• Title/Summary/Keyword: Acute Coronary Syndrome

Search Result 96, Processing Time 0.029 seconds

The Effect of Endogenous and Exogenous Estrogen on Risk Factors of Coronary Heart Disease -Part II : On Platelet Aggregation- (내인성 및 외인성 Estogen이 관상동맥질환 위험인자에 미치는 영향 -제2보: 내인성 및 외인성 Estrogen이 혈소판 응집에 미치는 영향-)

  • 박유신
    • Journal of Nutrition and Health
    • /
    • v.32 no.5
    • /
    • pp.561-569
    • /
    • 1999
  • In the atherosclerotic subjects, arterial endothelial cell injury and plaque formation are suspected to be strong causable factors in developing acute coronary syndrome, and it was revealed that platelets have a very important role in this case. Women are exposed to atherosclerosis at a different degree after menopause or oral contraception. The purpose of this study was to determine the effects of endogenous and exogenous estrogen on the degree of platelet aggregation in platelet rich plasma(PRP) in twenty nonsmoking healthy Korean women for 12 weeks. The subjects were assigned to three groups: (1) eight women aged 49 to 60(yr) for the postmenopausel(Pst) group, (2) eight, aged 22 to 30(yr) for the premenopausa(Pre) group, (3) four, aged 23 to 30(yr) for the oral contraceptive (OC) group which used triphasic OC formulation. Fasting blood sample were obtained from the subjects, (1) once per 6 weeks in the Pst group, (2) every phase of the menstrual cycle in the Pre group, (3) each once during and after OC administration in the OC group. ADP, collagen and epinephrine were used as aggregating reagents, and platelet aggregation and time(Δt: time reaching to the maximum point of aggregation) in PRP were measured at the maximum point of aggregation in five minutes. All the data were adjusted for dietary effects, personality type and body mass index(BMI) by using analysis of covariation(ANCOVA). Platelet aggregation to ADP and collagen(MADP and MCOLL) were not significantly different among the three groups, and Δt to ADP and collagen(TADP and TCOLL) were not either. But maximum platelet aggregability and Δt to epinephrine(MEPIN and TEPIN) were significantly different among the three groups, and the OC group showed the lowest value (p<0.01). Maxtimum platelet aggregability and Δt during the menstrual cycle were not significantly different in the Pre group. Any other significant differences in the maximum platelet aggregability and Δt were found between oral contraception phase and washing out phase(menstruation) in the OC group. In results, maximum platelet aggregability and aggregation time to ADP and collagen seemed not to be affected by endogenous and exogenous estrogen, even though MEPIN and TEPIN showed significantly low in the OC group among the three groups.

  • PDF

Surgical Treatment of Left Main Coronary Artery Diseases (좌주관동맥협착의 외과적 치료)

  • 안병희;장원채
    • Journal of Chest Surgery
    • /
    • v.29 no.12
    • /
    • pp.1323-1328
    • /
    • 1996
  • The obstructive diseases involving the left main coronary artery(LMCA) are serious. Surgical treatment is generally regarded as much more effective than medical therapy in terms of long-term survival and relief of symptoms. This study represents an attempt to present an analysis of early surgical results in 21 cases conducted at Chonnam University Hospital between October 1992 And August 1995. The subject. 12 males and 9 female, ranged in age from 25 to 67 years with a mean age of 49.3${\pm}$12.5 years. As for indications for operation, unstable angina was reported on 66.7% of the subjects, while stable angina and acute myocardial infarction in 4 and 3 cases, respectively. There were also 2 cases of Takayasu's aortitis and 1 case of failed percutaneous translumlnal coronary angioplasty(PTCA). Eleven subjects had isolated LMCA diseases compared to 10 subjects with associated LMCA diseases. Of the patients with ass;3ciated LMCA diseases, 4 subjects had single coronary artery disease, 3 had double coronary artery disease, remaining 3 suffered from triple coronary artery disease. As for the group with isolated LMCA disease, ostidl angioplasty llsing autopericardium was conducted with 5 subjects. The remaining subjects with the isolated diseases and all of the patients with associated LMCA disease underwent aortocoronary bypass grafts. The left internal mammary artery was used in all patients and the average number of anastomoses was 3.13 ${\pm}$0.93. One subject died of low cardiac output syndrome at the second postoperative day. There were 5 instances of postoperative complication including reoperation for bleeding in two patients, wound infection in two, and arrhythmia in one. Follow-up coronary angiogram were conducted with eights patients, including five patients who underwent ostial angioplasty. In these cases, the patients showed surf. ficient enlargement of the left coronary ostium and the grafted vessels kept their patency. In our experience, surgical treatment of the LMCA diseases has not shown a higher rAte of operative mortAlity or morbidity than other obstructive coronary artery diseases. To patients with ostial stenosis, which is frequently observed among young female, angioplasly utilizing autopericardium seems to be a desirable choice considering the cosmetic effect, chances of reoperation and hemodynamic characteristics.

