• Korean Circulation Journal
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• 제52권7호
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• pp.529-540
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• 2022

Background and Objectives: Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications. Methods: We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival. Results: TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12-2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03-8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26-2.83; p=0.002), previous bypass surgery (HR, 3.04; 95% CI, 1.28-7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19-7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25-3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07-3.24; p=0.028) were predictors for TLR. Conclusions: Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.

• 한국식품과학회지
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• 제26권3호
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• pp.213-220
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• 1994

본 연구는 고혈압을 비롯한 순환기 질환의 예방이나 치료의 목적을 위해 민간요법으로 전수되어 사용되고 있는 천마의 효능에 대한 사실성을 확인하고, 나아가서는 이러한 효능에 대한 천마의 작용기전을 유추하려고 하였다. 현재까지 천마 extracts에 대한 유효성분의 분석이 이루어져 있지 않기 때문에, 본 연구는 SD 실험쥐와 선천성 고혈압의 소질을 지닌 SHR 실험쥐를 이용하여 천마의 water-extracts나 ethanol-extracts의 심장 및 관상 순환기능에 대한 약리적인 효능을 과학적으로 구체적인 실험방법을 통해서 조사하였다. 천마 extracts는 추출과정에 사용된 용매, 추출기간 및 실험쥐 model에 따라 관상 순환기능에 대한 작용효과가 상반된 현상으로 나타났다. 물이나 50% ethanol에 16시간 추출된 extracts는 사용된 농도에서 SD 실험쥐의 관상 혈관저항을 저하시켜 혈관확장의 효과를 가져왔지만, SHR 실험쥐에서는 ethanol에 추출된 extracts는 사용된 농도에서 심장기능 그 자체에 유의적인 독성효과를 주지 않는다는 것을 말해준다. 본 연구결과는 천마의 water-extracts에 의해서 나타난 혈관확장작용이 일반적으로 국소적인 혈관확장에 관여한다는 lactate 생성의 증가에 기인하는 것보다는 오히려 extracts에 의한 대사적 acidosis 현상에 기인한다는 사실을 제시하고 있다. 본 연구에서 천마의 수용성 extracts가 혈관확장작용 또는 혈압강하작용을 나타낸다는 사실이 제시된 것은 심장이나 순환기 질환을 예방하고 치료하기 위한 천마의 임상적인 활용측면에서 매우 중요한 성과이다. 그러나, 천마의 순환기능에 대한 약리적 효능을 나타내는 성분추출은 조사되어야 할 과제로 아직 남아 있다. 또한, 천마를 한방에서 약재로써 이용되는 반면에 천마를 식이로 이용하기 위해서 식이성 천마에 대한 효능을 연구해야 할 필요가 있다. 이러한 연구결과로써, 천마는 혈관순환기질환의 예방이나 치료에 이용되는 생약으로써 활용될 뿐만 아니라 안전성을 가진 건강식품으로 개발되어 국민보건 향상에 이바지하리라 기대된다.

• 한국산학기술학회논문지
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• 제13권9호
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• pp.4009-4017
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• 2012

본 연구는 12주간 비만 중년여성의 복싱에어로빅 운동프로그램 참여가 신체조성, 혈액성분 및 혈관탄성에 미치는 영향을 규명하기 위해 수행되었다. 본 연구의 대상자는 40세 이상의 중년여성으로 체지방율 30%이상 병역 상심혈관질환 및 대사성 질환이 없는 신체적으로 건강한 사람을 대상으로 복싱에어로빅 운동집단 8명과 통제집단 8명으로 무선배정(random assignment)으로 나누었으며, 복싱에어로빅 운동강도는 초기 1-4주는 HRmax 50%, 5-8주는 HRmax 60%, 9-12주는 HRmax 70%로 총 60분간 실시한 후 다음과 같은 결론을 얻었다. 첫째, 복싱에어로빅 운동프로그램 참여 결과 운동집단에서 체중, 체지방률과 근육량은 측정시기, 그룹과 측정시기의 상호작용이 유의한 차이를 나타냈으며(p<.001), 그룹별 측정시기 간의 대응표본 t-test 결과에서도 운동집단에서 유의한 수준의 감소 및 증가를 나타냈다(p<.001). 둘째, 복싱에어로빅 운동프로그램 참여 결과 운동집단에서 TC, TG, HDL-C, LDL-C 모두 그룹, 측정시기, 그룹과 측정시기의 상호작용효과도 유의한 차이를 나타냈으며(p<.01, p<.001), 그룹별 측정시 기간의 대응표본 t-test 결과 운동집단에서 유의한 감소와 증가를 나타냈다(p<.01). 셋째, 복싱에어로빅 운동프로그램 참여 결과 운동집단에서 오른손, 왼손, 오른발, 왼발의 혈관탄성은 그룹, 측정시기, 그룹과 측정시기의 상호작용 효과도 유의한 차이를 나타냈으며(p<.001), 그룹별 측정시기 간의 대응표본 t-test 결과 운동집단에서 유의한 증가를 나타냈다(p<.001). 이상의 결과를 종합해 볼 때, 12주간 복싱에어로빅 운동프로그램 참여는 신체조성 및 혈액성분을 개선시키고, 혈관순환 능력을 향상시켜 심혈관질환 등의 예방 및 개선 할 수 있을 것으로 사료된다.

