{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:47:20Z","timestamp":1789602440077,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2005,6,15]],"date-time":"2005-06-15T00:00:00Z","timestamp":1118793600000},"content-version":"vor","delay-in-days":5613,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology"],"published-print":{"date-parts":[[1990,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The lungs from 16 cases of plexogenic pulmonary arteriopathy obtained at heart\u2010lung transplantation, half of which had primary pulmonary hypertension, were examined by electron microscopy. From these the probable pathogenesis of pulmonary arterial intimal fibrosis in plexogenic pulmonary arteriopathy was deduced. The earliest detectable change was migration of smooth muscle cells from the media; through the internal elastic lamina into the intima. These cells collected beneath the endothelium and lost many of their myofilaments to become myofibroblasts. They were associated with ground substance but scanty collagen fibrils. As the quantity of interstitial collagen increased, the myofibroblasts reverted to a muscular structure, became elongated, and assumed a regular, circumferential orientation. This later stage coincided with the development of plexiform lesions. At both early and later stages, the muscular pulmonary arteries were contracted but not markedly so, and muscular evaginations were not seen. On the other hand, the cellular intimal proliferations developed early and were occlusive. This suggests that occlusion of small pulmonary arterial vessels by myofibroblasts may be at least as important as vasoconstriction in the early elevation of the pulmonary vascular resistance in primary pulmonary hypertension.<\/jats:p>","DOI":"10.1002\/path.1711600204","type":"journal-article","created":{"date-parts":[[2005,6,22]],"date-time":"2005-06-22T10:00:57Z","timestamp":1119434457000},"page":"111-121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["The ultrastructure of plexogenic pulmonary arteriopathy"],"prefix":"10.1002","volume":"160","author":[{"given":"Paul","family":"Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Heath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdi","family":"Yacoub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Madden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Caslin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gosney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,6,15]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01102870"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.58.3.204"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1988.tb01915.x"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.34.2.177"},{"key":"e_1_2_1_6_2","unstructured":"CaslinAW HeathD MaddenB YacoubM GosneyJR SmithP.The hislopathology of 36 cases of plexogenic pulmonary arteriopathy.Histopathology(in press)."},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.1711300406"},{"key":"e_1_2_1_8_2","first-page":"428","volume-title":"The Human Pulmonary Circulation","author":"Harris P","year":"1986"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.70.3.641"},{"key":"e_1_2_1_10_2","first-page":"205","article-title":"Ultrastructural study of contraction of pulmonary vascular smooth muscle cells","volume":"35","author":"Dingemans KP","year":"1976","journal-title":"Lab Invest"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.33.5.579"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.1711240308"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.33.1.31"},{"key":"e_1_2_1_14_2","first-page":"337","article-title":"Pulmonary endocrine cells in pulmonary arterial disease","volume":"113","author":"Gosney J","year":"1989","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_1_15_2","unstructured":"HeathD YacoubM GosneyJR MaddenB CaslinAW SmithP.Pulmonary endocrine cells in hypertensive pulmonary vascular disease.Histopathology(in press)."},{"key":"e_1_2_1_16_2","first-page":"452","article-title":"Failure of certain anti\u2010platelet drugs to affect myointimal thickening following arterial endothelial injury in the rat","volume":"36","author":"Clowes AW","year":"1977","journal-title":"Lab Invest"},{"key":"e_1_2_1_17_2","first-page":"141","article-title":"A morphologic and permeability study of luminal smooth muscle cells after arterial injury in the rat","volume":"39","author":"Clowes AW","year":"1978","journal-title":"Lab Invest"},{"key":"e_1_2_1_18_2","first-page":"295","article-title":"Kinetics of cellular proliferation after arterial injury. 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