| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Cholesterol granuloma. Review of the literature apropos of a case Raveau, V., O. Vignaux, et al. (1992), Ann Radiol (Paris) 35(1-2): 81-4. Abstract: MRI allows the diagnosis of cholesterol granuloma in the presence of a non contrast-enhanced, erosive solid mass of the apex of the petrous bone or middle ear. Cholesterol granuloma has a suggestive low signal intensity on T1 and T2 weighted sequences (cholesterol crystals, haemoglobin degradation products). These specific features eliminate the principal CT differential diagnoses, particularly cholesteatoma. MRI is also useful for follow-up of treatment. |
| Cholesterol granulomas in mice deficient in apolipoprotein E Owiny, J. R. and J. D. Strandberg (2000), Contemp Top Lab Anim Sci 39(6): 57-8. Abstract: Three 12- to 16-month-old female B6,129 apolipoprotein E-deficient mice were presented for necropsy because of bilateral masses in the gluteal region. Histopathologic examination revealed cholesterol granulomas extending from the superficial dermis to the underlying gluteal muscles. Microscopic granulomas were found on the face, perivaginal tissues, mesenteric lymph nodes, spleen, joints, kidneys, and choroid plexus. Other lesions included severe atherosclerosis of the aortic valves, aorta, pulmonary artery, and renal artery. Here we show that macroscopic cholesterol granulomas can develop in apolipoprotein E-deficient that receive a normal rodent diet. |
| Cholesterol granulomas in three meerkats (Suricata suricatta) Sladky, K. K., F. G. Dalldorf, et al. (2000), Vet Pathol 37(6): 684-6. Abstract: Cholesterol granulomas are uncommon pathologic lesions in animals, although they are important intracranial tumors in humans. This report describes cholesterol granulomas associated with multiple organ systems of three captive meerkats. In the most severe case, meerkat No. 1, the pathologic behavior of the cholesterol granuloma was unique in that it appeared to locally invade the cerebrum and calvarium, possibly contributing to neurological deficits observed antemortem. A review of other meerkat necropsies revealed incidental, asymptomatic cholesterol granulomas in organs of two other individuals, meerkat Nos. 2 and 3. Histologically, all lesions were composed of cholesterol clefts admixed with large, foamy macrophages containing hemosiderin, multinucleated giant cells, lymphocytes, plasma cells, and foci of mineralization. Hypercholesterolemia was documented in two of the three meerkats. |
| Cholesterol granulomas of fronto-orbitary localization. 2 cases Dessi, P., R. Gras, et al. (1994), Presse Med 23(3): 139. |
| Cholesterol granulomas of the lungs associated with microangiopathic hemolytic anemia and thrombocytopenia in pulmonary hypertension Fischer, E. G., J. M. Marek, et al. (2000), Arch Pathol Lab Med 124(12): 1813-5. Abstract: Cholesterol granulomas unrelated to endogenous lipoid pneumonia, pulmonary alveolar proteinosis, or cholesterol pneumonia are a rare finding during pneumectomy or autopsy. They have been occasionally reported in association with pulmonary hypertension. We report a case where these lesions were associated with long-standing pulmonary hypertension and microangiopathic hemolytic anemia and thrombocytopenia. Plexiform lesions were present in the pulmonary vasculature secondary to pulmonary hypertension, causing hemolysis and thrombocytopenia. We suggest that destruction of red blood cells and platelets could provide membrane lipids that are taken up by phagocytic cells, which promotes the formation of these cholesterol deposits. |
| Cholesterol granulomas of the maxillary sinus presenting with nasal obstruction Rath-Wolfson, L., Y. P. Talmi, et al. (1993), Otolaryngol Head Neck Surg 109(5): 956-8. |
| Cholesterol granulomas of the petrous apex Berk, C. (2004), Acta Neurochir (Wien) 146(1): 89. |
