摘要:

The adult heart diseases, coronary artery disease and essential hypertension, are now clearly recognized to begin in childhood. The evidence comes from autopsy studies of cardiovascular-renal changes in the first two decades of life. Cardiovascular risk factors can be identified in children just as in adults and these have a high correlation with the anatomic disease. This relationship underscores the importance of risk factor screening of children. Of interest is that clinical risk factors tend to persist within a rank (track) so that studies in childhood can be predictive of future levels. Behavior and lifestyle of eating, cigarette smoking, alcohol intake, and use of oral contraceptive pills influence risk factors in children. Familial aggregation of risk factors are also noted. Studies of apolipoproteins, B and A-I, have identified subsets of children that have a greater frequency of paternal myocardial infarction. The findings from the Bogalusa Heart Study and other epidemiological studies of children show the need to begin prevention of adult heart disease in early life. Approaches to prevention should include high risk families and children and a public health or population approach. Cardiovascular health education for elementary school children should be directed to children in the general population in an effort to encourage them to adopt healthy life styles.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Low density lipoprotein (LDL)-dependent growth of mitogen-activated lymphocytes, inhibited in their capacity to synthesize cholesterol endogenously, can be used as an assay of functional receptors for LDL. Using this technique, abnormalities can be detected in circulating lymphocytes obtained from patients with familial hypercholesterolemia (FH). Functional lymphocyte LDL receptor activity was decreased in patients with heterozygous FH. Following treatment with the specific inhibitor of cholesterol synthesis, lovastatin, alone or in combination with a bile acid-binding resin, there was increased expression of functional lymphocyte LDL receptors in five of nine patients. Plasma LDL cholesterol levels decreased in all nine patients. Three other patients who were only studied while receiving therapy also manifested increased expression of functional lymphocyte LDL receptors. The degree of improvement in plasma LDL cholesterol did not predict the effect on lymphocyte LDL receptor function. Longitudinal studies indicated that an increase in functional LDL receptor activity could be observed with 4 weeks of therapy and persisted for at least 18 months on continuous treatment. These results provide direct evidence that therapy with lovastatin and a bile acid-binding resin can lead to increased expression of functional LDL receptors by lymphocytes in the majority (eight of 12) of patients with heterozygous FH.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The effects of acute alcohol ingestion on the left ventricular performance of nine normal subjects, mean age 25 years, were studied before and after incomplete autonomic blockade, produced by atropine, 0.04 mg/kg body weight, and propranolol, 0.2 mg/kg body weight. Left ventricular (LV) function curves (stroke volume vs. end-diastolic volume) were plotted from data generated before and after large variations in cardiac preload. Increase in preload was produced by five degrees of head-down tilt for 90 minutes; decrease in preload was produced by graduated lower body negative pressure to −40 mmHg.After incomplete autonomic blockade, the negative inotropic effects of acute alcohol ingestion were minimal but significant and manifest by the reduction in mean velocity of circumferential fiber shortening (p < 0.05). Studies during wide variations in preload confirmed the importance of maintaining central blood volume after alcohol ingestion. Lower body negative pressure after both incomplete autonomic blockade and alcohol produced a further deterioration in mean velocity of circumferential fiber shortening (p < 0.05).

