RESUMO
The cerebral arteries (common carotid, internal carotid, vertebral, middle cerebral, and basilar arteries) were examined from 1547 autopsied persons in five countries (Norway, Guatemala, United States, Jamaica, and Chile). Subgroups comparisons were made using a basal group of cases from which were excluded all persons with coronary heart disease, peripheral arterial disease, other atherosclerotic complication, hypertension, and diabetes. The prevalence and mean extent of atherosclerotic lesions increase in each succeeding age group. Lesions appear to develop later in life in the cerebral arteries than in the aorta and the cerebral arteries than in the aorta and the coronary arteries. Men have more raised atherosclerotic lesions than women. The mean extent of fatty streaks in the cartoid arteries does not differ among age groups from 35 to 69 years of age, nor does it differ among location-race groups. The mean extent of raised atherosclerotic lesions in the carotid arteries increases in each succeeding age group after 35 years of age, and differs among location-race groups.The pattern of development of atherosclerosis in the carotid arteries follows that of the aorta. Fatty streaks appear in the intracranial and vertebral arteries much later in life than they do in the carotid arteries.The mean extent of both fatty streaks and raised lesions increases in each succeeding age group after 35 years of age, and the average involvement of both types of lesions differs among location-race groups. The pattern of development of atherosclerosis in the vertebral and intracranial arteries follows that of the coronary arteries. When location-race groups are ranked by extent of cerebral atherosclerosis, they rank in approximately the same order as when they are ranked by aortic and coronary atherosclerosis. (AU)
Assuntos
Humanos , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Arteriosclerose Intracraniana/epidemiologia , Arteriosclerose/epidemiologia , Arteriosclerose/patologia , Artéria Basilar/patologia , Negro ou Afro-Americano , Artérias Carótidas/patologia , Artérias Cerebrais/patologia , Arteriosclerose Intracraniana/patologia , Chile , Etnicidade , Geografia , Guatemala , Jamaica , Louisiana , Noruega , Fatores Sexuais , Artéria Vertebral/patologiaRESUMO
The histologic characterictics of a standard site in the left interior descending coronary artery of 304 males between 10 and 39 years of age from seven different populations were examined. These seven location-race groups were ranked in the same order as the ranking based upon mean extent of raised atherosclerotic lesions in the coronary arteries and aorta to establish the tendency of each group to develop advanced atherosclerosis. Muscloelastic intimal thickening in the earlier decades does not predict the likelihood to develop severe atherosclerosis. Amount of intimal lipid and degree of cellular infiltration do predict the disposition to develop severe atherosclerosis later in life. Therefore, increased intimal lipid and cellular infiltration characterize coronary artery fatty streaks that are associated with their conversion to fibrous plaques. Necrosis of lipid-containing cells may release intracellular lipid into the extracellular space and thereby incite cellular infiltration and sequelae. (AU)
Assuntos
Humanos , Criança , Adolescente , Adulto , Masculino , Arteriosclerose/epidemiologia , Arteriosclerose/patologia , Vasos Coronários/patologia , Arteriosclerose/patologia , Negro ou Afro-Americano , Etnicidade , Guatemala , Jamaica , Lipídeos/metabolismo , Louisiana , África do Sul , América do SulRESUMO
The clinical features of 206 cases of a neuropathic syndrome in Jamaica are presented. The dominant feature is a spastic paraplegia. Approximately half of the cases have evidence of associated posterior column damage. In a minority optic atrophy, nerve deafness of selective anterior horn cell damage is found. The patients have been divided arbitrarily into two categories: 25 cases presenting predominantly with sensory ataxia, and in whom there is a high incidence of optic atrophy and eighth nerve deafness, with slight evidence of pyramidal tract damage. This group has a background of poor nutrition. (b) 181 cases presenting predominantly as a spastic myelopathy, and with a relative low incidence of optic atrophy and eight nerve deafness. The findings in ten necropsies from the spastic group are presented with their cases record. The histopathology is that of a chronic meningo-myelitis, with damage to the long tracts as the major lesion. Involvement of the brain, they grey matter of the cord and spinal nerve roots occurs to a lesser extent. An eleventh case is described with similar pathology, which clinically was thought to be an example of neurosyphilis. The relationship of this syndrome to other neuropathies is considered. The aetiology is discussed, with special reference to the possible role of syphilis and yaws in the spastic group. The