On CT, >130 units on the Hounsfield scale (some argue for 90 units) has been the radiographic density usually accepted as clearly representing tissue calcification within arteries. These deposits demonstrate unequivocal evidence of the disease, relatively advanced, even though the lumen of the artery is often still normal by angiography. Rupture and stenosis
Although the disease process tends to be slowly progressive over decades, it usually remains asymptomatic until an atheroma ulcerates, which leads to immediate blood clotting at the site of the atheroma ulcer. This triggers a cascade of events that leads to clot enlargement, which may quickly obstruct the flow of blood. A complete blockage leads to ischemia of the myocardial (heart) muscle and damage. This process is the myocardial infarction or "heart attack".If the heart attack is not fatal, fibrous organization of the clot within the lumen ensues, covering the rupture but also producing stenosis or closure of the lumen, or over time and after repeated ruptures, resulting in a persistent, usually localized stenosis or blockage of the artery lumen. Stenoses can be slowly progressive, whereas plaque ulceration is a sudden event that occurs specifically in atheromas with thinner/weaker fibrous caps that have become "unstable".Repeated plaque ruptures, ones not resulting in total lumen closure, combined with the clot patch over the rupture and healing response to stabilize the clot is the process that produces most stenoses over time. The stenotic areas tend to become more stable despite increased flow velocities at these narrowings.
Dakins solution is a dilute solution of sodium hypochlorite (0.4% to 0.5%) and other stabilizing ingredients, traditionally used as an antiseptic, e.g. to cleanse wounds in order to prevent infection. The preparation was for a time called also Carrel–Dakin solution or Carrel–Dakin fluid. Use
Carrel and Dakin used a variety of apparatuses to infuse the solution continuously over the wounds. In modern typical usage, the solution is applied to the wound once daily for lightly to moderately exudative wounds, and twice daily for heavily exudative wounds or highly contaminated wounds.The healthy skin surrounding the wound should preferably be protected with a moisture barrier ointment (e.g., petroleum jelly) or skin sealant as needed to prevent irritation. History
The solution takes the name from British chemist Henry Drysdale Dakin (1880–1952) who developed it in 1916, during World War I, while he was stationed at a field hospital in Compiègne. He worked there in collaboration with French physician Alexis Carrel, and the particular use they made of the solution is known as the Carrel–Dakin method for wound treatment. Sodium hypochlorite solution had been developed as a bleaching agent around 1820 by the French chemist Antoine Labarraque, as a cheaper substitute for Claude Berthollets potassium hypochlorite solution, produced as Eau de Javel since the late 18th century. Around that time, he also discovered the disinfectant properties of his Eau de Labarraque, which was quickly adopted for that purpose. His work greatly improved medical practice, public health, and the sanitary conditions in hospitals, slaughterhouses, and all industries dealing with animal products.