• Clinical and Experimental Pediatrics
• /
• v.48 no.2
• /
• pp.212-215
• /
• 2005

Renal artery stenosis is a major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. There are several methods to treat renal artery stenosis, including surgery, percutaneous transluminal renal angioplasty(PTRA), and renal artery stenting(RAS). But, renal artery embolization can be tried in atherosclerotic stenosis, multiple stenosis, microaneurysm, and stenosis difficult to try PTRA or RAS. We report a case of renovascular hypertension in a 14-year-old female who had multiple segmental renal artery stenosis. Hypertension was controlled by renal ablation therapy with renal artery embolization.

• Clinical and Experimental Pediatrics
• /
• v.49 no.12
• /
• pp.1363-1366
• /
• 2006

Aneurysmal dilatation of the ductus arteriosis has been considered a rare but potentially fatal abnormality. The mechanism of ductal aneurysmal formation remains uncertain. Plain chest radiography has proven helpful in the diagnosis of ductus arteriosus aneurysm (DAA), before the application of transthoracic echocardiography. The transthoracic echocardiography is an important tool for the diagnosis and follow-up of DAA. We present a case of congenital ductus arteriosus aneurysm in a newborn, that was an incidental discovery. The diagnosis was made by echocardiography, three-dimensional surface rendering computed tomography (CT), and spontaneous regression after four weeks of follow-up.

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.655-658
• /
• 2008

Subclavian artery aneurysms are quite rare and they are known to be as only 1% of all peripheral aneurysms. Atherosclerotic disease is the most common cause of subclavian artery aneurysms. These aneurysms can cause rupture, thrombosis, embolisms or symptoms by local compression. Surgical operations are generally performed as treatment. We report here on a case of successful surgical treatment for a right proximal subcalvian artery aneurysm, and the surgery was peformed via the medical exclusion method.

• Clinical and Experimental Pediatrics
• /
• v.49 no.4
• /
• pp.368-374
• /
• 2006

Purpose : The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. Methods : Thirty-eight obese children(14-16 years old of age, male, body mass index $29.40{\pm}3.18kg/m^2$) and forty-five age and sex-matched healthy control children(body mass index $18.43{\pm}1.01kg/m^2$) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flowmediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. Results : The obese children had significantly increased IMT($0.52{\pm}0.09mm$ vs $0.40{\pm}0.07mm$, P< 0.001) and markedly impaired FMD($7.35{\pm}7.78$ percent vs $20.34{\pm}16.81$ percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P<0.001) and reduced FMD(r=-0.414, P<0.001). Conclusion : We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.610-618
• /
• 2008

Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

• Journal of Life Science
• /
• v.32 no.3
• /
• pp.256-262
• /
• 2022

Oxysterols are oxygenated metabolites of cholesterol generated by serial enzymatic reactions during bile acid synthesis. Similar to cholesterol, oxysterols move rapidly to the intracellular region and modulate various cellular processes, such as immune cell responses, lipid metabolism, and cholesterol homeostasis. Different nuclear transcription factors, such as glucocorticoid, estrogen, and liver X receptors, can be modulated by oxysterols in multiple tissues. The most abundant oxysterol, 27-hydroxycholesterol (27-OHC), is a well-known selective modulator that can either activate or suppress estrogen receptor activity in a tissue-specific manner. The contribution of 27-OHC in atherosclerosis development is apparent because a large amount of it is found in atherosclerotic plaques, accelerating the transformation of macrophages into foam cells that uptake extracellular modified lipids. According to previous studies, however, there are opposing opinions about how 27-OHC affects lipid and cholesterol metabolism in metabolic organs, including the liver and adipose tissue. In particular, the effects of 27-OHC on lipid metabolism are entirely different between in vitro and in vivo conditions, suggesting that understanding the physiology of this oxysterol requires a sophisticated approach. This review summarizes the potential effects of 27-OHC in atherosclerosis and metabolic syndromes with a special discussion of its role in metabolic tissues.

