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

Over a period of 11 years, commencing in December 1967, 31 cardiac transplants, 10 orthotopic and 21 heterotopic, were performed at Groote Schuur Hospital. Two patients with orthotopic transplants have a long survival, 1 for 7 1/2 and 1 for 9 1/2 years, and 1 with a heterotopic transplant for 4 years. Eighteen patients have died, and autopsy was performed from 13 to 623 days postoperatively. Rejection of the donor heart was found in 61,1% and was the cause of death in 44,4% of cases. Infection, attributable to immunosuppression, was a common finding and consisted of extensive pneumonia, usually due to Klebsiella aerogenes and Pseudomonas aeruginosa (38,8%), herpesvirus infection (38,8%), cytomegalic virus infection (37,5%), aspergillosis and other opportunistic infections. A combination of cardiac rejection and infection accounted for most of the deaths. The cardinal microscopic features of acute rejection were interstitial lymphocytic infiltration and myocytolysis, while chronic rejection was typified by obliterative myo-intimal proliferation of coronary arteries, with concurrent lipid deposition in the major coronary arteries. These lesions resembled atherosclerosis and caused graft failure due to myocardial ischaemia. Ultrastructurally, severe myofibre damage was reflected in extensive loss of cytoplasmic myofilaments. The advantages of heterotopic over orthotopic transplantation are discussed.
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PMID:The pathology of human cardiac transplantation: an assessment after 11 years' experience at Groote Schuur Hospital. 39 Jul 37

The life expectancy of people living in the UK has been extended over the last century due to changes in the principal causes of death. Nowadays, people are more likely to die of diseases related to the ageing process rather than the infectious diseases which hitherto were more common causes of death in younger people. Ageing is associated with the degeneration of functional capacity in all parts of the body, and at all levels of organisation from molecules to complete organ systems. These functional changes are referred to as senescence. Both genetic and environmental factors govern senescence, although the precise mechanisms and the extent of their involvement are largely unknown. Senescence changes may themselves be responsible for certain diseases and disabilities associated with old age, or they may be a contributory factor and increase a person's susceptibility to particular diseases. The latter is the case with the most commonly encountered causes of morbidity and mortality today, namely atherosclerosis and cancer.
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PMID:Senescence and pathology in ageing. 133 31

The recombinant inbred (RI) set of strains, AXB and BXA, derived from C57BL/6J and A/J, originally constructed and maintained at the University of California/San Diego, have been imported into The Jackson Laboratory and are now in the 29th to 59th generation of brother-sister matings. Genetic quality control testing with 45 proviral and 11 biochemical markers previously typed in this RI set indicated that five strains had been genetically contaminated sometime in the past, so these strains have been discarded. The correct and complete strain distribution patterns for 56 genetic markers are reported for the remaining RI strain set, which consists of 31 living strains and 8 extinct strains for which DNA is available. Two additional strains, AXB 12 and BXA 17, are living and may be added to the set pending further tests of genetic purity. The progenitors of this RI set differ in susceptibility to 27 infectious diseases as well as atherosclerosis, obesity, diabetes, cancer, cleft palate, and hydrocephalus. Thus, the AXB and BXA set of RI strains will be useful in the genetic analysis of several complex diseases.
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PMID:The AXB and BXA set of recombinant inbred mouse strains. 147 75

Mortality trends of missionary staff serving in sub-Saharan Africa were tracked for the period 1945-1985. For 1945-1970, when more complete incidence data were available, the missionary death rate was approximately 40% lower, after adjustment, than would be expected in a comparable US population. This trend persisted through 1985. Between 1945 and 1970, the largest number of fatalities was attributable to malignancy, atherosclerosis, accidents, and infectious disease, and the greatest mortality risks, compared with the US experience, were from homicides, the complications of pregnancy, and infections, notably malaria, hepatitis, and polio. Beginning in the late 1950s, motor vehicle accidents became the leading cause of death. Since the 1960s, accidental causes of death have been approximately 50% higher than in the US, and homicides have been four times higher. During this same period, the infectious disease death rate decreased to approximately that within the US. Currently, the leading causes of mortality are motor vehicle accidents, malignancy, and atherosclerosis, followed by other accidental causes, notably aircraft mishaps and drownings. Viral hepatitis is presently the leading infectious disease cause of death. Other contemporary lethal infections include malaria, rabies, typhoid, Lassa fever, and retroviral infection. It was concluded that missionaries in sub-Saharan Africa had a death rate approximately half that expected in a comparable domestic control population. Preventive strategies, particularly relative to accident and infectious disease prevention, could effectively reduce mortality risk further.
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PMID:Mortality trends of American missionaries in Africa, 1945-1985. 162 93

