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Figure 5 Rupture of the internal elastic lamina (IEL). Photomicrograph of advanced aortic diabetic atherosclerosis illustrating an aggressive inflammatory pattern at the intimomedial junction. The continuity of IEL (left side) is interrupted (right side) where multiple round-nuclei inflammatory cells are observed, expanding the atherosclerotic process from the tunica intima into the tunica media (elastic trichrome stain). Courtesy of Dr. K-Raman Purushothaman (Mount Sinai Medical Center, New York, New York).