• Title/Summary/Keyword: Carotid atherosclerosis

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Measurements of Carotid Intima, Media, and Intima-media Thickness and Their Clinical Importance (경동맥의 내막, 중막, 내중막 두께 분리측정 및 임상적 중요성)

  • Kim Wuon-Shik;Jeong Hwan-Taek;No Ki-Yong;Bae Jang-Ho
    • Progress in Medical Physics
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    • v.16 no.4
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    • pp.207-213
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    • 2005
  • The severity of carotid Intima-media thickness (IMT) is an Independent predictor of atherosclerosis which causes transient cerebral ischemia, stroke, and coronary events such as myocardial Infarction. The IMT consists of Intima thickness (IT) and media thickness (MT). However, the Individual clinical significance of IT and MT has not been well studied. We devised a method of measuring IT, MT, and IMT using B-mode ultrasound Image processing technique for the diagnosis of atherosclerosis. To inspect the clinical significance of IT, MT, and IMT, one hundred forty-four consecutive patients (mean age; 57 years old, 72 males) were underwent common carotid artery scanning using high-resolution ultrasound. Results showed that, the IT (p<0.05), MT (p<0.05) as well as IMT (p<0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hyperiension showed significantly thicker IT (p<0.01), MT (p<0.001), and IMT (p<0.001). However, only IT was thicker in patients with smoking (p<0.01). The IT (r=0.374, p=0.001), MT (r=0.433, p=0.000), and IMT (r=0.479, p=0.000) showed positive correlation with age. The coefficients of determination ($r^2$) were estimated to be $92.4\%$ for IMT and MT, $49.1\%$ for IMT and IT, and $27.4\%$ for IT and MT. This result suggests that the Intima layer of the carotid artery has a different physiology with the media layer.

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LIGHT is Expressed in Foam Cells and Involved in Destabilization of Atherosclerotic Plaques through Induction of Matrix Metalloproteinase-9 and IL-8

  • Kim, Won-Jung;Lee, Won-Ha
    • IMMUNE NETWORK
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    • v.4 no.2
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    • pp.116-122
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    • 2004
  • Background: LIGHT (TNFSF14) is a member of tumor necrosis factor superfamily and is the ligand for TR2 (TNFRSF14/HVEM). LIGHT is known to have proinflammatory roles in atherosclerosis. Methods: To find out the expression pattern of LIGHT in atherosclerotic plaques, immunohistochemical analysis was performed on human carotid atherosclerotic plaque specimens. LIGHT induced atherogenic events using human monocytic cell line THP-1 were also investigated. Results: Immunohistochemical analysis revealed expression of LIGHT and TR2 in foam cell rich regions in the atherosclerotic plaques. Double immunohistochemical analysis further confirmed the expression of LIGHT in foam cells. Stimulation of THP-1 cells, which express TR2, with either recombinant LIGHT or immobilized anti-TR2 monoclonal antibody induced interleukin-8 and matrix metalloproteinase(MMP)-9. Electrophoretic mobility shift assay demonstrated that LIGHT induces nuclear localization of transcription factor, nuclear factor $(NF)-{\kappa}B$. LIGHT induced activation of MMP-9 is mediated by $NF-{\kappa}B$, since treatment of THP-1 cells with the $NF-{\kappa}B$ inhibitor PDTC (pyrrolidine dithiocarbamate) completely blocked the activation of MMP-9. Conclusion: These data indicate that LIGHT is expressed in foam cells in atherosclerotic plaques and is involved in atherogenesis through activation of pro-atherogenic cytokine IL-8 and destabilization of plaque by inducing matrix degrading enzyme.

Effect of Hwangryunagyotang Water Extract on Endothelial Cells by Free Cholesterol. (황련아교탕(黃連阿膠湯)이 Free Cholesterol에 의한 혈관내피세포 손상에 미치는 영향)

  • Lee, So-Yeon;Yoon, Hyun-Duk;Shin, Oh-Chul;Shin, Yoo-Jung;Park, Chi-Sang
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.589-602
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    • 2006
  • Hwangryunagyotang is supposed to have significant effects on some sorts of cardiovascular diseases like atherosclerosis. For this study. ACAT inhibitor was put in LDLR -/- mice to derive free cholesterol from it. This was to examine the effectiveness of Hwangryunnagyotang on its protecting and recovering function with endothelial cells damaged by free cholesterol through experimental. The results reported below. Hwangryunagyotang suppressed the crystallization of reactive oxygen species in macrophages and the numbers of free cholesterol crystal plate structured and reduced fragmentation of nucleus in ECV 304 cell strain by ACAT inhibitor significantly. Hwangryunagyotang also suppressed the necrosis of tissue in LDLR -/- mice' (treated with ACAT inhibitor) inflammatory portion which is adjacent to aortic root, proximal aorta and carotid artery by immunohistochemistry and fluorescence microscopy. On the whole, Hwangryunagyotang suppressed the necrosis of endothelial cells and especially it's effcet for the necrosis of para-myocardial tissues by free cholesterol. With this result, I suggest Hwangryunagyotang might have protective and recovery effects on atherosclerosis, so we need to carry on this study henceforth clinically and experimentally as well.

