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Biomedical subjects

M C Oalmann

Publications and source records attributed to M C Oalmann.

At least 37 records · Page 2Linked to original sources
PubMed1989

Two variants of coronary atherosclerosis in six populations.

Coronary arteries and aortas obtained at autopsy in six populations were examined microscopically. Two variants of atherosclerosis could be separately quantified by objective morphometry. These two variants, fibroplasia and atheronecrosis, were both found to increase with age and to correlate with each other from one autopsy to the next after age adjustment. Despite the correlation of these two variables among individuals, the measures of fibroplasia and atheronecrosis did not correlate with each other across population groupings. A positive correlation of this kind between some populations was canceled by an inverse correlation between other populations. For example, Manila was the population with the greatest intimal fibroplasia in the coronary arteries at each age, and Sao Paulo was among those with the least intimal fibroplasia. Nevertheless, Sao Paulo showed the greatest tendency toward atheronecrosis, while Manila was among the populations with the least tendency toward atheronecrosis. The possibility arises, therefore, that the subjects from Sao Paulo were exposed to a different assortment of etiologic agents than were the subjects from Manila, and that their arteries, therefore, manifested a different kind of atherosclerosis.

Adult↗
PubMed1988

Secular trends in atherosclerotic lesions: comparison of two studies of autopsied men conducted in different time periods.

The extent and prevalence of atherosclerotic lesions in the coronary arteries and aortas of deceased 25 to 44-yr-old men, autopsied in New Orleans during two different time periods (1960-64 and 1969-78), were evaluated to determine if changes in lesions had occurred in parallel with reported decreases in coronary heart disease death rates. Results of these evaluations showed that both the extent and prevalence of raised atherosclerotic lesions were significantly less in the coronary arteries of white men in the second time period. No significant difference was detected in black men. In the aorta there were no significant differences between studies in whites, but in blacks, there were significantly more extensive raised lesions in the second time period. These findings strongly suggest that the extent of involvement with atherosclerotic lesions in a given population may change over time. The underlying mechanisms responsible for these secular trends in atherosclerosis merit additional study.

Adult↗
PubMed1988

Two variants of nephrosclerosis separately related to age and blood pressure.

Two variants of nephrosclerosis, roughly corresponding to the arterial and the arteriolar forms, have been examined in a series of autopsy kidneys by five observers using quantitative morphometry. These two variants are both marked by fibroplastic intimal thickening and medial wastage in the arteries, but one of these affects vessels of sizes that are closer to the heart, whereas the other affects sizes that are more remote from the source of arterial pressure. Both types of nephrosclerosis were found to increase with aging in subjects without hypertension. Each year of aging added 0.15 units of intimal thickening to the close vessels and 0.11 to the remote vessels. Each millimeter of mercury of elevated blood pressure was equivalent to 1 year of aging in the close and 2 years in the remote levels of the arterial tree. The four variables, age, blood pressure, remote level intimal thickness, and close level intimal thickness, were found to hold complex curvilinear interrelationships when examined by regression analysis. A dynamic model was suggested by the following findings: The earliest changes shown by young normotensives are in the close vessels, possibly because of the aging effect of the normal pulse wave. Later, the changes extend into the remote level, perhaps because the thickened intima is rigid and propagates the pulse wave abnormally far into the smallest arteries. Hypertension could then be viewed either as a cause for an exaggeration of this normal process or as a consequence of its extension into the remote level vessels where resistance to blood flow is greater or both. The objective morphometric method showed good agreement in the findings by independent observers and is considered to be suitable for epidemiologic studies of nephrosclerosis.

Adult↗
PubMed1987

Differences in adipose tissue fatty acid composition between black and white men in New Orleans.

We report fatty acid composition in perirenal and buttock adipose tissue in 714 deceased black and white men aged 25-44 yr in New Orleans. Percent saturated fatty acids were higher (p less than 0.001) whereas percent monounsaturated fatty acids were lower (p less than 0.001) in perirenal than in buttock fat. Percent linoleic acid was similar in both races. We conclude that dietary intake of linoleic acid is similar in both races. The trend of decreasing linoleic acid with advancing age suggests that either intake of linoleic acid progressively decreases or its mobilization rate increasingly exceeds deposition rate or both. Percent palmitoleic acid (16:1) is lower (p less than 0.001) and that of stearic acid (18:0) is higher (p less than 0.001) in blacks than in whites. We believe no explanation can rest solely on differences in habitual dietary fat intake.

