• 제목/요약/키워드: Ischemic disease

검색결과 560건 처리시간 0.024초

Long-Term Clinical Effects of Carotid Intraplaque Neovascularization in Patients with Coronary Artery Disease

  • Hyemoon Chung;Bu Yong Kim;Hyun Soo Kim;Hyung Oh Kim;Jung Myung Lee;Jong Shin Woo;Jin Bae Kim;Woo-Shik Kim;Kwon Sam Kim;Weon Kim
    • Korean Journal of Radiology
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    • 제21권7호
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    • pp.900-907
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    • 2020
  • Objective: To investigate the predictive value of intraplaque neovascularization (IPN) for cardiovascular outcomes. Materials and Methods: We evaluated 217 patients with coronary artery disease (CAD) (158 men; mean age, 68 ± 10 years) with a maximal carotid plaque thickness ≥ 1.5 mm for the presence of IPN using contrast-enhanced ultrasonography. We compared patients with (n = 116) and without (n = 101) IPN during the follow-up period and investigated the predictors of major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, coronary artery revascularization, and transient ischemic accident/stroke. Results: During the mean follow-up period of 995 ± 610 days, the MACE rate was 6% (13/217). Patients with IPN had a higher maximal thickness than those without IPN (2.86 ± 1.01 vs. 2.61 ± 0.84 mm, p = 0.046). Common carotid artery-peak systolic velocity, left ventricular mass index (LVMI), and ventricular-vascular coupling index were significantly correlated with MACE. However, on multivariate Cox regression analysis, increased LVMI was independently related to MACE (p < 0.05). The presence of IPN could not predict MACE. Conclusion: The presence of IPN was related to a higher plaque thickness but could not predict cardiovascular outcomes better than conventional clinical factors in patients with CAD.

기허담성치방이 뇌병환에 미치는 기전연구 (The Mechanism Study of Prescription for Treatment Abundant Expectoration due to Deficiency of Qi on Brain Disease in Rats)

  • 이남구;성신
    • 동의생리병리학회지
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    • 제18권4호
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    • pp.1083-1088
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    • 2004
  • This Study was designed to investigate the mechanism of Prescription for Treatment Abundant Expectoration due to Deficiency of Qi(Yukgunja-Tang, YGT) on cerebral hemodynamics [regional cerebral blood f1ow(rCBF) and pial arterial diameter(PAD)] in cerebral ischemia rats. The results were as follows: Both rCBF and PAD were significantly and stably decreased by YGT (10㎎/㎏, i.p.) during the period of cerebral reperfusion, which contrasted with the findings of rapid and marked increase in Control group. Pretreatment with indomethacin(1㎎/㎏, i.p.), an inhibitor of cyclooxygenase and methylene blue(10㎍/㎏, i.p.), an inhibitor of guanylate cyclase significantly but unstably increased the YGT-induced increases in rCBF during the period of cerebral reperfusion. Pretreatment with indomethacin significantly and stably decreased the YGT-induced increases in PAD during the period of cerebral reperfusion, but pretreatment with methylene blue increased unstably the YGT-induced increases in PAD during the period of cerebral reperfusion. In conclusion, the present authors thought that mechanism of YGT on cerebral hemodynamics was connected with guanylate cyclase in cerebral ischemia rats.

A Retrieved Sparganum of Spirometra erinaceieuropaei from a Korean Man during Mechanical Thrombectomy

  • Hwang, Yang-Ha;Son, Wonsoo;Kim, Yong-Won;Kang, Dong-Hun;Chang, Hyun-Ha;Goo, Youn-Kyoung;Hong, Yeonchul;Chung, Dong-Il
    • Parasites, Hosts and Diseases
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    • 제58권3호
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    • pp.309-313
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    • 2020
  • Human sparganosis is a zoonotic disease caused by infection and migration of the plerocercoid of Spirometra spp. Although sparganosis were reported from most parts of the body, the sparganum parasitizing inside cerebral artery is remarkably uncommon. We report a case of cerebral intravascular sparganosis in an elderly patient with acute ischemic stroke who was diagnosed by retrieving sparganum during mechanical thrombectomy. Finally, the parasites were identified as Spirometra erinaceieuropaei using multiplex PCR and cox1 gene sequencing.

