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A Clinical, Ultrastructural and Immunochemical Study of Dupuytrens DiseaseFrom the Institute of General Pathology, and the Clinic of Orthopaedics, Hand Surgery Unit, University of Modena, Italy Correspondence: Prof I. Pasquali-Ronchetti, Institute of General Pathology, via Campi, 287 41100—Modena, Italy Aponeurotic tissue from seven normal subjects and from apparently unaffected branches, nodules and cords of 16 Dupuytrens patients were compared. Control tissue was characterized by polymorphous cells, showing cytoplasmic microfilament bundles, numerous pinocytic vesicles, basement membrane-like structures, and a thick coat of interwoven filaments, and by type I- and III-positive heterogeneous collagen fibrils, fibronectin, vitronectin, decorin and proteoglycans. The clinically normal branches consisted of fibroblast-like cells, small type III-highly positive collagen fibrils, fibronectin and proteoglycans. Nodules and fibrotic cords contained fibroblast-like cells, type I and III collagen, fibronectin and proteoglycans. Myofibroblast-like cells in only five out of 16 patients were present. There was no relation between clinical stage and structural alterations; the whole aponeurosis always seemed to be involved; cord retraction would seem to depend on the interactions among fibroblast-like cells and matrix components and among matrix macro-molecules themselves.
Journal of Hand Surgery (British and European Volume), Vol. 18, No. 2,
262-269 (1993) |
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