of the deposits among the different types of LCD. No amyloid deposits were observed in the skin from the LCD1 patient, whereas immunostaining showed the presence of high amounts of betaig-h3. CONCLUSION: Our results show that betaig-h3 is involved in amyloid deposition in all the LCDs included in the study (LCD1, His626Arg-LCD, and LCD3A). These three forms of LCD, clinically different, were also distinguishable histologically, confirming that they belong to distinctive groups of LCDs. The absence of amyloid deposition in skin from the LCD1 patient supports cornea-specific amyloid formation. In light of the present clinical, histologic, and ultrastructural data, His626Arg and related LCDs constitute a separate group of LCD that could be considered as of intermediate type on clinical grounds.

Aged↗

Cyclosporin A ameliorates mitochondrial ultrastructural injury in the ileum during acute endotoxemia.

OBJECTIVE: This study was designed to determine the role, if any, of the mitochondrial permeability transition in the pathogenesis of mitochondrial injury in a representative systemic organ during the acute phase of endotoxemia. DESIGN: A well-established, normotensive feline model was employed to determine whether pretreatment with cyclosporin A, a potent inhibitor of the mitochondrial permeability transition, reduces the severity of mitochondrial injury in the ileum during acute endotoxemia. SETTING: The Ohio State University Medical Center research laboratory. SUBJECTS Adult, male conditioned cats. INTERVENTIONS: Volume resuscitation and maintenance of acid/base balance and tissue oxygen availability were provided, as needed, to minimize the potentially confounding effects of tissue hypoxia and/or acidosis on the experimental results. Following isotonic saline vehicle (control; n = 6), lipopolysaccharide (3.0 mg/kg, intravenously; n = 10), or cyclosporin A (6 mg/kg, intravenously; n = 7) followed in 60 mins by lipopolysaccharide (3.0 mg/kg, intravenously) administration, ileal samples were obtained at 4 hrs posttreatment, and mitochondrial ultrastructure was assessed. Objective comparisons of mitochondrial ultrastructural morphology were performed by using digital image analyses. MEASUREMENTS AND MAIN RESULTS: As expected, significant mitochondrial injury was apparent in the ileal tissues by 4 hrs following LPS treatment, despite maintenance of regional tissue oxygen availability. Objective evaluation of mitochondrial morphology demonstrated characteristics consistent with high-amplitude swelling. Cyclosporin A pretreatment protected against the development of these LPS-induced mitochondrial ultrastructural abnormalities, an effect not attributable to the suppression of lipopolysaccharide-induced tumor necrosis factor-alpha production. CONCLUSIONS: These investigations are the first to demonstrate a protective effect of cyclosporin A against mitochondrial injury in a representative systemic organ during acute endotoxemia. We propose that mitochondrial injury likely related to induction of the mitochondrial permeability transition may participate in the pathogenesis of systemic organ injury and organ failures during acute sepsis.

Analysis of Variance↗

"Healed" experimental gastric ulcers remain histologically and ultrastructurally abnormal.

The present study was designed to assess histologic and ultrastructural features of gastric mucosa in the areas of grossly healed ulcers (acetic acid-induced gastric ulcers) in rats. The specific question we studied was whether the structure and cellular composition of the gastric mucosa in an area of grossly healed ulcer were fully restored. Eighty Sprague-Dawley rats underwent laparotomy; 100% acetic acid was applied to the lower gastric corpus serosa for 30 s and the abdomen was closed. The stomachs were reopened after 2 weeks or after 2, 3, or 4 months. Standardized gastric wall specimens from the area of grossly healed ulcers were obtained, processed, and evaluated by light microscopy and by transmission electron microscopy. The gastric mucosa of grossly healed ulcers demonstrated re-epithelialization at each study time but the mucosa beneath the surface epithelium displayed prominent histologic and ultrastructural abnormalities. Two different patterns of scar could be distinguished: (a) the mucosa in the area of healed ulcer was thinner (25-45% reduction vs. normal), with increased connective tissue and poor differentiation and/or degenerative changes in the glandular cells; or (b) the mucosa displayed ballooning dilatation of gastric glands, reduction in the microvascular network, and poor differentiation of glandular cells. We conclude that (i) the subepithelial mucosa of grossly healed gastric ulcer displays disorganized restoration of glandular and vascular structures and remains histologically and ultrastructurally abnormal; (ii) these abnormalities may interfere with oxygenation, nutrient supply, and with mucosal resistance and defense, and therefore could be the basis for ulcer recurrence.