majority of these cases have positive treponemal tests in the blood, but only 6 per cent have positive tests in the spinal fluid. The pathology has much in common with that of neurosyphilis, but lacks some of the features generally accepted as typical. The incidence is extremely high relative to other known forms of neurosyphilis in Jamaica. Other factors such as ingested toxins and vitamin deficiences may add to, or modify, the metabolic impairment. It is possible to envisage a spectrum of disease varying from a picture of non-inflammatory long tract degeneration to the active meningo-vascular reaction of florid adhesive arachnoiditis-a spectrum in which common causal factors could operate with variable degrees of intensity. This study emphasizes that our understanding of the pathogenesis and pathology of neurosyphilis in its many forms is far from complete (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Paraparesia Espástica Tropical/patologia , Doenças do Sistema Nervoso/patologia , Jamaica , Paraparesia Espástica Tropical/etiologiaRESUMO
There are marked diferences in the incidence of ischaemic (atherosclerotic) heart disease (I H D) between various populations, and between groups within the same population. This is usually attributed to differences in the extent and severity of atherosclerotic lesions in the coronary arteries of these populations and groups. There is evidence that these differences became apparent relatively early in life. In association with the International Artherosclerosis Project a pilot study of the histology of coronary atherosclerosis in different races has been done. Cases from high, intermediate and low risk (of I H D) groups were selected in the age bracket 10-39 years and a qualitative and quantitative histological assessment of the coronary arteries made. The results suggested that the incidence and severity of certain lesions in the coronary arteries paralleled the predictable incidence of I H D in later life in the groups (AU)
Assuntos
Humanos , Criança , Pessoa de Meia-Idade , Doença da Artéria Coronariana/história , Estudo ComparativoRESUMO
Using a quantitative method of assay the degree of atherosclerosis of the aorta, coronary arteries and cerebral arteries has been determined in a large, predominantly Negro, autopsy series in Jamaica, West Indies. There is a progressive worsening of the disease with age but there are considerable individual variations at all ages. The aorta, coronary and cerebral arteries are affected in that order in time and severity. Atherosclerosis is generally more severe in men and hypertension accentuates the disease, especially in women after the menopause. Hypertension is more important than atherosclerosis in causing cerebrovascular disease in Jamaica. Diabetes alone does not seem to influence adversely the development of atherosclerosis except in combination with hypertension. Evidence for the effect of malignant disease was inconclusive. Severe degrees of atherosclerosis are encountered in the Jamaican Negro but the supposed complications are relatively uncommon. This supports the view that factors other than initial disease, principally those connected with thrombosis, are concerned in the pathogenesis of ischaemic vascular disease. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Arteriosclerose/epidemiologia , Hipertensão/complicações , Fatores Sexuais , Menopausa , Diabetes Mellitus/complicações , Jamaica , Vasos Coronários/patologia , Aorta/patologiaRESUMO
Preliminary studies in Jamaica indicated that the incidence of athero-sclerosis of the aorta showed a similar pattern to that in the United States although the incidence of myocardial infarction, a presumed complication of atherosclerosis, is far lower in Jamaica than in the U.S.A. The study has been extended to include a comparative assay of the coronary arteries and it has been found that the degree of coronary atherosclerosis is significantly greater in comparable age groups in the United States of America than in Jamaica. The implications of this dissociation are discussed. The Jamaican results have been analysed to determine the influence of age, sex, hypertension and diabetes on the disease process (AU)
Assuntos
Humanos , Arteriosclerose , Jamaica , Infarto do Miocárdio , Estados UnidosRESUMO
Comparison of aortic and coronary atherosclerosis in the United States, Jamaica, Japan and India demonstrates that after the first two decades of life, there is a greater severity of intimal alteration in the United States than in the other population groups. The 3 foreign populations exhibited much less coronary atherosclerosis and a lower incidence of myocardial infarction. Their diets, too, were of lower caloric content and contained less than half the fat found in the United States diet. In Japan and Jamaica, atherosclerosis proved to be disproportionately more severe in the aorta than in the coronary arteries. Accordingly, appraisals of atherosclerosis limited to the aorta do no provide adequate indexes of geographical variations. A much lower proportion of complicated atheromatous lesions (ulcerated or calcified plaques) accounted for most of the differences observed. While there was a general parallelism between the severity of coronary atherosclerosis and the frequency of myocardial infarction, there were instances of cardiac infarction associated with relatively minor degrees of coronary intimal alteration. These situations indicate that virtually all grossly recognizable intimal lesions may be complicated by thrombosis (Summary)
