Intimal Calcification Research Articles

Systemic stress in the production of cardiac thrombosis in hypercholesterolaemic rats

An experimental study to elucidate the effects of feeding a high fat diet, hypercholesterolaemia and superadded acute and chronic stress on the production of cardiac thrombosis was carried out in rats. The high fat diet contained 25 percent butter rat providing 45 percent calories from fat which produced significant increase of serum cholesterol and other lipids. Acute stress was induced by two injections of adrenaline on a single day which caused a marked transient alteration of haemodynamics. Chronic stress was of two types, physical and metabolic. The physical stress was induced by repeated exposure of the rats to electric shock or roller drum exercise, while metabolic stress was caused by repeated injection of ACTH. Rats of both acute and chronic stress groups showed variable degree of medial degeneration, hyaline and fibrinoid intimal deposits and calcification in coronary arteries. Cardiac thrombi were seen in 30 percent animals subjected to adrenaline shock. Among the chronic stress procedure 17 percent rats exposed to electric shock and only one rat of the ACTH group developed cardiac thrombosis but no thrombus was detected in those exposed to roller drum exercise. The myocardium showed patchy necrosis with or without calcification, Spontaneous mortality was maximum following acute adrenaline shock (25 %) while electric shock caused mortality in 17 percent animals. The other procedures did not lead to spontaneous mortality. This study highlights the significant role of high fat intake, hypercholesterolaemia and systemic stress in the pathogenesis of acute cardiac thrombosis and myocardial necrosis/infarction.

Chronic Calcified Aortic Dissection

Two cases of chronic aortic dissection are presented. In both, plain chest roentgenograms revealed calcification in the outermost aspect of the dilated aorta. It is clear that this represented calcification of the dissection rather than of the true intima. These cases indicate that apparent aortic intimal calcification with dilatation of the aorta is not completely diagnostic of an arteriosclerotic aneurysm and that a chronic calcified aortic dissection must also be considered in the differential diagnosis.

Intimal and medial calcifications of the carotid siphon and cerebrovascular disease.

Skull films of 5,570 patients older than 40 years of age admitted to the neurological (4,308), ophthalmologic (1,151), and otorhinolaryngologic clinics (111) of the University of Milan over a period of 20 years were reviewed for carotid siphon calcification. The 485 positive findings were divided into intimal and medial calcifications on the basis of morphological criteria. Signs of cerebrovascular disease in the territory of the internal carotid artery were seen in 35.1% of the intimal group and 37.2% of the medial group. These findings suggest that the two types of calcification do not have different prognostic values as theorized previously.

Effect of an oral contraceptive drug on non-arteriosclerotic male and female virgin rats vs. arteriosclerotic, male and female breeder rats.

Male and female virgin rats with no arteriosclerosis and male and female breeder rats with preexisting arteriosclerosis were given daily injections 5 days/week (.15 mg/100 gm body weight) of the contraceptive drug Enovid (9.85 mg progestin (norethynodrel) and .15 mg estrogen (mestranol) for 4 8 and 12 weeks. There were a total of 864 animals 288 for each of the time intervals consisting of 48 controls 48 male and 48 female virgins 48 male breeders and 48 1-time and 48 4-5 time female breeders. After the 3-month period 1/3 of each group was autopsied. Examinations were made of the heart and vascular systems. Creatine phosphokinase (CPK) transaminases (SGOT SGPT) lactic dehydrogenase (LDH) triglycerides cholesterol free fatty acids glucose and blood urea nitrogen (BUN) were analyzed. All of the treated showed body weight loss adrenal glandular hypertrophy degranulation of pituitary gonadotrophic cells and testicular and ovarian atrophy. CPK SGOT SGPT and LDH were elevated and then their levels receded. The treated developed a fatty liver hypertriglycerdemia elevated free fatty acids and hypercholesterolemia. The treated were diabetic but eventually manifested hypoglycemia despite beta cells degranulation. Corticosterone levels were subnormal. Microscopic arterial lesions appeared in the previously nonarteriosclerotic virgin rats. There was no exacerbation of the arterial lesions in breeder rats with preexisting arteriosclerois. Lesions were in the aorta and its side branches consisting of intimal mucopolysaccharide collagen elastolytic changes and calcification. It was believed that the drug upset hypothalamic and gonadal hormone homeostasis which led to endogenous hormonal-metabolic alterations favoring the pathogenesis of cardiovascular disease in both male and female rats.(Authors modified)

Ultrastructure of the renal arterial bifurcation of rabbits

Intimal thickenings at renal artery bifurcations of 30 rabbits were studied ultrastructurally. After localization of intimal pads, the forks were cut on several planes. No microthrombi were observed at the fork but the endothelium of the fork and stem contained bundles of cytoplasmic fibrils incorporating dense bodies like those in smooth muscle cells. The densities were at times arranged as cross striations with a fairly regular periodicity. The internal elastic lamina external to the pads appeared thinned or deficient with much collagen and fibrillary elastica between the strata of muscle cells in the intimal thickenings. The intimal pads contained quantities of cell debris seemingly derived from both endothelium and muscle. Degenerate and undifferentiated cells were observed in the intimal pads and calcification but rarely. Intimal pads are apparently sites of enhanced degeneration of endothelium, smooth muscle cells and elastic tissue.