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A Novel Urotensin II Receptor Antagonist, KR-36996 Inhibits Smooth Muscle Proliferation through ERK/ROS Pathway

  • Kim, Tae-Ho;Lee, Dong Gil;Kim, Young-Ae;Lee, Byung Ho;Yi, Kyu Yang;Jung, Yi-Sook
    • Biomolecules & Therapeutics
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    • v.25 no.3
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    • pp.308-314
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    • 2017
  • Urotensin II (UII) is a mitogenic and hypertrophic agent that can induce the proliferation of vascular cells. UII inhibition has been considered as beneficial strategy for atherosclerosis and restenosis. However, currently there is no therapeutics clinically available for atherosclerosis or restenosis. In this study, we evaluated the effects of a newly synthesized UII receptor (UT) antagonist, KR-36996, on the proliferation of SMCs in vitro and neointima formation in vivo in comparison with GSK-1440115, a known potent UT antagonist. In primary human aortic SMCs (HASMCs), UII (50 nM) induced proliferation was significantly inhibited by KR-36996 at 1, 10, and 100 nM which showed greater potency ($IC_{50}$: 3.5 nM) than GSK-1440115 ($IC_{50}$: 82.3 nM). UII-induced proliferation of HASMC cells was inhibited by U0126, an ERK1/2 inhibitor, but not by SP600125 (inhibitor of JNK) or SB202190 (inhibitor of p38 MAPK). UII increased the phosphorylation level of ERK1/2. Such increase was significantly inhibited by KR-36996. UII-induced proliferation was also inhibited by trolox, a scavenger for reactive oxygen species (ROS). UII-induced ROS generation was also decreased by KR-36996 treatment. In a carotid artery ligation mouse model, intimal thickening was dramatically suppressed by oral treatment with KR-36996 (30 mg/kg) which showed better efficacy than GSK-1440115. These results suggest that KR-36996 is a better candidate than GSK-1440115 in preventing vascular proliferation in the pathogenesis of atherosclerosis and restenosis.

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.

A Study on the Relationship between Carotid Artery Intima-Media Thickness and Clinical Chemistry Tests (경동맥 초음파 결과와 임상화학 검사의 상관성 연구)

  • Kim, Dae-Sik;Sung, Hyun-Ho;Cho, Eun-kyung;Lee, Jong-Woo
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.188-193
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    • 2015
  • Carotid Intima-Media Thickness (CIMT) testing is a test that precisely assesses cerebrovascular and coronary heart diseases. According to many previous studies, CIMT predicts atherosclerosis and is highly correlated to cardiovascular disease risk factors. It has also been reported that CIMT is an independent predictor of risk factors for myocardial infarction and stroke. Therefore, the purpose of this study is to investigate CIMT and other independent factors through a correlation study with the clinical laboratory test results of a blood test. As a result, this study could not prove the correlation between CIMT and risk factors of cardiovascular disease (TC, TG, LDL cholesterol, and HDL cholesterol) due to an insufficient number of subjects. Nevertheless, a positive correlation was demonstrated between CIMT and ALT (p<0.05), GGT (p<0.05), Uric acid (p<0.05), and CEA (p<0.05) at a statistically significant level, suggesting a continuation of the study.

The Relationship between Perceived Stress Scale and Carotid Intima-Media Thickness Using Ultrasonography in University Students (대학생들의 스트레스 지각 정도와 경동맥 내막-중막 두께의 관계 연구)

