• Journal of Yeungnam Medical Science
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• 제18권2호
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• pp.215-225
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• 2001

동맥경화증의 생성 및 진행과정의 병태생리에 있어서 염증이 중요한 기전으로 여겨지고 있으며, 혈중에 이러한 염증반응을 나타내는 표식자들 중의 하나인 혈중 C-reactive protein(CRP) 농도가 동맥경화증의 중증도와 관계 있으며 심혈관사고와도 밀접한 연관이 있는 것으로 알려지고 있다. 본 연구는 협심증 환자에서 관동맥중재술에 의한 혈중 CRP의 변화가 단기간 임상경과에 미치는 영향을 알아보기 위해 시행하였다. 1999년 12월부터 2000년 1월까지 협심증으로 영남대학교 의과대학 부속병원 순환기내과에 입원하여 관상동맥확장술을 시행받은 36명의 환자를 대상으로 하였다. 환자는 내원직후 임상적 병력을 청취하였고 혈중 troponin-T, CRP를 측정하였다. 관동맥확장술 12시간，24시간，48시간 그리고 72시간 후에 혈중 CRP를 측정하였으며, 24시간 후에 혈중 troponin-T를 측정 하였다. 퇴원 6개월 후에 외래에서 환자의 임상증상 유무를 측정하였다. 1) 단일혈관질환이 $0.33{\pm}0.20$ mg/dL, 2혈관질환이 $0.36{\pm}0.14$ mg/dL, 그리고 3혈관질환이 $0.56{\pm}0.38$ mg/dL로 병변 혈관수가 증가할수록 CRP가 유의하게 증가하였다(p<0.05). 2) 내원시 안정형 협심증 환자의 CRP가 $0.30{\pm}0.01$ mg/dL, 불안정형 협심증 환자가 $0.46{\pm}0.28$ mg/dL로 불안정형 협심증 환자에서 유의하게 높았다(p<0.05). 3) 시술전 CRP는 $0.38{\pm}0.20$ mg/dL 였으며 시술 후 12시간 $0.56{\pm}0.36$ mg/dL(p<0.05), 24시간 $0.91{\pm}0.66$ mg/dL(p<0.01), 48시간 $0.87{\pm}0.62$ mg/dL(p<0.01), 72시간 $0.63{\pm}0.41$ mg/dL(p<0.01)로 시술전에 비해 시술후 증가하는 양상을 보였으며, 특히 시술 24시간 후에 가장 많이 증가하였다. 이러한 변환의 양상은 안정형 협심증 보다 불안정형 협심증에서 증가량이 많고 상승기간이 오래 유지되었으며, 시술 후 24시간에 절대적인 증가량은 안정형 협심증이 $0.32{\pm}0.31$ mg/dL, 불안정형 협심증이 $0.79{\pm}0.73$ mg/dL로 불안정형 협심증에서 유의하게 높았다(p<0.05). 4) 시술 후 troponin-T의 변화량과 CRP의 변화량에는 상관관계가 없었다(r=0.135. p=0.04). 5) 초기 CRP가 0.6미만인 군 32명 중 4명(13%)에서 재협착을 보였으며, 0.06이상인 군 4명 중 2명에서 재협착을 보였다(50%, p<0.05). 시술후 24시간 CRP가 1.0미만인 군 25명 중 3명(12%)에서 재협착을 보였으며, 1.0이상인 군 11명 중 3명(27%)에서 재협착을 보였다(p=0.257). 안정형 협심증 환자에서는 초기 CRP가 0.6이상인 환자가 없어 통계적인 분석을 하지 못하였고, 불안정형 협심증 환자에서 초기 CRP가 0.6미만인 군 13예 중 1예(8%)에서 재협착을 보였고 0.6이상인 환자 4명 중 2명(50%) 에서 재협착을 보였다(p<0.05). 이상의 결과로 불안정형 협심증 환자에서 안정형 협심증보다 증가된 염증반응을 보이며, 초기에 증가된 염증반응은 관동맥확장술 후 재협착에 영향을 미치는 것으로 사료된다.

