To evaluate the relationship between arteriolosclerosis and diabetic retinopathy, we graded the levels of diabetic retinopathy and arteriolosclerosis and compared each other in 255 patients with non-insulin dependent diabetes. And we also measured serum lipid levels and checked other risk fac-tors for diabetic retinopathy. SPSS was used for statistical analysis. Patients with advanced arteriolosclerosis were at higher risk of severe diabetic retinopathy. And patients with elevated plasma total cholesterol, LDL-C, TG had more severe levels of diabetic retinopathy than whose lipid levels were normal. These results suggested that advanced arteriolosclerosis and elevated serum lipid levels are associated with severe diabetic retinopathy. For preventing visual threatening complications of diabetic retinopathy, the degree of arteriolosclerosis and serum lipid levels should be carefully monitored in the evaluation of diabetic retinopathy.
Arteriolosclerosis ; Arteriosclerosis* ; Cholesterol ; Diabetic Retinopathy* ; Humans ; Plasma

The development of plaques along the inner layer of arterial walls is known as atherosclerosis. Atherosclerotic plaques can become hardened by calcium deposition and fibrous tissue of the arterial wall may proliferate leading to arteriosclerosis. In a typical textbook, arteriosclerosis only has three categories-atherosclerosis, Monckeberg medial calcific sclerosis, and arteriolosclerosis, leaving out vascular aging when in fact, aging is the strongest risk factor for atherosclerosis. Thus, vascular aging is often confused with atherosclerosis. Up to now, there has been no appropriate pathological term for vascular aging. And arteriosclerosis is different from vascular aging, as atherosclerosis includes some components of pathologic aging. But in actuality, physiological aging and pathological aging can not be clearly distinguished. Therefore, in terms of aging, arteriosclerosis is included in vascular aging. More research is required to define vascular aging.
Aging ; Arteriolosclerosis ; Arteriosclerosis ; Atherosclerosis ; Calcium ; Monckeberg Medial Calcific Sclerosis ; Plaque, Atherosclerotic ; Risk Factors

PURPOSE: To evaluate the correlation between diabetic retinopathy (DR) and arteriolosclerosis in patients with NIDDM (non-insulin-dependent diabetes mellitus), to investigate the risk factors of DR, and to assess the change of the correlation according to the risk factors. METHODS: The study subjects were selected from consecutive routine clinical visits by random sampling from July 2002 to June 2003. The patients were divided into two groups according to the presence of DR, and the patients' charts, fundus examination and blood test were retrospectively reviewed. ETDRS (Early Treatment DR Study) classification for DR and Scheie classification for arteriolosclerosis were used. Statistical analysis was conducted with SPSS program (version 10.0). The confidence interval was set to 95%, and the level of significance was set at p=0.05. RESULTS: DR had a statistically significant correlation with arteriolosclerosis, especially according to duration of diabetes mellitus (p<0.05). Risk factors including diabetes mellitus duration, HgA1c level, and LDL (low-density lipoprotein) cholesterol level showed statistically significant difference (p<0.05). CONCLUSIONS: From the result of analysis, DR has a statistically significant correlation with arteriolosclerosis, especially according to the duration of diabetes mellitus. To prevent vision-threatening complications of DR, the degree of arteriolosclerosis as well as risk factors such as diabetes mellitus duration, serum HgA1c level, and LDL (low-density lipoprotein) cholesterol level should be carefully considered and monitored in the evaluation, progression, and treatment of DR.
Arteriolosclerosis* ; Cholesterol ; Classification ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Hematologic Tests ; Humans ; Retrospective Studies ; Risk Factors