| Cholesterol granulomas of the petrous apex: combined neurosurgical and otological management Brodkey, J. A., J. H. Robertson, et al. (1996), J Neurosurg 85(4): 625-33. Abstract: Cholesterol granulomas of the head are relatively rare. Isolated lesions of the cerebellopontine angle are even more uncommon. In this report, 17 cases of petrous apex cholesterol granulomas are presented and management is discussed. Symptoms at presentation included dizziness (14 patients), pressure (nine patients), tinnitus (eight patients), hearing loss (eight patients), otalgia (six patients), headache (six patients), nausea (three patients), drainage from ear (two patients), facial pain (two patients), seizure (two patients), lightheadedness (one patient), hemifacial spasm (one patient), and facial numbness (one patient). Six cases were managed without surgery and 11 patients underwent operative procedures. The approaches used included the infralabyrinthine (eight patients), transcanal-infracochlear (two patients), and translabyrinthine (one patient). The mean follow-up period for all cases was 29.5 months. Of those patients managed without surgery, symptoms improved in all except one, whose tinnitus was slightly worse. Of surgically treated patients, symptoms improved or remained the same except in one with worsened dizziness. There were nine patients with hearing present presurgery and seven whose hearing was preserved postsurgery. The authors present a case that was managed at another center where an attempt at surgical resection through a subtemporal middle fossa approach was unsuccessful. This lesion was successfully treated using an infralabyrinthine approach with drainage into the mastoid cavity. Cholesterol granulomas of the petrous apex can be managed without surgery when symptoms are stable or improve. Otherwise, a transmastoid extradural approach with simple drainage into the mastoid sinus or middle ear produces symptomatic improvement with low morbidity. Resection of petrous apex cholesterol granulomas is not necessary. |
| Cholesterol granulomatosis of the lungs Flechsig, R., S. Bohmer, et al. (1990), Z Erkr Atmungsorgane 175(2): 88-9. Abstract: The cholesterol storage disease of the lung is seldom and therefore we hardly think of it. An evident diagnosis can be given only by histological examinations. 2 cases are described where during life was diagnosed a silicosis and declared as an occupational disease. Autopsy revealed cholesterol storage disease without any signs of silicosis. These findings suggest, that in cases with low occupational quartz-dust-exposure it is advisable to extend the field of diagnostic procedures. |
| Cholesterol granulomatous tympano-mastoiditis Gu, Z. and L. Tong (1996), Zhonghua Er Bi Yan Hou Ke Za Zhi 31(6): 328-30. Abstract: In order to investigate the early diagnosis and proper management of the cholesterol granulomatous tympanomastoiditis, 6 cases verified by pathology and surgery were reviewed. All of these cases had a longterm or a historical otitis media. Among them, different clinical features were presented, such as chronic serous otitis media, idiopathic blue eardrum, or as a primary occupying lesion of the middle ear. Depend on the extension of the disease, surgical procedure varied in the 6 cases, including exploratory tympanotomy, ventilation tube insertion, antroatticotomy, simple mastoidectomy, and radical mastoidectomy. Postoperative follow up for at least one--7 year showed no recurrence, and hearing improvement in 5 cases. The clinical basis of the diagnosis and management of this disease were also discussed. |
| 'Cholesterol' guidelines (first revision) of the Dutch College of Family Physicians; response from internal medicine Stalenhoef, A. F. (2000), Ned Tijdschr Geneeskd 144(9): 407-9. Abstract: The deviations of the revised standard 'Cholesterol' of the Dutch College of General Practitioners from other recent Dutch and European consensus guidelines are disputable in that it advises, only to measure serum lipids if the person will be eligible for treatment with statins according to the risk tables and to omit repeated measurements, since there exist more reasons for serum cholesterol assay: adequate risk estimation for primary prevention without drug treatment, relation between degree of lipid lowering and reduction in risk, estimation of response and compliance during drug treatment and estimation of type of lipid disturbance. Also, repeated serum cholesterol determination improves detection of persons with hereditary hyperlipaemia. Finally, by refraining in advance from treating older persons the possible gains in individual cases are lost. |
| Cholesterol guidelines debate Gidding, S. S. (2001), Pediatrics 107(5): 1229-30. |
| Cholesterol guidelines update: more aggressive therapy for higher-risk patients Huang, J. C. and R. J. Hoogwerf (2005), Cleve Clin J Med 72(3): 253-62. Abstract: The 2004 update to the National Cholesterol Education Program guidelines goes farther than the 2001 version in suggesting an optional low-density lipoprotein cholesterol (LDL-C) goal of less than 70 mg/dL for patients at "very high risk." It recommends starting both diet and drug therapy in all patients at high or very high risk whose LDL-C level is above the goal level, with the goal of reducing LDL-C by 30% to 40%. These more aggressive guidelines are based on results of five clinical studies published since 2001. |
