• 한국치위생학회지
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• 제12권2호
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• pp.235-249
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• 2012

Objectives : The purpose of this research is to use data from the third year of the 4th National Health and Nutrition Examination Survey to study relationship between oral disease and chronic disease that generally persist from 6 months to over a year, or more specifically, circulatory disease, diabetes, and osteoporosis. Methods : Of the data from the third year of the 4th National Health and Nutrition Examination Survey, 7,893 adults over 19 years old who completed medical examination, health survey, and nutrition survey were selected as the final research subjects. Relationship between chronic disease and oral disease was analyzed by cross tabulation (2-test) and logistic regression analysis using SPSSWIN ver 18.0. Results : 1. Differences in the rate of prevalence of periodontal disease and the rate of prevalence of missing teeth were statistically significant with respect to age, gender, marital status, education level, residential area, income level, and occupation. Rate of prevalence of dental caries was statistically significant with respect to age, education level, and income level. 2. After examining the relationship between existence of chronic disease as diagnosed by doctor with oral disease, rate of prevalence of periodontal disease and missing teeth, hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis showed statiscally significant difference. 3. Examination of rate of prevalence of chronic disease with respect to oral disease, periodontal disease and missing teeth exerted statistically significant influence on hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis (p<0.05), while dental caries did not have statistically significant effect. 4. Analysis of coupling effect of periodontal disease and missing teeth on chronic disease showed that they were related in all chronic diseases examined in this study (hypertension, hyperlipidemia, stroke, myocardial infarction, angina, diabetes, and osteoporosis) (p<0.05). Conclusions : Periodontal disease and missing teeth were found to increase the rate of prevalence of chronic disease.

• 대한핵의학회지
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• 제39권2호
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• pp.133-140
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• 2005

The potential for recovery of left ventricular dysfunction after myocardial revascularization represents a practical clinical definition for myocardial viability. The evaluation of viable myocardium in patients with severe global left ventricular dysfunction due to coronary artery disease and with regional dysfunction after acute myocardial infarction is an important issue whether left ventricular dysfunction may be reversible or irreversible after therapy. If the dysfunction is due to stunning or hibernation, functional improvement is observed. but stunned myocardium may recover of dysfunction with no revascularization. Hibernation is chronic process due to chronic reduction in the resting myocardial blood flow. There are two types of myocardial hibernation: "functional hibernation" with preserved contractile reserve and "structural hibernation" without contractile reserve in segments with preserved glucose metabolism. This review focus on the application of F-18 FDG and other radionuclides to evaluate myocardial viability. In addition the factors influencing predictive value of FDG imaging for evaluating viability and the different criteria for viability are also reviewed.

• 대한의생명과학회지
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• 제21권4호
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• pp.198-207
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• 2015

ST-segment elevation myocardial infarction (STEMI) and chronic total occlusion (CTO) of coronary artery are well-known atherosclerotic vascular diseases. However, the difference of intima-media thickness and plaque characteristics of carotid arteries between STEMI and CTO patients were not directly compared in previous studies. Medical records of a total of 158 (101 STEMI, 57 CTO) patients, who underwent carotid artery ultrasonography, were selected for the analysis. The baseline characteristics, ultrasonography findings, and clinical outcomes of the two groups were compared. The prevalence of hypertension, diabetes mellitus, and dyslipidemia was significantly higher in CTO patients. Carotid intima-media thickness ($0.97{\pm}0.13$ vs. $0.78{\pm}0.17cm$, P < 0.0001) and number of plaques ($2.2{\pm}1.0$ vs. $1.7{\pm}1.2$, P < 0.0001) were greater in CTO than STEMI patients. Multiple (${\geq}3$) or echogenic plaques were more frequently observed in CTO patients. During the median follow-up duration of 27 months, major adverse cardiovascular events occurred in 31% of CTO and 14% of STEMI patients (P = 0.008). We found that, compared with STEMI, CTO patients have higher burden of carotid artery atherosclerosis associated with more comorbid diseases and poor clinical outcomes.

• 임상간호연구
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• 제21권3호
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• pp.389-400
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• 2015

Purpose: The purpose of the study was to identify and describe illness experiences of men with myocardial infarction. Methods: Data were collected through individual in-depth interviews with 10 male patients. Analysis was done using phenomenological analysis. Results: Five theme clusters including 11 themes emerged. 1) "Unexpected grave disease instantly dividing life and death" describes the great ignorance of symptoms and experience as a survivor narrowly escaping death. 2) "A disease still not considered a disease" illustrates the paradoxical and confusing situation between low level of awareness of the severity of the disease and high level of reflection on their unhealthy lifestyles. 3) "Fighting against me for health" illustrates their resolution and action to maintain health while experiencing helplessness. 4) "Relationships in a no-win situation" contains defensive posture due to social stigma and the dilemma of family breadwinners. And 5) "Introspection of past and future life" describes positive turnings in life through enlightenment in addition to remorseful feeling about the past and persistent worry of death. Conclusion: Health professionals need to support men with myocardial infarction by providing family-oriented and empowerment-based self-management interventions to lead to success in their illness journey and to improve their quality of life.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1294-1304
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• 2020