• 동의생리병리학회지
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• 제16권1호
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• pp.104-110
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• 2002

Citri Reticulatae Viride Pericarpium extract(CRVP) have been used in oriental medicine for many centuries as a therapeutic agent for Soothing the liver and regulating the circulation of qi(疏肝理氣), and promoting digestion and removing stagnated food(消積化滯). The effects of CRVP on the vascular system is not known. The purpose of this Study was to investigate the effects of CRVP on the pial arterial diameter and regional cerebral blood flow(rCBF) in normal rats and ischemic cerebrovascular pathologic model rats. The changes in rCBF was determinated by Laser-Doppler Flowmetry(LDF), and the changes in pial arterial diameter were determinated by video microscopy methods and video analyzer. The results were as follows ; 1. Pial arterial diameter was significantly increased by CRVP in a dose-dependent manner. 2. Pretreatment with L-NNA significantly inhibited CRVP induced increased rCBF and pial arterial diameter. 3. Both the methylene chloride fraction and the hexane fraction of CRVP dose-dependently improved the altered cerebral hemodynamics of cerebral ischemic animal by increasing rCBF. 4. Pretreatment with L-NNA and indomethacin significantly inhibited CRVP(MC) induced increased rCBF. 5. Pretreatment with L-NNA and indomethacin significantly inhibited CRVP(hexane) induced increased rCBF. 6. Pretreatment with CRVP maredly stabilized the changes rCBF and pial arterial diameter during the period of cerebral reperusion. In conclusion, CRVP causes a diverse response of rCBF and pial arterial diameter, and CRVP dose-dependently improved the altered cerebral hemodynamics of cerebral ischemic animal by increasing rCBF and pial arterial diameter. These results suggest that the improvement of cerebral hemodynamics is also mediated by nitric oxide synthase and cyclooxygenase.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.437-447
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• 2013

The fibula is one of the most useful sources for harvest of a vascularized bone graft. The fibula is a straight, long, tubed bone, much stronger than any other available bone that can currently be used for a vascularized graft. It has a reliable peroneal vascular pedicle with a large diameter and moderate length. There is a definite nutrient artery that enters the medullary cavity, as well as multiple arcade vessels, which add to the supply of the bone through periosteal circulation. The vascularized fibula graft is used mainly for long segment defects of the long tubed bone of the upper and lower extremities. It can provide a long, straight length up to 25 cm in an adult. The fibula can be easily osteotomized and can be used in reconstruction of the curved mandible. Since the first description as a vascularized free fibula bone graft by Taylor in 1975 and as a mandibular reconstruction by Hidalgo in 1989, the fibula has continued to replace the bone and soft tissue reconstruction options in the field of maxillofacial reconstruction. For the better understanding of a fibular free flap, the constant anatomical findings must be learned and memorized by young doctors during the specialized training course for the Korean National Board of Oral and Maxillofacial Surgery. This article reviews the anatomical basis of a fibular free flap with Korean language.

• International Journal of Vascular Biomedical Engineering
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• 제2권2호
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• pp.27-32
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• 2004

The objective of the present study is to visualize the steady and pulsatile flow fields in a branching model by using a high-resolution PIV system. A bifurcated flow system was built for the experiments in the steady and pulsatile flows. Harvard pulsatile pump was used to generate the pulsatile velocity waveforms. Conifer powder as the tracing particles was added to water to visualize the flow fields. CCD cameras($1K{\times}1K$(high resolution camera) and $640{\times}480$(low resolution camera)) captured two consecutive particle images at once for the image processing of several cross sections on the flow system. The range validation method and the area interpolation method were used to obtain the final velocity vectors with high accuracy. The results of the image processing clearly showed the recirculation zones and the formation of the paired secondary flows from the distal to the apex of the branch flow in the bifurcated model. The results also indicated that the particle velocities at the inner wall moved faster than the velocities at the outer wall due to the inertial force effects and the helical motions generated in the branch flows as the flow proceeded toward the outer wall. Even though the PIV images from the high resolution camera were closer to the simulation results than the images from the low resolution camera at some locations, both results of the PIV experiments from the two cameras generally agreed quite well with the results from the computer simulations. Therefore, instead of using the expensive stereoscopic PIV or 3D PIV system, the three-dimensional flow fields in a bifurcated model could be easily and exactly investigated by this study.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.5-11
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• 2001