Cardiac allograft vasculopathy (accelerated transplant atherosclerosis) is considered by most to involve a chronic allogeneic immune response to one or more constituents in the coronary vascular wall. Recent evidence suggests that there is an association between cytomegalovirus infection and the development of cardiac allograft vasculopathy (CAV). To determine whether CMV directly infects and/or potentially influences immunogenicity of vascular tissue, human umbilical vein (HU-VECs) or human aortic (HAECs) endothelial cells and human aortic smooth muscle cells (HASMCs) were isolated, cultured, and infected with CMV strain AD 169. Infection was detected using an immunoperoxidase-labeled monoclonal antibody to CMV immediate-early antigen (L-14). The presence and relative quantity of MHC class I and II antigens were determined flow cytometrically using monoclonal antibodies to monomorphic class I and class II HLA determinants. Gamma interferon was used as a positive control stimulant for the upregulation of MHC determinants. Both pooled HUVECs as well as 2 cell lines of HAECs served as targets for CMV infection though less than 10% of the cells were infected despite inocula of 10 pfu/cell. Infection of the pooled HUVECs resulted in no significant changes in the cell surface density of either MHC class I or II determinants. In contrast, HASMCs were excellent targets for CMV infection with virtually 100% of cells infected. CMV infection of 2 distinct HASMC cultures resulted in an increase of 254 +/- 158 relative fluorescence units (RFUs) in MHC class I antigen expression, as assessed by fluorescence intensity, in a variable portion of the HASMCs. A second population of cells exhibited a decrease of 73 +/- 16 RFUs in MHC class I antigen expression. No significant change in MHC class II antigen expression was noted. These results demonstrate that while HUVECs and HAECs are targets of CMV infection, human aortic smooth muscle cells can more readily be infected by CMV. Furthermore, CMV can regulate smooth muscle cell MHC class I expression, hence potentially altering immunogenicity. A pathophysiologic link between cardiac allograft vasculopathy and CMV disease can therefore be hypothesized.
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PMID:Cytomegalovirus-induced regulation of major histocompatibility complex class I antigen expression in human aortic smooth muscle cells. 165 93

Koch's postulates contributed substantially to the evolution of scientific knowledge of infectious diseases, but are inapplicable to chronic non-infectious, degenerative diseases such as atherosclerosis. In experimental atherogenesis compliance with appropriately modified postulates is essential to preclude spurious causes from consideration. The crux of such postulates is that the experimental procedure must reproduce the disease and its complications and their pathogenesis and experimental conditions must be analogous to those prevailing in man. Since atherosclerosis is not species specific to man and consists of multiple lesions, which develop independently of one another but can ultimately coalesce, reproduction of the disease in a localized segment of a blood vessel in susceptible animals under conditions similar to those prevailing in man would comply with the spirit of Koch's postulates.
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PMID:Koch's postulates and experimental atherosclerosis. 194 76

The inflammatory reaction is a fundamental biological defence reaction which ensures the survival of the organism. Reaction of the organism to trauma includes local and systemic reactions which are integrated and which are often the basis for the clinical and paraclinical manifestations of disease. The reactions of the organism to trauma are, by and large, nonspecific and independent of the nature of the precipitating factor. This explains the similarity between the clinical and paraclinical manifestations in a series of inflammatory diseases. The basal inflammatory reaction pattern may be identified in apparently very different conditions: healing of wounds, infectious disease, non-infectious inflammatory disease, atherosclerosis, neoplastic disease and growth and regeneration. Identification of a series of humoral inflammation mediators and growth factors and the possibilities for direct monitoring of the inflammatory and reparative processes of connective tissue have increased the possibilities for identification of the etiological/pathogenetic factors and the possibilities for rational therapeutic pharmacological and immunological modulation of disease.
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PMID:[Inflammation as a basic biological mode of reaction]. 226 87

