• 한국콘텐츠학회논문지
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• 제12권10호
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• pp.349-356
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• 2012

관상동맥 죽상경화반(atheromatous plaque)의 진단에 있어 혈관내초음파(Intravascular Ultrasound: IVUS)와 비교하여 심장전산화단층촬영(Cardiac Computed Tomographic Angiography: CCTA)의 진단 정확도를 알아보고, IVUS에서 발견된 죽상경화반의 성상을 CCTA에서 전산화단층촬영 수치(Hounsfield Unit: HU)로 구하고자 하였다. 2006년 4월부터 2008년 8월까지 관상동맥질환(Coronary Artery Disease: CAD)으로 확진 되었거나 CAD가 의심스러운 환자들 중 CCTA를 시행하여 죽상경화반을 발견하고 추후 IVUS를 시행한 200명의 환자를 대상으로 하였다. CCTA후 IVUS를 시행한 200명의 환자에서 476개의 죽상경화반이 발견되었으며, CCTA에서는 460개의 죽상경화반이 발견되었다. IVUS의 결과는 soft plaque(n; 84), fibrous plaque(n; 63), mixed plaque(n; 97), calcific plaque(n; 232)이었다. 이 결과에 따라 IVUS에서 분류된 죽상경화반의 HU는 soft plaque : $53.8{\pm}10.5$, fibrous plaque : $108.1{\pm}20.0$, mixed plaque : $371.2{\pm}113.1$, 그리고 calcific plaque : $731.0{\pm}160.4$ 이었으며, CCTA에서 민감도와 신뢰구간은 97%, 95.0-98.3이었다. CCTA를 이용한 관상동맥 죽상경화반의 진단을 위한 이번 연구에서 IVUS와 비교하여 높은 민감도와 신뢰구간을 확인할 수 있었고, IVUS 결과를 기준으로 CCTA에서 분석한 HU를 통해 죽상경화반의 성상을 구분할 수 있어 CAD 환자의 치료에 도움을 줄 수 있을 것으로 기대된다.

• Journal of Yeungnam Medical Science
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• 제21권2호
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• pp.143-150
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• 2004

A thromboembolic stroke is believed to be precipitated by a rupture of vulnerable atheromatous plaques. Until recently the assessment of a further risk of stroke in high-risk patients in whom atherosclerosis has presented with a transient ischaemic attack (TIA), has been confined to a quantitative assessment of the luminal patency of the internal carotid artery. These traditional stratification parameters are no longer believed to be the most accurate predictors of a thrombo-embolism. This is because the process of vessel wall remodeling can maintain a luminal patency, and consequently, quite large friable plaques may remain unidentified. Accordingly, there is a need for an improved risk assessment. The fibrous cap of a vulnerable plaque is thinner, and an intraplaque hemorrhage and inflammation can occur during the development of atherosclerotic plaque. Several imaging methods for identifying vulnerable plaques have been developed. Recently, high resolution magnetic resonance (MR) imaging has emerged as an accurate non-invasive tool that can characterize the carotid plaque components in vivo. A High resolution carotid magnetic resonance is capable of distinguishing an intact, thick fibrous cap from a thin and ruptured cap in carotid plaque. In addition, a plaque MR can identify the active inflammation and detect a hemorrhage. High resolution carotid MR imaging is a valuable noninvasive method for quantifying the plaque components and identifying vulnerable plaque.

• Journal of Chest Surgery
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• 제28권3호
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• pp.324-327
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• 1995

Extracranial carotid artery disease is rare and closely related to cardiovascular morbidity and mortality.We experienced one case of surgical treatment of left common carotid artery stenosis using internal shunt.The patient was 54-year-old female presented as headache and dizziness for about 2 years.On Doppler ultrasound, an atheromatous plaque was noted along the posteromedial wall of left common carotid artery resulting in luminal narrowing in about 75s of cross section area.The atheroma was resected through carotid endarterectomy, measured about 5.2cm in length. Postoperative course was uneventful and she was discharged in good condition.

• Imaging Science in Dentistry
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• 제43권4호
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• pp.235-243
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• 2013

Purpose: This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. Materials and Methods: One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. Results: There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, "With CCAP" and "Without CCAP", there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. Conclusion: This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.

• 한국가시화정보학회지
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• 제15권3호
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• pp.41-46
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• 2017

The apoptosis of macrophages occurs throughout all stages of atherosclerosis. It is known to constitute atheromatous plaque, increase plaque instability, and thus contribute to the development of atherosclerosis. However, there still remains much to be elucidated on how the apoptotic macrophages affect the endothelial cells and also how they contribute to the development of atherosclerosis. Here we present a microfluidic system, which enables co-culture of apoptotic macrophages and endothelial cells in fibrin gel that mimics in vivo extracellular matrix. With the system, we can investigate the effect of macrophage apoptosis on vascular endothelial cells by quantitatively analyzing the level of reactive oxygen species of HUVECs, integrity of VE-cadherin and cell proliferation. We expect that this system could be utilized further for understanding different mechanisms of apoptotic macrophage on the development of atherosclerosis.

