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Article ; Online: Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia.

Zech, Loren A / Hoeg, Jeffery M

2008 Volume 7, Page(s) 7

Abstract: Background: A relationship between corneal arcus and atherosclerosis has long been suspected but is controversial. The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue. They have both ... ...

Abstract	Background: A relationship between corneal arcus and atherosclerosis has long been suspected but is controversial. The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue. They have both advanced atherosclerosis and corneal arcus. Methods: This is a cross-sectional study of 17 patients homozygous for familial hypercholesterolemia presenting to the Clinical Center of the National Institutes of Health. Plasma lipoproteins, circumferential extent of arcus, thoracic aorta and coronary calcific atherosclerosis score, and Achilles tendon width were measured at the National Institutes of Health. Results: Patients with corneal arcus had higher scores for calcific atherosclerosis (mean 2865 compared to 412), cholesterol-year score (mean 11830 mg-yr/dl compared to 5707 mg-yr/dl), and Achilles tendon width (mean 2.54 cm compared to 1.41 cm) than those without. Corneal arcus and Achilles tendon width were strongly correlated and predictive of each other. Although corneal arcus was correlated with calcific atherosclerosis (r = 0.67; p = 0.004), it was not as highly correlated as was the Achilles tendon width (r = 0.855; p < 0.001). Conclusion: Corneal arcus reflects widespread tissue lipid deposition and is correlated with both calcific atherosclerosis and xanthomatosis in these patients. Patients with more severe arcus tend to have more severe calcific atherosclerosis. Corneal arcus is not as good an indicator of calcific atherosclerosis as Achilles tendon thickness, but its presence suggests increased atherosclerosis in these hypercholesterolemic patients.
MeSH term(s)	Achilles Tendon/pathology ; Adolescent ; Adult ; Arcus Senilis/complications ; Atherosclerosis/complications ; Calcinosis/complications ; Cardiomyopathies/complications ; Child ; Child, Preschool ; Female ; Homozygote ; Humans ; Hypercholesterolemia/complications ; Hypercholesterolemia/genetics ; Infant ; Lipoproteins/blood ; Male
Chemical Substances	Lipoproteins
Language	English
Publishing date	2008-03-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2091381-3
ISSN	1476-511X ; 1476-511X
ISSN (online)	1476-511X
ISSN	1476-511X
DOI	10.1186/1476-511X-7-7
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Article ; Online: Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia

Zech Loren A / Hoeg Jeffery M

Lipids in Health and Disease, Vol 7, Iss 1, p

2008 Volume 7

Abstract: Abstract Background A relationship between corneal arcus and atherosclerosis has long been suspected but is controversial. The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue. They have ... ...

Abstract	Abstract Background A relationship between corneal arcus and atherosclerosis has long been suspected but is controversial. The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue. They have both advanced atherosclerosis and corneal arcus. Methods This is a cross-sectional study of 17 patients homozygous for familial hypercholesterolemia presenting to the Clinical Center of the National Institutes of Health. Plasma lipoproteins, circumferential extent of arcus, thoracic aorta and coronary calcific atherosclerosis score, and Achilles tendon width were measured at the National Institutes of Health. Results Patients with corneal arcus had higher scores for calcific atherosclerosis (mean 2865 compared to 412), cholesterol-year score (mean 11830 mg-yr/dl compared to 5707 mg-yr/dl), and Achilles tendon width (mean 2.54 cm compared to 1.41 cm) than those without. Corneal arcus and Achilles tendon width were strongly correlated and predictive of each other. Although corneal arcus was correlated with calcific atherosclerosis (r = 0.67; p = 0.004), it was not as highly correlated as was the Achilles tendon width (r = 0.855; p < 0.001). Conclusion Corneal arcus reflects widespread tissue lipid deposition and is correlated with both calcific atherosclerosis and xanthomatosis in these patients. Patients with more severe arcus tend to have more severe calcific atherosclerosis. Corneal arcus is not as good an indicator of calcific atherosclerosis as Achilles tendon thickness, but its presence suggests increased atherosclerosis in these hypercholesterolemic patients.
Keywords	Physiology ; QP1-981 ; Science ; Q ; DOAJ:Physiology ; DOAJ:Biology ; DOAJ:Biology and Life Sciences
Subject code	616
Language	English
Publishing date	2008-03-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
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Article ; Online: Vegetating Plaques on the Lips. Pyostomatitis vegetans.

