• 제목/요약/키워드: Vascular risk

검색결과 385건 처리시간 0.029초

혈관성 치매의 약침 치료에 대한 중의학 임상연구 동향 (A Review on the Trend of Clinical Research on Pharmacopuncture for Vascular Dementia in Traditional Chinese Medicine)

  • 홍민호;김만기;구병수;김근우
    • 동의신경정신과학회지
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    • 제31권4호
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    • pp.315-327
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    • 2020
  • Objectives: The aim of this study was to review the research trends in the treatment of pharmacopuncture for vascular dementia in Traditional Chinese medicine. Methods: We searched for articles in the China National Knowledge Infrastructure (CNKI) database from January 2000 to August 2020. Results: Among the total 63 articles, 9 articles were selected. All studies were randomized controlled trial studies. The Diagnostic and Statistical Manual of Mental Disorders (DSM) was most frequently used as diagnostic criteria. Effective rate and Activity of Daily Living (ADL) were most commonly used as outcome measurements. Angelica gigantis Radix (當歸), Salvia miltiorrhiza Bunge (丹蔘), and Astragali Radix (黃芪) were the most commonly used ingredients in pharmacopuncture. Joksamni (ST36) and Sinsu (BL23) were the most commonly used acupoints for pharmacopuncture treatment. Based on the Risk of Bias (RoB) of these 9 articles, the overall quality of studies was low. Conclusions: Pharmacopuncture could be considered for the treatment of vascular dementia. In the future, various systematic studies on dementia are needed.

나이와 성별에 따른 지역사회 거주 노인에서 무증상 경동맥 죽상경화증에 대한 혈관위험인자 및 인지장애와의 관련성 (Age and Gender Differences in the Relationship of Cognitive Impairment, Vascular Risk Factors, and Subclinical Carotid Atherosclerosis from Community-based Elderly)

  • 김지희;박현영;김대원;변승재;문효정;이인;양충용
    • 동의생리병리학회지
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    • 제26권3호
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    • pp.399-407
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    • 2012
  • To evaluate age and gender differences in the relation of cardiovascular risk factors, cognitive impairment, and subclinical carotid atherosclerosis from aged people using by a cross sectional method. Sixty-nine healthy elders living in the community who had not previously undergone carotid ultrasonography were included. We conducted life style surveys, and cognitive function tests including Korean-mini-mental state examination (K-MMSE) and clinical dementia rating-Korean. Various biomarkers from blood were assessed; fasting insulin-like growth factor-1, lipid-profile, high sensitivity C-reactive protein, total homocysteine, glucose, insulin, Homeostasis model assessment (HOMA) for insulin resistance index, vitamin B12, and folate level. Carotid intima-media thickness (C-IMT), and plaques were measured using carotid ultrasonography and aortic ultrasonography, a valid index of atherosclerosis. For the elderly subjects (aged 65-82 years), cognition impairment was more prevalent in females while subclinical atherosclerosis was more prevalentin males. Increased C-IMT has been kept in males, and C-IMT shows increasing trend and the peak at about 80 year-old in females with increasing age. The significant correlations between C-IMT and many vascular risk factors including age, triglyceride, abnormal homocysteinein male, and K-MMSE, insulin, HOMA index and abnormal aortic ultrasonography in female were different in each gender, with the exception of homocysteine (p<0.05). This data suggests that there were differences of age and gender characteristics in terms of subclinical atherosclerosis, cognitive impairment and vascular risk factors in community-living elders. Further larger and longitudinal studies across entire age are required to better understand the effects of risk factors on subclinical atherosclerosis.

