• Title/Summary/Keyword: 내막두께

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Histomorphological Comparison of the Coronary Artery and Available Graft Conduits (관상동맥 및 이식편으로 사용 가능한 혈관들의 조직형태학적 비교)

  • Kim, Yong-Ho;Lee, Seok-Ki;Yu, Jeong-Hwan;Kim, Si-Wook;Kang, Shin-Kwang;Lim, Seung-Pyung;Yu, Jae-Hyeon;Lee, Young
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.563-567
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    • 2008
  • Background: The histomorphological properties of the left anterior desecending artery (LAD), the left internal thoracic arteries (LITA), the radial arteries (RA) and the intercostal arteries (ICA) were studied for their use as a conduit for coronary artery bypass grafting (CABG), and we compared them with each other. Material and Method: All the vessels were harvested from nineteen cadavers (17 males and 2 females). The mid-portion of the LAD, the mid-portion of the LITA, the distal RA and the mid-portion of the 5th ICA were obtained. All of them were stained with hematoxylin-eosin and with Van Gieson's elastin stain. The morphological characteristics were examined and the thicknesses of the intima and media (I/M ratio: the intima to media ratio) were compared using one-way ANOVA tests. Result: The mean age of the cadavers was $61.5{\pm}9.6$ years. The LITA and ICA were elastic arteries, and the LAD and RA were muscular arteries. The I/M ratio showed statistically significant differences: $0.07{\pm}0.03$ in the LITA, $0.16{\pm}0.11$ in the ICA, $0.45{\pm}0.29$ in the RA and $0.93{\pm}0.52$ in the LAD, respectively. Conclusion: This study showed that the degrees of intimal hyperplasia of the CA and the various conduits for CABG were different significantly. The ICA was found to have relatively favorable characteristics as a coronary by pass conduit, but its suitability for clinical use is a challenging issue.

Expressions of Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-2 with Changes of Interleukin-6 and Interleukin-18 in Atherosclerotic Lesions of Hypercholesterolemic Rabbits (고콜레스테롤혈증 가토의 죽상경화성 병변에서 Interleukin-6와 Interleukin-18의 변화 및 Matrix Metalloproteinase-9과 Tissue Inhibitor of Metalloproteinase-2의 발현)

  • 권영무;김성숙;장봉현
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.407-419
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    • 2002
  • Atherosclerosis is a chronic inflammatory disease of the arterial wall characterized by progressive accumulation of lipids, cells, and extracellular matrix. Matrix metalloproteinases(MMPs) and tissue inhibitor of metalloproteinases(TIMPS) contribute to vascular matrix remodeling in atherosclerosis, and some cytokines may play role in the synthesis or activation of MMPs or TIMPs. Material and Method: We produced experimental atherosclerotic plaques in 9 rabbits by atherogenic hypercholesterol diet for 12 weeks, and 10 other rabbits were used as control group with standard laboratory chow, At that time, 19 rabbits were sacrificed and aorta, coronary arteries and blood specimens were prepared. The expressions of MMP-9, TIMP-2 and interleukin(IL)-18, and the bioactivity of IL-6 were investigated with H&E stain, immunohistochemical stain, immunoblotting(Western blot analysis), and bioassay. Result: Serum cholesterol in the experimental group increased up to 1258$\pm$262 mg/dL(control group: 41$\pm$7 mg/dL). All experimental group showed well-developed atherosclerotic plaques in aorta and coronary artery. The expression of MMP-9 in aorta and coronary artery of the experimental group showed significant increase than that of the control group by immunohistochemistry. Among the experimental group, complicated lesions with intimal rupture or complete luminal occlusion, demonstrated stronger expression of MMP-9. Interestingly, there was no difference in expression of TIMP-2 between the experimental and the control group. These findings were confirmed by Western blot analysis. The bioassay revealed significant up-regulation of serum bioactivity of IL-6 in the experimental group(4819.60$\pm$2021.25 IU/$m\ell$) compared to that of IL-6 in the control group(27.20 $\pm$ 12.19 IU/$m\ell$). IL-18 was expressed in all atherosclerotic plaques, whereas little or no expression was detected in the control group. Conclusion: The increased MMP-9 expression along with the unchanged TIMP-2 expression seem to be contributory factors in extracellular matrix degradation in atherosclerosis. Focal overexpression of MMP-9 may promote plaque destabilization and cause complications of atherosclerotic plaques such as thrombosis with/without acute coronary syndrome. Elevation of IL-6 and IL-18 may be more than just markers of atherosclerosis but actual participants in lesion development. Identification of critical regulatory pathway is important to improve the understanding of the cellular and molecular basis of atherosclerosis and may open the way for novel therapeutic strategies.

