Preventing, stopping, or reversing coronary artery disease--triglyceride-rich lipoproteins and associated lipoprotein and metabolic abnormalities: the need for recognition and treatment.

A substantial number of treated patients with or at high risk for coronary artery disease continue to have fatal and nonfatal coronary artery events in spite of significant reduction of elevated levels of low-density lipoprotein cholesterol. Other lipoprotein abnormalities besides an elevated level of low-density lipoprotein cholesterol contribute to risk of coronary artery disease and coronary artery events, and the predominant abnormalities that appear to explain much of this continued risk are an elevated serum triglyceride level and a low level of high-density lipoprotein cholesterol. Most patients with coronary artery disease have a mixed dyslipidemia with hypertriglyceridemia, which is associated and metabolically intertwined with other atherogenic risk factors, including the presence of triglyceride-rich lipoprotein remnants, low levels of high-density lipoprotein cholesterol, small, dense, low-density lipoprotein particles, postprandial hyperlipidemia, and a prothrombotic state. Aggressive treatment of these patients needs to focus on these other lipoprotein abnormalities as much as on low-density lipoprotein cholesterol. Combination drug therapy will usually be required. Reliable assessment of risk of coronary artery disease from lipoprotein measurements and response to therapy requires inclusion of all atherogenic lipoproteins in laboratory measurements and treatment protocols. At present this may be best accomplished by use of non-high-density lipoprotein cholesterol (total cholesterol minus high-density lipoprotein cholesterol) calculated from standard laboratory lipoprotein values. Ultimately, a more comprehensive assessment of coronary artery disease risk and appropriate therapy may include measurement of lipoprotein subclass distribution including determination of low-density lipoprotein particle concentration and sizes of the various lipoprotein particles.

A Personal history of the early development of the flowing afterglow technique for ion-molecule reaction studies.

A personal perspective of the historical development of the flowing afterglow (FA) technique for measuring thermal energy ion-molecule reaction rate constants is presented. The technique was developed in the period starting in late 1962 in what was then the National Bureau of Standards in Boulder, Colorado. The motivation was primarily to obtain a quantitative understanding of the ion chemistry of the terrestrial ionosphere, a program that was substantially achieved. The thermal energy measurements were extended in temperature from 300 K to a range of 80 K-900 K and subsequently to a center-of-mass kinetic energy range up to ∼ 2 eV with the introduction of a drift tube into the FA.The chemical versatility, in regard to both the ion and the neutral reactants measured, remains unequaled and FA systems are currently in widespread use around the world for a variety of chemical research programs.