관상동맥 우회술;심마비액을 사용하지 않은 수술방법 (Aortocoronary Bypass Surgery; with Noncardioplegic Myocardial Protection)

  • 서동만;송명근
    • Journal of Chest Surgery
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    • 제26권4호
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    • pp.276-281
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    • 1993
  • During the 3 years through December 1992, 118 cases of coronary bypass graft were performed at Department of Cardiothoracic Surgery, Asan Medical Center. They consisted of 80 males and 38 females with the mean age of 59. History of myocardial infarction was noted in 23 cases[20%], congestive heart failure in 11[10%], left ventricular aneurysm in 6, postinfarct VSD in 2, and mitral regurgitation in 1. The angina was stable in 13 cases, and unstable in 104 cases[89%]. Left main stem disease were 41 cases[35%], triple vessel 36[31%], double vessel 30[26%] and single vessel involvement[LAD] in 10. We performed 335 distal bypasses out of 117 cases, with single bypass in 9, double 29, triple 52, quadruple 23, and quintuple 4. Myocardial protections were cardioplegia in 29 and intermittent aortic occlusion 79 and continuous aortic perfusion 7. The ischemic time per graft was 13 minutes[intermittent aortic occlusion group] and 20 minutes [cardioplegia group] respectively, and the mean number of graft per patient is 2.85. Early mortality was 6.8% [8/117]. If we exclude the patients with LV aneurysm, the surgical mortality could be downed to 4.5% [5/111]. The causes of deaths were cardiogenic shock[6], aortic dissection[1], and neurologic complication[1]. We conclude that noncardioplegic myocardial protection may be equally beneficial or sometimes advantageous to cardioplegic technique in aortocoronary bypass graft surgery.

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단기 기억상실을 주증(主症)으로 하는 6례(例)의 임상보고 -중기(中氣), 건망(健忘), 해리성 기억장애 중심으로 (6 Clinical Reports of Temporary Severe Amnesia Patients -focusing on amnesia, hysteric convulsion, dissociative disorder)

  • 오영진;김보경
    • 동의신경정신과학회지
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    • 제16권2호
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    • pp.287-299
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    • 2005
  • Dissociative disorder is a psychiatric disorder characterized by a sudden loss of memory, but which has no organic disease or explanation. It usually occurs after heavy psychosocial stress or traumatic experience. A transient cerebral ischemic attack (TIA) is an acute episode of temporary and focal loss of cerebral function of vascular origin. TIAs are rapid in onset; symptoms reach their maximal manifestation in fewer than 5 minutes. Manifestations are of variable duration and typically last 2-15 minutes(rarely as long as 24 h). Most TIA durations are less than 1 hour. Of concern is the careful detection of changes in behavior, speech, gait, memory, movement, and vision. TIAs are uncommon in persons younger than 60 years. I treat 6 cases of Sudden Temporary Amnesia Patients with oriental medicine and they are improved. All of them had amnesia for $6{\sim}10\;hours$. During that time, they show behavioral changes and they are not on the state of unconsciousness. After recovery, they also forget what happen at the time. they have some emotional reason too. In conclusion, 4 cases of them belong to dissociative disorder and 2 other cases, TIA.

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The role of cytokines in seizures: interleukin (IL)-$1{\beta}$, IL-1Ra, IL-8, and IL-10

  • Youn, Youngah;Sung, In Kyung;Lee, In Goo
    • Clinical and Experimental Pediatrics
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    • 제56권7호
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    • pp.271-274
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    • 2013
  • Brain insults, including neurotrauma, infection, and perinatal injuries such as hypoxic ischemic encephalopathy, generate inflammation in the brain. These inflammatory cascades induce a wide spectrum of cytokines, which can cause neuron degeneration, have neurotoxic effects on brain tissue, and lead to the development of seizures, even if they are subclinical and occur at birth. Cytokines are secreted by the glial cells of the central nervous system and they function as immune system mediators. Cytokines can be proinflammatory or anti-inflammatory. Interleukin (IL)-$1{\beta}$ and IL-8 are proinflammatory cytokines that activate additional cytokine cascades and increase seizure susceptibility and organ damage, whereas IL-1 receptor antagonist and IL-10 act as anti-inflammatory cytokines that have protective and anticonvulsant effects. Therefore, the immune system and its associated inflammatory reactions appear to play an important role in brain damage. Whether cytokine release is relevant for the processes of epileptogenesis and antiepileptogenesis, and whether epileptogenesis could be prevented by immunomodulatory treatment should be addressed in future clinical studies. Furthermore, early detection of brain damage and early intervention are essential for the prevention of disease progression and further neurological complications. Therefore, cytokines might be useful as biomarkers for earlier detection of brain damage in high-risk infants.

