• Title/Summary/Keyword: Atherosclerotic disease

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A CT study of the prevalence of carotid artery calcification in dental patients (치과환자에서 경동맥 석회화 유발율에 대한 전산화단층사진 연구)

  • Yoon Suk-Ja;Lee Jae-Seo;Yoon Woong
    • Imaging Science in Dentistry
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    • v.36 no.3
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    • pp.151-155
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    • 2006
  • Purpose : Stroke is one of the leading causes of death in Korea. Atherosclerotic disease in the carotid artery bifurcation is the most common cause of stroke. The carotid artery calcification is easily appreciated by CT (Computed tomography). CT is often taken in a dental hospital for the diagnosis of inflammation, injury, cyst or tumor on maxillofacial region. However, there was no report of carotid artery calcification on CT in dental patients. This study was to determine the prevalence of carotid artery calcification on CT in dental patients. Materials and Methods : The presence of carotid artery calcification was evaluated by an experienced radiologist on CT scans of 287 patients (166 males, 121 females, average age 42, range 6 to 86 years) and the medical history of the patient and the interpretation of CT were reviewed. Results : Carotid artery calcification was detected on CT scans of 57 patients (19.8%; 35 males, 22 females). All the male patients with carotid artery calcification were older than 50, and all the female patients with carotid artery calcification were older than 60. Among the 57 patients, 10 had Diabetes mellitus, 20 had cardiovascular disease, 3 had history of stroke and 3 underwent radiation therapy for head and neck cancer. Carotid artery calcification was not included in the interpretation of CT of dental patients except one patient. Conclusion : The prevalence of carotid artery calcification on CT of dental patients was about 20% in this study. Carotid artery calcification should be included in the interpretation of CT of dental patients.

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The Effect of Endogenous and Exogenous Estrogen on Risk Factors of Coronary Heart Disease -Part II : On Platelet Aggregation- (내인성 및 외인성 Estogen이 관상동맥질환 위험인자에 미치는 영향 -제2보: 내인성 및 외인성 Estrogen이 혈소판 응집에 미치는 영향-)

  • 박유신
    • Journal of Nutrition and Health
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    • v.32 no.5
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    • pp.561-569
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    • 1999
  • In the atherosclerotic subjects, arterial endothelial cell injury and plaque formation are suspected to be strong causable factors in developing acute coronary syndrome, and it was revealed that platelets have a very important role in this case. Women are exposed to atherosclerosis at a different degree after menopause or oral contraception. The purpose of this study was to determine the effects of endogenous and exogenous estrogen on the degree of platelet aggregation in platelet rich plasma(PRP) in twenty nonsmoking healthy Korean women for 12 weeks. The subjects were assigned to three groups: (1) eight women aged 49 to 60(yr) for the postmenopausel(Pst) group, (2) eight, aged 22 to 30(yr) for the premenopausa(Pre) group, (3) four, aged 23 to 30(yr) for the oral contraceptive (OC) group which used triphasic OC formulation. Fasting blood sample were obtained from the subjects, (1) once per 6 weeks in the Pst group, (2) every phase of the menstrual cycle in the Pre group, (3) each once during and after OC administration in the OC group. ADP, collagen and epinephrine were used as aggregating reagents, and platelet aggregation and time(Δt: time reaching to the maximum point of aggregation) in PRP were measured at the maximum point of aggregation in five minutes. All the data were adjusted for dietary effects, personality type and body mass index(BMI) by using analysis of covariation(ANCOVA). Platelet aggregation to ADP and collagen(MADP and MCOLL) were not significantly different among the three groups, and Δt to ADP and collagen(TADP and TCOLL) were not either. But maximum platelet aggregability and Δt to epinephrine(MEPIN and TEPIN) were significantly different among the three groups, and the OC group showed the lowest value (p<0.01). Maxtimum platelet aggregability and Δt during the menstrual cycle were not significantly different in the Pre group. Any other significant differences in the maximum platelet aggregability and Δt were found between oral contraception phase and washing out phase(menstruation) in the OC group. In results, maximum platelet aggregability and aggregation time to ADP and collagen seemed not to be affected by endogenous and exogenous estrogen, even though MEPIN and TEPIN showed significantly low in the OC group among the three groups.

