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The quantitative and qualitative evaluation of atherosclerotic lesions by the ultrasonography has presented several problems, above all, the determination of accuracy and reproducibility of this methodology in humans. The present study aims to evaluated the results of B-mode imaging of extracranial carotid arteries in patients selected for surgery as compared with histologic results of the observations of the samples obtained by endarterectomy. Shrinkage effects of the histologic samples were taken into consideration. Several bidimensional images of atherosclerotic lesions, as obtained by ultrasound at different incident angles, were used to establish their maximum thickness. The maximum degree of the vessel stenosis calculated by ultrasound showed a high correlation (Y = 0.47X + 42.4, se = 0.11, r = 0.5, p less than 0.001) compared with the one obtained by histology. The imaging methodology provided however, a mean overestimation of the stenosis of about 7%. Relationships among the amount of calcium (p less than 0.03); necrotic core p less than 0.056); and echogenic types, ie, soft, mixed, and hard; have been suggested by a statistical trend. The results suggested that of the vascular lumen due to advanced atherosclerotic lesions. Qualitative interpretation of atherosclerosis by B-mode imaging, ie, morphologic characteristics, seem, at present, to be of value, but more investigations in depth are needed.

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The effects of 3-glucosaminoglycan sulfate on lipids and the hemorheologic parameters were observed in a preliminary double-blind crossover study in 30 hyperlipidemic peripheral vascular disease (PVD) patients. Parenteral administration of the test drug was associated with a reduction in serum lipids, especially in triglyceride levels, and a lowering of fibrinogen, plasma viscosity, and whole blood viscosity levels. These effects justify the drug's use in the treatment of PVD, especially when associated with hypertriglyceridemia and hemorheologic disturbances.

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An evaluation of the hemorheologic parameters and an ultrasonographic study of the extracranial carotid tract were performed on 48 patients, age range: sixty to seventy-five years, affected by acute stroke, 23 of whom had hypertension, while 27 were smokers. None of them was suffering from hyperlipidemia, diabetes mellitus, or symptomatic coronary heart or peripheral artery disease. The echotomographic analysis, using B-mode real-time echotomography revealed atherosclerotic lesions in 26 patients. The hemorheologic pattern (hematocrit, fibrinogen, whole blood filterability, whole blood and plasma viscosity) was determined in all the patients three months after the clinical event. Statistical analysis of the results indicates a possible link between atherosclerotic lesions of the extracranial carotid tract and age, fibrinogen levels, and whole blood filterability.

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High-resolution real-time echotomography was used in a longitudinal study on 118 atherosclerotic plaques of the extracranial carotid tract with the aim of identifying those most likely to cause a cerebrovascular event. Seventy patients (average age 61 +/- 7 years), referred to our Clinical Vascular Laboratory because suffering from transient cerebral ischemic attacks (TIA), coronary heart disease (CHD, peripheral artery disease (PAD), or cervical bruits (CB), were followed up for two years. Medical treatment remained that of the referring physician. Ten patients suffered from clinical events caused by stroke, TIA, and/or carotid occlusion during the follow-up. The echostructural profile of the lesions most often correlated with the clinical event was characterized by a mixed or hard echogenic pattern, and irregular surface, and an initial vascular stenosis of more than 50%.

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A two-year follow-up on 118 atherosclerotic lesions of the extracranial carotid tract observed in 70 patients was carried out using real-time high-resolution echotomography. The following plaque characteristics were monitored: the echogenic patterns (soft, intermediate, hard, and mixed), the surface aspects, and the degree of stenosis. The aim of the study was to evaluate plaque evolution, in relation both to the degree of vessel stenosis produced and to the echostructural characteristics of the lesion. After two years 68% of the lesions remained unchanged while the degree of vessel stenosis increased in 32%; no case of regression was observed. Intrinsic factors appearing to condition an increase in degree of stenosis were "mixed" and "hard" echogenic pattern, an irregular lesion surface, and an initial degree of stenosis of more than 50%. A modification in the echogenic pattern, which generally tended to progress toward more highly reflecting echogenic levels was observed in 27% of the lesions studied.

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An ultrasonographic study was performed in 187 hyperlipoproteinemia patients to evaluate the incidence of atheromatous lesions in the extracranial carotid tract. A high-resolution, real-time, B-mode instrument with two probes (4- and 8-MHz) was used. Fifty-five subjects had high blood cholesterol levels, 70 high triglyceride values, and 62 both. Arteriosclerotic disease was present at other sites in 39% of the patients. Atheromatous carotid lesions were revealed in 37% of the patients, and there seemed to be no significant correlation with the type of hyperlipoproteinemia. There was also no correlation between blood cholesterol levels and the presence or absence of atheromatous lesions. Increasing age and arteriosclerotic disease at other sites were the factors most frequently associated with atheromatous lesions in the extracranial carotid tract.

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Investigations were made on a total of 92 patients with gout and hyperuricemia. 30% had no clinical signs of spinal involvement. The remaining 70% were examined radiologically and by xero-radiography. Examination revealed signs of erosion of vertebral bodies, spondylodiscitis, osteopenia, manifestations of Forestier's disease and changes on sacroiliac joints. In 35% of subjects there were polytopic hyperostoses including an increased incidence of calcifications around the large joints and periosteal appositions at the periphery, particularly on the finger and toe tips. The hypothesis was raised that massive calcifications and manifestations of hyperostosis and ossification of the ligaments and tendons (osteodesmosis) in gout may correlate with a latent glycide metabolism disorder like in Forestier's disease.

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The analysis of the working population in a chemical plant demonstrates that back pain accounted for 6% of all working disabilities and for 7.3% of the total number of days of absence from work. Increased morbidity was generally found with increasing age. The exception was the high morbidity of the youngest group of male office staff.

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