• BMB Reports
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• 제47권1호
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• pp.1-7
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• 2014

Atherosclerosis is a pathologic process occurring within the artery, in which many cell types, including T cell, macrophages, endothelial cells, and smooth muscle cells, interact, and cause chronic inflammation, in response to various inner- or outer-cellular stimuli. Atherosclerosis is characterized by a complex interaction of inflammation, lipid deposition, vascular smooth muscle cell proliferation, endothelial dysfunction, and extracellular matrix remodeling, which will result in the formation of an intimal plaque. Although the regulation and function of vascular smooth muscle cells are important in the progression of atherosclerosis, the roles of smooth muscle cells in regulating vascular inflammation are rarely focused upon, compared to those of endothelial cells or inflammatory cells. Therefore, in this review, we will discuss here how smooth muscle cells contribute or regulate the inflammatory reaction in the progression of atherosclerosis, especially in the context of the activation of various membrane receptors, and how they may regulate vascular inflammation.

• Journal of Korean Neurosurgical Society
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• 제39권1호
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• pp.46-51
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• 2006

Objective : An Intracranial aneurysm is an important acquired cerebrovascular disease that can cause a catastrophic subarachnoid hemorrhage. Atherosclerosis is one of possible mechanism, but its contribution to aneurysm formation is unclear. Human apolipoprotein E[apoE] is best known for its arterial protection from atherosclerosis. In this study we observe apoE expression in experimental cerebral aneurysms of rats to elucidate the role of apoE in the process of cerebral aneurysm formation. Methods : Twenty-four male 7-week-old Sprague-Dawley strain rats received a cerebral aneurysm induction procedure. One month[12] and three months[12] after the operation, the rats were killed, their cerebral arteries were dissected, and the regions of the bifurcation of the right anterior cerebral artery-olfactory artery [ACA-OA] bifurcations were examined histologically and immunohistochemically. Results : In the 1 month group [n=12], the ACA-OA bifurcation showed no aneurysmal change in 7 rats and early aneurysmal change in 5 rats. In the 3 months group (n=12), the bifurcation showed no aneurysmal change in 2 rats and an advanced aneurysm in 10 rats. ApoE expression were in 3 specimen in early aneurysmal change, but not in advanced aneurysms. Conclusion : ApoE expression in early aneurysmal wall suggests a possible role for apoE in early events leading to aneurysm formation. Further studios are necessary to elucidate the exact role of apoE in the pathophysiology of cerebral aneurysm.

• Nutrition Research and Practice
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• 제10권5호
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• pp.516-523
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• 2016

BACKGROUND/OBJECTIVES: This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS: A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS: When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits ($73.1{\pm}83.2g$ vs. $230.9{\pm}202.1g$, P < 0.001), vegetables ($221.1{\pm}209.0g$ vs. $561.7{\pm}306.6g$, P < 0.001), and antioxidants, including vitamins C, E, $B_6$, ${\beta}$-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, $B_6$, $B_{12}$, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin $B_{12}$ intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS: When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.

• 한국방사선학회논문지
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• 제13권6호
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• pp.873-878
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• 2019

뇌혈관 질환은 우리나라의 주요 10대 사망 원인 중 3대 사인에 해당하며, 이러한 질환은 동맥경화와 관련이 있으므로 동맥경화를 예측할 수 있는 인자의 진단 방향의 제시가 필요하다. 본 논문에서는 연령대별 상완-발목동맥 맥파전달속도와 뇌동맥 혈관 협착 및 혈압, 비만도, 복부비만과의 유의성을 평가하였으며, 뇌동맥 혈관 협착과 연령대별 유의성 평가는 50대의 연령대에서만 유의한 결과를 나타내었으며, 동맥경화의 위험인자인 혈압, 비만, 복부비만의 경우 전체 연령대에서 유의한 결과를 나타내었다. 그리고 상완-발목동맥 맥파전달속도가 상승하였을 경우, 뇌동맥 혈관 협착은 전체 1,376명중 788명으로 57.2%의 분포를 나타내었으며, 위험인자인 혈압의 경우, 전체 7,557명중 3,255명으로 43%, 비만도는 2,708로 35.8%, 복부비만은 2,941명으로 38.9%의 분포를 나타내었다. 이러한 결과를 통하여 상완-발목동맥 맥파전달속도 검사 시, 동맥경화가 의심된다면 우선적으로 뇌동맥 혈관 협착을 의심하고 뇌동맥 혈관 검사를 시행할 것을 권한다. 동맥경화의 위험인자인 혈압, 비만, 복부비만과의 유의성 평가를 통하여 향 후 유사 연구 시, 기초자료로 활용될 것이라고 사료된다.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.116-123
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• 2008