  • PDF

New Methodology to Develop Multi-parametric Measure of Heart Rate Variability Diagnosing Cardiovascular Disease

  • Jin, Seung-Hyun;Kim, Wuon-Shik;Park, Yong-Ki
    • International Journal of Vascular Biomedical Engineering
    • /
    • v.3 no.2
    • /
    • pp.17-24
    • /
    • 2005
  • The main purpose of our study is to propose a new methodology to develop the multi-parametric measure including linear and nonlinear measures of heart rate variability diagnosing cardiovascular disease. We recorded electrocardiogram for three recumbent postures; the supine, left lateral, and right lateral postures. Twenty control subjects (age: $56.70{\pm}9.23$ years), 51 patients with angina pectoris (age: $59.98{\pm}8.41$ years) and 13 patients with acute coronary syndrome (age: $59.08{\pm}9.86$ years) participated in this study. To develop the multi-parametric measure of HRV, we used the multiple discriminant analysis method among statistical techniques. As a result, the multiple discriminant analysis gave 75.0% of goodness of fit. When the linear and nonlinear measures of HRV are individually used as a clinical tool to diagnose cardiac autonomic function, there is quite a possibility that the wrong results will be obtained due to each measure has different characteristics. Although our study is a preliminary one, we suggest that the multi-parametric measure, which takes into consideration the whole possible linear and nonlinear measures of HRV, may be helpful to diagnose the cardiovascular disease as a diagnostic supplementary tool.

  • PDF

Stress-induced Cardiomyopathy during Pulmonary Resection (Takotsubo Syndrome) - A case report -

  • Lee, Seok-Kee;Lim, Seung-Pyung;Yu, Jae-Hyeon;Na, Myung-Hoon;Kang, Shin-Kwang;Kang, Min-Woong;Oh, Hyun-Kong
    • Journal of Chest Surgery
    • /
    • v.44 no.4
    • /
    • pp.294-297
    • /
    • 2011
  • Stress-induced cardiomyopathy is caused by emotional or physical stressors and mimics acute myocardial infarction, though Stress-induced cardiomyopathy is characterized by reversible left ventricular (LV) apical ballooning in the absence of significant coronary artery disease. We describe a 51-year-old male who underwent left upper lobectomy for non-small cell lung cancer, and during which cardiogenic arrest occurred due to stress-induced cardiomyopathy, successfully managed by intra-aortic balloon pumping and extracorporeal membrane oxygenation.

The protective effect of Prunella vulgaris ethanol extract against vascular inflammation in TNF-α-stimulated human aortic smooth muscle cells