Involvement of the skin and subcutaneous tissue in azotaemic hyperparathyroidism.

Summary: Two patients with uraemia and secondary hyperparathyroidism who had severe involvement of the skin and subcutaneous tissue are described. Previous reports are reviewed and the lesions appear to be of two types, exemplified by our two patients. In the first there was massive calcification of the skin and subcutaneous tissue possibly due to calciphylaxis. In the second there was ischaemia and gangrene of the skin; histologically intimal proliferation and medial calcification of the arterioles were present.

A quantitative study of peripheral arterial calcification and glucose tolerance in elderly diabetics and non-diabetics.

A quantitative study of peripheral arterial calcification and glucose tolerance in elderly diabetics and non-diabetics has been performed. A correlation between radiological media calcification and glucose tolerance in non-diabetics was found. Intima calcification was not correlated. Severe media calcification was much more common in diabetics than in non-diabetics.

Aortitis and Malacoplakia-like Lesions of the Brain in Association with Neonatal Herpes Simplex

A report of a case of a neonate with herpes simplex infection, who died 85 days after development of skin vesicles, is presented. The clinical course was characterized by lethargy, convulsions, abnormal spinal fluid findings, irritability, microcephaly, and failure to thrive. Herpesvirus was isolated from the spinal fluid, throat, and stool. Necropsy revealed large porencephalic cysts and massive destruction of the cerebral cortex, thickening of the aorta and narrowing of the ascending aortic branches, and small pinpoint nodules in the adrenal glands. Microscopically, severe necrotizing meningoencephalitis with massive calcification and curious malacoplakia-like bodies was seen in the brain; necrotizing vasculitis with severe intimal fibrosis, calcification and giant cells of the aorta and its ascending branches, and focal necrosis with calcification, fibrosis and giant cells were found in the adrenal glands. A discussion of involvement of the brain in cases of neonatal herpes simplex and vascular involvement by herpes and other viruses is also presented.

Carotid siphon calcification and cerebral blood flow in the healthy aged male.

Radiographic calcification of the carotid artery siphon is frequently (75.6%) encountered in healthy, elderly males. Based on appearance, this calcification may be intimal or medial. Various radiographic-pathologic investigations support this subdivision. Patients with intimal carotid siphon calcification have diminished cerebral blood flow values (52.1 ml/100 g/rnin.) while subjects with medial calcification have values (60.6 ml/100 g/min.) closely resembling those found in the optimally healthy elderly (57.9 ml/100 g/min.). Thus, radiographic carotid siphon calcification acquires a new and more selective physiologic significance and potentially a more meaningful clinical value.

RADIOLOGICALLY DEMONSTRABLE ARTERIAL CALCIFICATION IN DIABETES MELLITUS.

SummaryA radiological study of the lower limbs of 250 diabetics and 250 controls has shown that medial arterial calcification at the knee and foot level is some two and a half times more frequent in the diabetic group. The incidence of intimal calcification at the knee level was higher in the diabetic group, but the difference was not statistically significant. Intimal calcification was not seen in the small arteries of the feet.In the diabetic group, there was correlation between the incidence of medial arterial calcification in the feet and the incidence of medial arterial calcification at the knee, but not with the incidence of intimal calcification at the knee.The incidence of arterial calcification in the feet of the diabetics bore a definite relationship to increasing patient age, sex (males being more affected), duration of the diabetes in the under‐fifty‐years age group, the presence of retinopathy and the incidence of gangrene. There was no correlation with the severity of, or control of, the diabetes.In a small group of non‐diabetic patients showing advanced arterial calcification in the feet, fasting blood sugar levels were slightly higher than in a control group, but response to a sugar load was similar. This did not support the hypothesis that advanced arterial calcification in arteries of the feet was a manifestation of the prediabetic state.

Correlation of anatomic and roentgen changes in arteriosclerosis and syphilis of the ascending aorta.

Calcification of the intima of the ascending arch of the aorta has long been recognized by radiologists as evidence of syphilitic aortitis. Jackman and Lubert (1) in 1945 reported the results of a comparison of chest roentgenograms from 66 autopsied cases of syphilitic aortitis and 62 autopsied cases of severe atherosclerosis of the ascending aorta. They found roentgen evidence of calcification in the ascending aorta in 22.7 per cent of the cases of syphilis as compared to 3.2 per cent of the cases of atherosclerosis. Leighton (2), having studied a series of patients whose chest roentgenograms demonstrated calcification of the ascending aorta, reported that 66 per cent showed positive serologic evidence of syphilis. Others have made similar observations (3). Intimal calcification not thus accounted for is due either to clinically unrecognized syphilis in individuals in whom the serologic evidence has become negative or “burned out,” or to calcific atherosclerosis resulting from arteriosclerosis. While the...