VII. EFFECTS OF DEFICIENCY 531 



-kclt'tal muscle, precedes the onset of inoipholoi;ic changes. The hitter are 

 characterized by interstitial edema, infiltration of iieutrophiles and mononu- 

 clear cells, hyaline necrosis of muscle fibers in association with coagulative 

 necrosis and vaeuolation of thesarcoplasni, gradual loss of myofibrillae, and 

 appearance of wide constriction bands. Cardiac capillai'ies and larger vessels 

 are prominently distended with blood; and sometimes small hemorrhages 

 occur. Usually the necrosis is j)atchy in its distribution. Neither Purkinje 

 fillers, neurons, nor fibers of the autonomic plexi show any changes. When 

 severe, the lesions are grossly \'isi))le as circumscribed grayish areas. Lesions 

 are most extensive in the peripheral myocardium of the \'entricles but occur 

 also in the papillaiy muscles, the interventricular septum, and the atrial 

 nnisculature. 



c. Smooth Muscle 



Kats deprived of vitamin E for several months exhil)it a yellowish dis- 

 coloration of the uteri which gradualh^ increases to a chestnut brown color 

 as deficiency progresses, due to the accumulation of brownish, fluorescent, 

 acid-fast pigment granules in the smooth muscle cells and macrophages of 

 the myometrium.^' -• ^' ^' ^-"^^ A similar but somewhat less pronounced 

 change occurs in the smooth musculature of the fallopian tul)e, cer\'ix, 

 vagina, seminal vesicle, prostate, vas deferens, ureter, trabeculae and cap- 

 sule of the spleen, small intestine, bronchi, and uterine and plumonary 

 veins.i--»- ^--^' 



The uterine changes constitute a prototype for those ol)served in smooth 

 muscle elsewhere. Pigment granules appearing first at each pole of the nu- 

 cleus gradually push the myofibrillae peripherally, eventually distending 

 and even distorting the muscle cells such that they are difficult to distin- 

 guish from intervening pigment-laden macrophages. It is more presumed 

 than established that much of the pigment in macrophages is derived from 

 muscle cells undergoing necrosis; some of it may be released to macrophages 

 without breakdown of the cells. Macrophages containing large globules of 

 pigment, produced perhaps by alteration and concentration of smaller pig- 

 ment granules, become numerous and conspicuous in the intermuscular 

 connective tissue and in the outer zone of the endometrium. Endometrial 

 fibrosis seems not to be accentuated.^^ 



Uterine pigmentation does not occur in rats ovariectomized before pu- 

 berty, but does appear if such rats are given estrogen treatment;'*' once 



'3W. Hessler, Intern. Z. Vitaminforsch. 11, 9 (1941). 



'^' V. Demote, Intern. Z. Vitaminforsch. 8, 338 (1939); Schweiz. med. Wochschr. 71, 



1251 (1941). 

 95 J. C. Radice and M. L. Herraiz, Ann. N. Y. Acad. Set. 52, 126 (1949). 

 9« J. Lopes (le Fariu, Ann. N. Y. Acad. Sci. 52, 121 (1949) ; Hospital (Rio de Janeiro) 



29, 583 (1946). 

 " W. B. Atkinson, H. Kaunitz, and C. A. Slanetz, Ann. .V. Y. Acad. Sri. 52, 68 (1949). 



