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Biomedical subjects

E J Schaefer

Publications and source records attributed to E J Schaefer.

At least 289 records · Page 16Linked to original sources
PubMed1984

Ocular abnormalities in abetalipoproteinemia. A clinicopathologic correlation.

The present paper documents the clinical characteristics and ocular pathology in a patient with abetalipoproteinemia. Noteworthy were: the predominant involvement of the posterior fundus characterized by a loss of photoreceptors; loss or attenuation of the pigment epithelium (producing a sharply demarcated white appearance on ophthalmoscopy); preservation of the submacular pigment epithelium with an excessive accumulation of lipofuscin (including bizarre laminar profiles by electron microscopy); invasion of the retina by macrophage-like pigmented cells. The retina and pigment epithelium in the periphery were morphologically normal. The patient died of a presumably unrelated brain tumor which was believed to have accounted for the terminal blindness and loss of ganglion cells in the retina.

Abetalipoproteinemia↗
PubMed1984

Neomycin and plasma lipoproteins in type II hyperlipoproteinemia.

Neomycin, a nonabsorbable aminoglycoside antibiotic, has been shown to exert a hypocholesterolemic effect in man. In a 9-mo, double-blind, randomized, crossover, placebo-controlled clinical trial, the effect of neomycin, 2 gm/day, on plasma lipoproteins, as well as its safety, was described in 20 subjects with type II hyperlipoproteinemia. A 15% (50 mg%) decline in plasma cholesterol concentration was observed with neomycin. Most of this effect resulted from a 41 mg% (16%) decrease in low-density lipoprotein cholesterol concentration. No significant or consistent effect on the concentration of high-density lipoprotein cholesterol was observed. Monthly audiologic and renal evaluation disclosed no oto- or nephrotoxicity. Neomycin treatment in patients with type II hyperlipoproteinemia is an inexpensive and effective means of lowering the concentration of low-density lipoproteins and is free of significant side effects over a 3-mo period.

Adult↗
PubMed1984

Characterization of hepatic low density lipoprotein binding and cholesterol metabolism in normal and homozygous familial hypercholesterolemic subjects.

Patients with familial hypercholesterolemia have elevated levels of plasma low density lipoproteins (LDL), increased hepatic synthesis of apolipoprotein B-containing lipoproteins, defective binding of low density lipoproteins to fibroblasts, and premature atherosclerosis. The role of a hepatic low density lipoprotein receptor in normal man and its importance in the pathogenesis of familial hypercholesterolemia have not been previously determined. In the present study, direct comparison was made of the binding of LDL to hepatic membranes from normal and receptor-negative homozygous familial hypercholesterolemic subjects. The effects of calcium, EDTA, and temperature on the binding of lipoproteins to the hepatic membranes were also evaluated. At 4 degrees C, no significant difference in specific binding of LDL to hepatic membranes from normal and familial hypercholesterolemic subjects was observed. At 37 degrees C, both total and specific binding of LDL were significantly reduced in patients with familial hypercholesterolemia. Hepatic membrane binding of LDL from the two patients homozygous for receptor-negative familial hypercholesterolemia was 53 and 59% of normal. The activity of the rate-limiting enzyme in cholesterol biosynthesis, 3-hydroxy-3-methylglutaryl coenzyme A reductase was normal; however, the total hepatic cholesterol and cholesteryl ester content was significantly increased from 53 to 129%. These results indicate that patients with familial hypercholesterolemia have a defect in the interaction of hepatic membranes with low density lipoproteins. This defect may lead to accelerated atherosclerosis by decreasing the cellular catabolism of LDL and enhancing the production of LDL, which is characteristic of patients homozygous for familial hypercholesterolemia.

Adult↗
PubMed1984

Apolipoprotein E metabolism in normolipoproteinemic human subjects.

