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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of cholesterol crystal embolization associated with secretory diarrhea, megacolon and acalculous cholecystitis. Cholesterol emboli were found within the submucosal arterioles of the small and large bowel as well as in the gallbladder wall. Cholesterol crystal embolization is an often unrecognized disease, occurring in elderly patients with severe atherosclerosis. Cholesterol emboli may induce misleading gastrointestinal manifestations with both hemorrhagic and ischemic lesions. Though an uncommon symptom in this setting, secretory diarrhea did not seem to be fortuitous and could have been also a consequence of cholesterol crystal embolization.
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PMID:[Embolisms of cholesterol crystals and their digestive manifestations]. 155 37

Acute acalculous cholecystitis is a virulent disease of uncertain etiology observed most commonly in critically ill patients. Although the precise mechanism is unknown, the most commonly postulated theories regarding its pathogenesis are bile stasis, sepsis, and ischemia. The role of ischemia in this process, whose etiology is multifactorial, has been difficult to elucidate. Consequently, we report two patients who developed acute acalculous cholecystitis without apparent risk for the disease other than severe visceral atherosclerosis. Both patients had symptomatic mesenteric vascular disease requiring revascularization and developed fulminant acalculous cholecystitis temporally related to exacerbation of their visceral ischemia. These cases suggest that patients with visceral atherosclerosis may be at increased risk for acute acalculous cholecystitis, perhaps due to impaired mucosal resistance when other factors, such as bile statis and sepsis, are also present.
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PMID:Does visceral ischemia play a role in the pathogenesis of acute acalculous cholecystitis? 230 85

From 1984 to 1987, a cholecystectomy for biliary lithiasis was carried out at the same time as aortic vascular surgery in 21 patients. Seventy six percent of patients presented an abdominal aortic aneurysm and 24% occlusive atherosclerosis. Thirty eight percent had previously presented symptoms related to biliary lithiasis. Biliary surgery was conducted after closure of the retroperitoneum. The gall bladder region was drained separately. The technique did not increase operative morbidity or mortality. Combined cholecystectomy and vascular surgery depends on two arguments. Firstly, patients with stones present a higher risk of post-operative cholecystitis. Secondly, a significant percentage of non-cholecystectomized patients will present with biliary symptomatology in the months following vascular surgery.
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PMID:[Aortic surgery in the presence of cholelithiasis. Should simultaneous cholecystectomy be performed?]. 265 4

To further understand the pathophysiology of arterial diseases induced by oral contraceptives (OCs), a case report is presented of a young woman who died of extensive visceral artery thrombosis. The possible role of estrogens and progestogens and of cigarette smoking as the predisposing factors in this patient are discussed. A 26-year-old woman, who complained of progressive abdominal pain and whose past medical and surgical history was negative, was admitted to the general surgery service. She was the mother of 1 child and had had 2 previous spontaneous abortions. She had received ethinyl estradiol 35 mcg with norethindrone 500 mcg and 1000 mcg for 3 months, but because of a problem with breakthrough bleeding the medication was changed to mestranol 50 mcg with norethindrone 1000 mcg. She had been taking Ortho-Novum 1/50 for 2 1/2 years. She had smoked 25-35 cigarettes daily for about 10 years but denied use of alcohol or other drugs. She was not known to be diabetic, hypertensive, or dyslipidemic, and had no history of atherosclerosis in her family. For 7 months prior to her admission, the patient complained of abdominal pain, which progressively increased in intensity and duration, interrupted by periods of well-being. The patient reported 2 recent, isolated episodes of mild proctalgia but no tenesmus or melena. There had been no fever, but the patient had been anorexic for the past 2 weeks and reported losing 10 kg in the past month. She had no complaints apart from those related to the gastrointestinal system. At an emergency laparotomy, gangrenous acalculous cholecystitis and infarction of the terminal ileum were discovered. A cholecystectomy with resection of the terminal ileum and the right colon was performed. An end-to-end primary anastomosis was performed. On exploration of the superior mesenteric artery, a thrombus was discovered at its origin. As a transverse arteriotomy showed a good retrograde flow, a thrombectomy was performed. There appeared to be an unsatisfactory antegrade flow. The superior mesenteric artery then was transposed in an end-to-end fashion on the abdominal aorta. An immediate postoperative arteriogram showed thrombosis of the celiac axis at its origin. Revascularization failed to improve the condition of the intestine. The patient died. The intent of this case report is to emphasize that the association between smoking and oral contraceptives can cause cardiovascular disease in young women, and a failure to recognize this association can result in delayed diagnosis and worsen the prognosis.
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PMID:Intimal hyperplasia and thrombosis of the visceral arteries in a young woman: possible relation with oral contraceptives and smoking. 337 98