Glomerular obsolescence is a common histologic feature in various renal diseases, of which histogenesis remains unclarified especially in renal tuberculosis, and little has been attributed for the postulation of low prevalence of hypertension in such occasion. One hundred and fifty consecutive nephrectomy specimens with renal tuberculosis under the age of 50 were histopathologically analyzed along with comparison of 18 cases of chronic pyelonephritis, 15 hydronephrosis and 10 acute traumatic kidneys. Glomerular sclerosis following tuberculous glomerulitis seemed little significant in its histogenesis except in one case, which presented epitheliold cell reaction and crescent formation. Wrinkling and thickening of glomerular basement membrane and subsequent simplification of tufts with mesangiolysis(Stage I and II) represented the major alternative glomerulopathy in nodular renal tuberculosis, whereas in confluent ulcero-cavitary lesion the development of hyalin-knot within the Bowman's space and collapse of the tufts (Stage III and IV) comprised the bulk, aside from frequent intraglomerular shunt formation between afferent and efferent arterioles mostly in autonephrectomized cases, Arteriolosclerosis was found in 17.2 % among nodular type, while 26.7% in ulcero-cavitary, variety, partly responsible for the histogenesis of glomerular obsolescence. Those cases with moderate arterio and arteriolar sclerosis showed a high tendency of transformation into stage III-IV obsolescence especially in ulcero-cavitary tuberculosis. Relative prevalence rate of systolic hypertension in ulcerocavitary tuberculosis was 5.8%, two times higher than nodular type, but in only one case the post-operative blood pressure returned to normal range. With the above findings it is assumed that glomerular oboslescence of so-called hypertensive glomerulopathy is a subtype of ischemic nature, and induced not only by vascular is chemic changes but also compromised through the intra-renal tubular obstruction and intraglomerular capillary shunt formaion may attribute to the development of secondary hypertension, though rare, in renal tuberculosis associated with arteriosclerot ic changes as well.
Arterioles ; Arteriolosclerosis ; Blood Pressure ; Capillaries ; Glomerular Basement Membrane ; Hydronephrosis ; Hypertension* ; Kidney ; Nephrectomy ; Prevalence* ; Pyelonephritis ; Reference Values ; Sclerosis ; Tuberculosis ; Tuberculosis, Renal*

Ischemic stroke is a heterogeneous disease caused by different pathogenic mechanisms, of which small artery and large artery stroke are the most common. Although the identification of the genes involved is unclear, genetic factors are increasingly recognized as influencing risk for atherosclerosis or arteriolosclerosis directly and indirectly. Genetic makeup may influence the development of major vascular risk factors or alter susceptibility of the cerebral vasculature to these risk factors. Some researchers have reported that atherosclerosis is high in people with functional variants of genes related to matrix deposition (matrix metalloproteinase 3), inflammation (interleukin-6), and lipid metabolism (hepatic lipase, apolipoprotein E, cholesteryl ester transfer protein, and paraoxonase) and clotting (factor V Leiden, fibrinogen). More recently, newly identified risk factors for atherosclerosis, such as plasma homocysteine (5,10-methylenetetrahydrofolate reductase). In this review, we assess the robustness of these associations and examine whether there is any evidence of risk modifications by factors, such as smoking.
Apolipoproteins ; Arteries ; Arteriolosclerosis ; Atherosclerosis ; Brain Ischemia ; Cholesterol Ester Transfer Proteins ; Genetics ; Homocysteine ; Inflammation ; Lipase ; Lipid Metabolism ; Molecular Biology* ; Plasma ; Risk Factors ; Smoke ; Smoking ; Stroke*