Korean Red Ginseng Water Extract Restores Impaired Endothelial Function by Inhibiting Arginase Activity in Aged Mice

  • Choi, Kwanhoon;Yoon, Jeongyeon;Lim, Hyun Kyo;Ryoo, Sungwoo
    • The Korean Journal of Physiology and Pharmacology
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    • 제18권2호
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    • pp.95-101
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    • 2014
  • Cardiovascular disease is the prime cause of morbidity and mortality and the population ages that may contribute to increase in the occurrence of cardiovascular disease. Arginase upregulation is associated with impaired endothelial function in aged vascular system and thus may contribute to cardiovascular disease. According to recent research, Korean Red Ginseng water extract (KRGE) may reduce cardiovascular disease risk by improving vascular system health. The purpose of this study was to examine mechanisms contributing to age-related vascular endothelial dysfunction and to determine whether KRGE improves these functions in aged mice. Young ($10{\pm}3$ weeks) and aged ($55{\pm}5$ weeks) male mice (C57BL/6J) were orally administered 0, 10, or 20 mg/mouse/day of KRGE for 4 weeks. Animals were sacrificed and the aortas were removed. Endothelial arginase activity, nitric oxide (NO) generation and reactive oxygen species (ROS) production, endothelial nitric oxide synthase (eNOS) coupling, vascular tension, and plasma peroxynitrite production were measured. KRGE attenuated arginase activity, restored nitric oxide (NO) generation, reduced ROS production, and enhanced eNOS coupling in aged mice. KRGE also improved vascular tension in aged vessels, as indicated by increased acetylcholine-induced vasorelaxation and improved phenylephrine-stimulated vasoconstriction. Furthermore, KRGE prevented plasma peroxynitrite formation in aged mice, indicating reduced lipid peroxidation. These results suggest KRGE exerts vasoprotective effects by inhibiting arginase activity and augmenting NO signaling and may be a useful treatment for age-dependent vascular diseases.

Adiponectin gene SNP 276G${\rightarrow}$T, nutrient intakes, and cardiovascular disease risk in Korean type 2 DM patients

  • Yu, So-Young;Ryu, Han-Kyoung;Park, Hee-Jung;Choi, Young-Ju;Huh, Kap-Bum;Kim, Wha-Young
    • Nutrition Research and Practice
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    • 제1권4호
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    • pp.363-370
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    • 2007
  • Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G${\rightarrow}$T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G${\rightarrow}$T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.

당뇨병성 발궤양 발생 위험 예측모형과 노모그램 개발 (Development of a Diabetic Foot Ulceration Prediction Model and Nomogram)

  • 이은주;정인숙;우승훈;정혁재;한은진;강창완;현수경
    • 대한간호학회지
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    • 제51권3호
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    • pp.280-293
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    • 2021
  • Purpose: This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM). Methods: This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients' electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow-Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples. Results: The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ2 = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years. Conclusion: The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.

제2형 당뇨병 환자의 발궤양 위험, 발관리 지식 및 발관리 수행 (Foot Ulcer Risk, Foot Care Knowledge, and Foot Care Practice in Patients with Type 2 Diabetics)

  • 고남경;송미순
    • 성인간호학회지
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    • 제18권1호
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    • pp.81-91
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    • 2006
  • Purpose: The purpose of this study was to investigate foot ulcer risk factors, foot care knowledge, and foot care practice in patients with type 2 diabetes. Method: One hundred fifty type 2 diabetic patients were in and out-patients in a large urban hospital. The data were collected using a self-report questionnaire, chart review and foot examination. The questionnaires were developed by the researchers through the experts consultation and literature review. High risk for foot ulcer was evaluated by peripheral neuropathy(PN), peripheral vascular disease(PVD), and prior foot ulcer. Foot risk scores(FRS) means numbers of present risk factors. Results: 31.3% of subjects show 1 FRS, and 13.3% showed 2 FRS. Mean foot care frequency was 3.5 times per week. There were significant differences in foot care knowledge according to DM education (t=2.96, p=.004) and foot care education (t=3.65, p=.001). There were significant differences in the foot care practice activities according to duration of DM (t=3.48, p=.010) and educational levels. Conclusion: There were high proportion of foot ulcer risk among the patients. It is necessary to screen high risk foot ulcer patients and provide practical education for foot care practice of diabetic patients.