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Coronary CT Angiography with Knowledge-Based Iterative Model Reconstruction for Assessing Coronary Arteries and Non-Calcified Predominant Plaques

  • Tao Li;Tian Tang;Li Yang;Xinghua Zhang;Xueping Li;Chuncai Luo
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.729-738
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    • 2019
  • Objective: To assess the effects of iterative model reconstruction (IMR) on image quality for demonstrating non-calcific high-risk plaque characteristics of coronary arteries. Materials and Methods: This study included 66 patients (53 men and 13 women; aged 39-76 years; mean age, 55 ± 13 years) having single-vessel disease with predominantly non-calcified plaques evaluated using prospective electrocardiogram-gated 256-slice CT angiography. Paired image sets were created using two types of reconstruction: hybrid iterative reconstruction (HIR) and IMR. Plaque characteristics were compared using the two algorithms. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the images and the CNR between the plaque and adjacent adipose tissue were also compared between the two reformatted methods. Results: Seventy-seven predominantly non-calcified plaques were detected. Forty plaques showed napkin-ring sign with the IMR reformatted method, while nineteen plaques demonstrated napkin-ring sign with HIR. There was no statistically significant difference in the presentation of positive remodeling, low attenuation plaque, and spotty calcification between the HIR and IMR reconstructed methods (all p > 0.5); however, there was a statistically significant difference in the ability to discern the napkin-ring sign between the two algorithms (χ2 = 12.12, p < 0.001). The image noise of IMR was lower than that of HIR (10 ± 2 HU versus 12 ± 2 HU; p < 0.01), and the SNR and CNR of the images and the CNR between plaques and surrounding adipose tissues on IMR were better than those on HIR (p < 0.01). Conclusion: IMR can significantly improve image quality compared with HIR for the demonstration of coronary artery and atherosclerotic plaques using a 256-slice CT.

Assessment of Coronary Stenosis Using Coronary CT Angiography in Patients with High Calcium Scores: Current Limitations and Future Perspectives (높은 칼슘 점수를 가진 환자에서 관상동맥 CT 조영술을 이용한 협착 평가의 한계와 전망)

  • Doo Kyoung Kang
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.270-296
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    • 2024
  • Coronary CT angiography (CCTA) is recognized for its role as a gatekeeper for invasive coronary angiography in patients suspected of coronary artery disease because it can detect significant coronary stenosis with high accuracy. However, heavy plaque in the coronary artery makes it difficult to visualize the lumen, which can lead to errors in the interpretation of the CCTA results. This is primarily due to the limited spatial resolution of CT scanners, resulting in blooming artifacts caused by calcium. However, coronary stenosis with high calcium scores often requires evaluation using CCTA. Technological methods to overcome these limitations include the introduction of high-resolution CT scanners, the development of reconstruction techniques, and the subtraction technique. Methods to improve reading ability, such as the setting of appropriate window width and height, and evaluation of the position of calcified plaque and residual visibility of the lumen in cross-sectional images, are also recommended.

A Comparison of Lovastatin and Simvastatin in Treatment of Hyperlipidemia (Lovastatin과 Simvastatin의 고지혈증 치료 비교)

  • Cho, Jeong Ju;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.1
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    • pp.39-50
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    • 2002
  • Hypercholesterolemia is one of main causes of coronary heart disease(CHD). Clinical trials demonstrated that lowering serum cholesterol levels would reduce incidence of new cardiovascular events and mortality by primary or secondary preventions. The objective of this retrospective study was to compare efficacy and side effects of lovartatin and simvastatin in treatement of hypercholesterolemia. In Boramae Hospital, patients were included when they have taken lovastatin 20 mg or simvastatin 10 mg for 52 weeks with laboratory monitoring for cholesterol at baseline, 3, 6 and 12 month period. As results, total 128 outpatients were included with their total cholesterol level <240 mg/dl and triglyceride level <400 mg/dl at baseline. Total cholesterol and LDL cholesterol of lovastatin group (n=60) and simvastatin group (n=68) were significantly reduced from baseline (p=0.001). Lovastatin maximally reduced total cholesterol by $23.9\%,\;triglyceride\;by\;12.3\%$, LDL cholesterol by $36.1\;\%$ and increased HDL cholerterol by $7.8\%$ and simvastatin reduced by $24.1\%,\;20.5\%,\;34.3\%\;respectively$ and HDL increased by $11.2\%$. There were no significant differences between lovastatin and simvastatin in mean percent change of lipid levels at 12, 24 and 52 weeks from baseline. Cumulative percentage of patients reaching the target LDL cholesterol concentration by 24 weeks was $61.7\%$ in lovastatin and $64.7\%$ in simvastatin. Average time to reach the target LDL goal was 100.1 days in lovastatin and 99.8 days in simvastatin. Both lovastatin and simvastatin also significantly reduced total cholesterol and LDL cholesterol in all subgroups (diabetes mellitus, hypertension, and coronary heart disease). In this study, treatment efficacy in patients with coronary heart disease was lower than other patients. Considering clinical importance of secondary prevention, more intensive treatment is necessary to decrease LDL cholesterol level of 100 mg/dl or lower in patients with coronary heart disease or other clinical atherosclerotic disease. There were no serious side effects during the study period. Digestive side effects were most frequently reported (lovastatin $8.3\%\;vs\;simvastatin\;8.8\%$). In conclusion, both lovastatin and simvastatin were similar in lipid lowering effects and there was no difference in incidence of side effects.

