• 제목/요약/키워드: vascular disease

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알츠하이머병과 뇌소혈관질환의 연관성 (Association between Cerebral Small Vessel and Alzheimer's Disease)

  • 이경훈;강경미
    • 대한영상의학회지
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    • 제83권3호
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    • pp.486-507
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    • 2022
  • 뇌소혈관질환은 뇌 자기공명영상에서 흔히 관찰되는 혈관성 변화로 뇌백질 고신호강도, 뇌미세출혈, 열공성 경색, 혈관주위공간 등을 포함한다. 이러한 혈관성 변화가 알츠하이머병(Alzheimer's disease; 이하 AD)의 발병 및 진행과 관련되어 있고, 대표 병리인 베타 아밀로이드 및 타우 단백의 침착과도 연관되어 있다는 증거들이 축적되고 있다. 혈관성 변화는 생활습관 개선이나 약물 치료를 통해 예방과 개선이 가능하기 때문에 뇌소혈관질환과 AD 및 AD 생체지표의 관련성을 연구하는 것이 중요하다. 본 종설에서는 AD와 AD 생체지표에 대해 간략히 소개하고, AD와 혈관성 변화의 관련성에 대해 축적된 증거들을 제시한 다음, 뇌소혈관질환의 병태 생리와 MR 영상 소견을 설명하고자 한다. 또 뇌소혈관질환과 AD 진단의 위험도 및 AD 생체지표와의 관련성에 대한 기존 연구 결과들을 정리하고자 한다.

MR Imaging of Congenital Heart Diseases in Adolescents and Adults

  • Yeon Hyeon Choe;I-Seok Kang;Seung Woo Park;Heung Jae Lee
    • Korean Journal of Radiology
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    • 제2권3호
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    • pp.121-131
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    • 2001
  • Echocardiography and catheterization angiography suffer certain limitations in the evaluation of congenital heart diseases in adults, though these are overcome by MRI, in which a wide field-of view, unlimited multiplanar imaging capability and three-dimensional contrast-enhanced MR angiography techniques are used. In adults, recently introduced fast imaging techniques provide cardiac MR images of sufficient quality and with less artifacts. Ventricular volume, ejection fraction, and vascular flow measurements, including pressure gradients and pulmonary-to-systemic flow ratio, can be calculated or obtained using fast cine MRI, phase-contrast MR flow-velocity mapping, and semiautomatic analysis software. MRI is superior to echocardiography in diagnosing partial anomalous pulmonary venous connection, unroofed coronary sinus, anomalies of the pulmonary arteries, aorta and systemic veins, complex heart diseases, and postsurgical sequelae. Biventricular function is reliably evaluated with cine MRI after repair of tetralogy of Fallot, and Senning's and Mustard's operations. MRI has an important and growing role in the morphologic and functional assessment of congenital heart diseases in adolescents and adults.

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Optimal Attenuation Threshold for Quantifying CT Pulmonary Vascular Volume Ratio

  • Hyun Woo Goo;Sang Hyub Park
    • Korean Journal of Radiology
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    • 제21권6호
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    • pp.756-763
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    • 2020
  • Objective: To evaluate the effects of attenuation threshold on CT pulmonary vascular volume ratios in children and young adults with congenital heart disease, and to suggest an optimal attenuation threshold. Materials and Methods: CT percentages of right pulmonary vascular volume were compared and correlated with percentages calculated from nuclear medicine right lung perfusion in 52 patients with congenital heart disease. The selected patients had undergone electrocardiography-synchronized cardiothoracic CT and lung perfusion scintigraphy within a 1-year interval, but not interim surgical or transcatheter intervention. The percentages of CT right pulmonary vascular volumes were calculated with fixed (80-600 Hounsfield units [HU]) and adaptive thresholds (average pulmonary artery enhancement [PAavg] divided by 2.50, 2.00, 1.75, 1.63, 1.50, and 1.25). The optimal threshold exhibited the smallest mean difference, the lowest p-value in statistically significant paired comparisons, and the highest Pearson correlation coefficient. Results: The PAavg value was 529.5 ± 164.8 HU (range, 250.1-956.6 HU). Results showed that fixed thresholds in the range of 320-400 HU, and adaptive thresholds of PAavg/1.75-1.50 were optimal for quantifying CT pulmonary vascular volume ratios. The optimal thresholds demonstrated a small mean difference of ≤ 5%, no significant difference (> 0.2 for fixed thresholds, and > 0.5 for adaptive thresholds), and a high correlation coefficient (0.93 for fixed thresholds, and 0.91 for adaptive thresholds). Conclusion: The optimal fixed and adaptive thresholds for quantifying CT pulmonary vascular volume ratios appeared equally useful. However, when considering a wide range of PAavg, application of optimal adaptive thresholds may be more suitable than fixed thresholds in actual clinical practice.