Adipose Tissue↗
PubMed1987

Clinical applications of the supraceliac aorta: anatomical and pathologic observations.

To assess the extent of atherosclerosis in the supraceliac aorta, we studied autopsy samples from 100 men with severe atherosclerotic disease and from 135 men who had died of noncoronary causes. In both groups, the extent of atherosclerotic involvement was consistently less in the supraceliac aorta than in the infrarenal aorta. For this reason and because of other desirable characteristics, the supraceliac aorta is useful as an anastomotic site for apicoaortic conduits; in cases of graft infection; in coarctation of the aorta, when a concomitant cardiac procedure has been performed; and when the infrarenal aorta is inaccessible.

Aorta, Abdominal↗
PubMed1984

Coronary heart disease in young black and white males in New Orleans: Community Pathology Study.

The biracial population of New Orleans has a high overall mortality rate, high coronary heart disease (CHD) mortality rate, and high autopsy rate. In the New Orleans Community Pathology Study we investigated atherosclerosis and CHD in all deceased males aged 25 to 44 years, with major focus on the 52% of subjects from whom heart and arterial specimens were collected and evaluated according to standardized procedures. Morphologic correlates of CHD are the same in young black and white males. CHD mortality and mortality from cerebral hemorrhage, hypertensive heart disease, chronic renal disease, and diabetes are greater in young black males than young white males. Age, serum cholesterol, and hypertension were identified as important associated factors in the atherosclerotic process, as well as in CHD. The extent of coronary lesions seems to have decreased between 1960-1964 and 1969-1978 in young white males but not in blacks. Racial differences in coronary lesion involvement in non-CHD deaths are smaller than in our earlier studies.

Adipose Tissue↗
PubMed1981

Community pathology of atherosclerosis and coronary heart disease: post mortem serum cholesterol and extent of coronary atherosclerosis.

Little is known about the direct relationship between serum cholesterol and the extent of coronary atherosclerosis in human populations even though the association of serum cholesterol levels with risk of developing coronary heart disease (CHD) is well documented. The results of this study of men 25-44 years of age, residents of Orleans Parish, Louisiana, show a significant relationship between post mortem serum cholesterol levels and extent of more advanced lesions (raised lesions) in the coronary arteries in 110 autopsied white men, but not in the cases of 221 autopsied black men. When disease categories comprising CHD cases and non-CHD cases (basal group) were evaluated, the racial difference in the cholesterol-lesion associations persisted. The reason for the racial difference in the observed cholesterol-lesion association is not clear. Additional research, where younger age groups are included, and considering earlier lesions and other risk factors in different environments may help in clearing this question.

Adult↗
PubMed1981

Sudden death from coronary heart disease in young men: Pathologic findings.

Thirty-five of 40 young men whose deaths were caused by coronary heart disease died suddenly (less than 24 hours after onset of terminal symptoms). Many had myocardial necrosis or scars consistent with ischemic episodes that occurred hours, days, or months prior to death, yet 94% did not reach a hospital or receive medical care during the terminal episode. These results are from an investigation of 579 men, aged 25 to 44 years, who lived, died, and were autopsied in Orleans Parish, Louisiana. Among those who died of coronary heart disease, the vast majority had extensive advanced atherosclerotic lesions in the coronary arteries irrespective of suddenness of death. The frequent occurrence of gross scars indicative of healed myocardial infarction among young men, both black and white, who died suddenly of coronary heart disease may offer new hope that improved case finding might identify persons who could benefit from vigorous programs of early intervention.

Adult↗
PubMed1981

Community pathology of atherosclerosis and coronary heart disease in New Orleans. Morphologic findings in young black and white men.

Mortality from coronary heart disease is greater in young black men than in their white counterparts. On the other hand, the morphologic correlates of coronary heart disease, namely, coronary artery stenosis and occlusion, thrombus, and myocardial lesions are strikingly similar in coronary heart disease deaths regardless of race. Diseases related to atherosclerosis and coronary heart disease such as cerebrovascular disease, hypertension, diabetes, and chronic renal disease are also more frequent in young black men than in young white men, but the excess of coronary heart disease in blacks is evident irrespective of these diseases. Our findings are based on a community-wide survey of black and white men, 25 to 44 years of age, who lived, died, and were autopsied in Orleans Parish (county) Louisiana. Since the morphologic features of the disease are similar in the two races, investigation of risk factors is needed to further explain mechanisms associated with the relatively high coronary heart disease death rate in young blacks.