BACKGROUND: IgA nephropathy is recognized as a disease affecting primarily young men under 30 years of age but it is relatively uncommon over 50 years of age. Findings on clinical and histological presentation and outcome of over 50 years of age have rarely published in Korea. METHODS: Between Febrary 1994 and July 2003, one hundred and thirty nine IgAN patients were recruited over 8 years. Nineteen patients over age 50 were compared to one hundred and twenty patients under age 50 clinical, histological findings, 5-Yr renal survival rate. Mean post-biopsy follow-up month was 23.8 +/- 23.5 months. RESULTS: Both group of patients were similar to baseline for gross hematuria, Male and female ratio. But older patients had a higher incidence of daily for 24 hour urine protein (p=0.010), systolic and diastolic blood pressure (p=0.010, p<0.01), serum C3 (p=0.001) and serum C4 (p=0.003). Albumin (p=0.011), creatinine clearance (p<0.01) were significantly lower in the older patients at the time of renal biopsy. Histologic grade IV was more common in the older patients (p=0.001). Moderate to severe mesangial proliferation (p=0.001) and crescent formation (p=0.043), arteriolosclerosis (p=0.006) were more common in older patients. Mesangial small deposition of IgA (p=0.007) and glomerular peripheral deposition of IgG, IgA, C1q (p=0.024, p=0.014, p=0.009) were more common in older patients than in under 50 years of age. Mesangial small electron dense deposits were more common in older patients than in younger patients (p=0.031). CRF (Ccr < 60 mL/min) was confirmed 55.6% over age 50 and 27.4% under age 50 (p=0.017). Renal replacement therapy was done 15.8% over age 50 and 4.3% under age 50 (p=0.048). 5-Year renal survival curves showed that kidney survival rate was 44.4% over age 50 and 72.6% under age 50 (p=0.0248). CONCLUSION: Poor prognostic factors were more common over age 50 than under age 50. CRF and renal replacement therapy were more common over age 50. Analysis of renal survival curves shows that the probability of developing ESRF increase after age 50. But, prolonged prospective follow-up is necessary to confirm this trend.
Arteriolosclerosis ; Biopsy ; Blood Pressure ; Creatinine ; Female ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Incidence ; Kidney ; Korea ; Male ; Prognosis ; Renal Replacement Therapy ; Survival Rate

Chronic glomerulonephritis (GN), which includes focal segmental glomerulosclerosis and proliferative forms of GN such as IgA nephropathy, increases the risk of hypertension. Hypertension in chronic GN is primarily volume dependent, and this increase in blood volume is not related to the deterioration of renal function. Patients with chronic GN become salt sensitive as renal damage including arteriolosclerosis progresses and the consequent renal ischemia causes the stimulation of the intrarenal renin-angiotensin-aldosterone system(RAAS). Overactivity of the sympathetic nervous system also contributes to hypertension in chronic GN. According to the KDIGO guideline, the available evidence indicates that the target BP should be < or =140mmHg systolic and < or =90mmHg diastolic in chronic kidney disease patients without albuminuria. In most patients with an albumin excretion rate of > or =30mg/24 h (i.e., those with both micro-and macroalbuminuria), a lower target of < or =130mmHg systolic and < or =80mmHg diastolic is suggested. The use of agents that block the RAAS system is recommended or suggested in all patients with an albumin excretion rate of > or =30mg/ 24 h. The combination of a RAAS blockade with a calcium channel blocker and a diuretic may be effective in attaining the target BP, and in reducing the amount of urinary protein excretion in patients with chronic GN.
Albuminuria ; Arteriolosclerosis ; Blood Volume ; Calcium Channels ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension* ; Ischemia ; Renal Insufficiency, Chronic ; Sympathetic Nervous System

PURPOSE: Recently, obesity with metabolic syndrome is considered as an important risk factor in the development and progression of chronic kidney disease (CKD). Glomerulomegaly and focal segmental glomerulosclerosis (FSGS) are found in the obese patients, suggesting that investigation of structural- functional relationship in the obesity-related glomerulopathy (ORG) is needed to prevent CKD. Thus, we report here clinical and pathologic characteristics of ORG and its association with other clinical variables. METHODS: Obesity was defined by body mass index >25 kg/m2 and ORG morphologically by FSGS and glomerulomegaly or glomerulomegaly alone. Clinicopathologic findings and glomerular sizes of ORG (14 cases) were compared with age-matched controls with thin basement membrane disease. Multiple variable analysis was performed between glomerular size and clinical variables. RESULTS: There was no nephrotic syndrome or pretibial pitting edema in all obese patients. Mean glomerular diameter was increased in obese patients compared to controls (240+/-21 micrometer vs 197+/-21 micrometer, p=0.001). Seven cases had lesions with FSGS with glomerulomegaly and seven cases glomerulomegaly alone. Mild tubular atrophy, interstitial fibrosis and arteriolosclerosis were observed in more than half of patients. In obese patients, seven patients with FSGS had more elevated systolic blood pressure and tubular interstitial fibrosis compared to patients with glomerulomegaly only. Patients' systolic blood pressure and waist circumference were independent risk factors influencing the glomerular size in obese patients. CONCLUSION: FSGS or glomerulomegaly are prominent even in the mild obesity with insignificant clinical symptoms. This indicates that the clinical attention to glomerular disease is needed in obese patients.
Arteriolosclerosis ; Atrophy ; Basement Membrane ; Blood Pressure ; Body Mass Index ; Edema ; Fibrosis ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrotic Syndrome ; Obesity ; Renal Insufficiency, Chronic ; Risk Factors ; Waist Circumference

AIMTo explore the effect of remodeling and biomechanical properties after chronic treating with tetrahydrobiopterin (BH4) in spontaneously hypertensive rats.

