• Title/Summary/Keyword: Coronary artery calcium

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Relationship between vitamin D levels and intravenous immunoglobulin resistance in Kawasaki disease

  • Jun, Jae Sung;Jung, Young Kwon;Lee, Dong Won
    • Clinical and Experimental Pediatrics
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    • v.60 no.7
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    • pp.216-220
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    • 2017
  • Purpose: Vitamin D is associated with various pathological conditions such as cardiovascular diseases and cancer. We investigated the relationship between vitamin D and Kawasaki disease (KD). Methods: We performed a retrospective review of the medical records of patients with KD between February 2013 and March 2016 in Daegu Fatima Hospital. Study participants were grouped according to vitamin D serum concentration. Group 1 included patients with 25(OH)-vitamin D ${\geq}20ng/mL$. Group 2 included patients with 25(OH)-vitamin D <20 ng/mL. We analyzed the clinical characteristics and laboratory data of the 2 groups. Results: Of the 91 patients, 52 were included in group 1, and 39 in group 2. Group 1 patients had significantly higher levels of calcium, phosphate, albumin and sodium than group 2 patients did. There were no differences in clinical characteristics, but the proportion of patients with polymorphic rash was significantly higher in group 2. Resistance to intravenous immunoglobulin was more frequent in group 2 (P=0.023). No significant difference in the incidence of coronary artery complications was observed. Conclusion: Low vitamin D levels are associated with resistance to intravenous immunoglobulin therapy in KD. Vitamin D deficiency might be a risk factor for immunoglobulin resistance in KD.

Some Factors Affecting Lipid Metabolism (지질대사(脂質代謝)에 관여하는 인자(因子))

  • Nam, Hyun-Keun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.15 no.2
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    • pp.191-200
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    • 1986
  • It is now generally accepted that individuals at increased risk for cardiovascular disease may be identified by certain traits or habbits. The factors such as high blood pressure, elevated blood cholestrol, age, sex and obesity are associated with increseaed frequency of disease. The blood cholesterol level lowering will decrease cardiovascular disease risk. The regression of atherosclerosis can be achieved by lowering the level of circulating cholesterol. Those things are connected with the quantity and quality of protein, fats, carbohydrates, especially soluble and non-soluble fiber, magnesium and calcium. The lipoprotein and lipid metabolism are connected with the lipid transport. The factors on lipid absorption and blood serum lipid pattern of human are exist. The factors have a variety of materials with different chemical and physical properties. The soluble fiber diet make a low blood and liver lipids. Many kind of soluble fiber results in a lowering of blood cholesterol and triglyceride levels. The cholesterol lowering effects of dietery fiber may be a results of alterations of in intestinal handling of fats, hepatic metabolism of fatty acid or triglyceride acid metabolism of lipoprotein. It is investigated that the high density lipoprotein (HDL) is inversely related to coronary artery disease. It has been postulated that HDL may be an important factor in cholesterol efflux from the tissues, therby reducing the amount of cholesterol deposited there. Alternatively, the HDL may pick up cholestyl ester and phospholipid during normal VLDL lipolysis in the plasma. The HDL levels are relatively insensitive to diet. At present time, the cause-and -diet effect of HDL's inverse relation to CHD remains unclear.

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Class duplication prescriptions in patients taking fixed-dose combination antihypertensives (고혈압 복합제 복용환자에서 동일계열약물 중복 현황)

  • Koo, Hyunji;Lee, Ji Won;Choi, Ha Eun;Je, Nam Kyung;Jeong, Kyeong Hye
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.2
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    • pp.125-132
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    • 2022
  • Background: Fixed-dose combinations have the advantage of improving patient compliance, but may increase the risk of duplicate prescriptions. As the use of fixed-dose combination antihypertensives increases, it is necessary to investigate the current status of class duplication prescriptions (CDP) in patients taking fixed-dose combination antihypertensives in Korea and to identify factors associated with CDP. Methods: We conducted a retrospective observational study using nationally representative claim data. Hypertensive patients aged 20 years or older taking fixed-dose combination antihypertensives were extracted. Among these patients, patients with CDP were identified. A chi-square test was applied to determine the differences between patients with CDP and non-CDP. The associated factors of CDP were identified through multiple logistic regression. Results: Of the 74,165 patients who were prescribed fixed-dose combination antihypertensives, 426 patients (0.6%) with CDP were identified. The most common antihypertensive class associated with CDP was calcium channel blockers (194 patients, 45.5%), followed by angiotensin II receptor blockers (136 patients, 31.9%). Patients aged 75 years or older (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.02-3.52), chronic kidney disease (OR 4.45, 95% CI 2.15-8.25), chronic heart failure (OR 2.71, 95% CI 1.93-3.72), coronary artery disease (OR 2.22, 95% CI 1.60-3.03) and Medical Aid/Patriots and Veterans Insurance (OR 1.49, 95% CI 1.04-2.07) were significantly associated with increased CDP. Conclusions: The factors associated with CDP were the elderly, comorbidities, and low socioeconomic status. Since CDP can result in negative clinical outcomes, active intervention by the pharmacist is warranted.

