Atherosclerosis regulation via media lipid-driven VSMC cholesterol efflux switch.

It is known, that initial events in atherosclerosis arise in the intima with a parallel influx of inflammatory cells. I propose the opposite - that the disease onset begins from the media vascular smooth muscle cell (VSMC) involvement and through its utilization of modified low-density lipoproteins (LDL), and free or esterified cholesterol. Other oxidized lipoprotein molecules remain in the media which are non-removed by high-density lipoproteins (HDL), owing to their structural damages after local vasa vasorum and adventitia lymphatic disorders.

[Functional assessment of the lymphatic bed of patients in the late clinical classes of chronic venous insufficiency according to the international GEAP classification].

The author revises the contents and limits of the anatomic CEAP classification. For this purpose 84 patients with different types of trophic disorders of the lower limbs were examined with the aid of the author's technique of functional lymphography and lymphoscintigraphy. Impairment of drainage and transport function of the lymphatic capillaries was established from the ulcer edge at the level of the outgoing (from skin to collector) and collecting (from foot to regional nodes) capillaries.

Ultrasonic endarterectomy for long superficial femoral artery atherosclerotic occlusive disease.

Objective: To report the long term results of ultrasonic superficial femoral artery endarterectomy (USFAE).

Design: Retrospective study.

Patients And Methods: From January 1998 to June 2004 218 USFAE were performed in 202 selected patients (178 males, 192 procedures) with a median age of 65 years (46-87 years).

[Pathogenesis of atherosclerosis in patients with lipid metabolism disturbances: hypothesis on cholesterol utilization and atheromatous plaque formation].

Cholesterol is known to participate in atheromatous plaque formation coming from blood stream and affecting vascular endothelium in environment of elevated low-density lipoproteins (LDL). Nevertheless, the occurrence of single atheromatous plaque evidences the possibility of local lipoprotein accumulation by vascular wall without systemic increase in serum LDLs. The author hypothesizes that in the absence of hypercholesterolemia atheroma can evolve through the utilization of modified LDL and free or etherified cholesterol, that remain in media non-removed by high density lipoproteins (HDL) owing to their structural damage after local vascular wall ischemia caused by vasa vasorum disorders.