• 한국임상약학회지
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• 제22권2호
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• pp.113-122
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• 2012

ACC/AHA/SCAI Guideline recommends for administration dual antiplatelet therapy after drug-eluting stent (DES) to prevent restenosis and stent thrombosis in patients with percutaneous coronary intervention (PCI). Recently triple antiplatelet therapy including cilostazol is known to reduce restenosis and stent thrombosis significantly after DES implantation. However, there is lack of data providing the efficacy of triple antiplatelet therapy. The purpose of this study is to evaluate the clinical effects of the triple therapy after DES implantation compared with the dual therapy. This retrospective study collected data from medical charts of 251 patients who received DES implantation between Jul 2006 and Jun 2008. They received either dual antiplatelet therapy (N = 154 clopidogrel and aspirin; Dual group) or triple antiplatelet therapy (N = 97 cliostazol, clopidogrel and aspirin; Triple group). Major adverse cardiac event rates (MACE, included total death, myocardial infarction, target lesion revascularization) at 12 months, 24 months, stent thrombosis, rates of bleeding complications and adverse drug reactions were compared between these two groups. Compared with the dual group, the triple group had a similar incidence of the MACE rates at 24months (12.3% vs. 12.4%, p = 0.99). There is no difference in overall stent thrombosis between two groups (Dual group 2.6% vs. Triple group 4.1%, p = 0.5). Subgroup analysis showed that diabetic patients got more benefit in reducing MACE rates but, there is no statistical difference. Bleeding complications and adverse drug effects were not different significantly. As compared with dual antiplatelet therapy, triple antiplatelet therapy did not reduce the 12-months, 24-months MACE rates and stent thrombosis. Bleeding complications and adverse drug effects were not different.

• Journal of Chest Surgery
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• 제20권1호
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• pp.213-217
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• 1987

; A 15 years old girl was operated due to tuberculous paratracheal lymph node enlargement resulted in marked narrowing of lower part of trachea. She had suffered from sputum expectoration difficulty, which was developed dyspnea and cyanosis. 1st operation was simple removal of enlarged paratracheal lymph node through Rt. thoracotomy but restenosis sign developed 2 months later in spite of Anti-Tbc. medication. 2nd operation was resection of constricted tracheal portion [2.5cm] 8 end to end anastomosis under Extra Corporeal Circulation. Under Extra Corporeal Circulation trachea reconstruction offered many conveniences during operation. Till now, she has been follow up checked for one year, she was very good post-operation state without any restenosis signs.

• Nuclear Medicine and Molecular Imaging
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• 제40권2호
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• pp.106-112
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• 2006

Tissue hyperplasia is one of the most frequently encountered complications when self-expanding metallic stents are placed in benign non-vascular luminal organ strictures, thus causing restenosis of the lumen. The investigators postulated that ionizing irradiation could be applied to prevent restenosis caused by tissue hyperplasia in non-vascular luminal organs as it reduced coronary or peripheral arterial narrowing successfully. The authors combined $\beta$-irradiation using $^{188}Re-MAG_3$ solution with balloon dilation for animal and clinical studies because this new treatment approach had the advantages such as low penetration depth of $\beta$-ray, self-centering irradiation, and mechanical effect of balloon dilation over using $\gamma$-irradiation with afterloading devices in this article, the concept and mechanism of radioisotope balloon dilation, and animal and clinical studies using radioisotope balloon dilation are reviewed.

• 공업화학
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• 제31권5호
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• pp.502-508
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• 2020

Dual drug-eluting stents (DES) is a primary treatment method for coronary arterial diseases in current interventional cardiology practice. However, their pathological results according to the sequence of coating of drugs have not been reported yet. The peptide-dopamine dissolved in acetonitrile was coated onto the Chonnam National University Hospital (CNUH) stent using an electrospinning coating machine. For secondary coating (e.g., sirolimus coating, designated as SPS), sirolimus (SRL) and poly lactic-glycolic acid (PLGA) were mixed in tetrahydrofuran (THF), and the solution was then coated on the CNUH stent that had underwent the primary peptide coating using an electrospinning and spray technique. Next, the peptide-dopamine was coated on the SRL-PLGA coated stent (PSS). In this study, it was confirmed that endothelialization was promoted without being significantly affected by the coating order (SPS or PSS). The sequence of drug and peptide coating may affect the development of restenosis and PSS was effective in the prevention of restenosis compared to that of using SPS.

• 대한핵의학회지
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• 제35권5호
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• pp.293-300
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• 2001

The search for an ideal radioisotope for radiotherapy continues. As a generator-produced radioisotope emitting both beta and gamma rays with a short physical half-life of 16.9 hr, $^{188}Re$ is an excellent candidate for radiotherapy. Its applications Include the irradiation of coronary artery to prevent restenosis, treatment of rheumatoid arthritis, treatment of peritoneal effusion, palliation of metastatic bone pain, and treatment of liver cancer.

