Ultrastructural examination of the skeletal muscles in polymyalgia rheumatica.

Skeletal muscle biopsies of 13 patients with polymyalgia rheumatica (PMR) were examined systematically with the electron microscope. Ultrastructural changes in the PMR specimens have been classified according to 14 criteria including nucleus, myofilaments, mitochondria, T-system, as well as glycogen deposition, lipid, lipofuscin, and myelin figures. The described muscle changes are of both regressive and progressive character and non-specific in themselves. The systematic recording of these criteria shows an extraordinaryly high incidence in PMR. This constellation of characteristics gives the ultrastructural picture of the skeletal musculature in PMR a definite profile. Similarities with the changes in other muscular diseases suggest that in PMR also neurogenous mechanisms may play a pathogenetic role.

[Relapsing polychondritis. A case report with special reference to otolaryngological manifestations]. / Rezidivierende Polychondritis Eine Fallbeschreibung unter besonderer Berücksichtigung der Manifestationen im HNO-Bereich.

Relapsing polychondritis is a rare disease of unknown etiology. The symptomatology is characterised by inflammatory and degenerative changes of multiple cartilaginous structures. --In this peculiar case the nose, the larynx and the cartilages of the ribs and of one hand were involved. Distinct inflammatory changes of the left vocal cord were seen. The diagnosis of the disease was assured by the presented electron microscopic studies. Treatment with high doses of corticosteroids did not prove effective. The disease process could only be controlled by in immunosuppressive combination therapy with prednisone, and cyclophosphamide. --Characteristic clinical features, diagnosis, pathogenesis and therapeutical problems are discussed.

Transformation of the capillary wall elements in synovial tissue in rheumatoid arthritis.

1. The morphologically comprehensible starting point of rheumatoid arthritis is a permeability change of the synovial capillaries. 2. In the context of rheumatoid arthritis all three building elements of the blood capillaries undergo a transformation. 3. In the endothelial cells and the pericytes the endoplasmatic reticulum, the Golgi-apparatus, as well as the mitochondria can be multiplied (progressive transformation). The cell structures can, however, be subject to a degeneration (regressive transformation). The basement membrane as a secretion product, in contrast, undergoes exclusively quantitative changes. 4. The transformation possibilities of the capillary elements will be treated and classified on a graph under general pathological aspects. 5. As an element of the connective tissue the endothelial cell, as are lining cell and stroma cell in rheumatoid arthritis, is subject to transforming influences which, however, at the synovial capillary will be the starter of fibrin exudation into the joint cavity.