Fantus, Sarah A / Zech, Loren A / Hensley, Jennifer / Norton, Scott A / Dugan, Elizabeth M

The American Journal of dermatopathology

2015 Volume 37, Issue 9, Page(s) 699–700, 730–2

MeSH term(s)	Anti-Inflammatory Agents/therapeutic use ; Female ; Fluocinonide/therapeutic use ; Humans ; Lip Diseases/drug therapy ; Lip Diseases/pathology ; Middle Aged ; Prednisone/therapeutic use ; Pyoderma/drug therapy ; Pyoderma/pathology ; Stomatitis/drug therapy ; Stomatitis/pathology
Chemical Substances	Anti-Inflammatory Agents ; Fluocinonide (2W4A77YPAN) ; Prednisone (VB0R961HZT)
Language	English
Publishing date	2015-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	448469-1
ISSN	1533-0311 ; 0193-1091
ISSN (online)	1533-0311
ISSN	0193-1091
DOI	10.1097/DAD.0000000000000217
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Article ; Online: Diaphragmatic hernia with strangulated loop of bowel presenting after colonoscopy

Sodhi Sandeep S / Zech Loren A / Batura Vijay / Kulasekhar Sampath

International Archives of Medicine, Vol 2, Iss 1, p

case report

2009 Volume 38

Abstract: Abstract Background The incidence of diaphragmatic hernias caused or exacerbated by diagnostic colonoscopy is not well elucidated at this time, and is believed to be very rare. Case Presentation We present the case of a 57 year old man with remote ... ...

Abstract	Abstract Background The incidence of diaphragmatic hernias caused or exacerbated by diagnostic colonoscopy is not well elucidated at this time, and is believed to be very rare. Case Presentation We present the case of a 57 year old man with remote history of traumatic injury who first presented with vague left shoulder pain for two weeks, mild anemia, and tested positive for fecal occult blood. Four days post colonoscopy the patient was found to have a strangulated loop of bowel herniated through the diaphragm into the left hemithorax. Conclusions In patients with previous history of serious traumatic injury and particularly those with previous splenectomy, a thorough history and physical examination before routine colonoscopy is important. A high level of suspicion for post-operative complications should also be maintained when assessing such patients.
Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2009-12-01T00:00:00Z
Publisher	International Medical Society
Document type	Article ; Online
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Article ; Online: Diaphragmatic hernia with strangulated loop of bowel presenting after colonoscopy: case report.

Sodhi, Sandeep S / Zech, Loren A / Batura, Vijay / Kulasekhar, Sampath

International archives of medicine

2009 Volume 2, Issue 1, Page(s) 38

Abstract: Background: The incidence of diaphragmatic hernias caused or exacerbated by diagnostic colonoscopy is not well elucidated at this time, and is believed to be very rare.: Case presentation: We present the case of a 57 year old man with remote history ... ...

Abstract	Background: The incidence of diaphragmatic hernias caused or exacerbated by diagnostic colonoscopy is not well elucidated at this time, and is believed to be very rare. Case presentation: We present the case of a 57 year old man with remote history of traumatic injury who first presented with vague left shoulder pain for two weeks, mild anemia, and tested positive for fecal occult blood. Four days post colonoscopy the patient was found to have a strangulated loop of bowel herniated through the diaphragm into the left hemithorax. Conclusions: In patients with previous history of serious traumatic injury and particularly those with previous splenectomy, a thorough history and physical examination before routine colonoscopy is important. A high level of suspicion for post-operative complications should also be maintained when assessing such patients.
Language	English
Publishing date	2009-12-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2421642-2
ISSN	1755-7682 ; 1755-7682
ISSN (online)	1755-7682
ISSN	1755-7682
DOI	10.1186/1755-7682-2-38
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Article: A systems modeling approach to the study of retinoid function: implications for evaluation of retinoids in cancer chemoprevention and/or chemotherapy.