Accurate Measurement of Agatston Score Using kVp-Independent Reconstruction Algorithm for Ultra-High-Pitch Sn150 kVp CT

  • Xi Hu;Xinwei Tao;Yueqiao Zhang;Zhongfeng Niu;Yong Zhang;Thomas Allmendinger;Yu Kuang;Bin Chen
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1777-1785
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    • 2021
  • Objective: To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose. Materials and Methods: This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared. The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared. Results: No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0-232.28) and C (median, 60.25; IQR, 0-195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0-120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode. Conclusion: The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.

Quality Assessment of Hypertension Management of Office-based Physicians in Korea (우리 나라 개원의 고혈압 관리의 질 평가)

  • Cho, Hong-Jun;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.36-49
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    • 1997
  • Background : Hypertension is one of the most important risk factors of the cerebrovascular accident and coronary artery disease which are the major causes of mortality in Korea. In Korea, the quality of care provided by office-based physicians has not been evaluated formally. The purpose of this study is to assess the quality of hypertension management of office-based physicians. Method : Self-administered questionnaires were mailed to the office-based physicians with the speciality of internal medicine, general surgery, family medicine, and general practitioners. Among 2,045 physicians, 981 doctors(48.0%) replied the questionnaires. Contents of questionnaires were based on the recommendation from the JNC-V report(the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure), and included the criteria of diagnosis, treatment, follow-up interval, and other characteristics of physicians(age, sex, type of speciality, and location of practice). Results : Eighty four percent of the office-based physicians made diagnosis of hypertension with less than 3 times of blood pressure measurements. The performance rate of required examination for hypertensives was very low in most items. Rate of fundoscopic examination is the lowest one among them(5.9%). The performance rate of laboratory examination was also low in most items. Internists tended to order more frequent laboratory examinations than any other type of physicians. Only 11.4% of the physicians did appropriate treatments for the mild hypertension case. The antihypertensives selected by the physicians as a first line drug were in the order of beta blocker(26.4%), calcium channel blocker(23.4%), diuretics(23.1%), ACE inhibitors(14.3%). The visit interval for established hypertensives was very short. Proportion of physicians with follow-up interval longer than 4 weeks was only 4.3%. Conclusions : The overall quality of hypertension management of office-based physicians in Korea is very problematic in many aspects. So further investigations to find out the reasons of low quality arid quality of care should be initiated.

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Aortic Unfolding Measurement Using Non-Contrast Cardiac CT: Normal Range of Low-Risk Subjects (관상동맥 석회화 CT에서 측정한 대동맥 전개: 저위험 환자군에서의 정상 범위)

  • Ji Won Lee;Byoung Wook Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.360-371
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    • 2022
  • Purpose This study aimed to assess the factors influencing aortic unfolding (AU) defined by aortic width on coronary artery calcium (CAC) scan and determine the normal limits for AU. Materials and Methods In this retrospective study, we measured AU in 924 asymptomatic subjects who underwent CAC scanning during routine health screening from June 2015 to June 2018. Multivariate regression analysis was used to evaluate the factors influencing AU. After the exclusion of subjects with risk factors associated with AU, 283 subjects were included in the analysis of normal values of AU. Mean AU, standard deviation, and upper normal limit were calculated. Results Sex, age, CAC score, body mass index, body surface area, hypertension, left ventricular hypertrophy, plasma creatinine, and smoking were significantly associated with AU. The mean AU was 102.2 ± 12.8 mm for men and 93.1 ± 10.7 mm for women. AU increased with advancing age (9.6 mm per decade). Conclusion AU determined from a single measurement on CAC scans was associated with cardiovascular risk factors. The normal limits of AU were defined by age, sex, and body surface area in low-risk subjects in this study.

