• Korean Circulation Journal
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• 제53권9호
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• pp.581-593
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• 2023

In the catheterization laboratory, the measurement of physiological indexes can help identify functionally significant lesions and has become one of the standard methods to guide treatment decision-making. Plaque vulnerability refers to a coronary plaque susceptible to rupture, enabling risk prediction before coronary events, and it can be detected by defining a certain type of plaque morphology on coronary imaging modalities. Although coronary physiology and plaque vulnerability have been considered different attributes of coronary artery disease, the underlying pathophysiological basis and clinical data indicate a strong correlation between coronary hemodynamic properties and vulnerable plaque. In prediction of coronary events, emerging data have suggested independent and additional implications of a physiology-based approach to a plaque-based approach. This review covers the fundamental interplay between coronary physiology and plaque morphology during disease progression with clinical data supporting this relationship and examines the clinical relevance of physiological indexes in prediction of clinical outcomes and therapeutic decision-making along with plaque vulnerability.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.178-187
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• 2020

Objective : The extensive vasa vasorum network functions as a conduit for the entry of inflammatory cells or factors that promote the progression of angiogenesis and plaque formation. Therefore, we investigated the correlation between the carotid vasa vasorum activities and carotid plaque vulnerability using indocyanine green video angiography (ICG-VA) during carotid endarterectomy (CEA). Methods : Sixty-nine patients who underwent CEA were enrolled prospectively from September 2015 to December 2017. During CEA, a bolus of ICG was injected intravenously before and after resecting the atheroma. Additionally, we performed immunohistochemistry using CD68 (a surface marker of macrophages), CD117 (a surface marker of mast cells), and CD4 and CD8 (surface markers of T-cells) antibodies to analyze the resected plaque specimens. Results : The density of active vasa vasorum was observed in all patients using ICG-VA. The vasa vasorum externa (VVE) and interna (VVI) were seen in 11 (16%) and 57 patients (82.6%), respectively. Macroscopically, the VVE-type patterns were strongly associated with preoperative angiographic instability (81.8%, p=0.005) and carotid plaque vulnerability (90.9%, p=0.017). In contrast, the VVI-type patterns were weakly associated with angiographic instability (31.6%) and plaque vulnerability (49.1%). CD68-stained macrophages and CD117-stained mast cells were observed more frequently in unstable plaques than in stable plaques (p<0.0001, p=0.002, respectively). Conclusion : The early appearance of VVE, along with the presence of many microvessel channels that provided nutrients to the developing and expanding atheroma during ICG-VA, was strongly associated with unstable carotid plaques. The degree of infiltration of macrophages and mast cells is possibly related to the formation of unstable plaques.

• Annals of Clinical Neurophysiology
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• 제23권1호
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• pp.17-28
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• 2021

The pathogenesis of many strokes originates in the vessel wall. Despite this, most traditional imaging focuses on the vascular lumen. Vessel-wall magnetic resonance imaging (VWMRI) is useful for establishing the etiology of intracranial stenosis. It also provides information regarding atherosclerotic plaque composition and thus plaque vulnerability, which is an indication of its potential to cause a stroke. In this review we focus on the characteristics of VWMRI findings in various arteriopathies related to intracranial artery stenosis, and discuss the clinical implications of these findings.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.93-99
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• 2013

Objective : Neurologic complications during carotid artery stenting (CAS) are usually associated with distal embolic event. These embolic incident during CAS are highly associated with the carotid plaque instability. The current study was undertaken to identify the angiographic characteristics of carotid plaque vulnerability, which was represented as filling defect in the cerebral protection filters during CAS. Methods : A total of 107 patients underwent CAS with use of a distal protection filter. Angiographic carotid plaque surface morphology was classified as smooth, irregular, and ulcerated. To determine predictable factors of filling defect in the protection filters, 11 variables were retrospectively analyzed which might influence filling defect in the protection filters during CAS. Results : Filling defects during CAS were presented in the 33 cerebral protection filters. In multivariate analysis, angiographic ulceration [odds ratio (OR), 6.60; 95% confidence interval (CI) : 2.24, 19.4; p=0.001], higher stenosis degree (OR, 1.06; 95% CI : 1.00, 1.12; p=0.039), and coexistent thrombus (OR, 7.58; 95% CI : 1.69, 34.05; p=0.08) were highly associated with filling defect in the cerebral protection devices during CAS. Among several variables, angiographic surface ulceration was the only significant factor associated with flow stagnation during CAS (OR, 4.11; 95% CI : 1.33, 12.72; p=0.014). Conclusion : Plaque surface morphology on carotid angiography can be a highly sensitive marker of plaque instability during CAS. The independent risk factors for filling defect in the filter devices during CAS were plaque ulceration, stenosis degree, and coexistent thrombus.

• 한국동물위생학회지
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• 제46권4호
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• pp.335-338
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• 2023

The COVID-19 pandemic, triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has not only impacted human health on a global scale but also raised concerns about the vulnerability of a wide array of animals that are in close contact with humans. Particularly, the potential for infection and the subsequent immune response in domestic pets such as dogs and cats remain largely unexplored under natural living conditions. In this study, we have undertaken the task of detecting and tracking the presence of antibodies against SARS-CoV-2 in a small cohort of household pets-specifically, two dogs and two cats. Employing techniques such as the indirect ELISA and plaque reduction neutralization tests, we observed that the neutralizing antibodies against SARS-CoV-2 in these animals were maintained for a duration of up to six months following their initial positive test result. This duration mirrors the antibody response documented in human cases of COVID-19, suggesting a comparable post-infection immune response timeline between humans and these domestic animals.