Lewis, Kevin C / Hochadel, James F / Zech, Loren A

Advances in experimental medicine and biology

2003 Volume 537, Page(s) 301–316

Abstract: We have used a mathematical/compartmental modeling approach along with a number of rationally designed complementary in vivo and in vitro systems to investigate the effects of administration of various retinoids and/or drug combinations on normal ... ...

Abstract	We have used a mathematical/compartmental modeling approach along with a number of rationally designed complementary in vivo and in vitro systems to investigate the effects of administration of various retinoids and/or drug combinations on normal physiological metabolism of native retinoids. The present paper focuses on our studies of the synthetic retinoid 4-HPR and our use of fairly simple mathematical/compartmental modeling techniques to investigate how this retinoid affects the metabolism of native retinoid overall, as well as in two specific tissues, the prostate and the eyes. We have presented our work with this particular retinoid and these tissues as an example of the type of studies we have been doing and to present some of the information that one can obtain using this approach. In addition, an important objective of this paper is to highlight the fact that a great deal of critical information can be derived from fairly simple mathematical/compartmental models. When used appropriately, such models provide a powerful tool to direct the design, conduct, and interpretation of experiments. The models we developed for the prostate and the eyes were used as hypotheses to direct our research efforts in both in vivo and in vitro systems. In the case of the eyes, we were able to elucidate the possible mechanisms involved in one of the most commonly reported complications (i.e., visual function abnormalities) associated with administration of an important chemopreventive and/or chemotherapeutic agent. We are in the process of further expanding our studies with the prostate as well as several other tissues in a similar manner. The immediate clinical relevance and application of our work with the eyes demonstrate the high translational potential of our approach. Without the use of the type of mathematical/compartmental modeling approach we used, which provided the basis for much of this work, we are not aware of any other way that we could have obtained the critical information that we did. We hope that the work presented here demonstrates the usefulness, power, and potential clinical applicability of a modeling approach to investigate different retinoid-based treatments as well as a variety of other chemopreventive and/or chemotherapeutic agents.
MeSH term(s)	Animals ; Anticarcinogenic Agents/therapeutic use ; Antineoplastic Agents/therapeutic use ; Disease Models, Animal ; Humans ; Kinetics ; Models, Biological ; Neoplasms/drug therapy ; Neoplasms/prevention & control ; Retinoids/therapeutic use ; Vitamin A/metabolism
Chemical Substances	Anticarcinogenic Agents ; Antineoplastic Agents ; Retinoids ; Vitamin A (11103-57-4)
Language	English
Publishing date	2003
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2214-8019 ; 0065-2598
ISSN (online)	2214-8019
ISSN	0065-2598
DOI	10.1007/978-1-4419-9019-8_20
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Article: Comparative in vivo metabolism of apolipoproteins E2 and E4 in heterozygous apoE2/4 subjects.

Ikewaki, Katsunori / Zech, Loren A / Brewer, H Bryan / Rader, Daniel J

The Journal of laboratory and clinical medicine

2002 Volume 140, Issue 5, Page(s) 369–374

Abstract: Apolipoprotein E (apoE) exists in three common forms in humans: the wild-type apoE3 and two common genetic variants, apoE2 and apoE4. Although previous studies have examined the metabolism of the different apoE isoforms in human subjects, they have not ... ...