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Effects of the Prunus persica Batsch var. davidiana Max. Extract on the Lipid Compositions and Enzyme Activities in Hyperlipidemic Rats (돌복숭아(Prunus persica Batsch var. davidiana Max.) 추출액이 고지혈증 흰쥐의 생체 내 지질성분 및 효소활성에 미치는 영향)

  • Kim Han-Soo
    • The Korean Journal of Food And Nutrition
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    • v.17 no.3
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    • pp.328-336
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    • 2004
  • The purpose of this study was designed to observe the effects of the feeding Prunus persica Batsch var. davidiana Max. extract on the concentrations of the lipids and blood glucose in the S.D. rats fed the experimental diets for 5 weeks. Concentrations of total cholesterol, atherosclerotic index, LDL, LDL-cholesterol, free-cholesterol, cholesteryl ester, triglyceride(TG), phospholipid(PL) and blood glucose in serum were significantly higher in the cholesterol administration groups (groups BCG (cholesterol+water), BCPG (cholesterol+ Prunus persica 5.0 g% extract) than those in the control group (group BG, basal diet+water). But the concentrations of total cholesterol, atherosclerotic index, LDL, LDL-cholesterol, free-cholesterol, cholesteryl ester, TG, PL and blood glucose in serum were remarkably lower in the group BCPG than those in the group BCG. In the ratio of HDL-cholesterol concentration to total cholesterol and HDL-cholesterol concentration, Prunus persica 5.0 g% extract administration group was higher percentage than in the group BCG. The activities of aspartate aminotransferase (AST), alanine aminotransferase(ALT), lactate dehydrogenase(LDH) and alkaline phosphatase (ALP) in serum were rather lower in the Prunus persica 5.0 g% extract administration group(group BCPG) than in the cholesterol diet group(group BCG). From the above research, Prunus persica Batsch var. davidiana Max. were effective on the improvement of the blood glucose, lipid compositions in serum of dietary hyperlipidemic rats. And particularly, Prunus persica Batsch var. davidiana Max. was more effective therapeutic regimen for the control of metabolic derangements in adult disease.

Effects of the Prunus persica Batsch var. davidiana Max. Extract on the Blood Glucose and Serum Lipid Components in Streptozotocin-Induced Diabetic Rats (돌복숭아(Prunus persica Batsch var. davidiana Max.) 추출액이 Streptozotocin 유발 당뇨성 흰쥐의 혈당 및 지질 성분에 미치는 영향)

  • Kim Han-Soo
    • The Korean Journal of Food And Nutrition
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    • v.17 no.3
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    • pp.337-345
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    • 2004
  • The purpose of this study was designed to observe the effects of the feeding Prunus persica Batsch var. davidiana Max. extract on the improvement of the blood glucose, lipid compositions in the serum of streptozotocin(STZ)-induced diabetic rats fed the experimental diets for 5 weeks. Concentrations of blood glucose, total cholesterol, atherosclerotic index, LDL, LDL-cholesterol, free-cholesterol, cholesteryl ester, triglyceride(TG) and phospholipid (PL) in serum were significantly higher in the STZ (55 mg/kg B.W.)-induced diabetic group (group 2) and STZ(I.P.)+Prunus persica 5.0 g% extract group(group 3) than those in the control group (group 1, basal diet + water). But the concentrations of blood glucose, total cholesterol, atherosclerotic index, LDL, LDL-cholesterol, free-cholesterol, cholesteryl ester, TG and PL in serum were remakably lower in the group 3 than those in the group 2. In the ratio of HDL-cholesterol concentration to total cholesterol and HDL-cholesterol concentration, Prunus persica 5.0 g% extract administration group(group 3) were higher percentage than in the group 2. The activities of aspartate aminotransferase(AST), alanine aminotransferase(ALT), lactate dehydrogenase (LDH) and alkaline phosphatase(ALP) in serum were rather lower in the Prunus persica 5.0 g% extract administration group(group 3) than in the STZ- induced diabetic group (group 2). From the above results, it was suggested that the Prunus persica Batsch var. davidiana Max. were effective on the improvement of the blood glucose, lipid compositions in serum of STZ-induced diabetic rats. Moreover, in Prunus persica Batsch var. davidiana Max. was effective therapeutic regimen for the control of metabolic derangements in adult disease.