산화적 손상에 의해 유발된 심근세포 독성에 대한 보양환오탕(補陽還五湯)의 방어효과 (Protective Effects of Boyanghwanoh-tang on Zinc-mediated Cytotoxicity in H9c2 Cardiomyoblast Cells)

  • 임은경;정현애;신선호;이윤재
    • 대한한방내과학회지
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    • 제26권2호
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    • pp.409-419
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    • 2005
  • The water extract of Boyanghwanoh-tang has been used for treatment of ischemic vascular disease in oriental medicine. However, little is known about the mechanism by which the water extract of Boyanghwanoh-tang rescues cells from these damages. Therefore, this study was designed to evaluate the protective effects of Boyanghwanoh-tang on zinc-mediated cytotoxicity in H9c2 cardiomyoblast cells. This study demonstrates that, after treatment of H9c2 cells with zinc, there was a decrease in cell viability in a dose dependent manner, and there was a chromatin condensation. Zinc induced the change of cell morphology. In addition, zinc induced mitochondrial dysfunction. Zinc-induced H9c2 cell death was remarkably prevented by the pretreatment of Boyanghwanoh-tang consistently with increase of the peroxoredoxin 1, 2, 3, 5, and 6 expression. Taken together, the results suggest that zinc induced severe cell death in H9c2 cardiomyoblast cells, and that protective effects of Boyanghwanoh-tang against oxidative injuries are achieved through regulation of peroxiredoin expression.

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Surgical Management of a Coronary-Bronchial Artery Fistula Combined with Myocardial Ischemia Revealed by 13N-Ammonia Positron Emission Tomography

  • Choi, Hang Jun;Kim, Hwan Wook;Kim, Do Yeon;Choi, Kuk Bin;Jo, Keon Hyon
    • Journal of Chest Surgery
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    • 제50권3호
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    • pp.220-223
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    • 2017
  • A 71-year-old male with known bronchiectasis and atrial fibrillation was admitted to Seoul St. Mary's Hospital with recurrent transient ischemic attack. R adiofrequency ablation was performed to resolve the patient's atrial fibrillation, but failed. However, a fistula between the left circumflex artery and the bilateral bronchial arteries was found on computed tomography. Fistula ligation and a left-side maze operation were planned due to his recurrent symptom of dizziness, and these procedures were successfully performed. After the operation, the fistula was completely divided and no recurrence of atrial fibrillation took place. A coronary-bronchial artery fistula is a rare anomaly, and can be safely treated by surgical repair.

Tumoral calcinosis and calciphylaxis treated with subtotal parathyroidectomy and sodium thiosulphate

  • Cho, Hyunjeong;Yi, Yongjin;Kang, Eunjeong;Park, Seokwoo;Cho, Eun Jin;Cho, Sung Tae;Chun, Rho Won;Lee, Kyu Eun;Oh, Kook-Hwan
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.68-71
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    • 2016
  • Tumoral calcinosis (TC) is a condition resulting from extensive calcium phosphate precipitation, primarily in the periarticular tissues around major joints. Calciphylaxis is a fatal ischemic vasculopathy mainly affecting dermal blood vessels and subcutaneous fat. This syndrome is rare and predominantly occurs in patients with end-stage renal disease. Here, we report on a rare case involving a patient with TC complicated with calciphylaxis. Our patient was a 31-year-old man undergoing hemodialysis who presented with masses on both shoulders and necrotic cutaneous ulcers, which were associated with secondary hyperparathyroidism, on his lower legs. He underwent subtotal parathyroidectomy, and sodium thiosulfate (STS) was administered for 27 weeks. Twenty months after beginning the STS treatment course, he experienced dramatic relief of his TC and calciphylaxis.

Refractory Vascular Spasm Associated with Coronary Bypass Grafting

  • Kim, Young Sam;Yoon, Yong Han;Kim, Jeoung Taek;Shinn, Helen Ki;Woo, Seong Ill;Baek, Wan Ki
    • Journal of Chest Surgery
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    • 제47권5호
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    • pp.468-472
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    • 2014
  • Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management.