Study on the Relationship between Carotid Intima-Media Thickness and The Second Derivative of Photoplethysmogram Waveforms in Ischemic Stroke Patients (뇌경색 환자의 경동맥 내막 두께와 사속도맥파 검사의 관련성 연구)

  • Kang, Kyung Hwa;Kim, Kyoung Min
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.2
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    • pp.160-167
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    • 2015
  • The purpose of this study was to investigate the correlation of Intima-Media Thickness of common carotid artery(CCA-IMT) and The Second Derivative of Photoplethysmogram Waveforms(SDPTG). 38 subjects with acute ischemic stroke were recruited from the patients admitted to Dong-Eui Medical Center from the June 2013 to January 2014. We assessed 38 patient's SDPTG data and CCA-IMT data by B Mode ultrasonography. then 38 subjects were divided into two groups by the CCA-IMT difference; CCA-IMT 〈 0.8 mm group(n=11), CCA-IMT $$\geq_-$$ 0.8 mm group(n=27). We analyzed their characteristics, risk factor, blood test result, life style by CCA-IMT difference. As a result, Age, Hypertension were significantly higher in the CCA-IMT $$\geq_-$$ 0.8 mm group then in the CCA-IMT < 0.8 mm group. Regular exercise were significantly higher in the CCA-IMT < 0.8 mm group then in the CCA-IMT $$\geq_-$$ 0.8 mm group. The result of Multiple regression analysis on the factors affecting the CCA-IMT was hypertension, total cholesterol, age. and The result of Pearson's Correlation analysis on CCA-IMT and SDPTG is that e/a ratio, SDPTG AI were respectively and significantly correlated with CCA-IMT. According to the analysis, the Relationship between CCA-IMT and SDPTG in Ischemic Stroke Patients were founded. We suggest that further investigation with larger and better controlled trials of the Relationship between CCA-IMT and SDPTG could contribute to better understand the effects of risk factors on atherosclerosis.

The Study on the Diameter Ratio of the Artery-PTFE Anastomosis for the Optimized Deformed Shape (변형후 형상의 최적화를 위한 동맥과 PTFE 문합의 직경비 연구)

  • 이성욱;심재준;한근조
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.113-119
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    • 2003
  • In this paper we introduced optimized deformed shape to prevent the blood vessel disease caused by the discord of deformed shape in the end-to-end anastomosis. This study considered the preliminary deformed shape induced by suture in the anastomosis of artery and PTFE, artificial blood vessel, with different diameters. Then we analyzed the final deformed shape of the anastomotic part under the systolic blood pressure. 120mmHg(16.0kPa). The final deformed shape of the anstomotic part was analyzed with respect to the change of initial diameter ratio(R$_{I}$) and the PTFE thickness. Equivalent and circumferential stresses induced by the systolic blood pressure in the anastomosis were also analyzed with respect to the initial diameter ratio(R$_{I}$). The results obtained were as follows : 1. Considering the preliminary deformed shape induced by suture and the systolic pressure in the anastomosis, not intimal hyperplasia, the optimal initial diameter ratio(R$_{I}$) was 1.073. 2. As the initial diameter ratio(R$_{I}$) became larger, higher equivalent and circumferential stresses were induced. And all the maximum stresses occurred on the side of PTFE 0.4mm apart from the anastomosis.

Is There Any Spousal Concordance of Cerebrovascular Risk Factors in Stroke Patients? : A Preliminary Study (뇌졸중 환자에서 배우자 사이에 뇌혈관 질환의 위험요인 일치성이 있는가? : 예비 연구)

  • Lee, Hyung-Suk;Ko, Young-Chai;Baek, Shin-Hye;Shin, Kyeong-Seob;Kim, Ji-Sun;Han, Hyun-Jeong;Shin, Dong-Ick
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.308-316
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    • 2011
  • Familial concordance of vascular risk factors is well understood and there are many studies about inter-spouse concordance of the risk factors for coronary heart disease. However, there are no studies for inter-spousal relation of the risk factors in cerebrovascular disease patients. We analysed inter-spouse correlation of cerebrovascular risk factors in patients admitted our hospital due to stroke and their spouses. There was statistically significant inter-spouse concordance in the presence of hypertension(p=0.025) and carotid IMT(r=0.479, p=0.001). However, the further age-adjusted analysis revealed no significant result. Differently from the results of previous studie,, the present study shows no significant spousal concordance. Althought there are tendencies of spousal concordance in some risk factors, the age is major determinant.