• Proceedings of the Korean Society of Applied Pharmacology
• /
• 2001.04a
• /
• pp.45-59
• /
• 2001

최근 급속한 산업화와 경제발전으로 인해 소득수준이 향상되면서, 고단백질 및 고지방질 식품의 섭취 및 운동부족으로 인한 성인병, 특히 비만증, 고지혈증, 당뇨병 및 심장순환기계질환이 급속히 증가되어 사회문제로 대두되었고, 한국을 포함한 선진각국의 고지혈증 및 심장순환기계질환의 발병빈도가 여전히 증가추세에 있다. 보건위생의 여건이 좋아지면서 전염성질환이 줄어들었으나, 심장 순환기 질환의 발병률은 계속 증가추세에 있고, 순환기질환은 고지혈증에 의하여 발병되며 이 질환의 사망률은 전체 사망률 중 상위를 차지하고 있다. 인간은 고지혈증에 의한 동맥경화로 인한 사망률은 전체 사망률 중에서 상위를 차지하고 있으며, 그에 따른 의약품의 개발이 요구되고 있고, 현재 임상적으로 사용되고 있는 고지혈증 치료제로는 체내의 cholesterol 생합성 저해제가 있으나, 보다 제한사항이 없고, 작용기작이 확실하며 부작용이 적은 새로운 고치혈증 치료제의 개발이 요구되고 있다. 콜레스테롤은 세포막의 구성과 스테로이드 호르몬의 전구체로서 생체를 구성하는데 필수적인 요소이지만 과다하게 공급되었을 경우 동맥경화와 같은 심혈관계 질환을 유발할 수 있다. 체내에 콜레스테롤의 공급은 체외 음식물로부터 섭취하는 방법과 체내에서 생합성에 의해 공급되는 방법이 있는데, 서로 유기적인 보완관계를 유지하면서 필요한 콜레스테롤의 양을 유지한다. 그러나, 현대인의 식생활이 급격한 서구화로 체외로부터 필요량 이상으로 콜레스테롤이 유입되어 각종 성인병 발명의 상승 요인이 되고 있다.

• Food Industry And Nutrition
• /
• v.9 no.1
• /
• pp.46-52
• /
• 2004

최근 생활수준의 향상으로 식생활의 서구화와 식품의 제조 및 가공기술의 발달로 장기저장 식품 및 인스턴트식품의 이용도가 현저히 증가하고 있으며 이를 위한 식품첨가물에 대한 관심도 높아지고 있다. 식문화가 바뀌면서 당뇨병, 고혈압, 동맥 경화증 등의 성인병 질환이 급증하고 (1,2) 이러한 만성병의 증가로 식품과 질병과의 연계성에 관한 관심이 급격히 증가하고 있다. 이러한 경향에 따라 식물성 원료의 생리활성 성분에 대한 관심이 높아지고 국내ㆍ외적으로 생리활성 성분을 함유한 신소재 식물들을 원료로 이용하려는 시도가 많이 이루어지고 있다(3,4). (중략)

• Clinical and Experimental Pediatrics
• /
• v.48 no.7
• /
• pp.745-752
• /
• 2005

Purpose : Adolescent obesity is known to be associated with complications such as hypertension, coronary artery disease and insulin resistance. We measured the common carotid artery by ultrasound as a predictor of atherosclerosis, and investigated the relationship between carotid artery parameters and serum cytokines in obese adolescents. Methods : Twenty-nine obese adolescents(16-17 years old, obesity index>130 percent) and twentyseven normal controls were included. Obesity index and body mass index were calculated from their height and weight. Skin fold thickness was measured at the triceps, and fat mass and fat distribution by bioelectrical impedence analysis. Blood pressure was measured at resting state and serum lipid, insulin, and homocysteine levels after a 12-hour fasting period. Intimal wall thickness, systolic and diastolic diameters of the common carotid artery were measured by ultrasound, and compliance and distensibility calculated by equation. Results : Systolic and diastolic diameters of the carotid artery significantly correlated with arm circumference, body mass index, fat distribution and fat mass. The higher systolic blood pressure was, the larger systolic and diastolic diameter. The higher diastolic blood pressure was, the larger carotid intimal thickness. Insulin levels had positive correlations with systolic, diastolic diameters and serum homocysteine level with intimal thickness. Conclusion : The carotid artery diameter significantly increased with the degree of obesity and blood pressure. The carotid intimal wall thickness significantly correlated with diastolic blood pressure. Measurement of carotid artery thickness, insulin and homocysteine levels might be useful to predict the development of coronary artery disease.

• The Monthly Diabetes
• /
• s.240
• /
• pp.52-53
• /
• 2009

최근 우리나라 당뇨 대란에 젊은 층의 당뇨 발병이 큰 몫을 하고 있다. 다행인 것은 이들 대부분은 당뇨 전 단계 수준이라는 것. 하지만 마음은 놓지 말자. 당뇨 전단계는 당뇨병 진단을 유보한 상태지만 수년 내에 당뇨병으로 진행할 가능성이 높고 동맥경화증에 걸릴 위험성도 있기 때문에 관리를 소홀히 해서는 안 된다. 병이 되기 직전에 확실하게 고치자!