Cholesterolosis and adenomyomatosis, two diseases of the gallbladder that are unrelated to cholelithiasis or cholecystitis, are detected on oral cholecystograms with considerable frequency. These disorders are of uncertain etiology, and it is also unclear if they cause clinical symptoms. Cholesterolosis is the result of the accumulation of triglycerides and esterified sterols in macrophages in the lamina propria. The abnormality is unassociated with cholesterol gallstones, supersaturation of bile with cholesterol, hyperlipidemia, obesity, or atherosclerosis. Adenomyomatosis involves hyperplasia of the tissues of the gallbladder wall with outpouches of the mucosa similar to diverticula of the colon. In this report, the pathology, etiology, clinical and radiologic features, and treatment of these two entities are reviewed.
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PMID:The hyperplastic cholecystoses: cholesterolosis and adenomyomatosis. 640 1

The Department of Steroid Biochemistry headed by Professor Vendt Volodymir Petrovich, Doctor of Biological Sciences (1906-1993) was created on the basis of the Department of Photobiochemistry in 1976. At that time the Department was headed by Kokunin Vasyl Andriyovich, Candidate of biological sciences, till 1990. Professor Yu.D.Kholodovais, Doctor of biological sciences, is the head of the department today. Study of action mechanism of low-molecular-weight biologically active substances of steroid nature (cholesterol, cholecalciferol, ecdysterone) under normal and pathological conditions (atherosclerosis, rickets) as well as the development of scientific grounds of production of new drugs used both in medicine and agriculture are the basic purposes of the Department. The department is engaged in: 1) the study of biosynthetic processes of de novo cholesterol and its precursors in different tissues and cells of the organism; 2) the elucidation of the role of sterols as the components of membrane structure in different cells as well as the study of cholesterol absorption processes in the intestine and the search of a hypocholesterolemic agents; 3) the study of localization and biological properties of vitamin D-dependent proteins in order to elucidate their role in intestinal calcium transport; 4) the investigation of different classes of blood plasma composition of intestine and liver lipoproteins (LP), their structural, functional properties and frequency of occurrence; 5) the search of highly effective biostimulators of steroid nature, the elucidation of their action mechanisms and elaboration of new preparations on their basis for medicine and agriculture. Sterols are components of lipids with cyclopentanoperhydrofenantren molecular structure. Cholesterol is the basic animal and human organism sterol. A new complicated, multi-step method of cholesterol biosynthesis and participation of a number of enzymes and cofactors in it have been studied (V. Vendt, R. Morozova, I. Nikolenko, Visnyk AN URSR, 1978). Cholesterol is the major component of cell membrane structures which determines their structure and permeability. The interest to study a new method of cholesterol biosynthesis regulation arises from the reason that cholesterol pools in membranes participate in such diseases as rachitis, atherosclerosis, arterial coronal disease, different forms of cholecystitis, etc. It is established that the nature, rate and intensity of de novo cholesterol biosynthesis depend on types of cells, tissues and organs, taking into account the functional state of final compounds in these biosystems under normal conditions.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Department of sterol biochemistry]. 757 Oct 72