Acetates↗

Effect of nicardipine treatment upon cardiac hypertrophy in spontaneously hypertensive rats: a morphometric and ultrastructural study.

OBJECTIVE: The present study was designed to investigate the effect of nicardipine administration upon systolic blood pressure (SBP) and cardiac hypertrophy in spontaneously hypertensive rats (SHR). DESIGN: SBP, heart: and left ventricle: body weight ratios, the cross-sectional area of cardiocytes, and the ultrastructure of the left ventricle were evaluated. METHODS: Ten-week old male SHR and age-matched normotensive Wistar-Kyoto rats were studied for 12 weeks. One group of SHR was treated for 12 weeks with a daily oral dose of 1 mg/kg nicardipine and another group with 1 mg/kg hydralazine; Wistar-Kyoto rats were used as a normotensive control group. Light and electron microscope techniques associated with image analysis and morphometry were used. RESULTS: Nicardipine administration normalized SBP values and significantly reduced the heart: and left ventricle: body weight ratios. Moreover, administration reduced the cross-sectional area of cardiocytes by approximately 38% in subendocardium and by 24% in subepicardium. Hydralazine administration significantly reduced SBP values but had no effect upon heart: or left ventricle: body weight ratios or the cross-sectional area of cardiocytes. Electron microscopy showed that nicardipine treatment was able to reduce the hypertension-dependent changes in cardiac ultrastructure consisting of alternations to intercalated discs and line Z morphology as well as in the decrease of the mitochondria: myofibrils ratio. CONCLUSIONS: The above data indicate that nicardipine administration is able to reduce SBP and to counter the development of structural and ultrastructural changes in cardiac morphology which represent a common complication of arterial hypertension.

Animals↗

Brain ultrastructure in Reye's syndrome.

Cerebral biopsies were obtained for electron microscopy 48 and 72 hours after the onset of encephalopathy from a child with severe Reye's syndrome. Gravely ill at the time of craniectomy to relieve cerebral hypertension, the child survived and recovered good brain function; therefore, the biopsy findings appear to reflect the organelle pathology of the brain at a severe yet reversible stage in the disease process. The cardinal ultrastructural changes in the brain in Reye's syndrome are astrocyte swelling and partial deglycogenation, myelin bleb formation and universal injury of neuron mitochondria. The mitochondrial injury consists of matrix disruption with moderate but not massive swelling. Dilatation of rough endoplasmic reticulum and nuclear changes occurred only in neurons with severely altered mitochondria. The organelle pathology of the brain in this case did not resemble the organelle pathology of the brain in human "hepatic encephalopathy" or in experimental ammonia intoxication in primates. The mitochondrial ultrastructure of the cerebral neurons resembled the unique mitochondrial ultrastructural changes seen in the liver parenchyma in Reye's syndrome.

Brain↗

A case of human rabies and ultrastructure of the Negri body.