• Investigative Magnetic Resonance Imaging
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• 제13권1호
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• pp.81-87
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• 2009

목적: 죽상경화반 유발 토끼 대동맥에서 자기공명영상을 이용하여 가돌리니움 조영제에 대한 경화반의 조영증강에 어떤 특징이 있는지 알아보고, 경화반 취약성의 대표적인 두 특징인 조직병리학적인 지질풍부 성분과 대식세포 풍부 성분과 비교하여 조영증강이 어떤 조직 소견에서 기인하는지 평가하고자 하였다. 대상 및 방법: 뉴질랜드 흰토끼 (4마리, 무게 3.0 $\sim$ 3.5 kg, 수컷)를 죽상경화반 모델로 사용하였다. 고콜레스테롤식이와 이중 풍선 손상을 이용하여 대동맥 죽상경화반을 유발하였다. 3-T 자기공명영상을 사용하여 가돌리니움 조영제를 투여하기 전과 후에 T1-강조영상을 얻었다. 자기공명영상과 상응하는 조직병리절편 (n=35)을 4개나 3개의 구역으로 나누었다 (n=130). 자기공명영상에서의 조영증강비 (ER, ER=SIpost/SIpre)를 각 구역마다 계산하여 조직병리의 지질풍부영역과 대식세포 풍부 영역과 비교하였다. 결과: 지질풍부 구역은 72개였고 섬유성구역은 58개였다. 대식세포풍부영역을 포함한 구역은 105개였고 포함하지 않은 구역은 25개였다. 조영증강비는 섬유성구역보다 지질풍부구역에서 높았다 (평균 조영증강비 2.25 $\pm$ 0.41 vs. 2.72 $\pm$ 0.65, p=0.013). 조영증강비는 지질성분을 제어했을 때 대식세포풍부영역과 잘 비례하지 않았다 (correlation coefficient -0.203, p=0.236). 결론: 표준 가돌리니움 기반의 세포외 조영제를 사용하였을 때 지질풍부 경화반은 섬유성 경화반보다 강한 조영증강을 보였다. 대식세포 침윤은 조영증강 정도와 비례하지 않았다. 초기부터 진행된 병기의 다양한 경화반 모델을 사용하고 조영증강과 관련된 모든 가능한 인자를 사용하여 조영제 투여 후 최적의 영상획득 시간을 결정하는 연구가 필요하다.

• Nutrition Research and Practice
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• 제2권2호
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• pp.134-137
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• 2008

Atherosclerosis is characterized by a chronic inflammatory disease, and chemokines play an important role in both initiation and progression of atherosclerosis development. Leukotactin-1 (Lkn-1/CCLl5), a new member of the human CC chemokine family, is a potent chemoattractant for leukocytes. Our previous study has demonstrated that Lkn-1/CCL15 plays a role in the initiation of atherosclerosis, however, little is currently known whether Lkn-1/CCL15 is associated with the progression of atherosclerosis. Matrix metalloproteinases (MMPs) in human coronary atherosclerotic lesions playa crucial role in the progression of atherosclerosis by altering the vulnerability of plaque rupture. In the present study, we examined whether Lkn-1/CCLl5 modulates MMP-9 release, which is a prevalent form expressed by activated macrophages and foam cells. Human THP-1 monocytic cells and/or human peripheral blood monocytes (PBMC) were treated with phorbol myristate acetate to induce their differentiation into macrophages. Foam cells were prepared by the treatment of THP-1 macrophages with human oxidized LDL. The macrophages and foam cells were treated with Lkn-1/CCL15, and the levels of MMP-9 release were measured by Gelatin Zymography. Lkn-1/CCL15 significantly enhanced the levels of MMP-9 protein secretion from THP-1 monocytic cells-derived macrophages, human PBMC-derived macrophages, as well as macrophage-derived foam cell in a dose dependent manner. Our data suggest that the action of Lkn-1/CCL15 on macrophages and foam cells to release MMP-9 may contribute to plaque destabilization in the progression of atherosclerosis.

• 대한기계학회논문집B
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• 제37권5호
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• pp.449-457
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• 2013

본 논문에서는 FSI(Fluid-Structure Interaction)기법을 이용하여 인체 회전의 영향을 고려한 혈류와 혈관벽의 거동을 이해하기 위한 수치해석을 수행하였다. 혈관은 협착률이 50%이고 편심이 없는 형상이며 인체 회전 효과를 묘사하기 위하여 혈관 주축에 대해 2 ~ 6 rps 의 회전을 가하였다. 협착과 축 회전의 영향으로 나선형, 비대칭 유동이 강체와 FSI 모델에서 모두 나타났다. 그러나 FSI 모델에서 혈관벽 움직임의 영향으로 혈류의 주기적, 과도적 차이가 발생했다. 특히 혈관 내 경화반의 진전과 경화반 위험성을 나타내는 대표적인 인자로 알려진 유동 재순환 영역이 감소하였다. 혈관벽의 움직임은 협착과 회전효과와 마찬가지로 유동 재순환 영역의 생성에 영향을 미친다.