{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:34:26Z","timestamp":1790076866566,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T00:00:00Z","timestamp":1097193600000},"content-version":"vor","delay-in-days":5608,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[1989,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Electron microscopic examination of muscle specimens taken at biopsy in 6 patients with complex I deficiency and 1 patient with an unknown primary chemical defect who had the clinical characteristics of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke\u2010like episodes (MELAS) revealed striking abnormalities in blood vessels in 5. Abnormalities consisted of an increased number of enlarged mitochondria with complicated cristae in the pericytes of capillaries, endothelial cells, and smooth muscle cells of the small arteries, including terminal arterioles and precapillary sphincters, predominantly in smooth muscle cells. On statistical analysis, the number of mitochondria and the ratio of mitochondrial area to the total area of the smooth muscle cells were increased approximately tenfold (<jats:italic>p<\/jats:italic> &lt; 0.001). Although stroke\u2010like episodes were not present, similar mitochondrial abnormalities in blood vessels were found in 1 patient who had the encephalomyopathic form of complex IV deficiency and in 2 patients in whom the primary chemical defects could not be clearly defined. Such abnormalities in small arteries might be responsible for the occasional occurrence of transient cerebral ischemia causing stroke\u2010like episodes and progressive mental deterioration.<\/jats:p>","DOI":"10.1002\/ana.410250611","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T14:12:06Z","timestamp":1104588726000},"page":"594-601","source":"Crossref","is-referenced-by-count":127,"title":["Vascular involvement in mitochondrial myopathy"],"prefix":"10.1002","volume":"25","author":[{"given":"Ryoichi","family":"Sakuta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikuya","family":"Nonaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,8]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"309","volume-title":"Skeletal muscle pathology","author":"Morgan\u2010Hughes JA","year":"1982"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410170602"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410160409"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01799670"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(87)80158-0"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410240609"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(73)90054-3"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(82)90132-0"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410210607"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00688185"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-2944(78)90037-6"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0076-6879(67)10094-3"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.jbchem.a128243"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(19)52451-6"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.11.1456"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.1.72"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00314025"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.35.6.749"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/105.3.553"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00442074"},{"key":"e_1_2_1_22_2","first-page":"218","article-title":"A histochemical and morphometrical analysis of biopsied muscles in MELAS (mitochondrial encephalomyopathy, lactic acidosis and strokelike episodes)","volume":"9","author":"Haginoya K","year":"1987","journal-title":"Brain Dev"},{"key":"e_1_2_1_23_2","first-page":"180","article-title":"Maternally inherited mitochondrial encephalomyopathy. 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