Low-Density Lipoprotein Particle Size Distribution in Subjects with Coronary Artery Disease

BACKGROUND: Low-density lipoprotein (LDL) cholesterol has been shown to be a major risk factor for coronary artery disease (CAD) in animal studies, clinical trials, and observational epidemiologic studies. It has a hydrated density of 1.019 to 1.063 kg/L, a diameter of 20 to 30 nm, and displays beta-mobility on paper or agarose gel electrophoresis. With technique such as density gradient ultracentrifugation and gel electrophoresis, it is possible to separate lipoproteins accurately on the basis of their density, charge, and particle size. Further, it has been shown that a smaller LDL is associated with an increased risk of coronary artery disease, even when total cholesterol level is only slightly raised. The aim of this study was to analyze LDL particle size distribution in patients with angiographically confirmed coronary artery disease and in control subjects, using nondenaturating gradient polyacrylamide gel electrophoresis, and to investigate the relationship between LDL particle size and the other traditional coronary risk factors. METHODS: Baseline characteristics such as age, sex, body mass index, history of hypertension or NIDDM, smoking habits, and plasma lipoprotein profiles were obtained in 33 and 27 subjects with and without CAD angiographically confirmed, respectively. We determined LDL peak particle diameter (LDL-PPD) using nondenaturating gradient polyacrylmide gel electrophoresis in CAD and control group. 4% to 12% polyacrylamide gradient gels were used for this assay, and the diameters of LDL subclass peaks were calculated by comparison with a standard calibration curve. This procedure permits the assignment according to distribution of particle diameters as exhibiting pattern A, B, or INT. RESULTS: Traditional coronary risk factors (age, sex, body mass index, history of hypertension or NIDDM, smoking habits, plasma triglyceride, HDL-cholesterol, and total to HDL-cholesterol ratio) were found to be significantly different between two groups, except the plasma total cholesterol and LDL-cholesterol. The mean value of LDL-PPD in patients with CAD was significantly lower than that in control subjects (26.110.4 nm versus 27.011.9 nm, p=0.006). LDL-PPD showed relatively strong associations with plasma triglyceride (r= - 0.536, p<0.01), HDL-cholesterol (r=0.497, p<0.01), and total to HDL-cholesterol ratio (r= - 0.516, p<0.01), but showed no relation to total cholesterol (r= - 0.168) or LDL-cholesterol (r= - 0.028). CONCLUSION: These results suggest an association between small LDL and the presence of CAD and also suggest that LDL-PPD may be associated with the plasma lipid levels.

Esophagus, Stomach & Intestine; A Case of Duodenal Leiomyoma Presenting with Upper Gastrointestinal Bleeding / 대한소화기내시경학회지

Leiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Recurrent bouts of severe melana remain the most frequent presenting symptom for leiomyoma. A 69-year-old man presented to us with a 4-day history of melena. Endoscopy revealed norinal mucosa covered ovoid elevated lesion with central linear depression and ulcer at the second portion of duodenum. Endoscopic biopsy showed chronic inflammation only. Duodenal mass was excised through a duodenotomy. Pathological diagnosis was leiomycena.

Primary Malignant Lymphoma of the Small Intestine Causing Adult Intussusception as an Initial Symptom / 대한소화기내시경학회지

While intussusception can occur at any age, the disease is most often seen in children and no etiologic factor can be seen in most cases of childhood intussusception. In contrast, the adult intussusception is rare and usually has an identifiable causes such as benign tumor, malignant tumor, sarcoma, Meckel's diverticulum and congenital anomaly. Especially, adult intussusception due to primary malignant lymphoma of small intestine is rare clinical condition. Here, we describe the case of a 49-year-old male patient with ileo-ileo-colic intussusception due to primary malignant lymphoma of the small intestine. The clinical, radiographic and pathologic findings are described with brief review of the literature.