Reverse cholesterol transport, although not well understood, is an important mechanism in the pathophysiology of atherosclerosis. Macrophages can eliminate some cholesterol from atherosclerotic lesions by an oxidative mechanism involving sterol 27-hydroxylase. Patients with inherited "cerebrotendinous xanthomatosis" lack sterol 27-hydroxylase (CYP27A1) and develop severe premature atherosclerosis despite normal serum cholesterol concentrations. Thus, it has been speculated that sterol 27-hydroxylase is an anti-atherosclerotic enzyme. Here, we report the case of a 25-year-old patient who presented to our emergency room with an acute non-ST elevation myocardial infarction due to severe coronary heart disease. Lipid analysis revealed dramatically increased 27-hydroxycholesterol and low high-density lipoprotein (HDL)-cholesterol levels. Previous reports suggest that 27-hydroxylase is upregulated to protect peripheral cells from severe cholesterol accumulation, especially in cases of ineffective reverse cholesterol transport due to low HDL-cholesterol levels. Our findings indicate that oxysterols could play an important and so far underestimated role in reverse cholesterol transport.

OBJECTIVE: Hypercholesterolemia is a risk factor for aortic stenosis (AS) and for coronary artery disease (CAD). Serum cholesterol concentrations are determined by intestinal cholesterol absorption and endogenous cholesterol synthesis. Vascular effects of differences in cholesterol metabolism in patients with AS are so far unknown. Therefore, the aim of this study was to investigate differences in cholesterol metabolism in relation to vascular diseases in this subset of patients. METHODS: In addition to identifying conventional coronary risk factors, we determined plant sterols (indicators of cholesterol absorption) and lathosterol (indicator of cholesterol synthesis) levels in 40 consecutive men and women with AS. Coronary angiograms before the aortic valve replacement determined the extent of CAD. RESULTS: Patients with a positive history of cardiovascular disease exhibited an increased campesterol-to-lathosterol ratio in plasma (P<0.005) and in aortic valve cusps (P<0.05). The plasma campesterol-to-lathosterol ratio increased with CAD severity (zero, single, two, three-vessel disease; P<0.05). Coronary vessel score strongly correlated with the campesterol-to-lathosterol ratio in plasma (r = 0.52; P<0.001) and in aortic valve cusps (r = 0.33; P<0.03). Logistic regression analysis revealed that the ratio of campesterol-to-lathosterol was the sole predictor of CAD among coronary risk factors tested (P<0.01). CONCLUSION: Enhanced absorption and reduced synthesis of cholesterol is related to a positive family history of cardiovascular diseases and the development of concomitant CAD in patients with AS.

Abstract Objective: This paper investigates a general concept of reproducibility with regard to its application on experiments with homeopathic potencies. Methods: The experimental situation for distinguishing a homeopathic potency and its solvent is described in a formal way. This allows the application of the weak law of large numbers. Experimental arrangements are described in a formal way. This allows conclusions to be drawn about the possible existence of nonlocal influences on an experiment. Conclusions: From a pragmatic as well as from a global point of view, a general concept of reproducibility supports decisions whether or not effects in experiments with homeopathic potencies do exist.

"Functional foods" supplemented with plant sterols are advertised and added to regular meals to reduce serum cholesterol concentrations. The effects of increased phytosterol levels on cardiovascular diseases, however, are not known. Findings in patients with sitosterolemia, data from epidemiological studies, and experimental data from animal studies suggest that plant sterols may potentially exert negative cardiovascular effects. Additional studies investigating relevant clinical endpoints are needed before a diet supplemented with plant sterols can be recommended in the prevention of cardiovascular diseases.

OBJECTIVES: The purpose of this study was to evaluate vascular effects of diet supplementation with plant sterol esters (PSE). BACKGROUND: Plant sterol esters are used as food supplements to reduce cholesterol levels. Their effects on endothelial function, stroke, or atherogenesis are not known. METHODS: In mice, plasma sterol concentrations were correlated with endothelial function, cerebral lesion size, and atherosclerosis. Plasma and tissue sterol concentrations were measured by gas-liquid chromatography-mass spectrometry in 82 consecutive patients with aortic stenosis. RESULTS: Compared with those fed with normal chow (NC), wild-type mice fed with NC supplemented with 2% PSE showed increased plant sterol but equal cholesterol plasma concentrations. The PSE supplementation impaired endothelium-dependent vasorelaxation and increased cerebral lesion size after middle cerebral artery occlusion. To test the effects of cholesterol-lowering by PSE, apolipoprotein E (ApoE)-/- mice were randomized to Western-type diet (WTD) with the addition of PSE or ezetimibe (EZE). Compared with WTD, both interventions reduced plaque sizes; however, WTD + PSE showed larger plaques compared with WTD + EZE (20.4 +/- 2.1% vs. 10.0 +/- 1.5%). Plant sterol plasma concentration strongly correlated with increased atherosclerotic lesion formation (r = 0.50). Furthermore, we examined plasma and aortic valve concentrations of plant sterol in 82 consecutive patients with aortic stenosis. Patients eating PSE-supplemented margarine (n = 10) showed increased plasma concentrations and 5-fold higher sterol concentrations in aortic valve tissue. CONCLUSIONS: Food supplementation with PSE impairs endothelial function, aggravates ischemic brain injury, effects atherogenesis in mice, and leads to increased tissue sterol concentrations in humans. Therefore, prospective studies are warranted that evaluate not only effects on cholesterol reduction, but also on clinical endpoints.

This paper discusses the nature of the active ingredient of homeopathic ultramolecular dilutions in terms of quantitative physics. First, the problem of the nature of an active ingredient in ultramolecular dilutions is analysed leading to the recognition of the necessity of characterizing the active ingredient as a non-local quality. Second, non-locality in quantum mechanics, which is used as a paradigm, is formally presented. Third, a generalization of quantum mechanics is considered, focussing on the consequences of weakening of the axioms. The formal treatment leads to the possible extension of the validity of quantum theory to macroscopic or even non-physical systems under certain circumstances with a while maintaining non-local behaviour. With respect to the survival of entanglement in such non-quantum systems a strong relationship between homeopathy and non-local behaviour can be envisaged. I describe how several authors apply this relationship. In conclusion, the paper reviews how quantum mechanics is closely related to information theory but why weak quantum theory and homeopathy have not hitherto been related in the same way.