Since the establishment of a new social order in 1949, China's attempts to feed and nurture its large population has been a topic of serious study in many disciplines. This review focuses on dietary sources of Chinese population and incidence, increase and decline of important diet related health disorders in China during the last four decades. Literature published since 1949 on goiter, rickets, riboflavin deficiency, beri beri, vision impairment, favism, cancer, atherosclerosis and coronary heart disease, hypertension, dental and smoking related diseases, diabetes mellitus, pancreatitis, lactose intolerance, mineral deficiency, Kashin-Beck disease, parasitic diseases and genetic disorders are reviewed. Also presented selectively are reports related to ethnodietetics, health care, maternal health and pediatric care as well as longevity. In the 1980s, total caloric intake of Chinese population showed a 19% increase on a daily basis from that of late 1940s. In overall terms, plant derived foods supplied 93% of energy, 87% of protein and 55% of fat to the Chinese. Among the animal foods, pork remains the most common and least expensive form of meat, contributing more than 90% of China's total meat production excluding poultry and fish. In 1949, the life expectancy in China was only 36 years. In early 1980s, it has increased to 68 years. This increase in life expectancy is attributed mostly to improved nutrition and lowering of mortality due to decrease in infectious diseases. Though population, disease and mortality statistics of modern China are spotty and sometimes questionable, common consensus among the researchers is that since 1949 the public health situation in China has improved tremendously.
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PMID:Nutrition and health in China, 1949 to 1989. 229 45

To elucidate the long-term effects of cyclosporine, we retrospectively studied 310 consecutive patients who have undergone cardiac transplantation at our institution since December 1980 and in whom immunosuppression has been maintained with cyclosporine. The ages of recipients ranged from 1 month to 64 years and of donors from 1 month to 48 years. The actuarial survival rates for cyclosporine-treated patients were 80.7% at 1 year and 59.7% at 5 years and were significantly greater than those for previous patients not treated with cyclosporine (p less than 0.005). Their actuarial prevalence of rejection was 60.0% at 1 month and 86.9% at 1 year; 206 patients are living. The actuarial prevalence of lymphoma development was 4.6% at 5 years but has been significantly lower with the current immunosuppression protocol of lower doses of cyclosporine, and OKT3 in place of rabbit anti-thymocyte globulin (p less than 0.005). Infection remains the most common cause of death. Recipients less than 50 years of age had a significantly higher actuarial survival than older recipients (p less than 0.01). Male and female recipients had similar overall prevalence of survival and rejection, but men died of graft atherosclerosis significantly more frequently (p less than 0.005). Rehabilitation has been successful in 85% of patients surviving 1 year after transplantation. Of those surviving 1 year, 96.5% were in New York Heart Association class I. Thus the results of orthotopic cardiac transplantation have improved since the introduction of cyclosporine and have allowed measured liberalization of the criteria for recipient selection.
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PMID:Eight-year results of cyclosporine-treated patients with cardiac transplants. 230 68

During infection the vascular endothelial cell (EC) undergoes important immunologic alterations leading to increased leukocyte-EC adherence and initiation of a host inflammatory response. ECs express class 2 immune response genes and the interleukin 1 gene to a greater degree during infection and thus may be capable of amplifying the lymphocytic proliferative process. Lymphokines generated from stimulated lymphocytes, notably interferon-gamma, may in turn further enhance EC-leukocyte adherence and class 2 antigenic presentation by ECs. The ECs of different organ systems appear variable in terms of their immunologic capabilities. Infection of the endothelium has been demonstrated for an array of human pathogens, and even subclinical infection of ECs may ultimately assume importance in disease processes such as atherosclerosis. A potential role of the EC in the pathogenesis of newer infectious diseases, such as AIDS, is becoming evident and warrants further attention.
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PMID:Vascular endothelium in immunology and infectious disease. 249 65


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