Adult↗
PubMed1981

The relation of antemortem factors to atherosclerosis at autopsy. The Puerto Rico Heart Health Program.

Among 9824 Puerto Rican men, aged 35-79, participating in a prospective study of cardiovascular risk factors, there were 970 deaths during the period 1965-1977. About 14%, or 139, of these deaths had a protocol autopsy following the procedures of the International Atherosclerosis Project. The percentage of involvement with raised atherosclerotic lesions in the coronary arteries was higher in the urban deceased than in the rural. The coronary heart disease death rate was also found to be higher in urban than in rural men in this population. Serum cholesterol and systolic blood pressure measured from up to 8 years before death were related both to raised lesions in the coronary arteries and in the aorta. Age and previous smoking status were associated with lesions only in the aorta. These results lend support for an etiologic relationship between serum cholesterol and blood pressure and the atherosclerotic process.

Aorta↗
PubMed1980

Reasonableness of use of the serum isoenzymes creatine kinase and lactate dehydrogenase for the diagnosis of myocardial infarction at a medical center.

At Charity Hospital of Louisiana at New Orleans, in 1978, there was considerable underuse of serum creatine kinase and lactate dehydrogenase isoenzymes for the diagnosis of myocardial infarction. Laboratory generation of creatine kinase isoenzyme tests for patients suspected of having had myocardial infarctions was only partially effective in correcting underuse. It unnecessarily generated some overuse. Appropriate modifications of this policy could improve performance. Additional, effective educational efforts are needed to improve reasonable use of laboratory tests. The study uncovered an unexpected problem in the laboratory--in a significant percentage of cases, results of indicated and ordered tests failed to appear in the charts.

Clinical Enzyme Tests↗
PubMed1980

Sudden death, coronary heart disease, atherosclerosis and myocardial lesions in young men.

A standardized method for examining hearts and coronary arteries was applied in a study of sudden deaths in 227 autopsies of New Orleans men aged 25-49 years. Of these autopsies, 102 deaths were due to external violence, 125 were from natural causes and 45 occurred suddenly. Of the sudden natural deaths, 14 (31%) were due to coronary heart disease (CHD), seven (16%) were possibly due to CHD and 24 (53%) were due to other causes without evidence of CHD. Large recent myocardial lesions (greater than or equal to 1 cm) were present in 19 (95%) of 20 CHD deaths and in 16 (18%) of 91 non-CHD deaths. The myocardial lesions in sudden CHD deaths were subendocardial involving preferentially the posterior septum and the apex of the heart. The lesions in non-sudden CHD deaths were transmural involving preferentially the anterior, lateral and posterior left ventricle and the base of the heart. Men who died of CHD had extensive coronary atherosclerosis, while those who died of other causes had minimal coronary atherosclerosis. The large proportion of CHD deaths which occurred suddenly (70%) reaffirms the need for primary prevention and the need for improved predictive factors for early detection of CHD.

Adult↗
PubMed1979

Fatty acid composition of human adipose tissue from two anatomical sites in a biracial community.

This report describes the age-race specific distribution of fatty acids in samples of adipose tissue taken from both the perirenal and buttock areas of 406 men autopsied in a community pathology study. This analysis of fatty acid composition of adipose tissue is part of a comprehensive investigation of atherosclerosis and coronary heart disease in a community setting. The findings from analysis of fatty acids are expressed as mass percentage of all fatty acids in adipose tissue triglyceride. For each age-site subgroup, white men tended to have higher mean percentages of myristic acid and palmitoleic acid than did black men. The converse was found for stearic acid. In the younger age groups only, the whites showed a higher mean percentage of linoleic acid than the blacks in adipose tissue from both sites. Age was associated with a decrease in mean percentage of stearic acid and an increase in mean percentage of oleic acid and palmitoleic acid in both races. The older age group had a lower mean percentage of linoleic acid than the younger age groups. The mean percentages of myristic, palmitic, and stearic acids were higher in perirenal tissue, while the mean percentages of palmitoleic and oleic acids were higher in buttock adipose tissue in both races.

Adipose Tissue↗