  • Kim, Dae-Sik;Sung, Hyun-Ho;Lee, Jong-Woo;Cho, Eun-Kyung
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.3
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    • pp.308-315
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    • 2017
  • Carotid artery intima-media thickness (CIMT) test is a standardized ultrasound procedure that screens for and monitors atherosclerosis in a safe and non-invasive manner, even in individuals with no symptoms of heart disease. The purpose of this study was to research the relationship between CIMT, as measured by ultrasonography, and the degree of individual perceived stress. There was a total of 168 (male: 46, female: 122) university students in Suwon-si, Gyeonggi-do, Korea, without other diseases. Written informed consent was obtained from all participants. CIMT was measured in the right and left common carotid arteries 1 cm below the bifurcation, and internal carotid artery, using non-invasive high-resolution Medison Accuvix V20 prestige ultrasound equipment and perceived stress, was measured with the 10-item PSS (Perceived Stress Scale) questionnaire. This study indicates that PSS may be appropriate to estimate perceived stress levels and weight. Failure to control stress anxiety could lead to weight and CIMT soaring to dangerous levels, resulting in a myocardial infarction or cerebrovascular accident. There was a statistically significant difference between left CIMT (p<0.05) and weight (p<0.05) according to each stress classification. The results of this study suggest that the weight measurement is influenced in part by one's generalized stress levels. Future continuous studies should be conducted to test the influences of perceived stress and generalized anxiety on CIMT when these are many continuous variables.

Inter-Rater Reliability of Carotid Intima-Media Thickness Measurements in a Multicenter Cohort Study (다기관 코호트 연구에서 경동맥 내막-중막 두께 측정의 측정자간 신뢰도 평가)

  • Lee, Jung Hyun;Choi, Dong Phil;Shim, Jee-Seon;Kim, Dae Jung;Park, Sung-Ha;Kim, Hyeon Chang
    • Journal of health informatics and statistics
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    • v.41 no.1
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    • pp.49-56
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    • 2016
  • Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632- 0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ${\pm}1.96$ SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.

Analysis of the Relationship between Fatty Pancreas and Cardiovascular Disease in Abdominal Ultrasonography (복부초음파검사에서 지방췌장증과 심혈관계질환과의 연관성 분석)

  • Cho, Jin-young;Ye, Soo-young
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.729-737
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    • 2019
  • Fatty pancreas is an abnormal process of lipid deposition in cells, resulting in increased fat tissue and obesity. The result is a risk factor for cardiovascular and metabolic diseases. The aim of this study was to evaluate the usefulness of pancreatic fat as a predictor of cardiovascular disease and metabolic syndrome in pancreatic ultrasonography. In 407 patients who underwent a comprehensive screening at the W Health Care Center in Busan from September 2. 2018 to December 31, 2018, the degree of fat deposition in the pancreas was evaluated as the degree of mild, moderate. Data on non-obstructive atherosclerosis, BMI, hyperlipidemia, hypertension, and diabetes were collected to assess the association of pancreatic fat deposition with cardiovascular disease and metabolic syndrome. In addition, we tried to analyze the correlation between liver dysfunction and thyroid dysfunction as the degree of fat pancreas increased. We examined the relationship between six parameters including atherosclerosis, BMI, hyperlipidemia, hypertension, diabetes, liver dysfunction, and thyroid dysfunction among patients with fatty pancreas. We concluded that the carotid intima-media thickness of atherosclerosis, which is a risk factor of cardiovascular disease, is most closely related to fatty pancreas.

Cerebral Aneurysms Arising from Unbranched Site of Intracranial Arteries (혈관가지가 없는 두개강내 혈관에서 발생한 뇌 동맥류)

  • Kim, Young Jin;Kim, Jae Min;Yi, Hyeong Joong;Bak, Koang Hum;Kim, Choong Hyun;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.521-527
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    • 2000
  • Objective : In general, most of saccular aneurysms arise at arterial divisions, but those arising at unbranched site are rare. These aneurysms might impose neurosurgeons a formidable surgical challenge, due to uncommon features and a difficult surgical technique. Methods : Between the period of Jan. 1996 and Dec. 1998, a total of 110 cases of aneurysms were operated. Among them, five cases of unbranched site aneurysms were retrospectively analyzed through medical records, angiographic and operative findings. Results : The incidence of aneurysms unrelated to arterial branches was 4.5%. All cases presented with subarachnoid hemorrhage(SAH) ; three(60%) were at internal carotid artery(ICA) and two(40%) at middle cerebral artery (MCA). Two had a history of hypertension and three showed atherosclerotic changes in the arterial wall. One ICA and one MCA aneurysms proved to be a blood blister-like aneurysm(BBA) in their shape. Strikingly, a rapid neurological deterioration was shown in two ruptured ICA variants, which resulted in death and another two aneurysms left with morbidity. Conclusion : The preoperative neurological status in most cases was relatively poor compared to that of aneurysms arising at a branched site. Regarding its pathogenesis, atherosclerosis as well as hemodynamic factors may play an important role in formation of these variant aneurysms among various etiological factors. The overall prognosis of unbranched site aneurysms was worse than that of branched site aneurysms. In cases of BBAs, special attention was requisite to handle them during clipping and/or wrapping due to an easy fragile, thin aneurysmal wall.

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