• 순환기질환의공학회:학술대회논문집
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• 순환기질환의공학회 2001년도 제1회 학술대회 초록집
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• pp.50-50
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• 2001

• Korean Circulation Journal
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• 제52권5호
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• pp.354-364
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• 2022

Background and objectives: To compare the safety and efficacy of a new everolimus-eluting stent with an abluminal-coated biodegradable polymer (Osstem Cardiotec Centum) with those of the Xience Alpine stent (Xience). Methods: This randomized, prospective, multicenter, parallel-designed, single-blind trial was conducted among patients with myocardial ischemia undergoing percutaneous coronary intervention (PCI) from 21st September 2018 until 3rd July 2020. The primary efficacy endpoint was in-segment late lumen loss (LLL) at 270 days after the procedure and the primary safety endpoints were major adverse cardiac events (MACE), composite of cardiac death, myocardial infarction, and target lesion revascularization. Results: We enrolled 121 patients and analyzed 113 patients who finished 270 days of follow-up for the primary efficacy endpoint. The mean age of the participants was 66.8 years. As for the primary efficacy endpoint, LLL of the Osstem Cardiotec Centum group was 0.09±0.13 mm and that of the Xience group was 0.12±0.14 mm (upper limit of 1-sided 95% confidence interval, 0.02; p for non-inferiority, 0.0084). This result demonstrates the non-inferiority of the Osstem Cardiotec Centum. As for the primary safety endpoint, MACE occurred in one patient (1.59% of the Xience group). Meanwhile, no MACE occurred in the Osstem Cardiotec Centum group. Conclusions: The Osstem Cardiotec Centum is non-inferior to the Xience Alpine^® stent and is confirmed to be safe. It could be safely and effectively applied to patients with coronary artery disease undergoing PCI.

• 한국임상약학회지
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• 제15권2호
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• pp.105-117
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• 2005

Following intracoronary stenting, antiplatelet therapy lead to greater protection from thrombotic complication. A few data are available about the effect of clopidogrel versus cilostazol, an antiplatelet commonly used after intracoronary stenting. To evaluate the efficacy and safety of clopidogrel plus aspirin compared with those of cilostazol plus aspirin in coronary stenting and to evaluate the efficacy of clopidogrel loading dose prior to coronary stealing in clopidogrel group. Data were retrospectively collected from medical charts of patients who had undergone coronary stenting and received either clopidogrel with or without loading 300 mg followed by 75 mg/d (n=58), or 200 mg/d cilostazol(n=72) for 1 year, between January 2000 and May 2002. All patients in both groups received aspirin 200 mg/d throughout the study. The primary endpoints at 7, 30, 180 and 365 days after stealing were the composite of death, Myocardial Infarction, stroke, angina, and revascularization in the intent to treat population and restenosis at follow up angiography. The secondary endpoints were the incidence of bleeding complications at 7, 30, and 365 days, and durg adverse effects at 365 days after stenting. At 180 and 365 days after stenting, the combined primary endpoints were significantly reduced in clopidogrel plus aspirin group (relative risk 0.39; 95% CI 0.17 to 0.92; p=0.021, RR 0.43; 95% CI 0.22 to 0.84; p=0.0085, respectively). However, the combined primary endpoints were not significantly different between the two groups at 7 and 30 days (p:1.00, p=0.79, respectively). Angiographic restenosis rate was 14.3% in clopidogrel plus aspirin uoup and 32.1% in cilostazol plus aspirin group (p=0.19). 300mg of clopidogrel loading dose did not significantly reduce the combined primary endpoints at 30 days after stenting (RR 0.14; 95% CI 0.01 to 2.65; p=0.23). The rate of bleeding complications and drug adverse effects were not different between the two groups. In patients undergoing intracoronary stenting, clopidogrel plus aspirin therapy is more beneficial than cilostazol plus aspirin in reducing major adverse cardiac events with similar rate of bleeding complication. A loading dose of clopidogrel did not lead to a statistically significant reduction in major adverse cardiac events.

• 공업화학
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• 제30권5호
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• pp.586-590
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• 2019

The aim of this study was to fabricate a dextran polyelectrolyte multi-layer on a bare metal stent (BMS) and to evaluate bio-physical properties of the layer. Diethylaminoethyl-dextran (DEAE-D) as a polycation and dextran sulfate (DS) as a polyanion were successively coated on the bare metal stent by a well-known layer-by-layer procedure. The morphology of the stent surface and its cell adhesion were studied after each coating step by scanning electron microscopy. The stent showed more blotched and slightly rougher morphology after dextran-DS coating. The contact angle of the DEAE-DS group ($39.5{\pm}0.15^{\circ}$) was significantly higher than that of the BMS group ($45.16{\pm}0.08^{\circ}$), indicating the improvement of hydrophilic. The SMC proliferation inhibition in the DEAE-DS-coated stent group ($20.9{\pm}0.04%$) was stronger than that in the control group ($21.7{\pm}0.10%$ in DS-coated group only). The DEAE-DS coating is desired for stent coating materials with biocompatibility and anti-restenosis effect.