In women with clue-cell-positive discharge (CCPD), light-microscopical examination of the wet mount suggests a preference of bacteria for certain vaginal epithelial cells (VECs). To investigate this further, a light- and electron-microscopical study of patients and healthy controls was performed, with special emphasis on vitality and glycogen content of VECs and bacterial-epithelial cell interaction. Our study did not reveal morphologic differences between VECs of patients and controls. There was, however, a significant decrease in the percentages of vital and glycogen-containing VECs in CCPD (p < 0.001), probably caused by an overgrowth of (anaerobic) bacteria. In CCPD vaginal bacteria preferably colonize vital VECs. This could account for the relatively low percentage of clue cells in this condition.
Following the administration of cholesterol for a period of 6-7 weeks, Scanning Electron Microscopic (S.E.M.) observations revealed mono-cellular, crater-like and dome-shaped endothelial changes on top of the large intimal plaques in the rabbit aortas. Finger-like and other shaped cell protrusions were observed at the edges of these crater-like and dome-shaped endothelial changes, giving the intimal plaques a rough appearance. At other sites, normal, smooth, although irregularly arranged, endothelial cells covered the lesions. By impregnating the cell borders with silver-nitrate or silver proteinate containing perfusates, it was possible in most cases to ascertain that the lesions were derived from changes in one cell or from changes in a small collection of cells. S.E.M.-observations further revealed crater-like and dome-shaped endothelial changes to be present in large fields or as isolated cell changes in normal areas at sites where no gross lesions were observed with the light microscope. In addition large, multi-cellular, crate-like endothelial changes were observed at the edges of the large intimal plaques. At these sites several endothelial cells were lacking, leaving behind a crater in which sometimes cells and a few fibrin threads were found. Following the administration of cholesterol for periods of 4-5 and 2-3 weeks similar monocellular changes were observed, some extending over large areas, other as single cells in apparently normal surroundings. Quantitatively the number of lesions was less than when the cholesterol was administered for a longer period. Transmission electron microscopic studies revealed the presence of large amounts of membrane-bound lipid globules in the subendothelial spaces and within some endothelial cells, structures which were assumed to be cross-sections of the crater-like or dome-shaped endothelial cell protrusions, visible with the S.E.M.
Silver nitrate and silver proteinate were both successfully used as electron stains for the demarcation of the aortic endothelial cell borders in the scanning electron microscope.
By energy-dispersive X-ray analysis it was demonstrated that silver was present in the demarcation lines around the endothelial cells. The presence of silver closely coincided with the places where secondary electrons were produced.
Judged by the quality of the aortic tissue in the transmission electron microscope, the method using silver proteinate was preferable to those using silver nitrate. The limited resolution of the method is demonstrated.
The role of the dextran solution in such procedures was investigated, and it was shown that the presence of such a dextran solution, or its particle size or charge, does not contribute to the formation of these silver lines around the endothelial cells. In ultrathin sections of such material the cell surface-contrasting capacity of colloidal thorium dioxide solutions was compared to the cell border-contrasting capacity of silver proteinate. It was found that prior aldehyde fixation abolished the cell border demarcation by silver proteinate, but only reduced the cell surface demarcation by thorium dioxide particles.
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