[Neovascularization of atheroma plaques, an aggravating factor in coronary atheromatosis].
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Biomedical subjects
Publications and source records attributed to C Vasilescu.
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In 25 adult diabetic patients, tissue fragments from myocardium were removed at necropsy and processed routinely. The morphometrical analysis was made using eye-piece ocular micrometer on a definite microscopic area. The arteriolar wall thickness increased from 5.10 mu +/- 1.71 in control group to 7.37 mu +/- 1.98 in the diabetic heart. The arterioles number decreased from 5.82/mm2 +/- 0.54 in the nondiabetics to 2.51/mm2 +/- 0.65 in the diabetic heart. The mean arteriolar diameter increased from 24.61 mu +/- 7.7 in the control group to 29.45 mu +/- 8.25 in the diabetic myocardium. The mean capillary diameter increased from 4.09 mu +/- 0.63 to 5.69 mu +/- 1.34 in diabetics. The capillaries number/mm2 decreased from 6.98 +/- 1.55 in the nondiabetics to 4.39 +/- 1.54 in diabetic patients. All differences, less the mean arteriolar diameter, are statistically significant. The following microscopical aspects were found in the small intramural coronary arteries: proliferation of endothelial cells with focal protuberances leading to partial narrowing of the lumen; increased thickness of the arteriolar wall due to fibrosis and accumulation of neutral mucopolysaccharides; alterations of elastic fibers. Frequently small areas of perivascular fibrosis and isolated foci of myocytolysis were found as well. These results suggest that the arteriolar impairment, especially the thickening of the arteriolar wall, could play a role in the pathogenesis of diabetic cardiomyopathy.
Measuring conduction velocity in slower fibres (CVSF), through a partial antidromic block (Hopf-Seppäläinen method), allows estimating the dispersal of conduction velocity in motor fibres by the difference between the maximal motor conduction velocity (MCV) and CVSF. Investigations performed in workers exposed to medium concentrations of carbon disulphide show difference between MCV and CVSF as providing a more sensitive indicator for early diagnosis of peripheral neuropathies than MCV.
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To compare the contribution of clinical, laboratory and imaging data for the diagnostic accuracy in establishing the cause of obstructive jaundice, the records of 333 patients operated on for a presumed obstruction of the biliary ducts were analysed. The final diagnoses, after surgery, were divided into six groups: stones of the gallbladder and biliary tract, pancreatic cancer, biliary tract neoplasms, ampullary carcinoma, postoperative stenosis of the bile ducts, intrahepatic cholestasis (biliary cirrhosis, chronic cholangitis) and other causes of jaundice (liver tumours, cysts, extended cancer of the upper abdomen). Twenty-three parameters (9 clinical symptoms and signs, 10 biochemical alterations and 4 imaging methods) were examined. Not every case had all the investigations performed but the number of each group of data was large enough to allow a statistically significant conclusion. The contribution of each of the 23 parameters in increasing the probability of correct diagnosis was determined using a computer program based on Bayes' theorem. This analysis showed that for patients which presented suggestive clinical signs and symptoms for stones of the gallbladder and biliary tract and for pancreatic cancer, the diagnosis can be predicted with a probability of 90% only on the basis of clinical findings. The probability of a correct preoperative diagnosis was increased to 99% by imaging methods. On the contrary, for patients with a less clear diagnostic probability (with ampullary carcinoma, intrahepatic cholestasis and other causes) only ultrasonography and computed tomography could increase the probability of correct diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
The following microscopical aspects were found in the small intramural arteries in the myocardium of 30 diabetic patients: endothelial proliferations with focal protuberances leading to partial narrowing of the lumen, increased thickness of the arterial wall due to fibrosis and accumulations of neutral mucopolysaccharides: alteration of elastic fibres. Morphometrically, the arterial wall thickness and the arterial diameter were increased whereas the arterial density decreased in the diabetic heart. In 25 rats with streptozotocin-induced diabetes the small intramyocardial arteries were investigated at 11 to 40 weeks of diabetic state. Using morphometrical analysis a constant increase of arterial wall thickness paralleling the diabetes duration was found. Microscopically, the lesions consist in endothelial proliferation with bridging across the vascular lumen and slight perivascular and diffuse fibrosis. Ultrastructurally, the capillary basal lamina was thickened in the diabetic myocardium. In order to investigate the morphometrical data we used symbolic-logic as a decision method, by applying an original computer program based on the Quine-McCluskey algorithm. All our results together with the final symbolic-logic expression suggest that damage of the small intramyocardial arteries plays an important role in the pathogenesis of diabetic cardiomyopathy.
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Serial sections of the hypophyseal-hypothalamic region processed by the Golgi-Cox and hematoxylin-eosin staining methods show features of the third ventricular wall which suggest the existence in the human fetus of an equivalent of the paraventricular organ, described in other species. In a 28 cm vertex-coccis long human fetus, there is a caudal extension of the infundibular recess that extends into the neural lobe of the hypophysis. This extension takes the shape of successive dilatations intercommunicating by narrow channels, lined by a thicker ventricular ependyma. Cellular processes, free in the cerebro-spinal fluid, form a supraependymal layer. A rich vascular network may be observed in the region to the modified ependyma.
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