Potential Risk Assessment of Cardiovascular Disease in Low Calcium-Score (낮은 칼슘 수치에서 심혈관질환의 잠재 위험도 평가)

  • Yoo, Heangsoo;Park, Jikoon;Jung, Bongjae;Noh, Sicheol;Choi, IlhHong;Jung, Hyungjn;Kang, Sangsik
    • Journal of the Korean Society of Radiology
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    • v.7 no.6
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    • pp.369-376
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    • 2013
  • Prepared her for the early detection of the risk of cardiovascular disease prevention for the various attempts being made ill through a lot of research to the criteria of coronary artery calcification, but the figure is more than 100 the progress of the flow can be expected to be was. In this study, we quantify the correlation between body composition analysis, blood lipid levels of calcium and public asymptomatic even at low calcium levels in comparison with the existing studies by analyzing potential risk of cardiovascular disease will be represented on the were evaluated. Studies, the calcium scores in the body composition analysis "1-10", and when "11-100" when there was a significant correlation in BMI and WHR look more normal frequency range of the mean values in the normal range meomulreoteuna 21% relative HDL and TG in lipid profiles, no significant correlation look more normal frequency range of risk were derived from the mean values in the normal range, 21% to 40% of the relative risk were derived. meomulreoteuna. In addition, there is no correlation between BFM and BMR Also, average increases in the frequency of a higher standard was higher relative risk derived 31 to 93%, and geological correlation test TC above 20mg/dl atherosclerotic sclerosis seems to be the value of HDL to act to remove cholesterol from atheroma already looking at the same time to suppress the occurrence of atherosclerosis, increased LDL showed higher values occurs rapidly increasing. At this time, the relative risk of 43-50% have been identified. In other words, even when calcium levels are low, that is inherent in the incidence of cardiovascular disease was unknown.

Effects of Aloe vera on the Cholesterol and Vitamin $D_2$-induced Atherosclerosis in Rats (Aloe vera가 콜레스테롤 및 비타민 $D_2$ 식이로 유발한 흰쥐의 동맥경화증에 미치는 영향)

  • 이용욱;노우섭;김종규;김판기
    • Journal of Food Hygiene and Safety
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    • v.11 no.4
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    • pp.243-259
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    • 1996
  • This study was performed to investigate the induction of experimental atherosclerosis in rats and inhibitory effects of aloe vera on progression of atherosclerosis in rats. Adose range finding study of cholesterol and vitamin D2 for the induction of atherosclerosis and studies on the subchronic effect of aloe vera and on the chronic effect of aloe vera were carried out. A total of 3-week old 125 male rats of Sprague-Dawley were divided into 25 groups and fed with the diet containing cholesterol (0.1, 0.2, 0.3, 0.5, 1.0 and 2.0%) and vitamin D2 (500, 5000, 50000 and 500, 000 IU/100 g) for 4 weeks. 35 male rats were divided into 7 groups and fed with the diet containing aloe vera with 1.0% of cholesterol and 50, 000 IU/100 g of vitamin D2 for 4 weeks. 200 male rats were divided into 5 groups and fed with cholesterol and vitamin D2 for 6 and 12 months. Growth, clinical and pathological changes of rats in the three experiments were observed. The results were as follows: 1. In the dose-range finding study, feed intake, feed efficiency ratio and weight to body weight were increased in all of the feed groups containing 500, 000 IU/100 g of vitamin D2. Serum biochemical values of total cholesterol, high-density lipiprotein cholesterol (HDL-cholesterol), triglyceride, calcium, inorganic phosphorous and chloride of male rats in treated groups. The aorta and coronary artery of rats in all of the diet group containing 500, 000 IU/100 g of vitamin D2 showed typical atherosclerotic lesions. 2. Male rats fed with the diet containing aloe vera with 1.0% cholesterol and 50, 000 IU/100 g of vitamin D2 for 6 and 12 months did not show significant difference of diet intake and weight gain, and relative organ weight. The level of serum HDL-cholesterol and triglyceride recovered to the normal range by the aloe vera ingestation. 3. The aorta showed irregular appearence in the tunica intima with swelling, necrosis and calcification. The aorta of rat fed aloe vera diet showed no pathological lesions such as atherosclerosis of aorta. Aloe vera could have a helpful effect of vitamin D2 and cholesterol induced atherosclerosis in rats. Long-term supplementation of aloe vera may slow down the process of experimental atherosclerosis in rats have effects on the development of atherosclerosis.

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