A 60-year old man, eight weeks after being bitten on his finger by a stray cat, developed symptoms and signs of rabies which progressed rapidly over the next two weeks and he died of respiratory failure. Pathological examination revealed characteristic cytoplasmic inclusions in neurons of various parts of the central nervous system and the dorsal spinal and sympathetic ganglia. The diagnosis of rabies was confirmed by direct fluorescent antibody staining of the brain tissue obtained at autopsy. On histological examination, most, if not all, of the neuronal cytoplasmic inclusions were eosinophilic and homogeneous and lacked the basophilic inner granules or bodies characteristic of Negri bodies. Nevertheless, they were ultrastructurally identical with Negri bodies by virtue of being made up of finely fibrillar matrix and virus and/or related particles in varying numbers. This indicates that ultrastructurally typica Negri bodies may or may not have the histologically visible basophilic inner bodies depending upon the degree of virus replication. In light of the ultrastructural evidence, lyssa bodies described in rabies in the past may represent Negri bodies without histologically recognizable inner bodies or cytoplasmic inclusions unrelated to rabies, occurring ordinarily in normal or degenerating neurons. It is, therefore, suggested that the term, lyssa body, is obsolete and should no longer be used.

Cerebellar Cortex↗

Anticonvulsant prolongation of survival in adult murine lymphocytic choriomeningitis. II. Ultrastructural observations of pathogenetic events.

Because previous ultrastructural studies of murine lymphocytic choriomeningitis (LCM) had revealed only mononuclear cell infiltration with no cytopathology of target cells in the choroid plexus, ependyma, and leptomeninges, diazepam treatment was used to prolong survival for characterization of late pathogenetic events. Mice which were treated with diazepam and sacrificed 8, 9, and 10 days after intracerebral inoculation with LCM virus showed an increasing amount of inflammatory infiltration into choroid plexuses, leptomeninges, Virchow-Robin spaces, and ependyma. Mononuclear cells, lymphocytes, and polymorphonuclear (PMN) leukocytes increased in number as compared with terminally infected mice sacrificed 7 days after inoculation. Ultrastructurally, choroidal epithelial cells showed cytopathological changes varying from dilated endoplasmic reticulum through necrosis. Greater numbers of PMN leukocytes, macrophages, and activated macrophages and fewer undifferentiated mononuclear cells were seen in choroid plexuses of the drug-treated survivors. Virions and larger, more numerous arenavirus inclusions were present in choroid plexus and ependyma. Ultrastructurally the leptomeningitis was characterized by large numbers of activated macrophages. Choroidal epithelial necrosis appears to be the in vivo correlate of T-cell-mediated cytotoxicity in vitro.

Animals↗

Ultrastructural study of alterations in the small intestinal epithelium of children with acute diarrhea.

We studied the ultrastructure of the jejunal epithelium of six children suffering from acute episodes of gastroenteritis. Ultrastructural alterations of the jejunal mucosa occurred in practically all of the fragments analyzed, although the intensity of the abnormalities observed varied considerably. In most of the patients the alterations were confined to the microvilli, which appeared shortened and tufted in comparison with controls. These ultrastructural alterations are nonspecific and may represent a general response of the intestinal mucosa against different noxious agents. Severe alteration of the epithelial cells was observed in only one patient. In this case the cytoplasm contained multiple vacuoles that may correspond to dilated endoplasmic reticulum. It is hypothesized that the small intestinal lesions observed in these patients may allow penetration of food antigens, resulting in the appearance of food intolerance frequently described in children suffering from acute diarrhea.

Acute Disease↗

Nasal ciliary function and ultrastructure in Down syndrome.

OBJECTIVES/HYPOTHESIS: To investigate the in vivo nasal ciliary beat and the ciliary ultrastructure in Down syndrome because, although in this condition an increased susceptibility to respiratory tract infections has been reported by several authors, the nature of this phenomenon is not fully understood. STUDY DESIGN: Experimental study of 18 subjects with Down syndrome and 18 healthy control subjects. METHODS: Ciliary beat frequency (CBF) was measured on samples of ciliated epithelium obtained from the inferior nasal turbinate; a further brushing for ultrastructural analysis was performed only in subjects showing a CBF reduction or a ciliary movement alteration. RESULTS: The mean CBF in the group with Down syndrome was 7 +/- 2.82 Hz, and in the control subjects it was 10.94 +/- 0.65 Hz. In the same 66.6% of subjects with Down syndrome, we observed a fibrillatory movement of cilia and no metachronicity was present. Moreover, in 14 subjects with Down syndrome as hyperproduction of mucus was present. Ultrastructural evaluation at transmission election microscopy instead revealed a normal architecture of cilia. CONCLUSION: We attribute the nature of the mucociliary defect in Down syndrome to recurrent respiratory tract infections causing changes in mucus properties as in rheological parameters and not to a primitive defect of cilia.