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Association between Serum Cystatin C and Vascular Complications in Type 2 Diabetes Mellitus without Nephropathy

  • Kim, Hye Jeong;Byun, Dong Won;Suh, Kyoil;Yoo, Myung Hi;Park, Hyeong Kyu
    • Diabetes and Metabolism Journal
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    • 제42권6호
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    • pp.513-518
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    • 2018
  • Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

Regional Differences in Blood-Brain Barrier Permeability in Cognitively Normal Elderly Subjects: A Dynamic Contrast-Enhanced MRI-Based Study

  • Il Heon Ha;Changmok Lim;Yeahoon Kim;Yeonsil Moon;Seol-Heui Han;Won-Jin Moon
    • Korean Journal of Radiology
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    • 제22권7호
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    • pp.1152-1162
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    • 2021
  • Objective: This study aimed to determine whether there are regional differences in the blood-brain barrier (BBB) permeability of cognitively normal elderly participants and to identify factors influencing BBB permeability with a clinically feasible, 10-minute dynamic contrast-enhanced (DCE) MRI protocol. Materials and Methods: This IRB-approved prospective study recruited 35 cognitively normal adults (26 women; mean age, 64.5 ± 5.6 years) who underwent DCE T1-weighted imaging. Permeability maps (Ktrans) were coregistered with masks to calculate the mean regional values. The paired t test and Friedman test were used to compare Ktrans between different regions. The relationships between Ktrans and the factors of age, sex, education, cognition score, vascular risk burden, vascular factors on imaging, and medial temporal lobar atrophy were assessed using Pearson correlation and the Spearman rank test. Results: The mean permeability rates of the right and left hippocampi, as assessed with automatic segmentation, were 0.529 ± 0.472 and 0.585 ± 0.515 (Ktrans, x 10-3 min-1), respectively. Concerning the deep gray matter, the Ktrans of the thalamus was significantly greater than those of the putamen and hippocampus (p = 0.007, p = 0.041). Regarding the white matter, the Ktrans value of the occipital white matter was significantly greater than those of the frontal, cingulate, and temporal white matter (p < 0.0001, p = 0.0007, p = 0.0002). The variations in Ktrans across brain regions were not related to age, cognitive score, vascular risk burden, vascular risk factors on imaging, or medial temporal lobar atrophy in the study group. Conclusion: Our study demonstrated regional differences in BBB permeability (Ktrans) in cognitively normal elderly adults using a clinically acceptable 10-minutes DCE imaging protocol. The regional differences suggest that the integrity of the BBB varies across the brains of cognitively normal elderly adults. We recommend considering regional differences in Ktrans values when evaluating BBB permeability in patients with neurodegenerative diseases.

Epidemiological and Genome-Wide Association Study of Gastritis or Gastric Ulcer in Korean Populations

  • Oh, Sumin;Oh, Sejong
    • Genomics & Informatics
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    • 제12권3호
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    • pp.127-133
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    • 2014
  • Gastritis is a major disease that has the potential to grow as gastric cancer. Gastric cancer is a very common cancer, and it is related to a very high mortality rate in Korea. This disease is known to have various reasons, including infection with Helicobacter pylori, dietary habits, tobacco, and alcohol. The incidence rate of gastritis has reported to differ between age, population, and gender. However, unlike other factors, there has been no analysis based on gender. So, we examined the high risk factors of gastritis in each gender in the Korean population by focusing on sex. We performed an analysis of 120 clinical characteristics and genome-wide association studies (GWAS) using 349,184 single-nucleotide polymorphisms from the results of Anseong and Ansan cohort study in the Korea Association Resource (KARE) project. As the result, we could not prove a strong relation with these factors and gastritis or gastric ulcer in the GWAS. However, we confirmed several already-known risk factors and also found some differences of clinical characteristics in each gender using logistic regression. As a result of the logistic regression, a relation with hyperlipidemia, coronary artery disease, myocardial infarction, hyperlipidemia therapy, hypotensive or antihypotensive drug, diastolic blood pressure, and gastritis was seen in males; the results of this study suggest that vascular disease has a potential association with gastritis in males.

심장이식 후 부신피질호르몬 투여로 인한 거골의 무혈성 괴사 - 1예 보고 - (Corticosteroid-induced Avascular Necrosis of Talus after Cardiac Transplantation)

  • 박홍기;엄기석
    • 대한족부족관절학회지
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    • 제4권2호
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    • pp.83-86
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    • 2000
  • A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

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