Objective : The objective of this study is to investigate clinical characteristics, management methods and possible causes of intracranial fusiform aneurysm. Methods : Out of a series of 2,458 intracranial aneurysms treated surgically or endovascularly, 22 patients were identified who had discrete fusiform aneurysms. Clinical presentations, locations, treatment methods and possible causes of these aneurysms were analyzed. Results : Ten patients of fusiform aneurysm were presented with hemorrhage, 5 patients with dizziness with/without headache, 4 with ischemic neurologic deficit, and 1 with 6th nerve palsy from mass effect of aneurysm. Two aneurysms were discovered incidentally. Seventeen aneurysms were located in the anterior circulation, other five in the posterior circulation. The most frequent site of fusiform aneurysm was a middle cerebral artery. The aneurysms were treated with clip, and/or wrapping in 7, resection with/without extracranial-intracranial (EC-IC) bypass in 6, proximal occlusion with coils with/without EC-IC bypass in 5, EC-IC bypass only in 1 and conservative treatment in 3 patient. We obtained good outcome in 20 out of 22 patients. The possible causes of fusiform aneurysms were regard as dissection in 16, atherosclerosis in 4 and collagen disease or uncertain in 2 cases. Conclusion : There is a subset of cerebral aneurysms with discrete fusiform morphology. Although the dissection or injury of internal elastic lamina of the cerebral vessel is proposed as the underlying cause for most of fusiform aneurysm, more study about pathogenesis of these lesions is required.

• Journal of Ginseng Research
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• 제46권4호
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• pp.585-591
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• 2022

Background: Korean Red Ginseng (KRG) extract has been shown to have beneficial effects in patients with atherosclerosis, suggesting that KRG extract may be effective in preventing subsequent ischemic stroke in patients with severe atherosclerosis. Methods: This double-blind, placebo-controlled trial randomized patients with severe atherosclerosis in major intracranial arteries or extracranial carotid artery, to ginseng group and placebo group. They were given two 500-mg KRG tablets or identical placebo tablets twice daily for 12 months according to randomization. The primary endpoint was the composite of cerebral ischemic stroke and transient ischemic attack during 12 months after randomization. The secondary endpoints were change in volumetric blood flow of the intracranial vessels and the incidence of newly developed asymptomatic ischemic lesions. Any adverse events were monitored. Results: Fifty-eight patients were randomized from June 2016 to June 2017, 29 to ginseng and 29 to placebo, and 52 (28 and 24, respectively) completed the study. One patient in the placebo group, but none in the ginseng group, experienced ischemic symptoms (p = 0.46). Changes in volumetric blood flow and the presence of ischemic brain lesions did not differ significantly in the two groups, and none of these patients experienced adverse drug reactions. Conclusion: Ginseng was well tolerated by patients with severe atherosclerosis, with these patients showing good compliance with ginseng dosing. Ginseng did not show significant effects compared with placebo, although none of the ginseng-treated patients experienced ischemic events. Long-term studies in larger patient populations are required to test the effect of ginseng.

