International Atherosclerosis

Evidence on the relationship of obesity to atherosclerosis has been confllct igg and inconclusive. From the International Atherosclerosis Project, results indicate no obvious association between extent of atherosclerotic fatty streaks or raised lesions in either the coronary ries or the aorta and any measure of body weight, height, or obesity. 

GELEIJNSE J M, LAUNER L J, HOFMAN A, POLS H A and wiTTEMAN J 0 (1999) Tea flavonoids may protect against atherosclerosis the Rotterdam study . Arch Intern Med, 159 (2), 2170-74. 

Internal medicine (characterization of the oxidation state of LDL relevant for atherosclerosis and cardiac infarction)... 

More interest has been generated by the potential effects of estrogens as modulators of LDL oxidation, a mechanism considered to be the authentic mediator of the detrimental action of LDL particles in atherosclerosis. Oxidized LDL becomes trapped in an artery and is then internalized by macrophages (Steinberg 1997 Navab et al. 1996 Morel et al. 1983 Griendling and Alexander 1997). This internalization leads to the formation of lipid peroxides resulting... 

The answer is D. This patient s tests indicate that he has severe hypercholesterolemia and high blood pressure in conjunction with atherosclerosis. The deaths of several of his family members due to heart disease before age 60 suggest a genetic component, ie, familial hypercholesterolemia. This disease results from mutations that reduce production or interfere with functions of the LDL receptor, which is responsible for uptake of LDL-cholesterol by liver cells. The LDL receptor binds and internalizes LDL-choles-terol, delivers it to early endosomes and then recycles back to the plasma membrane to pick up more ligand. Reduced synthesis of apoproteins needed for LDL assembly would tend to decrease LDL levels in the bloodstream, as would impairment of HMG CoA reductase levels, the rate-limiting step of cholesterol biosynthesis. Reduced uptake of bile salts will also decrease cholesterol levels in the blood. 

Vitamin K antagonists, such as dicoumarol (8.61, a natural product) and warfarin (8.62), are used as anticoagulants in human therapy (thrombosis, atherosclerosis) and as rat poisons that lead to internal bleeding and death in rodents. Heparin, a polysaccharide consisting of 2-0-sulfonated glucuronic acid and 2-N,6-0-disulfonated glucosamine, is also a widely used anticoagulant, but its effect is connected not with Vitamin K but with enzyme inhibition. 

After binding, the LDL-receptor complex is internalized by endocytosis. [Note A deficiency of functional LDL receptors causes a significant elevation in plasma LDL and, therefore, of plasma cholesterol. Patients with such deficiencies have type II hyperlipidemia (familial hypercholesterolemia) and premature atherosclerosis. The thyroid hormone, T3, has a positive effect on the binding of LDL to its receptor. Consequently, hypothyroidism is a common cause of hypercholesterolemia.]... 

Glueck CJ. Colestipol and probucol treatment of primary and familial hypercholesterolemia and amelioration of atherosclerosis. Ann Intern Med 1982 96(4) 452-82. 

Aviram, M., Pomegranate juice as a major source for polyphenolic flavonoids and it is most potent antioxidant against LDL oxidation and atherosclerosis, in Proceedings of the 11th Biennial Meeting of the Society for Free Radical Research International (Paris, July 16-20, 2002), by Monduzzi Editore S.p.A.—MEDIMOND, Inc., 523, 2002. 

Carotid revascularization, initially by CEA, was introduced in early 1950s as a method to prevent stroke due to atherosclerosis of the carotid bifurcation and internal carotid artery (ICA). At least four prospective randomized trials have demonstrated... 

C3. Calvert, G. D., and Abbey, M., The isolation and partial characterisation of two lipid transfer proteins (LTP-I and LTP-II), each of which facilitates the transfer of esterified cholesterol, triglyceride and phospholipid between plasma lipoproteins. In "Atherosclerosis VI, Proceedings of the Sixth International Symposium (F. G. Schettler, A. M. Gotto, G. Middelhoff, A. J. R. Habenicht, and K. R. Jurutka, eds.), pp. 428-431. Springer-Verlag, Berlin, 1983. 

In the course of the above-mentioned mechanisms Silics remains unchanged and thus preserves its activity during its residence in the intestine. Silics may also have promise in the clinical treatment for some internal diseases. The major lines of research into applications of this medicinal preparation in the relevant therapies are presented in Table 7. Of significance is the ability of Silics to lower cholesterol levels and triglycerides, as well as to retard aggregation of thrombocytes. Thus, with the help of Silics it becomes possible to treat the main pathogenic factors of atherosclerosis, namely hyperlipidemia and hypercoagulation (Table 7). 

Plaques are formed on the internal surfaces of arteries during the development of atherosclerosis. The plaques consist of collagen, elastin, cholesterol, and calcium. LaCb was tested at 20-40 mg/kg of body weight in animals and was found to be effective in reducing coronary atherosclerosis [196,197]. 

Asymptomatic Carotid Atherosclerosis Study Group (1995). Carotid endarterectomy for patients with asymptomatic internal carotid artery stenosis. Journal of the American Medical Association 273 1421-1428 Barnett HJ, Taylor DW, Ehasziw M etal. (1998). The final results of the NASCET trial. New England Journal of Medicine 339 1415-1425 Cardiac Arrhythmia Suppression Trial (CAST) Investigators (1989). Preliminary report effect of encainide and flecainide on mortality in a randomised trial of arrhythmia suppression after myocardial infarction. New England Journal of Medicine 321 406-412 Charleson ME, Horwitz RI (1984). Applying results of randomised trials to clinical practice impact of losses before randomisation. British Medical Journal 289 1281-1284... 

Abnormalities of the internal carotid artery Unilateral vascular headache syndromes Direct or indirect trauma Spontaneous or traumatic occlusion Aneurysms Atherosclerosis Spontaneous dissection Lesions involving the middle cranial fossa and cavernous sinus Basal skull fractures... 

Figure 4. Gas chromatograph-FID chromatogram of Wistar rat (A B) and atherosclerosis-susceptible Japanese quail (C D) aorta derivatized nonsaponifiables. (A) 0.05% low cholesterol, rat (B) 0.5% high cholesterol, rat (C) 0.05%, low cholesterol, quail (D) 0.5%o high cholesterol quail aorta. 1 = internal standard, 5a-cholestane 2 = cholesterol 3= 7 -hydroxycholesterol 4 = 7-ketocholesterol. Samples were analyzed according to Yuan et at. (69).

E. Maggi. R. Bellazzi, F. Falaschi, A. Frattoni and G. Perani, Enhanced LDL Oxidation in Uremic Patients An Additional Mechanism for Accelerated Atherosclerosis Kidnev International 45... 

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