The molecular pathophysiology of vascular anomalies: Genomic research

  • Kim, Jong Seong;Hwang, Su-Kyeong;Chung, Ho Yun
    • Archives of Plastic Surgery
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    • 제47권3호
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    • pp.203-208
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    • 2020
  • Vascular anomalies are congenital localized abnormalities that result from improper development and maintenance of the vasculature. The lesions of vascular anomalies vary in location, type, and clinical severity of the phenotype, and the current treatment options are often unsatisfactory. Most vascular anomalies are sporadic, but patterns of inheritance have been noted in some cases, making genetic analysis relevant. Developments in the field of genomics, including next-generation sequencing, have provided novel insights into the genetic and molecular pathophysiological mechanisms underlying vascular anomalies. These insights may pave the way for new approaches to molecular diagnosis and potential disease-specific therapies. This article provides an introduction to genetic testing for vascular anomalies and presents a brief summary of the etiology and genetics of vascular anomalies.

혈관성 치매와 속발성 치매 치험 및 호전 3례 (Three Case Reports about Improving Vascular Dementia and Secondary Dementia)

  • 윤경선;이지훈;김재우;정승현;신길조;이원철
    • 대한한방내과학회지
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    • 제24권2_4호
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    • pp.1103-1111
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    • 2003
  • Dementia is classified into Alzheimer's disease, vascular dementia and secondary dementia by its causes. Alzheimer's disease is hard to expect cognitive improvement, whereas vascular dementia and secondary dementia are reversible by medical treatments Dementia can be categorized as Chi-Mae(痴?), Geon-Mang(健忘), Huh-Ro(虛勞), Guang(狂), in the oriental medicine and treated by 'purgation therapy' when it is classified into excessive syndrome. We observed some significant improvements in the cognitive function from three patients diagnosed vascular dementia and secondary dementia by herbal medications of $\ulcorner$Dong-Eui-Su-Sheh-Bo-Won(東醫壽世保元)$\lrcorner$. We report the process of the treatment.

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개별 심장재활 교육프로그램이 관상동맥중재술을 받은 환자의 질병관련지식, 환자역할이행과 혈관 건강상태에 미치는 효과 (Effects of an Individualized Cardiac Rehabilitation Education Program on Knowledge about Coronary Artery Disease, Compliance of Sick Role, and Vascular Health Status in Patients of Percutaneous Coronary Intervention)

  • 이경심;성경미
    • 재활간호학회지
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    • 제18권2호
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    • pp.135-144
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    • 2015
  • Purpose: This study was conducted to examine the effects of an individualized cardiac rehabilitation education program on knowledge about coronary artery disease (CAD), compliance of sick role and vascular health status in patients with percutaneous coronary intervention (PCI). Methods: Quasi-experimental design-based nonequivalent control group pretest-posttest design was employed. Using convenience sampling, data were collected from 60 patients who underwent PCI at S Hospital in S City from September 2014 to February 2015. For examining the effects of an individualized cardiac rehabilitation education program, knowledge about CAD, compliance of sick role and vascular health status were measured. Results: The experimental group showed statistically significant differences in knowledge about CAD (t=24.21, p<.001), compliance with sick role (t=20.81, p<.001) and vascular health status (t=15.07, p<.001) compared to the control group. Conclusion: The individualized cardiac rehabilitation education program is effective in improving knowledge about CAD, compliance of sick role and vascular health status in patients who underwent PCI. Based on the findings of this study, nursing intervention programs focusing on individualized approach will be useful for patients undergoing PCI.

Losartan Inhibits Vascular Smooth Muscle Cell Proliferation through Activation of AMP-Activated Protein Kinase

  • Kim, Jung-Eun;Choi, Hyoung-Chul
    • The Korean Journal of Physiology and Pharmacology
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    • 제14권5호
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    • pp.299-304
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    • 2010
  • Losartan is a selective angiotensin II (Ang II) type 1 ($AT_1$) receptor antagonist which inhibits vascular smooth muscle cells (VSMCs) contraction and proliferation. We hypothesized that losartan may prevent cell proliferation by activating AMP-activated protein kinase (AMPK) in VSMCs. VSMCs were treated with various concentrations of losartan. AMPK activation was measured by Western blot analysis and cell proliferation was measured by MTT assay and flowcytometry. Losartan dose- and time-dependently increased the phosphorylation of AMPK and its downstream target, acetyl-CoA carboxylase (ACC) in VSMCs. Losartan also significantly decreased the Ang II- or 15% FBS-induced VSMC proliferation by inhibiting the expression of cell cycle associated proteins, such as p-Rb, cyclin D, and cyclin E. Compound C, a specific inhibitor of AMPK, or AMPK siRNA blocked the losartan-induced inhibition of cell proliferation and the $G_0/G_1$ cell cycle arrest. These data suggest that losartan-induced AMPK activation might attenuate Ang II-induced VSMC proliferation through the inhibition of cell cycle progression.