| Cholesterol hepatolithiasis with peribiliary cysts Terada, T., H. Matsushita, et al. (2003), Pathol Int 53(10): 716-20. Abstract: A 78-year-old man was admitted to our clinic because of fatigue. Imaging modalities showed beaded stricture and dilation of the intrahepatic left segmental bile duct. Anomalous pancreatico-biliary ductal union and polycystic kidney disease were absent. Resection of the hepatic left lobe was performed. Grossly, cholesterol stones were impacted in the dilated intrahepatic large bile ducts, and multiple tiny cysts measuring 2-8 mm were noted in the peribiliary areas (peribiliary cysts). Histologically, the cholesterol hepatoliths consisted of cholesterol empty spaces and fibrinous materials, and, in places, foreign body giant cells were seen around the cholesterol crystals. The peribiliary cysts were lined by a layer of cuboidal epithelia. They were intimately intermingled with intrahepatic peribiliary glands, and a close association between the two components was recognized in some places. A mild degree of ascending cholangitis was noted. Bile duct anomalies including von-Meyenburg complexes and simple cysts were not recognized. Peribiliary cysts have been reported in various liver diseases, including portal hypertension, portal thrombosis, cirrhosis, hepatocellular carcinoma, and adult polycystic kidney disease. However, to the best of our knowledge, there have been no reports on peribiliary cysts developing in hepatolithiasis. The present case indicates that peribiliary cysts occur in cholesterol hepatolithiasis, and suggests that they are derived from cystic dilations of intrahepatic peribiliary glands. |
| Cholesterol heterogeneity in the plasma membrane of epithelial cells el Yandouzi, E. H. and C. Le Grimellec (1992), Biochemistry 31(2): 547-51. Abstract: The distribution of cholesterol in the plasma membrane of epithelial cells has been determined using renal brush border vesicles as a model. In brush borders treated with Brevibacterium sp. or Nocardia erythropolis cholesterol oxidases, a significant fraction of the free cholesterol was oxidized rapidly, without glutaraldehyde fixation, and the remaining cholesterol was oxidized at a slower rate. The size of the readily accessible cholesterol pool, however, depended on the enzyme used, varying from 16% of the total in membranes treated with N. erythropolis oxidase, to 27% using the Brevibacterium sp. enzyme. The slowly accessible pool detected by the Brevibacterium oxidase was suppressed upon sphingomyelinase addition. On the other hand, the restricted activity of the Nocardia oxidase might depend on phosphatidylcholine/cholesterol interactions. These results indicate that cholesterol distribution is heterogeneous in intact renal brush border vesicles. They suggest that, as proposed for model system Demel, R.A. Jansen, J.W.C.M., van Dijck, P.W.M., & van Deenen, L.L.M. (1977) Biochim. Biophys. Acta 465, 1-10, preferential interactions between some classes of phospholipids and cholesterol define cholesterol pools in the plasma membrane of epithelial cells. |
| Cholesterol homeostasis and function in neurons of the central nervous system Pfrieger, F. W. (2003), Cell Mol Life Sci 60(6): 1158-71. Abstract: Cholesterol is a multifaceted molecule. First, it serves as an essential membrane component, as a cofactor for signaling molecules and as a precursor for steroid hormones; second, its synthesis, intercellular transport and intracellular distribution present a logistic tour de force requiring hundreds of cellular components, and third, it plays a crucial role in major human diseases. Despite intense research on this molecule, its metabolism in the central nervous system and its role in neuronal development and function are not well understood. Here I summarize recent results and hypotheses about how neurons maintain their cholesterol level and how cholesterol influences the establishment and maintenance of synaptic connections. |
| Cholesterol homeostasis and infertility: the liver X receptor connection Papadopoulos, V. (2005), Endocrinology 146(6): 2517-8. |