• BMB Reports
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• 제42권4호
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• pp.200-205
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• 2009

Thromboxane A2 (TBXA2) is a potent vasoconstrictor in cerebral circulation and is a known contributor to the pathogenesis of cerebral infarction. Thromboxane A2 synthase 1 (TBXAS1) and thromboxane A2 receptors (TBXA2R) are key components in TBXA2 function. We examined whether genetic variants in TBXA2R and TBXAS1 are risk factors for cerebral infarction by genotyping 453 Korean patients with noncardiogenic cerebral infarction and 260 controls. A few, specific polymorphisms in the TBXA2R (-3372G>C, +4710T>C and 4839T>C) and TBXAS1 (+16184G>T, +141931A>T and +177729G>A) genes were chosen and investigated. Logistic regression showed the frequencies of TBXAS1+16184G>T and TBXAS1-ht3 were significantly more frequent in cerebral infarction (P = 0.002, OR = 2.75 and P = 0.01, OR = 1.57, respectively), specifically in small-artery occlusion (SAO) type of cerebral infarction (P = 0.0003 and 0.005, respectively). These results suggest specific TBXAS1 gene polymorphisms may be a useful marker for development of cerebral infarction, especially SAO type in Korean population.

• 한방안이비인후피부과학회지
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• 제11권1호
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• pp.240-250
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• 1998

Background: Ginkgo biloba extract is used in disorser of cerebral and peripheral blood circulation, dysfunction of brain, atherosclerosis etc., but there are little study about GbE in oriental medicine. We wished to assessthe efficacy of GbE for the treatment of cerebral infarction Method : The study group comprised 40 patients who arrived at hospital during 48 hours after attack. All patient were devided into two group. The control group was treated with Uhuangcheongsimhuan, Seonghyangjeonggisan, acupuncture therapy only, while the GbE group was treated with above therapy plus 5 days of administration of GbE(40mg three times per day). Result: 1. Symptom improve scores did not showed significant difference between control and GbE group. 2. Vasoreactivity of carotid siphon increased significantly in GbE group after treatment (in the left only : p<0.05). 3. Vasorcactivity of radial artery increased significantly in GbE group after treatment(in the right only ; p<0.05). 4. PT, a-PTT, Fibrinogen did not showed significant changes between before and after treatment in both group. Conclusion: These findings suggest that vasoreactivity increasing effect of GbE may be useful in the prevention and treatment of cerebral infarction. But the vasoreactivity increasing effect of GbE may be different from symptom imroving.

• 한국산학기술학회논문지
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• 제19권7호
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• pp.239-244
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• 2018

뇌경색의 주요 원인인 동맥 박리와 죽상경화증으로 인한 동맥 폐색 모두 고식적 자기공명혈관조영술이나 컴퓨터단층혈관조영술에서 혈관이 막힌 것처럼 보이지만, 발생 기전이 다르기 때문에 치료 방향에 차이가 생길 수 있다. 최근 고해상도MRI가 발달하면서 비침습적으로 혈관벽의 영상을 확인할 수 있게 되었다. 임상적으로 혹은 영상학적으로 동맥 박리가 의심되는 환자에게 고해상도MRI는 매우 유용한 검사방법으로 자리 잡고 있으나, 아직 두 질환의 감별점이 완전히 적립 되지는 않았다. 저자들은 컴퓨터단층혈관조영술에서 척추동맥폐색이 관찰된 두 환자에서 고해상도MRI를 통해 척추동맥박리와 죽상경화증의 차이점을 찾아보았고, 이를 추적 관찰하였다. 지금까지 알려진 혈관벽의 형태, 내막 판, 이중 내막, 혈관벽내 혈종, 가성 동맥류, 동맥벽의 초승달 모양 고신호 강도와 같은 동맥박리의 특징뿐만 아니라 저자들이 경험한 증례와 같이 긴 협착 길이, 폐쇄 부위 혈관의 재개통도 동맥 박리를 시사하는 소견이라고 판단하였다. 고해상도MRI를 통해 확인된 추가적인 동맥박리의 특징과 함께 향후 다양한 연구들을 통해 진단 기준이 명확해 진다면 치료에 많은 도움을 줄 수 있을 것으로 생각한다.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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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.