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

Cells of gut, skin, and muscle frequently suffer transient survivable plasma membrane disruptions ("wounds") under physiological conditions, but it is not known whether endothelial cells of the aorta, which are constantly exposed to hemodynamically generated mechanical forces, similarly are injured in vivo. We have used serum albumin as a molecular probe for identifying endothelial cells of the rat aorta that incurred and survived transient plasma membrane wounds in vivo. Such wounded endothelial cells were in fact observed in the aortas of all rats examined. However, the percentage of wounded cells in the total aortic endothelial population varied remarkably between individuals ranging from 1.4% to 17.9% with a mean of 6.5% (+/- 4.6% SD). Wounded endothelial cells were heterogeneously distributed, being found in distinct clusters often in the shape of streaks aligned with the long axis of the vessel, or in the shape of partial or complete rims surrounding bifurcation openings, such as the ostia of the intercostal arteries. Physical exercise (running) did not increase the frequency of aortic endothelial cell membrane wounding, nor did spontaneous hypertension. Surprisingly, 80% of mitotic endothelial cell figures were identified as wounded. This article identified a previously unrecognized form of endothelial cell injury, survivable disruptions of the plasma membrane, and shows that injury to the endothelial cells of the normal aorta is far more commonplace than previously suspected. Plasma membrane wounding of endothelial cells could be linked to the initiation of atherosclerosis.
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PMID:Transient disruptions of aortic endothelial cell plasma membranes. 146 99

A delayed clearance of postprandial lipoproteins from the plasma may play a role in the etiology of premature coronary atherosclerosis. To address this hypothesis, we studied chylomicron (remnant) metabolism in two groups of 20 selected normolipidemic men aged 35-65 years, a group of coronary artery disease (CAD) patients, and a matched control group with documented minimal coronary atherosclerosis. Subjects received an oral fat load supplemented with cholesterol and retinyl palmitate. Plasma samples obtained during the next 24-hour period were analyzed for total as well as d less than 1.019 g/ml and d greater than 1.019 g/ml triacylglycerol, cholesterol, and retinyl ester concentrations. Although both groups of patients responded identically in terms of the appearance of gut-derived lipids in the plasma, CAD patients showed a marked delay in the clearance of retinyl esters as well as in the normalization of plasma triacylglycerol concentrations. Postheparin plasma hepatic lipase activity was significantly lower in the CAD group. Apolipoprotein E phenotype measurements did not reveal marked differences in frequency between both groups. The frequency distribution was not unusual in comparison with the normal Dutch population. The magnitude of the postprandial responses of triacylglycerol and retinyl esters was correlated positively with the fasting levels of plasma triacylglycerol and negatively with high density lipoprotein subfraction 2 cholesterol concentrations. These data indicate that the clearance of postprandial lipoproteins in normolipidemic CAD patients as selected in the present study is delayed as compared with that of controls without coronary atherosclerosis and suggest that postprandial lipoproteins may play a role in the etiology of their disease.
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PMID:Postprandial lipoprotein metabolism in normolipidemic men with and without coronary artery disease. 202 3

We report our experience in the surgical treatment of visceral arterial occlusive disease in 9 patients. The etiology was atherosclerosis in 7 cases and arteritis in 2. Four patients were admitted because of acute mesenteric ischemia, but only two had a previous history of intestinal angina. Four consulted because of chronic mesenteric angina and only 1 asymptomatic patient received prophylactic revascularization. The clinical picture of postprandial abdominal pain, weight loss, bowel habit disturbance, abdominal bruit or signs of occlusive disease elsewhere, should lead to clinical diagnosis. Angiographic evaluation is mandatory to plan the best surgical approach. In this series we revascularized 14 vessels in 9 patients using different technics. Two patients died (42 and 90 days) following revascularization and partial resection of the gut for extensive infarction. All survivors achieved symptom relief and or recovered or stabilized their weight.
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PMID:[Mesenteric vascular insufficiency caused by chronic occlusive disease: experience with the surgical management of 9 cases]. 251 15