Assuntos
Humanos , Adulto , Doença da Artéria Coronariana/etnologia , Arteriosclerose/etnologia , Aorta , Infarto do Miocárdio , Fatores Etários , Índia , Jamaica , Estados Unidos , Japão , Dieta , HipertensãoRESUMO
The seventh case of solitary plasmocytoma of the stomach is reported. It is suggested that in this case and possibly in others the tumor arose as a rare type of malignant change in a chronic peptic ulcer. The literature on extramedullary plasmocytoma of the gastro-intestinal tract is reviewed (Summary)
Assuntos
Humanos , Pessoa de Meia-Idade , Masculino , Plasmocitoma/patologia , Plasmocitoma/cirurgia , Neoplasias Gástricas , Plasmocitoma/sangue , Linfonodos/patologia , Causas de Morte , Mieloma Múltiplo/etiologia , JamaicaRESUMO
Using a standardised technique, the incidence of atherosclerosis of the aorta at 500 necropsies in Jamaica has been compared with the incidence in published series in which the same method was employed. The predominantly Negro population in Jamaica develops a degree of aortic atherosclerosis similar to that of a mixed population in New Orleans, U.S.A. The incidence of myocardial infarction, however, is much lower in the Jamaican series. Other thrombotic diseases are also rarer in Jamaica. Since there is no constant relation between the incidence of atherosclerosis and the incidence of coronary thrombosis, they are very unlikely to have the same cause. Atherosclerosis may or may not be promoted by a dietetic factor; but, if it is, the same factor can hardly be responsible for the thrombosis which results in ischaemic heart-disease. In aetiological studies the two conditions need to be clearly distinguished. Since advanced atherosclerosis is compatible with health and long life, investigation of the cause of thrombosis is of more immediate concern (AU)
Assuntos
Humanos , Arteriosclerose/epidemiologia , Doença das Coronárias/etiologia , Jamaica , DietaRESUMO
Biopsies of the placental bed have been taken from 36 patients. Histological examination has been carried out with particular reference to pathological changes in the maternal vessels and these changes have been related to the clinical histories of the patients. Vascular lesions have been found in material obtained from hypertensive and from toxaemic women. These changes are in no way distinguishable from those generally acknowledged to occur as a result of systemic hypertension. They are directly related in extent to the clinical severity of the disease. No such changes have been found in normal patients. Apart from differences of degree, the vessel changes in essential hypertension and pre-eclampsia appear identical. They are thought to be due to hypertension (AU)
Assuntos
Humanos , Feminino , Placenta/irrigação sanguínea , Pressão Arterial , Biópsia , Cesárea , Hipertensão , Pré-Eclâmpsia , Eclampsia , Hipertensão Renal , Hemorragia , JamaicaRESUMO
During Caesarean section biopsies of the placental bed have been taken from normotensive and hypertensive women. Historical examination has been especially directed at the maternal vessels and any changes found related to the clinical histories of the patients. Changes have been found in the maternal vessels of women suffering from essential hypertension and pre-eclampsia. They do not differ from one another except in degree and are indistinguishable from those changes known to occur in association with systemic hypertension. They have not been found in normotensive patients. It is felt that the hypertension and the accompanying vasular lesions may be responsible for the reduction of the maternal placental blood flow found to occur in patients with pre-eclampsia and essential hypertension. (AU)
Assuntos
Humanos , Feminino , Placenta , Gravidez , HipersensibilidadeRESUMO
As part of a geographical survey of atherosclerosis a method has been used to assess qualitatively and quantitatively the degree of sortic atherosclerosis at routine autopsy. To date 368 cases from all age groups have been studies in Jamaica. A preliminary analysis of the results has been made and compared with similar published series. Contrary to what has been claimed by other authors the Jamaican figures would appear to indicate that there is not necessarily a direct correlation between the degree of aortic atherosclerosis and the liability to the development of the serious sequelae of atherosclerosis such as myocardial infarction. (AU)