Human apolipoprotein E (apoE) is a constituent of plasma very low density and high density lipoproteins and is important in modulating the catabolism of remnants of triglyceride-rich lipoproteins. There are three common isoforms of apoE, designated apoE-2, E-3, and E-4, which are coded by three separate alleles (epsilon 2, epsilon 3, and epsilon 4) at a single genetic locus and inherited in the population in a co-dominant fashion. ApoE-3 is the predominant apoE isoform in the normolipidemic population, and epsilon 3 has been proposed to be the normal allele. ApoE-3 metabolism was studied in nine normolipidemic subjects homozygous for the epsilon 3 allele. In these subjects, the plasma apoE-3 concentration was 4.8 +/- 1.2 mg/dl (mean +/- SD), the plasma apoE-3 residence time was 0.73 +/- 0.18 days, and the plasma apoE-3 production rate was 3.4 +/- 1.5 mg/kg-day. The apoE in males, when compared to females, tended to have a shorter residence time (0.63 +/- 0.15 days versus 0.83 +/- 0.16), a higher production rate (4.20 +/- 1.73 mg/kg-days versus 2.60 +/- 0.78), but a similar plasma concentration (5.1 +/- 1.5 mg/dl versus 4.5 +/- 0.8). ApoE-3 had a more rapid catabolism from plasma than other apolipoproteins previously studied (apolipoproteins A-I, A-II, A-IV, B-100, C-II, and C-III) except for apolipoprotein B-48. The catabolism of apoE-3 in the individual lipoprotein subfractions was also examined and apoE was shown to be catabolized most rapidly from the VLDL and slowest from the HDL. The results of the kinetic analysis of apoE metabolism are consistent with apoE being important in the catabolism of triglyceride-rich lipoproteins and with HDL serving as a reservoir for apoE to reassociate with newly secreted triglyceride-rich lipoproteins.

Adult↗
PubMed1983

Massive omental reticuloendothelial cell lipid uptake in Tangier disease after splenectomy.

Tangier disease is a rare, autosomal recessive condition characterized by cholesterol ester deposition in reticuloendothelial cells, abnormal chylomicron remnants, decreased low-density lipoprotein levels, and a marked deficiency of high-density lipoproteins. Apolipoprotein A-I, a major protein constituent of chylomicrons and high-density lipoproteins, has been shown to be structurally and metabolically abnormal in this disease (apolipoprotein A-ITangier). A 63-year-old Tangier homozygous man is described, who underwent splenectomy because of thrombocytopenia and splenomegaly. Subsequently, a large orange mass developed at the base of the mesentery, with several smaller omental masses and thickening of the entire omentum due to infiltration with lipid-laden macrophages. Splenectomy appears to predispose to such deposition, since such masses have not been observed in other Tangier homozygotes. The spleen appears to play a significant role in the removal of abnormal lipoproteins in Tangier homozygotes; therefore, splenectomy may be contraindicated in Tangier disease.

Apolipoproteins↗
PubMed1983

Normolipemic subcutaneous xanthomatosis.

A patient with diabetes mellitus is described in whom an unusual xanthomatosis developed involving large areas of the subcutaneous tissue and vocal cords. Few lesions were present on the skin. Plasma lipid, lipoprotein, apolipoprotein, and cholestanol levels revealed normal patterns. Electron microscopy showed macrophages with vacuolar and crystal lipid inclusions. Results of lipid and enzyme analysis of the subcutaneous xanthoma were similar to those of xanthomas derived from a patient with diabetes mellitus and type V hyperlipidemia. The mechanism of this xanthomatosis remains unknown.

Diabetes Complications↗
PubMed1983

Fluorescence polarization as a parameter of plasma lipids in patients with hematologic malignancies.

