FURTHER STUDIES IN EXPERIMENTAL ATHEROSCLEROSIS.

Cholesterol dissolved in sesame oil and injected regularly for a period of from 7 to 8 months into the jugular vein of four young dogs has caused in each animal larger and smaller nodules protruding to some degree into the lumen of the pulmonary artery and also here and there some diffuse thickenings, the whole closely resembling human arteriosclerosis. These changes commence at the origin of the pulmonary artery immediately behind the semilunar valves. They seem a little more pronounced in those dogs that had the aorta tied. Microscopically the lesions are seen to be primary in the media. They consist of a more or less violent disorganization of the elastic elements and displacement of the muscular tissue. As a consequence wide gaps, apparently filled with plasma, are formed in the media. The entire process is localized principally in the inner third of the media. There is no evidence of fatty degeneration either in the elastic elements or the muscle. Typical sclerotic hyperplasia of the intima is found over some of the prominent median nodulations while over others the intima is normal. Hyperplastic sclerosis of the intima is also found in places where the media is intact or only slightly damaged. Some of the larger branches of the pulmonary artery well within the lung tissue are somewhat dilated and show extensive hyperplasia of the intima over almost normal media. Peculiar small nodules are seen in the media of the two main branches of the pulmonary artery which are found to consist of frank hyperplasia of the elastic and muscular elements arranged in more or less regular concentric circles. The capillaries and smaller and smallest arteries within the lungs are not affected. Cholesterol in phagocytes and in droplets between the tissue elements is present in very small quantities and does not take any active part in the process. The entire process represents in all probability an early stage of arteriosclerosis, a result of purely mechanical stress brought about by the very extensive but more or less intermittent blocking of the pulmonary circulation by the oil. The musculature of the artery appears to be the main force applied to overcome the resistance in the circulation. In no case has hypertrophy of the right heart been found. The lesions in the pulmonary arteries of the dogs produced experimentally are closely analogous to atherosclerosis of the human pulmonary artery.