Technological advances have reduced and refined man's plant food intake and consequently brought about an unprecedented decline in his consumption of dietary fibre (DF). The emergence of certain diseases selectively in regions which have been affected the most by this dietary change has led to an enhanced awareness of the functions of DF. DF is a heterogeneous group of substances which resist digestion by the endogenous enzymes of the human gut, although they are fermented to a substantial extent by the bacterial flora of the large intestine. Chemically, DF essentially consists of nonstarch polysaccharides and lignin, and its major constituents are cellulose, hemicelluose, lignin and pectin. The physiological effects of DF are attributable largely to its physicochemical properties. DF primarily affects gastrointestinal (GI) function; its effects are observable at all stages from ingestion through defaecation. It restricts caloric intake, shows gastric and small intestinal transit, and affects the activity of digestive enzymes and release of GI hormones. Its overall impact is to reduce apparent digestibility of nutrients marginally but consistently. In the large intestine, DF accelerates transit, supports bacterial growth and serves to hold water. As a result, the faecal weight and water content increase, and the transit time generally becomes shorter. Secondary to its GI effects, DF attenuates postprandial glycaemia and has long term effects on glucose tolerance and lipoprotein metabolism. These effects have important implications in the aetiopathogenesis of constipation and its sequelae including diverticulosis, cholesterol gallstones, colorectal cancer, obesity, diabetes mellitus and atherosclerosis. DF has traditionally been used therapeutically for constipation; now its use in diabetes is also well established. Our appreciation of the role of DF in human nutrition has undergone a major change in the last two decades. From a redundant constituent of plant foods, it has now moved to the position of an essential nutrient, the deficiency of which seems to have serious consequences.
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PMID:Dietary fibre: consensus and controversy. 301 Mar 80

.ur current model for cholesterol transport is summarized in Figure 10. In this figure we have put together the various steps in cholesterol transport that were described previously in this review. Under normal conditions, cholesterol metabolism and transport are well regulated. If the transport system is overloaded for a long time, however, hypercholesterolemia caused mainly by increased plasma LDL may develop in several species, including humans. Under such circumstances reverse transport of cholesterol may also fail, giving rise to deposits of cholesterol. Tissue macrophages may be responsible for this lipid accumulation, because receptor-mediated (adsorptive) endocytosis of lipoprotein-associated cholesterol in these cells is not under negative-feedback control. The deposits are mainly found in tissues poorly supplied with blood and lymph: the skin, tendons, the cornea, and arteries. Overload of cholesterol transport may be the result of too much fat and cholesterol in the diet, giving rise to cholesterol-rich lipoproteins from the gut and to increased production of liver (formula; see text) VLDL, which in humans ends up as LDL. In many individuals, however, no hypercholesterolemia is seen, even after eating large amounts of a "western" diet for decades; others may develop increased LDL on a relatively "prudent" diet. Obviously many of the factors and mechanisms in cholesterol transport are influenced by genetic factors. Although studies of several inborn errors of lipid metabolism have given information about some mechanisms, the quantitatively more important differences in genetic patterns, which determine whether or not a western diet will result in hyperlipidemia, are not well known. Perhaps studies of different forms of apoB and apoE and of HDL subgroups and hyper-alpha-lipoproteinemia will explain why certain individuals develop hypercholesterolemia and premature atherosclerosis. All the recent information related to cholesterol metabolism and transport gives rise to new questions. There are many problems of interest for future research: What are the metabolic differences between the apoB produced in the liver and that produced in the gut? To what extent is the protein moiety of LDL modified in the plasma of blood and lymph and in interstitial tissue? Are such modifications important to whether LDL uptake goes through the classic LDL pathway or through the macrophage (i.e., scavenger?) pathway? Are some changes in apoB important for liver recognition of LDL?(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Transport of cholesterol. 636 11

On the basis of observation of 227 patients with the acute disturbance of mesenteric circulation the author considers intestinal infarction to be one of serious complications of atherosclerosis. Early diagnosis and operative treatment (reestablishment of circulation in mesenterial vessels, resection of the gut), postoperative intensive therapy allow improving results of the treatment.
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PMID:[Role of arteriosclerosis in the development of an acute disorder of the mesenteric circulation]. 651 59