Abnormal diphenylhexatriene fluorescence polarization measurements (FP values) of plasma have previously been reported in patients with hematologic malignancies. However, the biological significance of this measurement is unclear. We have prospectively studied plasma from 39 patients with leukemia and lymphoma as well as normal donors for total cholesterol, total triglyceride, and lipoprotein-cholesterol fractions, and correlated these values with measured FP values. Total triglyceride, very low density lipoproteins (VLDL), high density lipoprotein (HDL) levels, and FP values were all strongly correlated with clinical and biochemical measures of tumor burden and varied directly with the presence of malignancy. Although the presence of abnormal FP values was confirmed in patients with leukemia and lymphoma, it was not a particularly sensitive measure for minimal tumor and it appeared to correlate directly with other measures of lipids and cholesterol, particularly triglyceride. It is suggested that further studies of conventional plasma lipids and lipoproteins be pursued in order to elucidate the apparently pervasive alterations in lipid metabolism present in these patients.

Adolescent↗
PubMed1983

Tangier disease with oral abnormalities.

A patient with Tangier disease, pulpal calcifications, and bilateral mandibular intrabony lesions (unusual odontomas) is presented. A relationship between Tangier disease and the oral manifestations found in this patient has not been established. Of the 27 known patients with Tangier disease, only 2 have been examined.

Adult↗
PubMed1983

Mobilization of triglyceride but not cholesterol or tocopherol from human adipocytes during weight reduction.

Adipocyte triglyceride, cholesterol, and tocopherol contents were examined in three human obese subjects, all over 150% of ideal weight, who were placed on weight reduction formula diets for 11, 21, and 25 wk, respectively. Body weight decreased from 77 to 63 kg, 188 to 147 kg, and 147 to 99 kg, respectively. All subjects had normal serum cholesterol and triglyceride levels, and these did not vary greatly during weight reduction. Subcutaneous fat was obtained at frequent intervals by needle aspiration from the buttocks before and during weight reduction. Adipocyte size was measured by osmium tetroxide fixation technique, tissue cholesterol content by GLC, tissue triglyceride content by lipid extraction, and tissue tocopherol by thin-layer chromatography. Initial adipocyte size was 0.54, 1.06, and 0.96 micrograms of lipid per cell, respectively (normal 0.60), and the mean cell size decrease during weight reduction was 40%, all due to triglyceride mobilization. Adipocyte cholesterol and tocopherol content did not change significantly during weight reduction. These data are consistent with the concepts that triglycerides but not cholesterol or tocopherol are mobilized from the fat cell during up to 6 months of weight reduction and that independent mechanisms control the efflux of these adipocyte constituents.

Adipose Tissue↗
PubMed1983

Portacaval shunt in patients with familial hypercholesterolemia.

Portacaval shunt was performed in ten patients with homozygous and two with heterozygous familial hypercholesterolemia (FH). Total serum cholesterol was lowered by 20% to 55.4% during follow-up periods of 14 months to almost 9 years, with commensurate decreases in LDL cholesterol. The effect on HDL cholesterol and triglyceride levels was variable. Tendinocutaneous xanthomas diminished or disappeared. Growth and development in children proceeded or accelerated. There was no detectable emotional or intellectual deterioration. Hepatic failure did not occur, although blood ammonia concentrations and serum alkaline phosphatase levels increased relative to preoperative values. Cardiac symptoms were often improved, but evidence of reversal of cardiovascular lesions was inconclusive. Three patients with pre-existing heart disease died of cardiac complications after 4 months, 18 1/2 months, and 30 months. Portacaval shunt has been effective therapy for patients with FH who were refractory or intolerant to medical treatment; it should be performed before the development of irreversible cardiovascular damage.

Adolescent↗
PubMed1983

The effects of estrogen administration on plasma lipoprotein metabolism in premenopausal females.