Adolescent↗

The ultrastructure of normal and denervated human facial muscle.

The ultrastructure of normal human facial muscles from 25 nonparalytic and 17 paralytic patients revealed normal features in nondenervated human facial muscles, identical to the fine structure of other normal human and mammalian cross-striated muscle fibers. However, in denervated facial muscle, a broad spectrum of ultrastructural lesions had affected sarcomeres, abnormal inclusions, and organelles. A large variety of inclusion bodies, some of which have not been described, were also found. The spectrum of ultrastructural changes showed no dependence on the length of the denervation period. There were no inclusion bodies in all the normal facial muscle biopsies. To our knowledge, this study represents the first systematic electron microscopic investigation of normal and denervated human facial muscles.

Adolescent↗

Ultrastructural analysis of rabbit retina irradiated with a new 670-nm diode red laser at different powers.

PURPOSE: Diode lasers have compact dimensions, efficient electric-optical conversion, absence of major cooling requirements, long useful life, and minimal maintenance. We verified the structural and ultrastructural effects of diode red laser emissions at 670 nm on pigmented rabbit retina. METHODS: Transpupillary laser pulses were applied to rabbit retinas at variable powers with a spot size of 500 microm ( approximately 1,000 microm at the retina level) and duration of 200 milliseconds. Light and electron microscopic analyses were performed. RESULTS: Subthreshold non-visible lesions were produced using a power of 200 mW. Ophthalmoscopically visible lesions were produced using a power of 400 mW. More prominent lesions were obtained using a higher power (600 mW). Structural and peculiar ultrastructural changes correlated with the power used. In general, damage was incurred by the retinal pigment epithelium with extension into the superficial choroid posteriorly and into the outer retina anteriorly. The inner retina was involved at higher power levels. CONCLUSIONS: Ultrastructural analysis of rabbit retina treated with the 670-nm diode laser adds newer insights on tissue changes after thermal irradiation. The effects observed are consistent with those reported for the krypton red laser. The 670-nm diode laser is an economic small-size photocoagulator that appears to be a promising modality for transpupillary laser photocoagulation of the retina.

Animals↗

Immunocytochemical and ultrastructural changes of islet cells in rats treated long-term with cyclosporine at immunotherapeutic doses.

Daily cyclosporine doses of 10 mg/kg body weight for 21 days in Wistar rats cause impairment in glucose homeostasis and changes in the amount of immunostainable hormones and in the ultrastructure of the cells of the pancreatic islets. CsA induces hyperglycemia and reduced glucose tolerance, and causes a decrease in immunoreactive insulin and an increase of somatostatin and pancreatic polypeptide (PP) immunoreactivities, leaving glucagon immunoreactivity unaffected. Ultrastructurally, different degrees of dilation of rough endoplasmic reticulum cisternae and enlargement of Golgi apparatus can be observed in B cells, together with a pronounced reduction in the number of secretory granules. Nevertheless, there were no apparent morphological changes of the other cytoplasmic organelles, suggesting that the drug, besides a depression of protein synthesis, as previously stated, also induces a substantial defect in granulogenesis, probably due to impairment in the intracellular transport of the hormone from the sites of synthesis to the secretory granules. The B cell alterations are not accompanied by any sign of B cell degeneration or death. Non-B cells did not show any of the ultrastructural changes found in B cells and were similar to those of the control rats. The above findings indicate that CsA at immunotherapeutic doses causes impairment in the secretory processes of B cells specifically. An hypothesis on the mode of action of CsA on B cells is drawn.