  • Park, Sun Haeng;Koo, Hyun Jung;Sung, Yoon Young;Kim, Ho Kyoung
    • BMB Reports
    • /
    • v.46 no.7
    • /
    • pp.352-357
    • /
    • 2013
  • Atherosclerosis, which manifests as acute coronary syndrome, stroke, and peripheral arterial diseases, is a chronic inflammatory disease of the arterial wall. Prunella vulgaris, a perennial herb with a worldwide distribution, has been used as a traditional medicine in inflammatory disease. Here, we investigated the effects of P. vulgaris ethanol extract on TNF-${\alpha}$-induced inflammatory responses in human aortic smooth muscle cells (HASMCs). We found that P. vulgaris ethanol extract inhibited adhesion of monocyte/macrophage-like THP-1 cells to activated HASMCs. It also decreased expression of intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin and ROS, No production in TNF-${\alpha}$-induced HASMCs and reduced NF-${\kappa}B$ activation. Furthermore, P. vulgaris extract suppressed TNF-${\alpha}$-induced phosphorylation of p38 mitogen-activated protein kinase (MAPK) and extracellular signal-regulated kinase (ERK). These results demonstrate that P. vulgaris possesses anti-inflammatory properties and can regulate TNF-${\alpha}$-induced expression of adhesion molecules by inhibiting the p38 MAPK/ERK signaling pathway.

Recent Research Trends of Sayeok-tang Used in Ischemic Heart Disease (허혈성 심질환에 활용된 사역탕(四逆湯)의 최신 연구 동향)

  • Jang, Il-Woong;Hong, Jun-yeong;Lee, Soong-in
    • 대한상한금궤의학회지
    • /
    • v.13 no.1
    • /
    • pp.1-19
    • /
    • 2021
  • Purpose : Sayeok-tang (Sini decoction, SND) is a cold-dispelling formula used for cold deficiency syndrome and is composed of Aconiti Lateralis Radix Preperata, Zingiberis Rhizoma, and Glycyrrhizae Radix et Rhizoma. It is used for diseases such as myocardial infarction, heart failure, acute and chronic gastroenteritis, and gastric effusion. This study proposes the possibility of expansion of basic research and clinical applications for ischemic heart disease (IHD) through systematic analysis of domestic and foreign studies on SND. Methods : We collected studies within the last 10 years on the use of SND in IHD and excluded those lacking relevance. Selected studies were classified by research method and the main themes of the studies were analyzed for each classification. Result: Out of 15 studies, there were 5 animal studies, 8 metabolite analyses in animals, 1 in vitro study, and 1 systematic review. Our review suggests that SND may be used as an adjuvant to nitroglycerin and percutaneous transluminal coronary angioplasty, and may improve symptoms and quality of life of patients with IHD. Myocardial protective effects through antioxidant, anti-inflammatory, anti-apoptotic, and anti-hypertensive actions were confirmed through these studies. Effects on carbohydrate, protein, and lipid metabolism were also reported. Conclusions : This study suggests that SND has potential as a treatment for IHD.

Infliximab treatment for a patient with refractory Kawasaki disease (Infliximab으로 치료한 난치성 가와사끼병 1례)

  • Yu, Hyo-Jung;Lee, Soo-Jin;Sohn, Sejung
    • Clinical and Experimental Pediatrics
    • /
    • v.49 no.9
    • /
    • pp.987-990
    • /
    • 2006
  • Intravenous immunoglobulin (IVIG) infusion is an effective therapy for acute Kawasaki disease (KD). Nonetheless, approximately 10 percent to 20 percent of patients have persistent or recrudescent fever despite IVIG treatment, leading to a higher risk for coronary artery aneurysms (CAA). This unresponsiveness may pose a challenge to the clinicians. Tumor necrosis $factor-{\alpha}$ levels are elevated in the acute phase of the disease, especially in patients who develop CAA. We report a 10-month-old male with KD who failed to respond to multiple doses of IVIG and methylprednisolone and who then was treated with infliximab (5 mg/kg single dose). After infliximab treatment, he became afebrile with normalization of inflammatory markers and no further progression of CAA.

Emergency Coronary Artery Bypass Operation for Card iogen ic Shock (심인성 쇼크에 대한 응급 관상동맥 우회술)

  • 김응중;이원용
    • Journal of Chest Surgery
    • /
    • v.30 no.10
    • /
    • pp.966-972
    • /
    • 1997
  • Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ve'ntricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Pive out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical sten sis limited to left main coronary artery, left main coronary angioplasty was performed. Pive patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.