New Carotid Artery Stenosis Measurement Method Using MRA Images (경동맥 MRA 영상을 이용한 새로운 내경 측정 방법)

  • 김도연;박종원
    • Journal of KIISE:Software and Applications
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    • v.30 no.12
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    • pp.1247-1254
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    • 2003
  • Currently. the north american symptomatic carotid endarterectomy trial, european carotid surgery trial, and common carotid method are used to measure the carotid stenosis for determining candidate for carotid endarterectomy using the projection angiography from different modalities such as digital subtraction angiography. rotational angiography, computed tomography angiography and magnetic resonance angiography. A new computerized carotid stenosis measuring system was developed using MR angiography axial image to overcome the drawbacks of conventional carotid stenosis measuring methods, to reduce the variability of inter-observer and intra-observer. The gray-level thresholding is one of the most popular and efficient method for image segmentation. We segmented the carotid artery and lumen from three-dimensional time-of-flight MRA axial image using gray-level thresholding technique. Using the measured intima-media thickness value of common carotid artery for each cases, we separated carotid artery wall from the segmented carotid artery region. After that, the regions of segmented carotid without artery wall were divided into region of blood flow and plaque. The calculation of carotid stenosis degree was performed as the following; carotid stenosis grading is(area measure of plaque/area measure of blood flow region and plaque) * 100%.

Clinical Outcome of Elective Single Embryo Transfer Compared to Elective Double Embryo Transfer Performed at the Cleavage Stage (2개 대비 1개의 난할기 선발배아 이식에 따른 임상 결과)

  • Kang, Sang-Min;Lee, Sang-Won;Jeong, Hak-Jun;Chae, Soo-Jin;Yoon, San-Hyun;Lim, Jin-Ho;Lee, Seong-Goo
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.349-359
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    • 2010
  • Objective: This study was performed to compare the clinical outcome of elective single embryo transfer (eSET) performed at the cleavage stage to that of elective double embryo transfer (eDET). Methods: Of the women less than 36 years old who visited Daegu Maria from January 2008 to April 2009, the only women (n=330) with more than 8 mm of endometrial thickness and at least one good quality embryo, who were treated with GnRH agonist long protocol, were included in this study. After information about complications that can arise by multiple embryo transfer, either eSET or eDET was conducted by their request (167 and 163, respectively).Results: The implantation rate of eSET group was significantly higher than that of eDET group (53.9% vs. 40.2%, p<0.01). The twin pregnancy rate of eSET group was significantly lower than that of eDET group (1.1% vs. 32.3%, p<0.001). However, there were no significant differences between two groups in the clinical pregnancy (53.3% vs. 60.7%, p=0.172), ongoing pregnancy (47.3% vs. 54.6%, p=0.185) and live birth rates (44.9% vs. 50.9%, p=0.275). The number of the surplus embryos which developed to the blastocyst stage and cryopreserved at that stage was significantly higher in eSET group than that of eDET group ($3.2{\pm}2.6$ vs. $2.1{\pm}2.4$, p<0.001). Conclusion: These results suggest that eSET should reduce significantly the multiple baby pregnancy without decreasing the whole pregnancy rate in women with less than 36 years old.

Relationship of Thickness of Carotid Artery according to Smoking and Drinking in University Students (대학생들의 흡연 및 음주에 따른 목동맥 두께의 상관성)

  • Kim, Dae-Sik;Sung, Hyun-Ho;Cho, Eun-Kyung;Lee, Jong-Woo
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.345-353
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    • 2018
  • This study examined the associations of smoking, alcohol drinking habits and both with the carotid intima-media thickness (CIMT) in university students. This study was performed using a CAGE (test for alcohol: cutting down, annoyance by criticism, guilty feeling, and eye-openers) questionnaire, FTND (the Fagerstrom test for nicotine dependence) questionnaire, and CIMT of university students. No statistically significant differences were observed among the CIMT results according to each CAGE level classified into 3 groups. The results of CIMT according to the FTND smoking categorization showed that the smoking group was higher than nonsmoking group (P<0.01). A statistically significant difference was observed between the left and right CIMT regarding smoking and drinking (P<0.01). In the only drink risk group, the left CIMT (19.84 rank) showed a low-ranking. The CIMT on the left (42.38 rank) and right (42.81 rank) showed high scores in the group with only the risk of smoking (P<0.01). These results suggested that there are distinct differences in CIMT and relevant risk factors between smokers and drinkers, particularly among those with a high smoking status. This study had several limitations: the study population was small; the relatively young age of the study subjects; and limited of focus on smoking, drinking and CIMT. In conclusion, cigarette smoking significantly exacerbates the adverse effects and higher CIMT on the subclinical atherosclerosis risk in young adults, which underscores the importance of prevention and cessation of cigarette smoking in young adults.