We retrospectively studied the clinical features of all 44 patients (35 men, 9 women, mean age 74.5 years) registered with a diagnosis of hepatic, biliary, and/or pancreatic cholesterol crystal embolization (CCE) in the Dutch National Pathology Information System (DNPIS) from 1973 through 1994. Liver CCE was found in 12 (11 autopsies and 1 biopsy), gallbladder CCE in 2 (resection specimens), pancreas CCE in 19 (18 autopsies and 1 biopsy), and both liver and pancreas CCE in 11 (all autopsies) patients. Five patients presented with focal liver cell necrosis, 1 with acalculous necrotizing cholecystitis, 1 with chronic cholecystitis, 10 with necrotizing pancreatitis, and 1 with chronic fibrosating pancreatitis. Four patients died of CCE-induced pancreatitis. Nineteen patients died as a consequence of other CCE sites. These were reported in 37 patients. All patients had a history of atherosclerotic vascular disease. In half the patients a possibly CCE provoking factor (vascular surgery and/or cannulation, anticoagulant treatment) was present. We conclude that liver cell necrosis, cholecystitis, and pancreatitis may be caused by CCE, particularly in elderly male patients with a history of atherosclerosis.
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PMID:Cholesterol crystal embolization to liver, gallbladder, and pancreas. 879 1

Cholesterol crystal embolism is a serious complication of atherosclerosis resulting in renal, cutaneous and rarely digestive manifestations. We report two cases of systemic cholesterol crystal embolization with gallbladder involvement in two patients with gallstones, severe atherosclerosis with an abdominal aortic aneurysm as well as predisposing factors for cholesterol crystal migration. These two cases show that, like vasculitis, cholesterol crystal embolization may result in ischemic cholecystitis, and that diagnosis of cholesterol crystal embolization on routine cholecystectomy suggests severe systemic involvement and a poor prognosis.
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PMID:[Ischemic cholecystitis from cholesterol crystal embolism]. 1042 67

The development of acute acalculous cholecystitis (AAC) after cardiovascular surgery is an infrequent but devastating complication, the etiology and management of which remains controversial. To evaluate the etiology, treatment, and outcome of patients with AAC, the cases of six patients encountered within an 8-year period who developed AAC after cardiovascular surgery requiring cardiopulmonary bypass (CPB) were reviewed. Atherosclerotic risk factors including diabetes, hyperlipidemia, and smoking were evident in five patients, three of whom had a history of stroke or arteriosclerosis obliterans, while low cardiac output was recognized in three. Percutaneous transhepatic cholecystostomy was performed in five patients, and another required cholecystectomy for peritonitis due to gangrene of the gallbladder. Two patients died of respiratory failure and sepsis after 15 and 82 days of percutaneous drainage, respectively; however, the four survivors had an excellent outcome without any biliary tract disease during a mean follow-up period of 5.3 years. In conclusion, AAC after cardiovascular surgery may result from hypoperfusion of the gallbladder due to various factors including CPB, visceral atherosclerosis, and low cardiac output. We advocate early percutaneous cholecystostomy for patients without peritonitis, while early cholecystectomy is indicated for those with peritonitis.
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PMID:Acute acalculous cholecystitis after cardiovascular surgery. 1087 May 75

Cholesterol crystal embolization (CCE) is a complication of atherosclerosis. A 67-year-old Japanese man underwent coronary artery bypass grafting. After the surgery, he underwent coronary angiography via the right femoral artery. Twelve days later, he suddenly developed acalculous cholecystitis and was treated with antibiotics. Gradual deterioration in renal function, purplish discoloration of the distal portion of his toes, and eosinophilia were noted. We performed a skin biopsy and made a diagnosis of CCE. Cilostazol and intravenous heparin improved the symptoms and decreased the creatinine level. We retrospectively studied the clinical features of 36 cases registered with a diagnosis of CCE in the Japanese literature.
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PMID:Cholesterol crystal embolization (CCE) after cardiac catheterization: a case report and a review of 36 cases in the Japanese literature. 1458 58


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