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)

From January 1978 through December 1987, 22 patients underwent 23 renal autotransplantation procedures for the treatment of renovascular hypertension through the retroperitoneal approach. The causes of the renal artery stenosis were as follows: atherosclerosis (15), fibromuscular dysplasia (6), and Takayasu's arteritis (1). Indications for renal autotransplantation were as follow: disease extending into the renal artery branches (10), stenosis of multiple renal arteries (6), atherosclerotic aorta in high-risk patients (4), and stenosis of renal artery in children (2). The mean preoperative blood pressure of 205 +/- 6/109 +/- 3 mm Hg decreased significantly to 139 +/- 4/77 +/- 2 mm Hg (p less than 0.001). The serum creatinine decreased significantly from a mean preoperative level of 2.2 +/- 0.8 mg/dl to a mean postoperative level of 1.4 +/- 0.4 mg/dl (p less than 0.05). Eleven patients with preoperative renal dysfunction had a significant decrease in the serum creatinine from a mean preoperative level of 3.4 +/- 0.3 mg/dl to a mean postoperative level of 1.9 +/- 0.2 mg/dl (p less than 0.001). One operative death occurred as a result of myocardial infarction. There were three postoperative complications, none of which affected the ultimate result in blood pressure or renal function. This experience demonstrates that in selected patients, renal autotransplantation is an excellent alternative in the surgical treatment of renovascular hypertension.
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PMID:Renal autotransplantation: an alternative to standard renal revascularization procedures. 305 72

To determine the long-term prognosis for hypertension control, mortality, renal function, and maintenance of renal blood flow in patients operated on to control renovascular hypertension, we studied 60 patients managed surgically between 1969 and 1984. Thirty-six patients had atherosclerotic disease, 22 had fibromuscular dysplasia, one had neurofibromatosis, and one had a combination of atherosclerosis and pyelonephritis. We confined the analysis to the 58 patients with pure atherosclerosis or fibromuscular dysplasia. In the atherosclerosis group 14 patients died and the results of hypertension control in the remaining 22 were classified as cured, three (14%); improved, 15 (68%); failed, one (5%); and unknown, three (14%). In the fibromuscular dysplasia group one patient died and results of hypertension control in the remaining 21 patients were (1) cured, 10 (48%); improved, 10 (48%); and failed, one (5%). The 5- and 10-year survival rates were 79% and 40%, respectively, for the atherosclerosis group and 95% and 89%, respectively, for the fibromuscular dysplasia group. Renal function was well maintained for patients in both groups. The mean serum creatinine value was 1.4 mg/dl in the atherosclerosis group and 1.0 mg/dl in the fibromuscular dysplasia group. To evaluate the effect of operation on the maintenance of renal blood flow we compared the blood flow of the operated and unoperated sides in patients who had a unilateral operation and had a second kidney for comparison. Eight of these patients had scans in each of the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term prognosis of surgical treatment of renovascular hypertension: a fifteen-year experience. 308 37

Lipid, carbohydrate and protein metabolic parameters, such as triglycerides, total and alpha-cholesterol, total protein and albumin, urea nitrogen, creatinine, glucose and the activity of alanine and aspartate aminotransferases, alkaline phosphatase, total lactate dehydrogenase and creatine phosphokinase, were measured in 50 patients with obliterating atherosclerosis and 60 patients with arteritis. The latter showed more marked lipid metabolic disturbance, as compared to the former, as well as indirect signs of hepatic dysfunction.
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PMID:[Characteristics of metabolism in patients with arteriosclerosis obliterans and arteritis]. 323 41

Cardiac transplantation represents an expanding therapeutic modality for end-stage heart disease in children and adolescents. During the past 5 years, 27 patients (15 boys; 12 girls) between the ages of 2 and 18 have undergone cardiac transplantation. The preoperative diagnosis was cardiomyopathy in 24 (six familial), congenital heart disease in two, and endocardial fibroelastosis in one. Immunosuppression included cyclosporine, azathioprine, and prednisone. There were 22 survivors, with four hospital deaths (three infection, one pulmonary hypertension), and one death at 4.5 years from graft atherosclerosis. The actuarial survival at 4 years was 83 +/- 7.4% and that at 5 years was 69 +/- 14.2%. Renal function was stable at 4 years, with an average creatinine clearance of 69.75 +/- 27.0 ml/min/m2. Hypertension was present in 21 of 22 patients, who require multiple drug therapy. Rehabilitation is 100% among discharged patients, with 14 in school, six employed, and two toddlers.
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PMID:Cardiac transplantation in children and adolescents. 331 54