ART Outcomes in WHO Class I Anovulation: A Case-control Study (저성선자극호르몬 성선저하증 여성에서 보조생식술의 임신율)

  • Han, Ae-Ra;Park, Chan-Woo;Cha, Sun-Wha;Kim, Hye-Ok;Yang, Kwang-Moon;Kim, Jin-Young;Koong, Mi-Kyoung;Kang, Inn-Soo;Song, In-Ok
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.1
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    • pp.49-56
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    • 2010
  • Objective: To investigate assisted reproductive technology (ART) outcomes in women with WHO class I anovulation compared with control group. Design: Retrospective case-control study. Methods: Twenty-three infertile women with hypogonadotropic hypogonadism (H-H) who undertook ART procedure from August 2003 to January 2009 were enrolled in this study. A total of 59 cycles (H-H group) were included; Intra-uterine insemination with super-ovulation (SO-IUI, 32 cycles), in vitro fertilization with fresh embryo transfer (IVF-ET, 18 cycles) and subsequent frozenthawed embryo transfer (FET, 9 cycles). Age and BMI matched 146 cycles of infertile women were collected as control group; 64 cycles of unexplained infertile women for SO-IUI and 54 cycles of IVF-ET and 28 cycles of FET with tubal factor. We compared ART and pregnancy outcomes such as clinical pregnancy rate (CPR), clinical abortion rate (CAR), and live birth rate (LBR) between the two groups. Results: There was no difference in the mean age ($32.7{\pm}3.3$ vs. $32.6{\pm}2.7$ yrs) and BMI ($21.0{\pm}3.1$ vs. $20.8{\pm}3.1kg/m^2$) between two groups. Mean levels of basal LH, FSH, and $E_2$ in H-H group were $0.62{\pm}0.35$ mIU/ml, $2.60{\pm}2.30$ mIU/ml and $10.1{\pm}8.2$ pg/ml, respectively. For ovarian stimulation, H-H group needed higher total amount of gonadotropin injected and longer duration for ovarian stimulation (p<0.001). In SO-IUI cycles, there was no significant difference of CPR, CAR, and LBR between the two groups. In IVF-ET treatment, H-H group presented higher mean $E_2$ level on hCG day ($3104.8{\pm}1020.2$ pg/ml vs. $1878.3{\pm}1197.7$ pg/ml, p<0.001) with lower CPR (16.7 vs. 37.0%, p=0.11) and LBR (5.6 vs. 33.3%, p=0.02) and higher CAR (66.7 vs. 10.0%, p=0.02) compared with the control group. However, subsequent FET cycles showed no significant difference of CPR, CAR, and LBR between the two groups. Conclusion: H-H patients need higher dosage of gonadotropin and longer duration for ovarian stimulation compared with the control groups. Significantly poor pregnancy outcomes in IVF-ET cycles of H-H group may be due to detrimental endometrial factors caused by higher $E_2$ level and the absence of previous hormonal exposure on endometrium.

The Clinical Efficiency of Clomiphene Citrate vs Clomiphene Citrate/GnRH Antagonist on Infertile Women with Normal Ovulatory Cycles (정상 배란주기의 불임 여성에서 Clomiphene Citrate 단독 사용과 GnRH Antagonist 병합 요법의 임상적 효용성에 관한 연구)

  • Lee, Woo Seok;Sang, Jae Hong;Kim, Jae Joon;Kim, Gwang June;Kim, Dong Ho;Lee, Sang Hun
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.3
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    • pp.149-157
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    • 2006
  • Objective: This study was to investigate the clinical efficiency of clomiphene citrate/GnRH antagonist protocol comparing with the clomiphene citrate only protocol in infertile women with normal ovulatory cycles. Method: Among 116 patients, 43 were received assisted reproductive technologies using natural ovulatory cycle, 38 and 35 were received clomiphene citrate only protocol and clomiphene citrate/GnRH antagonist combined protocol, respectively, and the clinical results were compared and analyzed Results: In each group, basal levels of LH, FSH, $E_2$ and FSH, $E_2$ on hCG day injected were not different, but LH level and endometrial thickness on hCG injected day were decreased significantly and the pregnancy rate was increased significantly in clomiphene citrate/GnRH antagonist group. Conclusion: The pregnancy rate was increased significantly in clomiphene citrate/GnRH antagonist group compared with natural ovulatory cycle and clomiphene citrate only group.