Objective: To determine whether T1 mapping could monitor the dynamic changes of injury in myocardial infarction (MI) and be histologically validated. Materials and Methods: In 22 pigs, MI was induced by ligating the left anterior descending artery and they underwent serial cardiovascular magnetic resonance examinations with modified Look-Locker inversion T1 mapping and extracellular volume (ECV) computation in acute (within 24 hours, n = 22), subacute (7 days, n = 13), and chronic (3 months, n = 7) phases of MI. Masson's trichrome staining was performed for histological ECV calculation. Myocardial native T1 and ECV were obtained by region of interest measurement in infarcted, peri-infarct, and remote myocardium. Results: Native T1 and ECV in peri-infarct myocardium differed from remote myocardium in acute (1181 ± 62 ms vs. 1113 ± 64 ms, p = 0.002; 24 ± 4% vs. 19 ± 4%, p = 0.031) and subacute phases (1264 ± 41 ms vs. 1171 ± 56 ms, p < 0.001; 27 ± 4% vs. 22 ± 2%, p = 0.009) but not in chronic phase (1157 ± 57 ms vs. 1120 ± 54 ms, p = 0.934; 23 ± 2% vs. 20 ± 1%, p = 0.109). From acute to chronic MI, infarcted native T1 peaked in subacute phase (1275 ± 63 ms vs. 1637 ± 123 ms vs. 1471 ± 98 ms, p < 0.001), while ECV progressively increased with time (35 ± 7% vs. 46 ± 6% vs. 52 ± 4%, p < 0.001). Native T1 correlated well with histological findings (R² = 0.65 to 0.89, all p < 0.001) so did ECV (R² = 0.73 to 0.94, all p < 0.001). Conclusion: T1 mapping allows the quantitative assessment of injury in MI and the noninvasive monitoring of tissue injury evolution, which correlates well with histological findings.

• Investigative Magnetic Resonance Imaging
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• 제11권1호
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• pp.1-9
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• 2007

심장의 영상화에 장애가 되는 요인은 심장 운동, 호흡, 심장 내 혈류 등에 의한 인공물(artifact) 과 심장 조직의 용적이 작음으로 인한 낮은 신호 대 잡음비 등이 있다. 심장 운동에 의한 화질 저하를 막기 위해 신속영상기법(fast imaging technique) 을 이용하여 심장 운동의 특정 위상(phase) 에서만 영상을 얻는 심장동기(cardiac gating) 방법을 이용하고 있다. MRI를 이용한 심장의 검사는 심장의 형태, 심실 기능, 심근 관류, 심근 대사, 관상동맥 영상 등을 대상으로 한다. 심장의 형태적 진단에 있어서 심근내 수분의 정도와 지방조직을 보기 위해 이중(double) 혹은 삼중역전회복기법(triple inversion recovery technique) 을 사용한다. 심근관류검사를 위해서는 조영증강신속경사에코법(contrast-enhanced fast gradient echo technique)을 사용하여 일차통과조영증강(first-pass enhancement) 을 검사한다. 또한 10-15분 지연영상을 얻어 심근내 조영제의 재분포를 검사하여 만성심근경색 등의 심근파괴부위를 확인한다. 심실기능 평가를 위해서는 신속경사에 코법을 이용한 영화영상(cine image) 이 사용되며 심실의 국소적 운동이상 및 심실기능의 정량적 검사가 가능하다. MRI는 관상동맥영상을 제외한 포괄적 심장검사에 실용성이 있다. 특히 지연영상은 다른 검사장비에선 얻을수 없는 유용한 정보이다.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.46-56
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• 2022

The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

• 대한상한금궤의학회지
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• 제13권1호
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• pp.1-19
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• 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.

• 대한핵의학회지
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• 제34권3호
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• pp.260-263
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• 2000

A uremic patient on hemodialysis, who had concurrent cardiomyopathy showed intense myocardial uptake of $^{99m}Tc$-methylene diphosphonate (MDP). The presumed cause of uptake in the myocardium is metastatic calcification due to hypercalcemia secondary to the renal failure. However, supplementary mechanism caused by cardiomyopathy should be considered. We describe a case with bone tracer uptake in the myocardium in the absence of infarction in a patient with chronic renal failure.

• Korean Journal of Radiology
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• 제20권1호
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• pp.83-93
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• 2019

Objective: The purpose of this study was to prospectively investigate the value of the myocardial extracellular volume fraction (ECV) in predicting myocardial functional outcome after revascularization of coronary chronic total occlusion (CTO). Materials and Methods: Thirty patients with CTO underwent cardiovascular magnetic resonance (CMR) before and 6 months after revascularization. Three baseline markers of functional outcome were evaluated in the dysfunctional segments assigned to the CTO vessels: ECV, transmural extent of infarction (TEI), and unenhanced rim thickness (RIM). At the global level, the ECV values of the whole myocardium with and without a hyperenhanced region (global and remote ECV) were respectively measured. Results: In per-segment analysis, ECV was superior to TEI and RIM in predicting functional recovery (area under receiver operating characteristic curve [AUC]: 0.86 vs. 0.75 and 0.73, all p values < 0.010), and it emerged as the only independent predictor of regional functional outcome (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.77-0.89; p < 0.001) independent of collateral circulation. In per-patient analysis, global baseline ECV was indicative of ejection fraction (EF) at the follow-up examination (β = -0.61, p < 0.001) and changes in EF (β = -0.57, p = 0.001) in multivariate regression analysis. A patient with global baseline ECV less than 30.0% (AUC, 0.93; sensitivity 94%, specificity 80%) was more likely to demonstrate significant EF improvement (OR: 0.38; 95% CI: 0.17-0.85; p = 0.019). Conclusion: Extracellular volume fraction obtained by CMR may provide incremental value for the prediction of functional recovery both at the segmental and global levels in CTO patients, and may facilitate the identification of patients who can benefit from revascularization.