| Cholesterol homeostasis failure as a unifying cause of synaptic degeneration Koudinov, A. R. and N. V. Koudinova (2005), J Neurol Sci 229-230: 233-40. Abstract: We previously showed that fine tuning of neural cholesterol dynamics is essential for basic synapse function, plasticity and behavior. Significant experimental evidence indicates that cholinergic function, ionotropic and metabotropic receptor machinery, excessive tau phosphorylation, the change of amyloid beta (Abeta or Abeta) biochemistry, neural oxidative stress reactions, and other features of neurodegeneration also depend on fine tuning of brain cholesterol homeostasis. This evidence suggest that (i) cholesterol homeostasis break is the unifying primary cause of sporadic and familial Alzheimer's disease (AD), neuromuscular diseases (particularly inclusion-body myositis), Niemann-Pick's type C disease and Down syndrome, and (ii) explains the overlap of neurodegenerative hallmarks across the spectrum of neurodegenerative diseases. Provided is evidence-based explanation of why extremely rare (but scientifically popular) cases of AD associated with mutations in amyloid beta protein precursor (APP) and presenilin (PS) genes, are translated into the disorder via membrane cholesterol sensitivity of APP processing by secretases and Abeta generation. The reciprocal effect of Abeta on cholesterol synthesis, cellular uptake, efflux and esterification is summarized, as well as the potential implication of such biological function for the compensatory Abeta-assisted restoration of the synaptic long-term potentiation (LTP) and resulting inability of tackling amyloid to cure AD. |
| Cholesterol homeostasis in cultures of rat heart myocytes: relationship to cellular hypertrophy Shmeeda, H., D. Petkova, et al. (1994), Am J Physiol 267(5 Pt 2): H1689-97. Abstract: The mechanism leading to accumulation of cholesterol in hypertrophic cultures of neonatal rat heart myocytes was investigated in light of its relevance to aging-related hypertrophy of myocardial tissue. Lipoprotein turnover was low in young cells (days 4-6) and further depressed in older cells (days 12-14), and therefore could not account for the increase in cholesterol levels. 3H2O incorporation into cell monolayers and 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase activity in cell-free extracts demonstrated a substantial increase in cholesterogenesis during culture aging. Cholesteryl ester (CE) synthesis, cellular levels, and acyl-CoA:cholesterol O-acyltransferase (ACAT) activity decreased. The rate of CE hydrolysis did not change. Although cholesterol efflux from cells decreased 50%, its relative contribution to cholesterol accumulation was small. Our results indicate that accumulation of cholesterol in aging rat myocyte cultures is primarily due to changes in the endogenous metabolism of cholesterol and not due to a lipoprotein-mediated pathway. This implicates an impairment of the feedback regulation of HMG-CoA reductase and ACAT. These findings have important implications for understanding the molecular mechanisms underlying aging-related myocardial hypertrophy. |
| Cholesterol homeostasis in human brain: evidence for an age-dependent flux of 24S-hydroxycholesterol from the brain into the circulation Lutjohann, D., O. Breuer, et al. (1996), Proc Natl Acad Sci U S A 93(18): 9799-804. Abstract: We have investigated whether side chain-hydroxylated cholesterol species are important for elimination of cholesterol from the brain. Plasma concentrations of 24-hydroxycholesterol (24-OH-Chol) in the internal jugular vein and the brachial artery in healthy volunteers were consistent with a net flux of this steroid from the brain into the circulation, corresponding to elimination of approximately 4 mg cholesterol during a 24-h period in adults. Results of experiments with rats exposed to 18O2 were also consistent with a flux of 24-OH-Chol from the brain into the circulation. No other oxysterol measured showed a similar behavior as 24-OH-Chol. These results and the finding that the concentration of 24-OH-Chol was 30- to 1500-fold higher in the brain than in any other organ except the adrenals indicate that the major part of 24-OH-Chol present in the circulation originates from the brain. Both the 24-OH-Chol present in the brain and in the circulation were the 24S-stereoisomer. In contrast to other oxysterols, levels of plasma 24-OH-Chol were found to be markedly dependent upon age. The ratio between 24-OH-Chol and cholesterol in plasma was approximately 5 times higher during the first decade of life than during the sixth decade. There was a high correlation between levels of 24-OH-Chol in plasma and cerebrospinal fluid. It is suggested that the flux of 24-OH-Chol from the brain is important for cholesterol homeostasis in this organ. |