The effects of estrogen administration (ethinyl estradiol; 0.1 mg, orally, daily) on plasma lipoprotein metabolism were investigated in five normolipidemic premenopausal females. Estrogen administration resulted in significant (P less than 0.05) mean increases in plasma cholesterol, triglyceride, very low density lipoprotein (VLDL)-cholesterol, and high density lipoprotein (HDL)-cholesterol of 18.8%, 87.0%, 123.1%, and 38.3%, respectively. Analytical ultracentrifugation demonstrated that HDL increases occurred mainly in the HDL2b subfraction (150.0% increase). Lipoprotein compositional analysis showed that estrogen administration caused significant increases in all VLDL and HDL constituents (protein, cholesterol, phospholipid, and triglyceride) as well as VLDL apolipoprotein (apo) B (118.9% increase) and HDL apoA-I (27.4% increase). No significant changes in LDL constituents were noted. Measurement of lipoprotein lipase and hepatic lipase enzymic activity in post-heparin plasma revealed no major change in lipoprotein lipase activity, but showed a significant decrease (43.8%) in hepatic lipase activity during estrogen administration. Radioiodinated VLDL and HDL kinetic data indicated increased VLDL apoB (86.1% rise) and HDL apoA-I (24.9% rise) synthesis during estrogen administration. These data are consistent with the concept that estrogen administration at the dose level studied in premenopausal females causes significant elevations in VLDL and HDL constituents, associated with enhanced production of VLDL apoB and HDL apoA-I.

Adult↗
PubMed1983

The effect of growth hormone administration on lipids and lipoproteins in growth hormone-deficient patients.

Plasma lipids, lipoproteins, and lipoprotein cholesterol levels were studied in a group (n = 8) of prepubertal growth hormone-deficient patients before and after growth hormone (GH) administration. Determination of plasma lipoproteins by a sensitive agarose gel electrophoretic technique demonstrated: (a) in the patients with two prebeta bands an intensification of the fast prebeta lipoprotein fraction after growth hormone administration; and (b) in the patients with one prebeta band the appearance of a second prebeta band after growth hormone administration. The mean (+/- SD) plasma triglyceride level before GH was 86 +/- 60 mg/dl and 158 +/- 95 mg/dl after GH (P less than 0.01). Mean (+/- SD) plasma cholesterol level before GH was 196 +/- 25 mg/dl and 174 +/- 28 mg/dl after GH (P less than 0.05). High-density lipoprotein cholesterol concentrations decreased significantly (P less than 0.001) from mean (+/- SD) 55 +/- 12 mg/dl before GH to 37 +/- 10 mg/dl after GH. Very-low-density lipoprotein cholesterol concentrations increased significantly (P less than 0.05) from mean (+/- SD) 13 +/- 12 mg/dl before GH to 23 +/- 15 mg/dl after GH. Low-density lipoprotein cholesterol concentrations decreased (N.S.) from mean (+/- SD) 123 +/- 15 mg/dl before GH to 114 +/- 15 mg/dl after GH. These lipid and lipoprotein changes could be mediated through the insulin antagonism, hyperinsulinemia, and a decrease in lipoprotein lipase activity caused by growth hormone.

Adolescent↗
PubMed1983

NIH conference. Type III hyperlipoproteinemia: diagnosis, molecular defects, pathology, and treatment.

Type III hyperlipoproteinemia is characterized by increased plasma levels of triglycerides and cholesterol, palmar-tuberoeruptive xanthoma, and premature cardiovascular disease. Three major classes of molecular defects will predispose patients to develop type III hyperlipoproteinemia: a deficiency in apolipoprotein E, a structural defect in the E apolipoprotein, and a functional defect in the liver receptor system. Most patients with type III hyperlipoproteinemia have a structural defect in apolipoprotein E associated with increased synthesis and decreased catabolism of apolipoprotein E, delayed catabolism of chylomicron remnants, and development of plasma lipoprotein abnormalities characteristic of type III hyperlipoproteinemia. Analysis of cardiovascular disease in patients with type III hyperlipoproteinemia showed extensive coronary and peripheral vascular atherosclerosis indistinguishable from the atherosclerosis of non-hyperlipidemic and other dyslipoproteinemic patients. The xanthoma and elevated plasma cholesterol and triglyceride levels in patients with type III hyperlipoproteinemia respond to dietary and drug therapy.