Abstract	Apolipoprotein E (apoE) exists in three common forms in humans: the wild-type apoE3 and two common genetic variants, apoE2 and apoE4. Although previous studies have examined the metabolism of the different apoE isoforms in human subjects, they have not involved direct comparison of two different isoforms in subjects heterozygous for the same two isoforms. We conducted this study to directly compare the catabolism of apoE2 and apoE4 in heterozygous E2/4 subjects in vivo. Iodine 131-labeled apoE2 and iodine 125-labeled apoE4 were simultaneously injected into three E4/2 heterozygous subjects. The mean residence time of apoE4 (0.40 +/- 0.01 day) was found to be one-third that of apoE2 (1.20 +/- 0.18 day). ApoE2 was present primarily in high-density lipoprotein, whereas apoE4 was present equally in very low density and high-density lipoprotein. In all lipoprotein subfractions, apoE4 was catabolized at a much faster rate than apoE2. In conclusion, E4 is catabolized three times faster than apoE2 in heterozygous E2/4 subjects, indicating that these two apoE isoproteins have distinct metabolic pathways.
MeSH term(s)	Adult ; Apolipoprotein E2 ; Apolipoprotein E4 ; Apolipoproteins E/genetics ; Apolipoproteins E/pharmacokinetics ; Drug Combinations ; Female ; Heterozygote ; Humans ; Iodine Radioisotopes ; Lipoproteins, HDL/metabolism ; Lipoproteins, VLDL/metabolism ; Male ; Protein Isoforms/genetics ; Protein Isoforms/pharmacokinetics
Chemical Substances	Apolipoprotein E2 ; Apolipoprotein E4 ; Apolipoproteins E ; Drug Combinations ; Iodine Radioisotopes ; Lipoproteins, HDL ; Lipoproteins, VLDL ; Protein Isoforms
Language	English
Publishing date	2002-11
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	80208-6
ISSN	1532-6543 ; 0022-2143
ISSN (online)	1532-6543
ISSN	0022-2143
DOI	10.1067/mlc.2002.129066
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Article: Abnormal in vivo metabolism of apoB-containing lipoproteins in human apoE deficiency.

Ikewaki, Katsunori / Cain, William / Thomas, Fairwell / Shamburek, Robert / Zech, Loren A / Usher, David / Brewer, H Bryan / Rader, Daniel J

Journal of lipid research

2004 Volume 45, Issue 7, Page(s) 1302–1311

Abstract: The present study was undertaken to elucidate the metabolic basis for the increased remnants and lipoprotein(a) [Lp(a)] and decreased LDL apolipoprotein B (apoB) levels in human apoE deficiency. A primed constant infusion of (13)C(6)-phenylalanine was ... ...

Abstract	The present study was undertaken to elucidate the metabolic basis for the increased remnants and lipoprotein(a) [Lp(a)] and decreased LDL apolipoprotein B (apoB) levels in human apoE deficiency. A primed constant infusion of (13)C(6)-phenylalanine was administered to a homozygous apoE-deficient subject. apoB-100 and apoB-48 were isolated, and tracer enrichments were determined by gas chromatography-mass spectrometry, then kinetic parameters were calculated by multicompartmental modeling. In the apoE-deficient subject, fractional catabolic rates (FCRs) of apoB-100 in VLDL and intermediate density lipoprotein and apoB-48 in VLDL were 3x, 12x, and 12x slower than those of controls. On the other hand, the LDL apoB-100 FCR was increased by 2.6x. The production rate of VLDL apoB-100 was decreased by 45%. In the Lp(a) kinetic study, two types of Lp(a) were isolated from plasma with apoE deficiency: buoyant and normal Lp(a). (125)I-buoyant Lp(a) was catabolized at a slower rate in the patient. However, (125)I-buoyant Lp(a) was catabolized at twice as fast as (131)I-normal Lp(a) in the control subjects. In summary, apoE deficiency results in: 1) a markedly impaired catabolism of VLDL/chylomicron and their remnants due to lack of direct removal and impaired lipolysis; 2) an increased rate of catabolism of LDL apoB-100, likely due to upregulation of LDL receptor activity; 3) reduced VLDL apoB production; and 4) a delayed catabolism of a portion of Lp(a).
MeSH term(s)	Adolescent ; Adult ; Aged ; Apolipoprotein B-100 ; Apolipoprotein B-48 ; Apolipoproteins B/blood ; Apolipoproteins B/metabolism ; Apolipoproteins E/deficiency ; Apolipoproteins E/genetics ; Case-Control Studies ; Chylomicrons/blood ; Female ; Homozygote ; Humans ; Lipoprotein(a)/blood ; Lipoprotein(a)/metabolism ; Lipoproteins/blood ; Lipoproteins/metabolism ; Lipoproteins, LDL/blood ; Lipoproteins, VLDL/blood ; Metabolism, Inborn Errors/etiology ; Metabolism, Inborn Errors/metabolism
Chemical Substances	Apolipoprotein B-100 ; Apolipoprotein B-48 ; Apolipoproteins B ; Apolipoproteins E ; Chylomicrons ; Lipoprotein(a) ; Lipoproteins ; Lipoproteins, LDL ; Lipoproteins, VLDL
Language	English
Publishing date	2004-04-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	80154-9
ISSN	1539-7262 ; 0022-2275
ISSN (online)	1539-7262
ISSN	0022-2275
DOI	10.1194/jlr.M400020-JLR200
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Article: Type III hyperlipoproteinemia: Defective metabolism of an abnormal apolipoprotein E