Animals↗

Coronary artery ultrastructural changes in cardiac transplant atherosclerosis in the rabbit.

Accelerated coronary atherosclerosis is the limiting factor for long-term survival of cardiac transplant recipients, but its pathogenesis is poorly understood. Morphologic and ultrastructural changes in suitable models may help explain the underlying mechanisms. In this study, early (3, 7, 14, and 21 days) and late (42 days) ultrastructural changes of the coronary artery were characterized in rabbit cardiac allografts. Thirty-four New Zealand white male rabbits (3.0-4.0 kg) served as donors and recipients. All recipients received cyclosporine (10 mg/kg/day i.m.) as immunosuppressant. In order to increase the normally very low cholesterol levels in rabbits, both the donor and recipient animals were fed a 0.5% cholesterol diet. Recipient animals were sacrificed between 3 days and 6 weeks after transplantation. The specimens from both donor and recipient were examined by transmission electron microscopy, immunohistochemistry, and morphometry. Our data indicate that intimal thickening was initiated with smooth muscle cell migration within 1 week after transplantation, and occurrence of macrophage-derived foam cells and vacuolized smooth muscle cells 3 weeks after transplantation. These changes occurred in the presence of an ultrastructurally intact endothelium. Platelets were only seldom seen adhering to the endothelium. In contrast, lymphocytes and monocytes were frequently found adhering to the endothelium at 2 and 3 weeks posttransplantation. From 3 weeks posttransplantation, lymphocytes were seen only occasionally in the intima but not in the media. This study suggests that early events elicit a change in the smooth muscle cells in the media to the secretory phenotype that migrates to the intima and proliferate. Lymphocyte and monocyte adhesion to the endothelium may enhance smooth muscle migration and proliferation. The large macrophage involvement may relate to the high serum cholesterol levels induced by the cholesterol diet. All these changes occurred in the presence of a structurally normal endothelium and without apparent platelet involvement.

Animals↗

Ultrastructural localization and distribution of proteoglycan in normal and scoliotic lumbar disc.

STUDY DESIGN: Comparative ultrastructural study of normal and scoliotic intervertebral discs. OBJECTIVE: To examine the ultrastructural organization and distribution of proteoglycan in relation to collagen and elastic fibers in normal and scoliotic discs. SUMMARY OF BACKGROUND: The mechanical properties of intervertebral discs depend on the collagens and proteoglycans in the matrix; proteoglycan content and the organization of collagen fibers are altered in degenerate discs. However, little is known about the structural relations among disc components and alterations to them in scoliosis. METHODS: Samples of normal and scoliotic disc from individuals aged between 12 and 16 years were fixed in 2.5% glutaraldehyde containing cuprolinic blue and examined by transmission electron microscopy. The sizes and distribution of proteoglycan particles throughout different matrix regions were quantified. RESULTS: In anulus fibrosus of normal disc, collagen and elastic fibers in lamellas were covered with small proteoglycan particles in a regular pattern; proteoglycan particles of similar sizes were evenly distributed throughout the matrix. Anulus fibrosus of scoliotic disc contained degenerate collagen lamellas, few elastic fibers, and a pericellular accumulation of large proteoglycan aggregates; scoliotic nucleus pulposus also contained an accumulation of proteoglycan aggregates. Most cells in both regions of scoliotic discs were degenerate and vacuolated. CONCLUSION: We provide ultrastructural confirmation of the disruption of the lamellar organization of collagen and elastic fibers in scoliosis. Our observations of altered proteoglycan distribution in scoliotic tissue suggest that impaired proteoglycan turnover plays a key role in the disruption of the structural integrity of the disc in scoliosis.

Adolescent↗