Early changes in lipid metabolism and appearance of atherosclerosis risk factors play a key role in the development of cardiovascular disease of chronic renal failure (CRF). In the effort to evaluate the effects of protein restricted diet on dyslipidemia, we studied 122 patients with CRF (S-creatinine 1.3-9 mg/dl); 58.2% of whom were on antihypertensive drugs treatment. Patients had been separated into 6 groups: group 1 was kept on a free diet; groups 2, 3, 4, 5, 6 were kept on a protein-restricted diet from 12, 24, 36, 48, 60 months, respectively. We found hypertriglyceridemia, pathologic levels of esterified cholesterol in high density lipoprotein (HDL-C) and pathologic apolipoprotein A1/B ratio in group 1; the comparison with other groups--whose values were normal range after 12, 24 months of treatment--showed significant differences. The lipidic parameters were independent of the duration of CRF and of patients' age. Serum creatinine showed a significant correlation with tryglicerides and HDL-C values only in group 1. Total cholesterol and apolipoprotein B were significantly greater in hypertensives than in normotensives. In our opinion, a moderate restriction in protein intake could be effective in preventing and in halting the early alterations of lipid metabolism in CRF.
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PMID:Effect of protein-restricted diet on serum lipids and atherosclerosis risk factors in patients with chronic renal failure. 335 2

Between 1974 and 1986, 17 patients (16 men and 1 woman) with renal insufficiency (serum creatinine greater than 1.5 mg/dl, mean 3.75 mg/dl), with a mean age of 51.3 years, underwent surgical renal revascularization. Two of them were on maintenance haemodialysis. All were severely hypertensive in spite of antihypertensive drugs. Atherosclerosis was the cause of renal stenosis in 14 cases and fibromuscular dysplasia in 3. Operative procedures included splenorenal shunt (5), autotransplantation (3), aortorenal bypass (3), hepatorenal bypass (1), bilateral renal endarterectomy (1), renal ostial closure (1) and nephrectomy (3). Mean serum creatinine showed a decrease from 3.76 to 1.65 mg/dl (P less than 0.005). Mean arterial pressure dropped from 161 mmHg to 103 mmHg (P less than 0.001). Systolic and diastolic pressures also showed significant decreases. Two patients died. Four patients required a second operation and the renal function and blood pressure then improved. Renovascular disease must be ruled out in patients with renal insufficiency associated with hypertension, including those patients on haemodialysis. We conclude that renal revascularization surgery is a reliable and efficient form of treatment in selected cases of renal failure of renovascular origin.
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PMID:Improvement of renal function in azotaemic hypertensive patients after surgical revascularization. 339 25

Changes in eicosanoid production may contribute to some of the complications of the aging process such as atherosclerosis and glomerular sclerosis. Polyunsaturated fatty acids of the n-6 and n-3 series are precursors of eicosanoids. We fed diets containing safflower oil as a source of n-6 fatty acids, fish oil as a source of n-3 fatty acids or beef tallow as a source of saturated fats to three groups of normal rats from 2-18 months of age. We demonstrated incorporation of the n-3 fatty acids, 20:5n-3 and 22:6n-3 into kidney phospholipids. Feeding of the diet containing n-3 fatty acids was associated with a markedly decreased glomerular production of PGE, 6-keto-PGF1 alpha and TXB2. It also decreased the aortic production of 6-keto-PGF1 alpha and platelet production of TXB2. No significant effect of n-6 fatty acids on dienoic eicosanoid production was observed. There were no adverse effects on kidney function as measured by urinary protein excretion and serum creatinine levels or on renal morphology by any diet. A diet enriched in n-3 fatty acids for 18 months remains effective in decreasing dienoic eicosanoids in the aging rat.
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PMID:The influence of n-6 and n-3 fatty acids on kidney phospholipid composition and on eicosanoid production in aging rats. 339 17

