Day 254 - 22 May 96 - Page 37


     
     1        A.  That is correct.
     2
     3   Q.   And that affects the wall up and down which the blood is
     4        running?
     5        A.  That is correct.
     6
     7   Q.   Or actually running in only one direction, depending
     8        whether it is an artery or a vein, and then that has the
     9        facility for clots to stick?
    10        A.  That is correct.
    11
    12   Q.   Rather than being rejected as they would be by a healthy
    13        endothelia?
    14        A.  Indeed, yes, my Lord.
    15
    16   Q.   So the unhealthy endothelium is the result of the atheroma
    17        between the walls of the vessel?
    18        A.  Yes, that is correct.
    19
    20   Q.   So unhealthy endothelia and atheroma is synonymous really?
    21        A.  Yes, indeed, but the changes in the endothelium is
    22        secondary to the deposit of the fat within the wall of the
    23        blood vessel.
    24
    25   Q.   You say that that process is never found in the arteries
    26        supplying the liver and is found in the lungs only when
    27        pre-existing pulmonary hyper-tension exists?
    28        A.  That is correct, and lung metastases are common and
    29        high blood pressure within the pulmonary circulation is not
    30        common.  Liver metastases are common and these are vessels
    31        where you never ever see fat depositions within the walls
    32        of the arteries.
    33
    34   MS. STEEL:  Can I just say that the note I have got, and
    35        obviously if it is going to get too detailed I am going to
    36        have to wait until Professor Crawford comes back, but his
    37        evidence was not that the tumours cells would stick to the
    38        atheroma but that they might stick to any surface which was
    39        partially damaged in some way.
    40
    41   MR. JUSTICE BELL:  Yes.  I may be wrong, but I thought that --
    42        and I will be only too willing to accept that I have either
    43        miss-remembered it, or failed to remember it -- it was all
    44        part of events which resulted from atheromatosis?
    45
    46   MS. STEEL:  No, I think it was just the same process, that was
    47        all.
    48
    49   MR. JUSTICE BELL:  Yes, but I would like to explain it in case I
    50        have misunderstood.  You have the unhealthy endothelium 
    51        which, just as it may enable blood clots to stick to the 
    52        vessel wall leading to a vascular accident -----. 
    53        A.  It is the platelets actually.
    54
    55   Q.   The platelets, right.  So you might get a cancerous cell
    56        sticking to the artery wall, and that might be part of the
    57        cause of the progression of the cancer?
    58        A.  My understanding of the theory was that was suggested.
    59
    60   Q.   What I understand you to say, for better or worse, is that

Prev Next Index