A study of the transfer of serum proteins into tissue injured by tourniquet

The fine structure of capillaries and small arteries

Details of capillary endothelia of the mammalian heart are described and compared with capillaries of other organs and tissues. Continuous invagination and pinching off of the plasma membrane to form small vesicles which move across the cytoplasm are suggested as constituting a means of active and selective transmission through capillary walls (12). This might be designated as cytopempsis (transmission by cell). The fine structure of the different layers in the walls of small heart arteries is demonstrated. Endothelial protrusions extend through windows of the elestica interna to make direct contact with smooth muscle plasma membranes. The elastica interna appears to vary greatly in both thickness and density, and probably restricts filtration, diffusion, and osmosis to such an extent that windows and the transport mechanisms described (cytopempsis) are necessary for the functional integrity of the smooth muscle layer. The contractile material consists of very fine, poorly oriented filaments.

Electron microscopic and histochemical observations of muscle degeneration after tourniquet

As an experimental model for the different forms of muscle degeneration, injury caused by 2 hours' ischemia has been studied from 20 minutes to 16 hours after release of the tourniquet. Discoid degeneration developed in stretched fibers by dissolution of the I bands (Z substances and actin). The discs represented the Q bands (A-H-A). In fibers which passively maintained contraction lengths during degeneration, the Z substances were dissolved, but the continuity of the fibrils was preserved, since the filaments are continuous over all sarcomeres under these conditions. Mitochondria and the tubules of the endoplasmic reticulum swelled, ruptured, and disintegrated. Granular degeneration developed in fibers where mitochondria were abundant. Unstretched degenerating fibers with few mitochondria gave a homogeneous or hyaline appearance. The different forms of degeneration therefore were dependent on the status of stretch and the fiber type. The extent of degeneration was not a function of time after ischemia, there being both nearly normal and severely damaged fibers at 20 minutes and 16 hours after the release of tourniquets. When degeneration occurred, however, the basic alterations were the same in all fibers; there was mitochondrial and reticular swelling, dissolution of the Z substances, and finally disintegration of the contractile material. Some damage developed in the sarcolemmas and capillaries. The mitochondrial disintegration was not linked with inactivation of the succinic dehydrogenase system.