Gregg, Richard E / Zech, Loren A / Schaefer, Ernst J / Brewer, H. Bryan Jr

Science. Feb 6, 1981. v. 211 (4482)

1981

Abstract: Abstract: Isoelectric focusing of apolipoprotein E isolated from the plasma of patients with type III hyperlipoproteinemia (HLP) indicates an abnormal biochemical pattern as compared to apoliprotein E from normal subjects. Metabolic studies using labeled ...

Abstract	Abstract: Isoelectric focusing of apolipoprotein E isolated from the plasma of patients with type III hyperlipoproteinemia (HLP) indicates an abnormal biochemical pattern as compared to apoliprotein E from normal subjects. Metabolic studies using labeled apolipoprotein from healthy (apoE3+) or type III HLP subjects (apoE3-) demonstrated that apoE3+ was cleared much more rapidly in both groups of subjects. In normal and HLP individuals, the residence time of apoE3+ was about half that of apoE3-. These data indicated a metabolic difference between the 2 apolipoproteins and suggest a decreased fractional catabolic rate of apoE3-, with delayed lipoprotein remnant catabolism in patients with type III hyperlipoproteinemia. This defect in metabolism may cause the plasma lipid and lipoprotein abnormalities which are characteristic of the disorder. The molecular basis for the defect is not yet known but may be alleviated by estrogen therapy.
Keywords	hyperlipoproteinemia ; lipoproteins ; lipid metabolism disorders ; lipid metabolism ; metabolic studies
Language	English
Dates of publication	1981-0206
Size	p. 584-586., ill., charts.
Document type	Article
ZDB-ID	128410-1
ISSN	1095-9203 ; 0036-8075
ISSN (online)	1095-9203
ISSN	0036-8075
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Article: Normalization of plasma lipoprotein concentrations in patients with type II hyperlipoproteinemia by combined use of neomycin and niacin

Hoeg, Jeffrey M / Maher, Martha B / Bou, Ernestina / Zech, Loren A / Bailey, Kent R / Gregg, Richard E / Sprecher, Dennis L / Susser, Jodi K / Pikus, Anita M / Brewer, H. Bryan Jr

Circulation. Dec 1984. v. 70 (6)

1984

Abstract: Abstract: A double-blind, randomized, placebo-controlled, cross-over clinical trial examined the effect of combined neomycin and niacin therapy in 25 type II hyperlipoproteinemia patients. The results indicated that elevated total and low density ... ...

Abstract	Abstract: A double-blind, randomized, placebo-controlled, cross-over clinical trial examined the effect of combined neomycin and niacin therapy in 25 type II hyperlipoproteinemia patients. The results indicated that elevated total and low density lipoprotein were normalized in most of these patients with neomycin or combined neomycin-niacin therapy. (wz)
Keywords	hyperlipoproteinemia ; niacin ; lipoproteins ; disease prevention ; diet therapy ; drug therapy ; patient care ; clinical trials ; diet study techniques
Language	English
Dates of publication	1984-12
Size	p. 1004-1011., ill., charts.
Document type	Article
ZDB-ID	80099-5
ISSN	1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
ISSN (online)	1524-4539
ISSN	0009-7322 ; 0069-4193 ; 0065-8499
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