Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Non-fatal or small infarction, especially with multiple occurrence, is a feature of cerebrovascular disease complicating diabetes mellitus. The atherosclerosis of the cervical and cerebral arteries, especially in the posterior circulation, in diabetes is more severe than that in non-diabetics. We reviewed the incidence of vascular lesions, and clinical history in 25 male and 26 female diabetic autopsy subjects. In addition, the long-term effects of blood pressure and glucose values were evaluated in 267 stroke patients without cerebral embolism, 99 of whom had diabetes mellitus. Asymptomatic cerebral infarction is not rare in diabetic subjects, and can now be accurately pathologically and clinically evaluated using MRI. The results of our study indicate that high blood pressure and poor blood glucose control are associated with the higher incidence of cerebral infarction in the diabetic patients.
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PMID:Diabetes mellitus and cerebral vascular disease. 785 6

Decreased levels of plasma high density lipoprotein (HDL) cholesterol have been associated with premature cardiovascular disease (CVD). Tangier disease is an autosomal co-dominant disorder in which homozygotes have a marked deficiency of HDL cholesterol and apolipoprotein (apo) A-I levels (both < 10 mg/dl), decreased low density lipoprotein (LDL) cholesterol levels (about 40% of normal), and mild hypertriglyceridemia. Homozygotes develop cholesterol ester deposition in tonsils (orange tonsils), liver, spleen, gastrointestinal tract, lymph nodes, bone marrow, and Schwann cells. Our purpose was to assess the prevalence of CVD in Tangier disease. We reviewed published clinical information on 51 cases of homozygous Tangier disease, report 3 new cases and provide autopsy information on 3 cases. Mean (+/- S.D.) lipid values of all cases were as follows: total cholesterol 68 +/- 30 mg/dl (32% of normal), triglycerides 201 +/- 118 mg/dl (162% of normal), HDL cholesterol 3 +/- 3 mg/dl (6% of normal) and LDL cholesterol 50 +/- 38 mg/dl (37% of normal). The most common clinical finding in these subjects (n = 54) was peripheral neuropathy which was observed in 54% of cases versus < 1% of control subjects (n = 3130). CVD was observed in 20% of Tangier patients versus 5% of controls (P < 0.05), and in those that were between 35 and 65 years of age, 44% (11 of 25) had evidence of CVD (either angina, myocardial infarction or stroke) versus 6.5% in 1533 male controls and 3.2% in 1597 female controls in this age group (P < 0.01). In 9 patients who died, 2 died prior to age 20 of probable infectious diseases, 3 of documented coronary heart disease at ages 48, 64, and 72, 2 of stroke at ages 56 and 69, one of valvular heart disease, and 1 of cancer. In three autopsy cases, significant diffuse atherosclerosis was observed in one at age 64, moderate atherosclerosis and cerebral infarction in another at age 56, but no atherosclerosis was noted in the third case who died of lymphoma at age 62. In one patient with established coronary heart disease, none of the lipid lowering agents used (niacin, gemfibrozil, estrogen or lovastatin) raised HDL cholesterol levels above 5 mg/dl. However, these agents did have significant effects on lowering triglyceride and LDL cholesterol levels. Our data indicate that there may be heterogeneity in these patients with regard to CVD risk, that peripheral neuropathy is a major problem in many patients, and that CVD is a significant clinical problem in middle aged and elderly Tangier homozygotes.(ABSTRACT TRUNCATED AT 400 WORDS)
Atherosclerosis 1994 May
PMID:Homozygous Tangier disease and cardiovascular disease. 794 62

Does the use of warm-body perfusion in elderly patients with severe cerebrovascular disease lead to a higher incidence of stroke, due to hypotension secondary to low systemic vascular resistance? Two thousand, three hundred eighty-three (2,383) consecutive myocardial revascularizations were performed (1987-1992) using warm-body (perfusion 37 degrees C), cold-heart surgery (cold cardioplegic arrest). The perfusion pressure was maintained between 50-70 torr; hematocrit was kept around 20%. Prospective data during hospitalization revealed 23 operative deaths (1%), and 24 patients (1%) who developed new neurological signs after surgery. The latter formed three groups: Group I consisted of six patients with severe neurological deficits, who never regained consciousness and died after support systems withdrawal. Group II included 14 patients with postoperative clinical evidence of focal cerebral infarction (9 had hemiplegia, 2 had visual disturbance, and 3 showed alteration of memory), all of whom had residual defects at discharge; Group III was composed of four patients with minor neurological deficits after surgery (hemiparesis, gait disturbance, mental changes) which had cleared up by discharge. These data were compared retrospectively with 1605 patients (1980-1986) undergoing myocardial revascularization with moderate (25-30 degrees C) hypothermia and the same surgical team and operative techniques. Both groups had similar preoperative demographics except the warm group included more elderly patients, higher numbers with unstable angina and poor ejection fraction, and more frequent use of a mammary artery conduit. Neurological complications were 1% and 1.3% for the normothermic and hypothermic perfusion groups respectively. Incremental risk factors of stroke remain: age over 70 years, diffuse atherosclerosis of the aorta, carotid occlusive disease, and severe hypotension during perfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Neurological complications during myocardial revascularization using warm-body, cold-heart surgery. 804 89

Atherosclerosis of the aortic arch is common in individuals aged over 60. Plaques are very often ulcerated. The normal healing process results in the regular formation of thrombi on these ulcerations. A mural thrombus can thus be the source of systemic or cerebral emboli. Since the advent of transesophageal echocardiography, it has become possible to detect atherosclerotic plaques of the aortic arch. However, a causal relationship has never been demonstrated and it is possible that they may merely be a marker of atherosclerotic disease. Certain arguments suggest that the aortic arch may be a source of cerebral emboli: the high incidence of aortic mural thrombi and atheroma emboli during aortography or coronary arteriography, or cardiac surgery with extracorporeal circulation requiring cannulation of the aorta. Recent studies have also shown that plaques of the aortic arch are commoner in cases of cerebral infarction of unknown origin than when another potential cause is detected. The natural history of this type of lesion must be studied before any management attitude can be defined. In the present state of knowledge, the only possible advice is antiplatelet treatment and case-by-case consideration of anti-coagulant treatment, in particular in the presence of a mobile thrombus of the aortic arch.
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PMID:[Atherosclerosis of the aortic arch: a possible new source of cerebral embolism]. 807 23

One hundred and twenty cases of stroke occurring in Saudi Arabian subjects aged 15 to 45 years are reviewed. These constituted 12.7% of a group of 946 stroke patients. Males outnumbered females (76/44). The frequency of intracranial hemorrhage, including subarachnoid hemorrhage, was slightly lower than cerebral infarction (41.5 vs 58.5%). The causes of large cerebral infarction were as follows: atherosclerosis 17 (28%), cardiac embolism 12 (19.5%), uncommon and uncertain causes 21 (34.5%). Some unusual causes were encountered such as dissecting arterial aneurysm due to popular healing manoeuvres or to traditional dance, retrograde embolism from a thoracic outlet syndrome or embolism from a fibroelastoma of the mitral valve chorda. Lacunar cerebral infarction was diagnosed in nine cases. Hypertension (25.5%) and arteriovenous malformations (20.5%) were the main causes of cerebral hemorrhage; all subarachnoid hemorrhages except one were due to berry aneurysms. The cause was undetermined in 16% of cerebral infarction and 26% of intracranial hemorrhage. The high frequency of stroke in young Saudi Arabian adults is probably a reflection of the demographic structure of the predominantly young Saudi society. The observed causes were relatively similar to those in industrial societies. Contrary to other developing countries infectious disease no longer seems to be an important cause of stroke. Drug abuse, which is becoming an important cause in Western societies, was encountered in only two of our cases.
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PMID:Stroke in Saudi Arabian young adults: a study of 120 cases. 808 29

Lipoprotein(a)[Lp(a)] concentrations and their correlation to total cholesterol (TC), low-density and high-density lipoprotein cholesterol (LDL-C, HDL-C) and triglycerides (TG) were estimated in 20 normal weight children affected with familial hypercholesterolemia (FH) and for comparison in 20 overweight, but otherwise healthy children, matched for sex and age. The mean value of Lp(a) in patients with FH (0.29 g/l, SD = 0.27) was markedly higher than in the control group (0.17g/l, SD = 0.19), but the difference was not statistically significant. However, the frequency distribution of Lp(a) in both groups was different: the proportion of Lp(a) levels above 0.60g/l was significantly greater in patients with FH than in the controls (p < 0.05). These results indicate that even pediatric patients with FH have increased Lp(a) levels. Since Lp(a) elevation above 0.25 to 0.30g/l--in particular in combination with increased LDL concentrations--is is associated with a markedly increased risk of coronary heart disease, cervical atherosclerosis and cerebral infarction, it seems very important to detect these high-risk individuals as early as possible and to treat them appropriately.
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PMID:Elevated levels of lipoprotein (a) in children with familial hypercholesterolemia. 819 53

We report a 37-year-old man with cerebral infarction due to meningovascular neurosyphilis. He developed right hemiplegia and motor aphasia preceded by left retroorbital pain lasting a month. Bilateral tonic pupils were also observed. Magnetic resonance imaging (MRI) disclosed cerebral infarction in the distribution of perforating branches of the left middle cerebral artery. Abnormal enhancement was absent in the meninges on T1-weighted MRI examination. SPECT study with I-123 iodoamphetamine showed decreased perfusion in the area of the left middle cerebral artery on early phase. A delayed SPECT 4 hour later demonstrated redistribution of the cerebral blood flow in the area of its cortical branches. On cerebral angiograms, marked stenoses were disclosed at the supraclinoid segments of the bilateral internal carotid arteries as well as the M1 segment of the left middle cerebral artery. These stenoses were associated with increased collateral circulations on the left side. Atherosclerosis was not apparent, on angiography. The cerebrospinal fluid (CSF) showed pleocytosis and positive TPHA. The CSF/serum ratio of TPHA was 1/16. Oligoclonal IgG band was present in the CSF. CSF IgG index was elevated. These findings were consistent with meningovascular neurosyphilis. Causes of angiitis other than syphilis were excluded. A test for antibodies against human immunodeficiency virus was negative. The clinical course of his recovery was similar to that in patients with atherosclerotic thrombosis. The stenosis of the right internal carotid artery demonstrated by angiography could not be expected from the clinical manifestations and SPECT study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Bilateral internal carotid artery stenoses in a patient with meningovascular neurosyphilis]. 826

From November 1982 to June 1991, a total of 81 cases of ischemic stroke in persons under 45 years of age were analyzed retrospectively. There were 44 males and 37 females, aged from 2 to 45 years (average 34.6 years). The modes of onset were immediately completed in 55 cases, progressed over a period of 1 hour to 5 days in 23 cases, and fluctuated over a period of 1 to 2 days in 3 cases. Fifty-six cases had one stroke episode; the others had transient ischemic attack or/and several episodes of cerebral infarction. Sixty-five cases had symptoms arising from the region of the carotid artery, more than 3.4 times those arising from the basilar artery territory. Probable causes of stroke were atherosclerosis (54.3%), embolism (28.5%), arteropathy (8.6%), hematological disease and coagulopathy (3.7%) and undetermined (4.9%).
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PMID:The causes of ischemic stroke in patients under 45 years of age. 829 27

Autopsy cases from Annual Report of Autopsy Cases published by the Japan Society of Pathology showed an increase of myocardial infarction from 13.2% in the years 1958-65 to 26.6% in the years 1983-85. However, cerebral infarction and hemorrhage showed no definite increase during the period. Frequency of diabetes mellitus was extremely increased among the cases of myocardial infarction who were admitted to our hospital. Arteriographic characteristics of coronary atherosclerosis in diabetics consist of multiple tight stenoses in one major artery and two or three arterial obstructions. Carotid arterial blood flow and plaque formation and calcification of the arteries were examined by doppler imaging technology and B-mode (5 MHz) real time ultrasound using ultrasonographic equipment in diabetic patients. Both blood flow volume and blood flow velocity in the elderly patients with diabetes mellitus (over 65 years old) were significantly reduced compared with those in the younger patients with diabetes mellitus (7.4 +/- 0.4 vs. 8.5 +/- 0.2 in blood flow volumes. p < 0.01; 12.4 +/- 0.8 in blood flow velocities. p < 0.01). Plaque formation and calcification of carotid arteries were significantly more frequent in the elderly patients with diabetes mellitus than in the younger patients with diabetes mellitus (p < 0.05). Asymptomatic cerebral infarction was studied in 37 diabetic patients by brain magnetic resonance imaging (MRI) in the absence of prior stroke. T2 weighted MRI imaging showed 27 patients among 37 patients (73%) to suffer from lacunar infarction. Hyperintensities were seen in the brain stem (28.6%), white matter (62.9%), basal ganglia (60.0%), and paraventricular areas (PVH) (20.0%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diabetic macroangiopathy in the elderly]. 831 44

Atherosclerosis is the principal cause of myocardial and cerebral infarction. Atherosclerotic lesions are present in localized regions of the vasculature where abrupt changes in vessel geometry occur, such as bends and bifurcations. In order to develop features of the risk profile, flow systems which simulate closely the pertinent anatomy and surface properties of the human vasculature are used with test fluids which mimic the physicochemical properties of blood. Analysis of the flow regimes were made by one-, two- or three-dimensional laser Doppler anemometry. Rigid and elastic model vessels with simple flow geometry as well as true-to-scale models of human arterial casts were used. Viscous pseudoplastic and viscoelastic fluid suspensions were employed under both steady and pulsatile flow. From the measured velocity profiles, the shear rates were estimated and with the local viscosity the shear stresses calculated. Flow behaviour was visualized using dyes and birefringent solutions. It was found that the geometry and flow rate ratio at bifurcations greatly influence the flow separation zones. It is also important to consider elasticity, pulsatility and non-Newtonian flow behavior in large blood vessels in zones where secondary flow is developed and flow separation zones are formed.
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PMID:Fundamental flow studies in models of human arteries. 832 83


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