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The glucocorticoid and progestin antagonist, RU 486 (17 β-hydroxy-11β-[4-dimethylaminophenyl]-17α-[1-propynyl]-estra-4, 9-dien-3-one), antagonizes the suppressive effect of dexamethasone on [14C]2-deoxyglucose uptake by intact human mononuclear leukocytes in a concentration-dependent fashion. The authors found at least two types of specific-binding sites for this compound in the mononuclear leukocytes. The first type of sites (receptor content [Ro], 10.8 ± 1.6 fmoles/106cells [mean ± SD of 4 experiments]; equilibrium dissociation constant (Kd), 0.3 ± 0.1 nM) have a capacity similar to that of the dexamethasone binding site (Ro, 11.2 fmoles/106cells; Kd, 1.2 nM). The second type of sites (Ro, 56 ± 27 fmoles/106cells: Kd, 19 ± 5 nM) have a higher capacity and lower affinity for RU 486 than the first type of sites and do not interact with dexamethasone. The authors were unable to demonstrate the presence of the second type of binding sites in subcellular fractions. This finding suggests that this site is unstable and lost in the fractionation process. The role of the second type of low-affinity, high-capacity RU 486 specific-binding site in intact human mononuclear leukocytes, as well as its possible occurrence in other tissue, requires further investigation.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Remodeling of the extracellular matrix is an important function of interstitial collagenase. The activity of this enzyme forms the initial and rate limiting step in collagen degradation; moreover, this enzyme appears representative of a family of connective tissue metalloproteinases. Conversely, a widely distributed glycoprotein, tissue inhibitor of metalloproteinases (TIMP), may be an important regulator of matrix degradation. To study the roles of collagenase and TIMP in pathologically altered dermal connective tissue, immunohistochemistry was used to localize collagenase and TIMP in an eruptive xanthoma, a chronic tuberous xanthoma, and normal skin. Normal skin and the chronic tuberous xanthoma showed mild diffuse staining of both proteins throughout the dermis. In contrast, intense dermal staining of both collagenase and TIMP was present in the eruptive xanthoma. Thus, the marked accumulation of lipid in dermal macrophages was associated with a significant increase in matrix collagenase and TIMP. This increase may reflect direct production of these two proteins by macrophages. Alternatively, it may be due to increased production by fibroblasts stimulated by macrophage-derived cytokines. The balance of degradative and inhibitory activities in the extracellular matrix may regulate the extent and nature of dermal remodeling.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Poloxalene, a hydrophobic surfactant, is known to prevent hypercholesterolemia in animals fed a high-fat, high-cholesterol diet. It has not been demonstrated, however, whether this agent is of benefit when hypercholesterolemia is induced in animals by means other than the feeding of a high-fat diet. In this study, hypercholesterolemia was produced in rabbits by feeding a low-fat, cholesterol-free diet with dietary protein supplied by casein for a period of 8 weeks. Controls were given this diet without poloxalene and experimentals were given the diet with poloxalene. Total serum cholesterol levels increased in both groups, but the rise was greater for the control group. Lipoprotein analysis performed at the conclusion of the study showed significantly greater low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels in the control group as compared to the experimental group. Total protein and apolipoprotein B (apo B) were also greater in control LDL. It was concluded that poloxalene favorably affects this model of hypercholesterolemia as total serum cholesterol, LDL cholesterol, and LDL apo B were all less and the HDL cholesterol to LDL cholesterol ratio was higher in surfactant-treated rabbits.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Surgically induced hypoparathyroidism often responds satisfactorily to intravenous Ca administration, oral CaCO3and vitamin D2. A 17-year-old girl developed hypoparathyroidism following partial thyroidectomy for thyrotoxicosis. Hypocalcemia was refractory to treatment with massive doses of vitamin D2, up to 150,000 U, 3–6 gm of oral Ca as CaCO3and 2 µg of 1,25-dihydroxycholecalciferol per day. Intravenous Ca gluconate (360 mg of elemental Ca/d, in divided doses) was needed to correct tetany. After 25 days of unsuccessful therapy, oral administration of 30 ml of a 10% solution of CaCl2(1.09 gm of elemental Ca) was followed by normalization of serum Ca (8.9 mg/dl) within 7 hours. This dose was repeated every 8 hours for 6 days and oral CaCO3and IV Ca gluconate were discontinued. Serum Ca remained within normal range but hyperchloremic acidosis developed. This was corrected by providing, in addition to vitamin D, 2 g/d of Ca supplementation, 1 gm in the form of 10% CaCl2solution and 1 gm as CaCO3in two doses given simultaneously. During 12 months of observation, serum Ca, P and Cl have been consistently within normal limits. This patient was found to have achlorhydria, unresponsive to normalization of thyroid function and serum Ca. These findings indicate that refractoriness to oral CaCO3and vitamin D may be caused by achlorhydria. Oral administration of CaCl2solution can promptly correct this defect. Monitoring of serum Cl and CO2is needed to avoid hyperchloremic acidosis. [Am J Med Sci 1989; 298(3):182–184.]

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Toxoplasma gondii is a common pathogen in patients with acquired immune deficiency syndrome (AIDS). The most common modes of presentation are related to the central nervous system (CNS), usually with headache, fever, and focal neurological signs. Extra-neural manifestations are unusual in patients with AIDS. The authors present a patient with AIDS who had disseminated toxoplasmosis whose initial clinical presentation was symptomatic orchitis and the nephrotic syndrome (NS). Testicular involvement with toxoplasmosis has been described only rarely, predominantly as an incidental finding at autopsy. Toxoplasmosis is a rare cause of nephrotic syndrome, with the majority of cases associated with congenital infection. In this case, the nephrotic syndrome remitted only after orchiectomy and chemotherapy for toxoplasmosis, but recurred when the patient had a relapse of his CNS disease. Toxoplasmosis in AIDS may present with extra-neural manifestations and may be an etiologic agent for NS in some patients with AIDS.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Nicotinic acid has a proven efficacy in the treatment of hypercholesterolemia. Therapeutic use of this water-soluble B vitamin has resulted in a survival benefit among patients enrolled in the Coronary Drug Project. Conversely, nicotinic acid has been associated with a high side-effect profile when used at therapeutic doses. Nevertheless, there are no previously reported cases of hematemesis temporally associated with nicotinic acid use. The authors report the case of a previously healthy 20-year-old man who developed hematemesis and hepatitis 1 week after self-initiating the daily consumption of 6 g of nicotinic acid. Supportive therapy and discontinuing nicotinic acid resulted in rapid clinical improvement in this patient. The clinical circumstances suggest a possible causal relationship between nicotinic acid consumption and his presenting problems. The use of large doses of nicotinic acid may be rapidly complicated by hematemesis and hepatitis.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID