• Title/Summary/Keyword: Coronary artery atherosclerosis

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Synergistic Efficacy of Concurrent Treatment with Cilostazol and Probucol on the Suppression of Reactive Oxygen Species and Inflammatory Markers in Cultured Human Coronary Artery Endothelial Cells

  • Park, So-Youn;Lee, Jeong-Hyun;Shin, Hwa-Kyoung;Kim, Chi-Dae;Lee, Won-Suk;Rhim, Byung-Yong;Shin, Yung-Woo;Hong, Ki-Whan
    • The Korean Journal of Physiology and Pharmacology
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    • v.12 no.4
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    • pp.165-170
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    • 2008
  • In the present study, we aimed to identify the synergistic effects of concurrent treatment of low concentrations of cilostazol and probucol to inhibit the oxidative stress with suppression of inflammatory markers in the cultured human coronary artery endothelial cells (HCAECs). Combination of cilostazol (0.3${\sim}3{\mu}$M) with probucol (0.03${\sim}0.3{\mu}$M) significantly suppressed TNF-${\alpha}$-stimulated NAD(P)H-dependent superoxide, lipopolysaccharide (LPS)-induced intracellular reactive oxygen species (ROS) production and TNF-${\alpha}$ release in comparison with probucol or cilostazol alone. The combination of cilostazol (0.3${\sim}3{\mu}$M) with probucol (0.1${\sim}0.3{\mu}$M) inhibited the expression of vascular cell adhesion molecule-1 (VCAM-1) and monocyte chemoattractant protein-1 (MCP-1) more significantly than did the monotherapy with either probucol or cilostazol. In line with these results, combination therapy significantly suppressed monocyte adhesion to endothelial cells. Taken together, it is suggested that the synergistic effectiveness of the combination therapy with cilostazol and probucol may provide a beneficial therapeutic window in preventing atherosclerosis and protecting from cerebral ischemic injury.

Segmentation of Intima/Adventitia of IVUS Image using Fuzzy Binarization (퍼지 이진화를 이용한 IVUS 영상의 내막/외막 분할)

  • Kim, Kwang Baek
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.23 no.12
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    • pp.1514-1519
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    • 2019
  • IVUS is an intra-operative imaging modality that facilitates observing and appraising the vessel wall structure of the human coronary arteries. IVUS is regularly used to locate the atherosclerosis lesions in the coronary arteries. Auto-segmentation of the vessel structure is important to detect the disorder of coronary artery. In this paper, we propose a simple strategy to extract Intima/Adventitia area effectively using fuzzy binarization from intravascular images. The proposed method apply fuzzy binarization to find the adventitia but apply average binarization to locate the intima since they have different homogeneity of pixel intensity comparing with the environment. In this paper, we demonstrate an effective auto-segmentation method for detecting the interior/exterior of the vessel walls by differentiating the fuzzy binarization result and average binarization result from IVUS image. Important statistics such as Intima-Media Thickness (IMT) or volume of a target area can be easily computed from result.

The Clinical Value of Intima-media Thickness in Patients with Stable Coronary Artery Disease and C-reactive Protein within Normal Limits (경동맥 내중막 두께가 정상 C-반응성 단백질 농도를 가진 안정형 협심증 환자에서 가지는 임상적 의의)

  • Kwon, Jong-Bum;Park, Kuhn;Choi, Si-Young;Park, Chan-Beom;Kim, Yong-Hwan;Her, Sung-Ho;Park, Mahn-Won;Lee, Jong-Ho
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.482-489
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    • 2010
  • Background: The purpose of this study was to determine whether hand-measured carotid intima-media thickness (IMT) was a reliable and simple tool that could be used to evaluate the severity of stable coronary artery disease (CAD) with normal high-sensitivity C-reactive protein (CRP). Material and Method: We examined left carotid IMTs in 688 patients with stable CAD and excluded 121 patients with abnormally elevated hs-CRP ($\geq$0.5 mg/dL). We sought to determine the association between risk factors and the severity of stable CAD and carotid IMT in 567 patients who were divided into lower and higher groups based on the median value. Patients underwent a coronary artery angiogram and had at least significant stenosis (>50% of the original luminal diameter involving one or more major coronary artery). Result: Of the 567 patients, 300 (52.9%) were in the lower IMT group and 267 (47.1%) were in the higher IMT group; the median value was 0.76 mm. By multivariable logistic regression analysis, the following groups were different: older age (~49 vs. 70~ years, respectively; OR=6.552), high FBS (~99 vs. 120~ mg/dL; OR=1.713) and severity of CAD (1 vessel vs. 2 vessel disease; OR=1.711, 1 vessel vs. 3 vessel disease; OR=1.714). Conclusion: We conclude that there are correlations between increased carotid IMT and severity of CAD in stable angina patients with normal CRP levels.

The Comparative Study between the Transformations(傳變症) of Sogal(消渴) and the Complications of Diabetes Mellitus (소갈(消渴)의 전변증(傳變症)과 당뇨병(糖尿病)의 만성합병증(慢性合倂症)에 대한 비교고찰(比較考察))

  • Kang, Seok-Bong
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.137-152
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    • 1998
  • Acute complications of diabetes mellitus were diminished after Banting and Best discovered insulin. But chronic complications of diabetes mellitus have been increased. The main complications of diabetes mellitus are diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic foot lesion and macrovascular complication. These complications can result in renal failure, loss of sight, cerebral infarction and myocardial infarction. So it is very difficult to treat the complications of diabetes mellitus. In oriental medicine, the transformations(傳變症) of Sogal(消渴) are edema, carbuncle, loss of sight and so on. The comparative study between the trcmsformations(傳變症) of SogaI(消渴) and the complications of diabetes mellitus has come to the following conclusions. 1. In oriental medicine, diabetic retinopathy was expessed as loss of sight and the treament of diabetic retinopathy should be started at an early stage, to prevent vitreous hemorrhage and traction retinal detachment. 2. In oriental medicine. diabetic nephropathy was expressed as edema and the treatment should be started at an early stage of renal injury when the protein comes from urine.3. Symmetrical distal polyneuropathy is the main part of diabetic neuropathy and it was expressed as weakness of the lower limbs and pain of joints in the symptoms of Haso(下消). In Oriental medicine, acupuncture and herb medicine which effect is SopungHwalHyul can treat polyneuropathy. 4. Chief macrovascular complications are coronary artery disease and cerebrovascular disease, The cause of macrovascular complication is atherosclerosis. So the method of treating atherosclerosis should be studied in oriental medicine. 5. Diabetic foot were expressed as carbuncle and its main causes are decreasing perfusion of fool, diabetic neuropathy and infection. So these causes should be studied in oriental medicine. 6. The complications of diabetes mellitus afe very similar to the transfonnatiuns of Sogal(消渴).The control of blood glucose is indispensable to prevent and delay the complication of diabetes mellitus.

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Homocysteine and Total Antioxidant Status in Acute Myocardial Infarction Patients Among Tamil Population

  • Angeline, T.;Aruna, Rita Mary;Devi, K. Rama;Jeyaraj, Nirmala
    • Animal cells and systems
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    • v.11 no.2
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    • pp.161-164
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    • 2007
  • Oxidative stress is prerequisite for the development of atherosclerosis. Apart from the traditional risk factors that contribute to this devastating condition, in the past few decades, much attention has been focused on plasma total homocysteine mainly because of its strong association with coronary artery disease. It has been suggested that homocysteine induces oxidative stress and hence the present work was undertaken to assess the total homocysteine status and plasma total antioxidant capacity in the acute myocardial infarction (AMI) patients among Tamil population. The study subjects included only the Tamil population. Blood samples were collected from 100 AMI patients and 100 controls. Plasma was separated and the total antioxidant status was assessed as a measure of ferric reducing power of antioxidants using spectrophotometric method. Plasma total homocysteine concentrations were assessed by automated chemiluminescence method. While Total antioxidant status was significantly decreased, the plasma homocysteine concentrations were elevated in AMI patients compared to the controls. However, there was no correlation between the homocysteine levels and total antioxidant status. The findings of this study may have therapeutic implications, including food sources rich in antioxidants for all AMI patients to minimize the effect of free radicals formed during oxidative stress among Tamil population.

Some Factors Affecting Lipid Metabolism (지질대사(脂質代謝)에 관여하는 인자(因子))

  • Nam, Hyun-Keun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.15 no.2
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    • pp.191-200
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    • 1986
  • It is now generally accepted that individuals at increased risk for cardiovascular disease may be identified by certain traits or habbits. The factors such as high blood pressure, elevated blood cholestrol, age, sex and obesity are associated with increseaed frequency of disease. The blood cholesterol level lowering will decrease cardiovascular disease risk. The regression of atherosclerosis can be achieved by lowering the level of circulating cholesterol. Those things are connected with the quantity and quality of protein, fats, carbohydrates, especially soluble and non-soluble fiber, magnesium and calcium. The lipoprotein and lipid metabolism are connected with the lipid transport. The factors on lipid absorption and blood serum lipid pattern of human are exist. The factors have a variety of materials with different chemical and physical properties. The soluble fiber diet make a low blood and liver lipids. Many kind of soluble fiber results in a lowering of blood cholesterol and triglyceride levels. The cholesterol lowering effects of dietery fiber may be a results of alterations of in intestinal handling of fats, hepatic metabolism of fatty acid or triglyceride acid metabolism of lipoprotein. It is investigated that the high density lipoprotein (HDL) is inversely related to coronary artery disease. It has been postulated that HDL may be an important factor in cholesterol efflux from the tissues, therby reducing the amount of cholesterol deposited there. Alternatively, the HDL may pick up cholestyl ester and phospholipid during normal VLDL lipolysis in the plasma. The HDL levels are relatively insensitive to diet. At present time, the cause-and -diet effect of HDL's inverse relation to CHD remains unclear.

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Effects of Dietary Intervention and Simvastatin on Plasma Nitric Oxide in Patients with Hyperlipidemia

  • Yim, Jungeun;Choue, Ryowon;Park, Changshin;Cha, Youngnam;Chyun, Jonghee
    • Nutritional Sciences
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    • v.7 no.4
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    • pp.214-217
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    • 2004
  • Dietary intervention and simvastatin is beneficial in the prevention cardiovascular diseases by lowering plasma lipid levels. Endothelial dysfunction is associated with coronary artery disease and its risk factors and is reversed by dietary intervention. It has been suggested that hyperlipidemia contributes to the development of atherosclerosis by increasing inducible nitric oxide synthase (iNOS) expression via intimal thickening. Statins treatment has been found to decrease iNOS expression and atherogenensis in animal models. We hypothesized that dietary intervention and simvastatin therapy could decrease plasma nitric oxide in hypercholesterolemic patients, which would suggest the opportunity for modulation of iNOS expression through the use of statins in a clinical situation. We measured the plasma levels of nitrite and nitrate (NOx) in 19 hyperlipidemia patients. The subjects were under dietary intervention following simvastatin therapy for 12 weeks. As a result, the plasma level of NOx, stable metabolites of nitric oxide (NO), saw a two-fold elevation in hyperlipidemic patients as compared to normal levels. Although 12 weeks of dietary intervention did not lower NOx levels, subsequent 12-week simvastatin (10 mg/day) treatment, along with dietary intervention, lowered NOx levels significantly. This NOx reduction, induced by simvastatin therapy, positively correlated with lowered coronary risk factors (r=0.40, p=0.02). It indicated that simvastatin therapy decreases plasma NOx levels by, perhaps, decreasing iNOS expression or activity leading to the attenuation of the development of neointima.

A Study on the Relationship between Carotid Artery Intima-Media Thickness and Clinical Chemistry Tests (경동맥 초음파 결과와 임상화학 검사의 상관성 연구)

  • Kim, Dae-Sik;Sung, Hyun-Ho;Cho, Eun-kyung;Lee, Jong-Woo
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.188-193
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    • 2015
  • Carotid Intima-Media Thickness (CIMT) testing is a test that precisely assesses cerebrovascular and coronary heart diseases. According to many previous studies, CIMT predicts atherosclerosis and is highly correlated to cardiovascular disease risk factors. It has also been reported that CIMT is an independent predictor of risk factors for myocardial infarction and stroke. Therefore, the purpose of this study is to investigate CIMT and other independent factors through a correlation study with the clinical laboratory test results of a blood test. As a result, this study could not prove the correlation between CIMT and risk factors of cardiovascular disease (TC, TG, LDL cholesterol, and HDL cholesterol) due to an insufficient number of subjects. Nevertheless, a positive correlation was demonstrated between CIMT and ALT (p<0.05), GGT (p<0.05), Uric acid (p<0.05), and CEA (p<0.05) at a statistically significant level, suggesting a continuation of the study.

Risk Factors of Neurologic Complications After Coronary Artery Bypass Grafting (관상동맥 우회수술후 신경계 합병증의 위험인자)

  • Park, Kay-Hyun;Chae, Hurn;Park, Choong-Kyu;Jun, Tae-Gook;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.790-798
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    • 1999
  • Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

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Measurements of Carotid Intima, Media, and Intima-media Thickness and Their Clinical Importance (경동맥의 내막, 중막, 내중막 두께 분리측정 및 임상적 중요성)

  • Kim Wuon-Shik;Jeong Hwan-Taek;No Ki-Yong;Bae Jang-Ho
    • Progress in Medical Physics
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    • v.16 no.4
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    • pp.207-213
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    • 2005
  • The severity of carotid Intima-media thickness (IMT) is an Independent predictor of atherosclerosis which causes transient cerebral ischemia, stroke, and coronary events such as myocardial Infarction. The IMT consists of Intima thickness (IT) and media thickness (MT). However, the Individual clinical significance of IT and MT has not been well studied. We devised a method of measuring IT, MT, and IMT using B-mode ultrasound Image processing technique for the diagnosis of atherosclerosis. To inspect the clinical significance of IT, MT, and IMT, one hundred forty-four consecutive patients (mean age; 57 years old, 72 males) were underwent common carotid artery scanning using high-resolution ultrasound. Results showed that, the IT (p<0.05), MT (p<0.05) as well as IMT (p<0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hyperiension showed significantly thicker IT (p<0.01), MT (p<0.001), and IMT (p<0.001). However, only IT was thicker in patients with smoking (p<0.01). The IT (r=0.374, p=0.001), MT (r=0.433, p=0.000), and IMT (r=0.479, p=0.000) showed positive correlation with age. The coefficients of determination ($r^2$) were estimated to be $92.4\%$ for IMT and MT, $49.1\%$ for IMT and IT, and $27.4\%$ for IT and MT. This result suggests that the Intima layer of the carotid artery has a different physiology with the media layer.

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