Effects of the Zizyphus jujuba Seed Extract on the Blood Glucose and Serum Lipid Components in Streptozotocin-Induced Diabetic Rats (대추씨(Zizyphus jujuba Seed) 추출액이 Streptozotocin 유발 당뇨성 흰쥐의 혈당 및 지질성분에 미치는 영향)

  • 김한수
    • Journal of Life Science
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    • v.12 no.1
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    • pp.1-7
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    • 2002
  • The purpose of this study was designed to observe the effects of the feeding Zizyphus jujuba seed extract on the improvement of the blood glucose, lipids in the serum of streptozotocin (STZ)-induced diabetic rats fed the experimental diets for 4 weeks. Concentrations of blood glucose, total cholesterol, atherosclerotic index, LDL, LDL-cholesterol, free-cholesterol, cholesteryl ester, triglyceride (TG) and phospholipid (PL) in serum were significantly higher in the STZ (55mg/kg B.W.)-induced diabetic group (group 2) and STZ (I.P.)+ Zizyphus jujuba seed extract group (group 3) than those in the control group (group 1, basal diet + water). But the concentrations of blood glucose, total cholesterol, atherosclerotic index, LDL, LDL-cholesterol, free-cholesterol, cholesteryl ester, TG and PL in serum were remakably lower in the group 3 than those in the group 2. In the ratio of HDL-cholesterol concentration to total cholesterol and HDL-cholesterol concentration, Zizyphus jujuba seed extract administration group (group 3) were higher percentage than in the group 2. The activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) in serum were rather lower in the Zizyphus jujuba seed extract administration group (group 3) than in the STZ- induced diabetic group (group 2). From the above results, it was suggested that the Zizyphus jujuba seed were effective on the improvement of the blood glucose, lipid compositions in serum of STZ-induced diabetic rats. Moreover, in Zizyphus jujuba seed was effective therapeutic regimen for the control of metabolic derangements in adult disease.

Prognostic Value of Coronary CT Angiography for Predicting Poor Cardiac Outcome in Stroke Patients without Known Cardiac Disease or Chest Pain: The Assessment of Coronary Artery Disease in Stroke Patients Study

  • Sung Hyun Yoon;Eunhee Kim;Yongho Jeon;Sang Yoon Yi;Hee-Joon Bae;Ik-Kyung Jang;Joo Myung Lee;Seung Min Yoo;Charles S. White;Eun Ju Chun
    • Korean Journal of Radiology
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    • v.21 no.9
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    • pp.1055-1064
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    • 2020
  • Objective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison to a clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemic stroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac disease and underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) were assessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed: low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognostic value of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%, respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS, and stenosis degree were positively associated with MACE (all p < 0.05). Patients with high-risk plaque type showed the highest incidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p < 0.001). Among the prediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared to FRS or the FRS + CACS model (all p < 0.05). Furthermore, incorporating plaque type in the prediction model significantly improved reclassification (integrated discrimination improvement, 0.08; p = 0.023) and showed the highest discrimination index (C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p > 0.05). Conclusion: Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS and FRS to risk stratify stroke patients without prior history of CAD better.

Visualization of Borderline Coronary Artery Lesions by CT Angiography and Coronary Artery Disease Reporting and Data System (관상동맥 질환 판독과 자료 체계와 CT 혈관조영술에서의 경계성 관상동맥 병변)

  • Hyewon Park;Yu-Whan Oh;Ki Yeol Lee;Hwan Seok Yong;Cherry Kim;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.297-307
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    • 2024
  • Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.