METHODSThe spontaneously hypertensive rat(SHR) were given with BH4 chronically. The opening angle in the zero-stress state , wall-to-lumen area ratios (W/L) of thoracic aorta and the relationship between pressure and diameter (P-D) of mesenteric artery were measured by computer image analysis in 4, 16, and 26 week-old respectively.

RESULTSTreating with BH4 chronically from 4 weeks-old in SHR, there was a significant decrease in morphometric parameters of the thoracic aorta and an increase in the zero-stress state of opening angle of elastic artery. The P-D curve of mesenteric artery moved upward.

CONCLUSIONTreating with BH4 prevented the structure and function of artery from abnormal changing, including to attenuate the resistant vascular hypertrophy and recover the vascular elasticity and expansibility.

Animals ; Arteries ; physiopathology ; Arteriolosclerosis ; prevention & control ; Biomechanical Phenomena ; Biopterin ; analogs & derivatives ; therapeutic use ; Hypertension ; drug therapy ; physiopathology ; Male ; Nitric Oxide Synthase ; Random Allocation ; Rats ; Rats, Inbred SHR

BACKGROUND: TGF-beta is involved in the pathogenesis of various kidney diseases characterized by glomerulosclerosis and tubulointerstitial fibrosis. It is reported that urinary TGF-beta reflects the grade of interstitial fibrosis in glomerular disease. Here, we evaluated the relationship between the histological findings and beta ig-h3 in IgA nephropathy. METHODS: In patients with IgA nephropathy, we measured blood pressure (BP), serum creatinine, 24-hour urinary protein excretion (UTp), creatinine clearance (Ccr), serum and urine beta ig-h3 levels, and urine TGF-beta levels at the time of renal biopsy. Histologic findings were semiquantitively scored according to the extent of glomerulosclerosis (GG), tubulointerstitial fibrosis (TIG) and hyaline arteriolosclerosis (HA) by the criteria suggested by To. Semiquantitive scoring of immunohistochemistry for beta ig-h3 was done. RESULTS: Mean BP 95.4+/-14.5 mmHg, serum creatinine 1.06+/-0.35 mg/dL, 24-hour UTp 1, 423+/-1, 439 mg/day, and Ccr was 97.84+/-59.73 mL/min. The number of patients that showed GG 3 were 5, GG 2 was 1, GG 1 were 12. And, the number of patients that showed TIG 3 were 2, TIG 2 were 5, TIG 1 were 11. HA was shown in 4 patients. beta ig-h3 immunostaining was observed in glomerular Bowman's capsules and basement membrane of proximal tubules. The degree of beta ig-h3 immunostaining was positively correlated with the degree of glomerulosclerosis (r=0.72, p<0.001), interstitial fibrosis (r=0.91, p<0.001), serum creatinine (r=0.592, p<0.05) and Ccr (r=-0.626, p<0.05), but not with 24-hour UTp. Serum and urine beta ig-h3 levels did not correlate with any of these parameters. CONCLUSION: Renal beta ig-h3 expression in patients with IgA nephropathy may be related to glomerulosclerosis and interstitial fibrosis. However, urinary beta ig-h3 levels did not represent the pathologic changes of IgA nephropathy. Long-term study to measure renal beta ig-h3 expression and urinary beta ig-h3 is required to elucidate the roles of beta ig-h3 in IgA nephropathy.
Arteriolosclerosis ; Basement Membrane ; Biopsy ; Blood Pressure ; Capsules ; Creatinine ; Fibrosis ; Glomerulonephritis, IGA* ; Humans ; Hyalin ; Immunoglobulin A* ; Immunohistochemistry ; Kidney Diseases ; Transforming Growth Factor beta ; Uridine Triphosphate