Adolescent↗
PubMed1983

Metabolism of human apolipoproteins A-I and A-II: compartmental models.

The metabolism of radioiodinated apolipoproteins (apo) A-I and A-II have been examined using the techniques of compartmental modeling. The model for apoA-I contains two plasma compartments decaying at different rates. One component of apoA-I has a residence time of 3.8 days and the second has a residence time of 6.1 days. In contrast, the apoA-II model has only one plasma component, with a residence time of 5.5 days, which decays through two distinct pathways. Twenty-seven percent of apoA-II decays through a pathway that takes 1.1 days longer to reach the urine than the remaining 73% which decays through the more direct path. These differences in the metabolism exist in both male and female populations. Comparison of fasting and nonfasting concentrations of apoA-I revealed that apoA-I concentration was elevated 0.5 standard deviations in the nonfasting samples while there was no significant difference in the apoA-II concentrations. The fasting apoA-I concentrations were found to be less stable over the study period when compared to fasting apoA-II concentrations. These findings are interpreted as indicating that apoA-I and apoA-II each have a separate metabolism which overlaps when they are present on the same lipoprotein particle. Furthermore, these findings are consistent with the concept that apoA-I metabolism is influenced more by perturbations such as dietary modulation.

Adult↗
PubMed1983

Apolipoprotein A-I isoforms in human lymph: effect of fat absorption.

The effect of fat feeding (100 g of cream) on the apoA-I isoproteins distribution has been analyzed by two-dimensional gel electrophoresis in the chylomicrons, VLDL, LDL, and HDL isolated from the thoracic duct lymph of patients undergoing lymph drainage for immunosuppression, Isoforms apoA-I3 and apoA-I4 are the most abundant apoA-I isoproteins in plasma lipoproteins as well as in lymph lipoproteins collected in the fasting state. Fat feeding, on the other hand, results in a marked change in the apoA-I isoform pattern in lymph chylomicrons and VLDL, with a significant increase in the relative concentration of the apoA-I1 isoform. As a result the total concentration of this isoprotein in the lymph increased. The data indicate that fat feeding is associated with major changes in the distribution of the apoA-I isoforms in the lymph (d less than 1.006 g/ml lipoproteins), which may be of significance in their plasma catabolism.

Apolipoprotein A-I↗
PubMed1983

Presence of two forms of apolipoprotein B in patients with dyslipoproteinemia.

Current information suggests that the major forms of the human B apolipoproteins, B-100 and B-48, are under separate genetic control and are synthesized by the liver and intestine, respectively. The apolipoprotein B composition of plasma lipoproteins has been determined in order to gain insight into the metabolic defects in patients with dyslipoproteinemias. Patients with type I and type V hyperlipoproteinemia can be separated into two groups based on apolipoprotein composition and triglyceride concentration. The first group had markedly elevated plasma triglycerides with B-48 in the 1.006 g/ml density fraction and only B-100 within IDL and LDL. The second group had plasma triglycerides less than 1200 mg % and only B-100 in all density fractions. Patients with type III hyperlipoproteinemia had B-48 in only the density less than 1.006 g/ml with B-100 in IDL and LDL; the type III hyperlipoproteinemic patient with apolipoprotein E deficiency, however, had B-48 in density less than 1.006 g/ml fraction, IDL, and LDL. Patients with type IIa, IIb, and IV hyperlipoproteinemia had only B-100 in all density fractions. These combined results are interpreted as indicating that B-48 is associated with triglyceride-rich lipoproteins synthesized by the intestine and that patients with phenotypes I, III, and V have defects in chylomicron remnant metabolism. In addition, in patients with types I and V hyperlipoproteinemia, mild hypertriglyceridemia appears to be associated with lipoprotein particles of liver origin.

Apolipoproteins↗