Objectives and Importance : The present study investigated the levels of basic fibroblast growth factor(bFGF) in the CSF of patients with moyamoya disease and its clinical significance. Methods : The levels of bFGF in CSF, taken from 26 hemispheres of 14 moyamoya patients and 20 patients without vascular anomaly(control group), were measured by an enzyme-linked immunosorbent assay. We analyzed the correlation between the level of bFGF and the clinical factors such as age, onset pattern, development of neovascularization, and cerebral circulation. Results : The CSF of moyamoya patients contained a high concentration of bFGF to a significant extent. The bFGF level was apparently elevated in the patients in whom neovascularization from indirect revascularization, such as modified encephalo-duro-arterio-synangiosis(EDAS) was well developed. A linear correlation between the values of bFGF and clinical progression was noted. Conclusions : The elevation of bFGF in moyamoya disease seems to be specific. Clinically, the bFGF level may be considered a useful indicator to predict the efficacy of indirect revascularization.

• International Journal of Vascular Biomedical Engineering
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• 제1권1호
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• pp.32-40
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• 2003

Axillo-bifemoral (Ax-Fem) bypass are now well accepted for bilateral iliac artery occlusion as the second best option. This extra-anatomical (unnatural) bypasses, however, have various hemodynamic liabilities affecting the patency. Hemodynamic conditions of each different type of Ax-Fem bypass were assessed with computer simulation model to determine the hemodynamically more sound type. Simulation models of five different types of Ax-Fem bypass were constructed. Our investigation based on the computer simulation models have shown distinct differences between two most popular Lazy-S type and Inverted-C type on the distribution of flow volume, shear stress and recirculation zone, etc., though both types have shown similar clinical results. Lazy-S type has shown better hemodyanmic status than inverted-C type. The theoretical advantage of "Lazy-S" type has never been adequately proved for its superiority clinically over the inverted-C type. Inverted-C type is now in more favor with clinically better results in spite of many hemodynamic liabilities including retrograde flow to the branching graft. The improvement of over-all long-term patency rate of various extra-anatomical bypasses is still warranted through proper correction of the hemodynamic liability. Even though clinical outcome of the extra-anatomical bypass has been equal regardless of the type of crossover femoral graft configuration, there are distinct differences on the hemodynamic characteristics among various types of configuration. Further hemodynamic study in the pulsatile flow status is warranted to correct hemodynamic defects with proper modification of various hemodynamic factors of each model.

• International Journal of Vascular Biomedical Engineering
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• 제2권1호
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• pp.11-16
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• 2004

Both flow visualizations and computational fluid dynamics were performed to determine hemodynamics in a total cavopulmonary connection (TCPC) model for surgically correcting congenital heart defects. From magnetic resonance images, an anatomically correct glass model was fabricated to visualize steady flow. The total flow rates were 4, 6 and 8L/min and flow rates from SVC and IVC were 40:60. The flow split ratio between LPA and RPA was varied by 70:30, 60:40 and 50:50. A pressure-based finite-volume software was used to solve steady flow dynamics in TCPC models. Results showed that superior vena cava(SVC) and inferior vena cava(IVC) flow merged directly to the intra-atrial conduit, creating two large vortices. Significant swirl motions were observed in the intra-atrial conduit and pulmonary arteries. Flow collision or swirling flow resulted in energy loss in TCPC models. In addition, a large intra-atrial channel or a sharp bend in TCPC geometries could influence on energy losses. Energy conservation was efficient when flow rates in pulmonary branches were balanced. In order to increase energy efficiency in Fontan operations, it is necessary to remove a flow collision in the intra-atrial channel and a sharp bend in the pulmonary bifurcation.

• Journal of Chest Surgery
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• 제46권2호
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• pp.150-152
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• 2013

Arterial adventitial cystic disease is an uncommon type of non-atherosclerotic peripheral vessel disease. Most cases of arterial adventitial cystic disease occur in the popliteal arteries; however, fewer cases have been reported in the femoral arteries. A 59-year-old male patient visited the hospital with a complaint of a swelling on the lower extremity that had begun two months earlier. Suspecting deep vein thrombosis based on a physical examination and ultrasonography from another hospital, tests were performed. Magnetic resonance imaging (MRI) was performed for exact diagnosis because venous adventitial cystic disease was suspected by computed tomography venography. The MRI indicated venous adventitial cystic disease as well. Thus, a cystic mass excision was performed. In the end, a cystic mass compressing the common femoral vein that originated from the common femoral artery was diagnosed based on the macroscopic findings. This case is reported because blood circulation in the vein was impeded due to arterial adventitial cystic disease, and the symptoms improved after the cystic mass excision and polytetrafluoroethylene roofing angioplasty.