  • PDF

A case of adolescent Kawasaki disease with Epstein-Barr virus-associated infectious mononucleosis complicated by splenic infarction (전염성 단핵구증과 비경색증이 동반된 청소년 난치성 가와사끼병 1예)

  • Choi, Byeong Sam;Kwon, Bo Sang;Kim, Gi Beom;Jeon, Yoon Kyung;Cheon, Jung-Eun;Bae, Eun Jung;Noh, Chung Il;Choi, Jung Yun;Yun, Yong Soo
    • Clinical and Experimental Pediatrics
    • /
    • v.52 no.9
    • /
    • pp.1029-1034
    • /
    • 2009
  • Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that affects children. There are few reports that describe the Epstein-Barr virus (EBV) as the possible infectious agent of KD. Here, we describe a case of KD in a 15-year-old boy complicated with giant coronary artery aneurysms, pericardial effusion, and splenic infarction. The clinical course of KD was refractory to intravenous gamma globulin and aspirin. Our patient also showed typical findings of concomitant EBV-associated infectious mononucleosis, such as hepatosplenomegaly and generalized lymphadenopathy, with EBV-positive atypical lymphoid hyperplasia. He improved dramatically after receiving intravenous methylprednisolone followed by oral prednisolone. Ultimately, the coronary artery aneurysms remained as the only sequelae. We report a rare case of adolescent KD with EBV-associated infectious mononucleosis and splenic infarction.

Current Status of Systems Biology in Traditional Chinese medicine - in regards to influences to Korean Medicine (최근 중의학에서 시스템생물학의 발전 현황 - 한의학에 미치는 영향 및 시사점을 중심으로 -)

  • Lee, Seungeun;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
    • /
    • v.21 no.2
    • /
    • pp.1-13
    • /
    • 2017
  • Objectives : This paper serves to explore current trends of systems biology in Traditional Chinese Medicine (TCM) and examine how it may influence the Traditional Korean medicine. Methods : Literature review method was collectively used to classify Introduction to systems biology, diagnosis and syndrome classification of systems biology in TCM perspective, physiotherapy including acupuncture, herbs and formula functions, TCM systems biology, and directions of academic development. Results : The term 'Systems biology' is coined as a combination of systems science and biology. It is a field of study that tries to understand living organism by establishing a theory based on an ideal model that analyzes and predicts the desired output with understanding of interrelationships and dynamics between variables. Systems biology has an integrated and multi-dimensional nature that observes the interaction among the elements constructing the network. The current state of systems biology in TCM is categorized into 4 parts: diagnosis and syndrome, physical therapy, herbs and formulas and academic development of TCM systems biology and its technology. Diagnosis and syndrome field is focusing on developing TCM into personalized medicine by clarifying Kidney yin deficiency patterns and metabolic differences among five patterns of diabetes and analyzing plasma metabolism and biomarkers of coronary heart disease patients. In the field of physical therapy such as acupuncture and moxibustion, researchers discovered the effect of stimulating acupoint ST40 on gene expression and the effects of acupuncture on treating functional dyspepsia and acute ischemic stroke. Herbs and formulas were analyzed with TCM network pharmacology. The therapeutic mechanisms of Si Wu Tang and its series formulas are explained by identifying potential active substances, targets and mechanism of action, including metabolic pathways of amino acid and fatty acid. For the academic development of TCM systems biology and its technology, it is necessary to integrate massive database, integrate pharmacokinetics and pharmacodynamics, as well as systems biology. It is also essential to establish a platform to maximize herbal treatment through accumulation of research data and diseases-specific, or drug-specific network combined with clinical experiences, and identify functions and roles of molecules in herbs and conduct animal-based studies within TCM frame. So far, few literature reviews exist for systems biology in traditional Korean medicine and they merely re-examine known efficacies of simple substances, herbs and formulas. For the future, it is necessary to identify specific mechanisms of working agents and targets to maximize the effects of traditional medicine modalities. Conclusions : Systems biology is widely accepted and studied in TCM and already advanced into a field known as 'TCM systems biology', which calls for the study of incorporating TCM and systems biology. It is time for traditional Korean medicine to acknowledge the importance of systems biology and present scientific basis of traditional medicine and establish the principles of diagnosis, prevention and treatment of diseases. By doing so, traditional Korean medicine would be innovated and further developed into a personalized medicine.