Download Pathobiology of the Human Atherosclerotic Plaque by Henry C. McGill Jr (auth.), Seymour Glagov MD, William P. PDF
By Henry C. McGill Jr (auth.), Seymour Glagov MD, William P. Newman III MD, Sheldon A. Schaffer PhD (eds.)
Seymour Glagov The final assembly, committed completely to an exam of the atherosclerotic plaque, happened in Chicago 25 years in the past lower than the joint auspices of the Council on Arteriosclerosis of the yank middle organization and the Chicago middle organization. The court cases have been released hence in a quantity entitled "Evolution of the Atherosclerotic Plaque", edited via Richard J. Jones (1). either experimental and human lesions have been thought of and several other provocative new ways to the ailment have been mentioned. The electron microscope was once being utilized systematically to the learn of blood vessels at the moment, in order that info of the infrastructure and mobile composition of the artery wall and of atherosclerotic lesions have been awarded in a few element. there has been, as one results of those explorations, substantial dialogue of morphologic proof suggesting that the central cellphone focused on the atherogenic strategy used to be neither the fibroblast nor the macrophage, as were meant, however the soft muscle mobile. specifically, the findings indicated that this mobile might include lipid and turn into a foam cell.
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Smoking habits must be reconstructed from interviews of surviving family members or associates. Family histories are also difficult to obtain. Some progress has been made in measuring these risk factor variables in deceased persons by analyzing postmortem blood for serum lipids and apolipoproteins, estimating blood pressure by examining renal arterioles, and measuring plasma thiocyanate as marker for recent smoking. Considerable efforts have been devoted to validating these methods, and they offer some promise in answering these questions about the conditions associated with the progression of atherosclerosis in young persons.
By about 10 years of age, macrophage foam cells 10 began to appear in clusters and often are associated with lipid in smooth muscle cells. These microscopic lipid deposits are not visible as gross fatty streaks on the intimal surface because of the thickness of the overlying intima. Endotheli~, connective tissue, and smooth muscle show no morphologic abnormalities in these sites. One, of course, must simultaneously acknowledge the limits of even the best light and electron microscopy to detect subtle functional changes, but the presence of lipid-filled macrophages and smooth muscle cells appears to support strongly the primary roles of abnormal lipid and lipoprotein metabolism and of the tissue monocyte-macrophage in the earliest stages of atherogenesis.
In summary, the transitional lesion is important, and the answer will make a difference in our concept of pathogenesis and also in our strategies for prevention of atherosclerotic disease. The questions are difficult to answer, but are not impossible. 7 The Fatty Streak Juvenile fatty streaks remain one of the great mysteries of atherosclerosis. They appear in the aorta shortly after birth, and increase rapidly in extent in the aorta during the second decade. They occur in children of all populations, regardless of environment or disposition to advanced lesions later in life.