Cholesterol excretion from the body is achieved almost exclusively via the hepatobiliary axis. Disruption of the integrity of this pathway by interruption of the enterohepatic circulation produces profound changes in cholesterol metabolism that affect every body tissue. This is particularly evident in the liver and gut which are the major sources of this sterol in the plasma. Elevated plasma cholesterol levels have been implicated in the pathogenesis of atherosclerosis and, in consequence, strenuous efforts have been made to find appropriate hypocholesterolemic therapy to reduce this risk. Medical or surgical interruption of the enterohepatic circulation is, to date, the most successful means of lowering plasma cholesterol, and in this review we examine the ramifications of such therapy on lipid and lipoprotein metabolism in the liver, gut, and plasma.
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PMID:The hepatobiliary axis and lipoprotein metabolism: effects of bile acid sequestrants and ileal bypass surgery. 675 55

Four cases of acute gut ischemia in elderly patients due to non-occlusive disease (NOD) are presented. Bowel necrosis occurred after episodes of hypotension in the course of myocardial infarction, arrhythmias and sepsis. Symptoms and clinical findings were blurred by the underlying extraintestinal disease. Angiography showed coexistent atherosclerosis but no occlusion of the major celiac and mesenteric vessels. At laparotomy (three cases) or autopsy (one case) extensive small and large bowel necroses were detected. Early laparotomy (possibly preceded by laparoscopy) is recommended for patients with suspected acute gut ischemia even if angiography fails to reveal occlusion of the large splanchnic arteries.
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PMID:[Nonobstructive mesenteric ischemia--a diagnostic problem in internal intensive care]. 779 21

Chylomicron retention disease (CRD) is a rare autosomal recessive disorder characterized by the absence of post-prandial chylomicrons and apolipoprotein (apo) B-48 in sera from affected individuals. Apo B-100 is synthesized, and apo B-100-containing lipoproteins are present in sera. A crucial difference between the synthesis and secretion of apo B-containing lipoproteins from the liver and gut in man is the generation of apo B-48 by editing of apo B mRNA in the gut to create a premature stop-translation codon. In this study the hypothesis that CRD may represent an absence of editing of apo B mRNA in the gut was investigated. Two affected sisters were identified as having low cholesterol levels and an absence of post-prandial chylomicronemia. Segregation analysis in the family showed that the apo B locus is not the site of the defect. Using reverse transcription-polymerase chain reaction (RT-PCR), duodenal biopsy-mRNA from the affected sisters was isolated and analyzed. The apo B editing site was amplified after cDNA synthesis, and the products analyzed by the primer extension assay. The results show that editing of apo B mRNA is normal in patients with CRD. The data provides strong confirmation that the primary defect in CRD is not in the synthesis, or editing of apo B mRNA in the gut. More likely, the disease arises from a defect in a gene crucial to the assembly and/or secretion of the chylomicron particle.
Atherosclerosis 1994 Aug
PMID:Chylomicron retention disease: exclusion of apolipoprotein B gene defects and detection of mRNA editing in an affected family. 798 Jul 20

Lymphatic absorption and transport of cholesterol and triacylglycerols were examined in rats treated with pravastatin, an inhibitor of 3-hydroxy-3-methyglutaryl-CoA (HMG-CoA) reductase. Pravastatin-treatment for 1, 7 and 28 days did not affect the recovery of cholesterol and triacylglycerols during 24 h after the lipid administration: the recovery was 52-59% and 82-93% for cholesterol and triacylglycerols, respectively. Rats treated with pravastatin for 28 days had a higher lymphatic recovery of the lipids during 3-6 h after the lipid administration than did control rats. Pravastatin treatment did not affect the ratio of phospholipid to cholesterol in the gut mucosa, the fatty acid composition of the lymph and mucosal lipids. We concluded that an inhibitor of HMG-CoA reductase would exert no adverse effect on absorption of fat-soluble nutrients by gut.
Atherosclerosis 1996 Jul
PMID:Lymphatic transport of cholesterol in normocholesterolemic rats treated with pravastatin, an inhibitor of HMG-CoA reductase. 880 Apr 97


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