• Journal of Chest Surgery
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• 제52권2호
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• pp.112-115
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• 2019

We describe aortic arch endarterectomy performed concomitantly with on-pump cardiac surgery in 2 patients with grade V arch atherosclerosis. In both patients, transesophageal echocardiographic findings led to the diagnosis of severe arch atherosclerosis associated with a mobile atheromatous plaque in the aortic arch. The severe arch atherosclerosis was managed with endarterectomy under deep hypothermic circulatory arrest. In patients with severe grade V atherosclerosis in the aortic arch, performing endarterectomy simultaneously with primary cardiac surgery may be justified as a way to reduce the risk of peripheral embolism, including cerebrovascular accidents, with minimal additional surgical risk.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.508-511
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• 2011

Purpose: Blue toe syndrome consists of blue or purplish toes in the absence of a history of obvious trauma, serious cold exposure, or disorders producing generalized cyanosis. It is a life-threatening and still underrecognized disease. It can be commonly occurred by vascular surgery, invasive cutaneous procedures or anticoagulant therapy. Our case is presented of blue toe syndrome related to atheromatous embolization that was presumably triggered by angio CT. Methods: A 69-year-old man presented with the suddenly developed pain, cyanosis and livedo reticularis of the toes in right foot. Dorsalis pedis pulses were palpable. He had been performed a diagnostic angio CT 1 month earlier. Angio CT revealed diffuse aortic atheromatous plaque in lower abdominal aorta and both common iliac artery. One month after angio CT, he visited our clinic. There was no visible distal first dorsal metatarsal artery and digital artery of right first toe in lower extremity arteriography. A diagnosis was established of blue toe syndrome. Because his symptom was aggravated, we performed the exploration of the right foot. After exposure of first dorsal metatarsal artery, microsurgical atheroembolectomy was done. Results: There were no postoperative complications. After three months the patient had no clinically demonstrable problems. Conclusion: Patient with blue toe syndrome is at high risk of limb loss and mortality despite treatment. Blue toe syndrome produces painful, cyanosed toes with preserved pedal pulses. It needs to be aware of blue toe syndrome. Careful history should reveal the diagnosis. Treatment is controversial, however, most believe that anticoagulation therapy should be avoided.

• 동의생리병리학회지
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• 제16권2호
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• pp.380-388
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• 2002

The inhibitory effects of the traditional herbal medicine Hwao-tang on the progression of the atherosclerotic lesions were studied using the spontaneous familial hypercholesterolemia (FH) model, Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits. Hwao-tang is activate blood circulation, vital energy and regulate menstruation, etc. Nowadays, Hwao-tang is mainly used for the treatment of inflammation, hyperlipemia and arteriosclerosis. However, pharmacological mechanisms of Hwao-tang on lipid metabolism and atherosclerosis formation are poorly understood. We have investigated the pharmacological effects of Hwao-tang on hypercholesterolemia and atherosclerosis using a spontaneous experimental model. In conclusion, the protection of extracts of HOT and its herbs on the ischemic infarction induced artificially might be related to their inhibitory effects on DIC, platelet coagulation and thrombic action. These suggest that Hwao-tang has inhibitory effects on the development of atheromatous plaque formation in spontaneous FH model rabbits. It is possible that the anti oxidative effects of Hwao-tang on LDL led to the beneficial effects observed in this study.

• 대한의생명과학회지
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• 제11권3호
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• pp.383-388
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• 2005

This study reports that the effect of Mori radicis cortex, Mulberry root-bark, on the lipid peroxidation products formation in the liver, blood serum and atherosclerosis of hypercholesterolemia rabbits fed Mulberry root-bark for eight weeks. The rabbits were permitted a fixed quantity to extract of Mulberry root-bark mixed hypercholesterol fodder. The lipid peroxidation products, malondialdehyde (MDA) was significantly diminished. Total cholesterol in serum worthily decreased. Also, triglyceride and high density lipoproteins (HDLs) increased after feeding Mori radicis cortex. Besides, thicky atheromatous plaque on the wall of aorta of rabbits fed on hypercholesterol diet were markedly attenuated by Mulberry root-bark extract. These results support and substantiate the extract of Mulberry root-bark as protection against lipid peroxidation in the liver, blood serum and atherosclerosis.

• Molecules and Cells
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• 제38권10호
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• pp.851-858
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• 2015

Disturbed blood flow with low-oscillatory shear stress (OSS) is a predominant atherogenic factor leading to dysfunctional endothelial cells (ECs). Recently, it was found that disturbed flow can directly induce endoplasmic reticulum (ER) stress in ECs, thereby playing a critical role in the development and progression of atherosclerosis. Ursodeoxycholic acid (UDCA), a naturally occurring bile acid, has long been used to treat chronic cholestatic liver disease and is known to alleviate endoplasmic reticulum (ER) stress at the cellular level. However, its role in atherosclerosis remains unexplored. In this study, we demonstrated the anti-atherogenic activity of UDCA via inhibition of disturbed flow-induced ER stress in atherosclerosis. UDCA effectively reduced ER stress, resulting in a reduction in expression of X-box binding protein-1 (XBP-1) and CEBP-homologous protein (CHOP) in ECs. UDCA also inhibits the disturbed flow-induced inflammatory responses such as increases in adhesion molecules, monocyte adhesion to ECs, and apoptosis of ECs. In a mouse model of disturbed flow-induced atherosclerosis, UDCA inhibits atheromatous plaque formation through the alleviation of ER stress and a decrease in adhesion molecules. Taken together, our results revealed that UDCA exerts anti-atherogenic activity in disturbed flow-induced atherosclerosis by inhibiting ER stress and the inflammatory response. This study suggests that UDCA may be a therapeutic agent for prevention or treatment of atherosclerosis.