Platelet activation, with subsequent formation of thromboxane A2 (TxA2), is thought to play a role in the development of arterial occlusion. In patients with severe atherosclerosis of the lower limbs, characterized by leg ulcers and rest pain, the basal formation of TxA2 and prostacyclin (PGI2) is increased. Corresponding data in patients with more moderate atherosclerosis of the lower limbs have not been reported. Since the capacity to physical exercise is not blunted in such patients proper evaluation of their TxA2-PGI2 synthesis should comprise not only assessment of the basal formation, but also TxA2/PGI2 biosynthesis during conditions of elevated cardiovascular activity. To address this, we analysed these eicosanoids in patients with a history of intermittent claudication. Urinary dinor-metabolites of TxB2 and PGI2 (Tx-M and PGI-M, respectively) were estimated by gas chromatography/negative ion-chemical ionization mass spectrometry in samples collected prior to, during and immediately after 20 min of severe treadmill exertion. The basal excretion of Tx-M was 105 +/- 26 pg/mg creatinine. It was not changed during exercise, but increased to 176 +/- 48 pg/mg creatinine (P less than 0.05) during the recovery. The basal excretion of PGI-M was 142 +/- 25 pg/mg creatinine. The PGI-M response to exercise varied from no change at all to a 30-fold increase, without any obvious correlation to experienced leg pain, walking distance or other recorded variables. During the recovery period the outflow of PGI-M was significantly higher than at rest (482 +/- 145 pg/mg creatinine; P less than 0.01). We conclude that in patients with intermittent claudication due to atherosclerosis (1) platelet activation does not occur during the course of the exercise, and (2) vascular prostacyclin formation can be dissociated from of TxA2 synthesis. The observed increase in PGI-M in some of the patients is suggested to reflect tissue ischaemia induced by the lack of adequate hyperaemia during exercise.
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PMID:Excretion of thromboxane A2 and prostacyclin metabolites during treadmill exercise in patients with intermittent claudication. 340 85

From 1965 to 1985, 19 patients with a single, ischemic kidney underwent renal revascularization. Thirteen patients had a single kidney and six had a single functioning kidney. The cause of the renal artery lesions was atherosclerosis in 17 patients and fibromuscular dysplasia in two. All but one were hypertensive with a mean diastolic blood pressure of 119 mm Hg and they were taking an average of 2.6 antihypertensive medications. Most had diminished renal function with a mean serum creatinine value of 3.7 mg/dl (range 0.8 to 9.0 mg/dl) and a mean creatinine clearance of 38 ml/min (range 8 to 75 ml/min). Three patients required preoperative hemodialysis. The first two patients treated died postoperatively, but no deaths have occurred since 1970. Follow-up among the survivors averaged 32.9 months. The mean serum creatinine value decreased significantly to 2.2 mg/dl postoperatively (p less than 0.04); the mean diastolic pressure decreased significantly to 86 mm Hg (p less than 0.001). One patient was normotensive preoperatively. Of the 16 patients surviving operation, 14 had improvement of their hypertension, one was cured, and only one did not benefit. No patient's hypertension was worse. The mean number of postoperative antihypertensive medications decreased significantly to 1.5 medications per patient (p less than 0.02). These data suggest that an aggressive surgical approach is warranted in patients with a single ischemic kidney in need of revascularization because of the gratifying response both in control of hypertension and improvement of renal function.
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PMID:Renal revascularization in patients with a single functioning ischemic kidney. 361 67

Lipids and lipoproteins are known to increase substantially during pregnancy and to decrease rapidly after delivery. The factors responsible for the changes have not been identified, however, they could be related to changes in one or more of the endocrine hormones. Since studies relating lipid and lipoprotein changes to cortisol or estradiol concentrations have not been made, we sought to perform such a study. For this study, we measured cholesterol, HDL-C, VLDL/LDL-C, cortisol, and estradiol concentrations from early gestation through delivery in 32 normal pregnant women. During the course of pregnancy, cholesterol increased from 145 to 211 mg/dl (45%); plasma cortisol increased from 8.6 to 17.8 micrograms/dl (107%); and urinary cortisol increased from 0.10 to 0.177 microgram/mg of creatinine (72%). Further significant increases in cholesterol (256 mg/dl, P less than 0.005) and cortisol (77.6 micrograms/dl, P less than 0.001) occurred during labor, and both decreased after delivery. Pooled correlations were calculated and both cholesterol and VLDL/LDL-cholesterol concentrations were found to be related to plasma cortisol as well as to urinary cortisol (P less than 0.001). Plasma estradiol concentrations increased during pregnancy, but not during labor. The results suggest that the increases in cholesterol during pregnancy and labor could be due, in part, to the metabolic and stress-related increases in cortisol. The studies also suggest that both pregnancy and labor and delivery might be useful "natural" models for studying hormonal mechanisms involved in lipid and lipoprotein metabolism.
Atherosclerosis 1987 Oct
PMID:Cortisol and the hypercholesterolemia of pregnancy and labor. 367 17


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