• International Journal of Oral Biology
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• v.33 no.4
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• pp.163-177
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• 2008

Periodontal disease, a form of chronic inflammatory bacterial infectious disease, is known to be a risk factor for cardiovascular disease (CVD). Porphyromonas gingivalis has been implicated in periodontal disease and widely studied for its role in the pathogenesis of CVD. A previous study demonstrating that periodontopathic P. gingivalis is involved in CVD showed that invasion of endothelial cells by the bacterium is accompanied by an increase in cytokine production, which may result in vascular atherosclerotic changes. The present study was performed in order to further elucidate the role of P. gingivalis in the process of atherosclerosis and CVD. For this purpose, invasion of human aortic smooth muscle cells (HASMC) by P. gingivalis 381 and its isogenic mutants of KDP150 ($fimA^-$), CW120 ($ppk^-$) and KS7 ($relA^-$) was assessed using a metronidazole protection assay. Wild type P. gingivalis invaded HASMCs with an efficiency of 0.12%. In contrast, KDP150 failed to demonstrate any invasive ability. CW120 and KS7 showed relatively higher invasion efficiencies, but results for these variants were still negligible when compared to the wild type invasiveness. These results suggest that fimbriae are required for invasion and that energy metabolism in association with regulatory genes involved in stress and stringent response may also be important for this process. ELISA assays revealed that the invasive P. gingivalis 381 increased production of the proinflammatory cytokine interleukin (IL)-$1{\beta}$ and the chemotactic cytokines (chemokine) IL (interleukin)-8 and monocyte chemotactic (MCP) protein-1 during the 30-90 min incubation periods (P<0.05). Expression of RANTES (regulation upon activation, normal T cell expressed and secreted) and Toll-like receptor (TLR)-4, a pattern recognition receptor (PRR), was increased in HASMCs infected with P. gingivalis 381 by RT-PCR analysis. P. gingivalis infection did not alter interferon-$\gamma$-inducible protein-10 expression in HASMCs. HASMC nonspecific necrosis and apoptotic cell death were measured by lactate dehydrogenase (LDH) and caspase activity assays, respectively. LDH release from HASMCs and HAMC caspase activity were significantly higher after a 90 min incubation with P. gingivalis 381. Taken together, P. gingivalis invasion of HASMCs induces inflammatory cytokine production, apoptotic cell death, and expression of TLR-4, a PRR which may react with the bacterial molecules and induce the expression of the chemokines IL-8, MCP-1 and RANTES. Overall, these results suggest that invasive P. gingivalis may participate in the pathogenesis of atherosclerosis, leading to CVD.

• Journal of Periodontal and Implant Science
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• v.48 no.6
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• pp.337-346
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• 2018

Purpose: Peripheral artery disease (PAD) is a form of arteriosclerosis that occurs in the extremities and involves ischemia. Previous studies have reported that patients with periodontitis are at high risk for PAD. However, the relationship between these 2 diseases has not yet been fully elucidated. In this cross-sectional study, we investigated this relationship by comparing patients with PAD to those with arrhythmia (ARR) as a control group. Methods: A large-scale survey was conducted of patients with cardiovascular disease who visited Tokyo Medical and Dental University Hospital. We investigated their oral condition and dental clinical measurements, including probing pocket depth, bleeding on probing, clinical attachment level, and number of missing teeth; we also collected salivary and subgingival plaque samples and peripheral blood samples. All patients with PAD were extracted from the whole population (n=25), and a matching number of patients with ARR were extracted (n=25). Simultaneously, ARR patients were matched to PAD patients in terms of age, gender, prevalence of diabetes, hypertension, dyslipidemia, obesity, and the smoking rate (n=25 in both groups). Real-time polymerase chain reaction was performed to measure the bacterial counts, while the enzyme-linked immunosorbent assay method was used to measure anti-bacterial antibody titers and proinflammatory cytokine levels in serum. Results: PAD patients had more missing teeth ($18.4{\pm}2.0$) and higher serum levels of C-reactive protein ($1.57{\pm}0.85mg/dL$) and tumor necrosis factor-alpha ($70.3{\pm}5.7pg/mL$) than ARR patients ($12.0{\pm}1.7$, $0.38{\pm}0.21mg/dL$, and $39.3{\pm}4.5pg/mL$, respectively). Meanwhile, no statistically significant differences were found in other dental clinical measurements, bacterial antibody titers, or bacterial counts between the 2 groups. Conclusions: Our findings suggested that PAD patients had poorer oral and periodontal state with enhanced systemic inflammation.

• Nutrition Research and Practice
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• v.8 no.6
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• pp.644-654
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• 2014

BACKGROUND/OBJECTIVES: Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors. MATERIALS/METHODS: We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP). RESULTS: The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively. CONCLUSIONS: This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.

• Korean Journal of Human Ecology
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• v.2 no.1
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• pp.80-88
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• 1999

Hypercholesterolemia is a well known major risk factor for cardiovascular disease, now the leading cause of death in Korea. This study was carried out to examine the relationships of hypercholesterolemia(HC$\geq$240 mg/dL) with obesity, blood pressure and blood glucose level in 649 male subjects aged 20-69 in Kwangju, Korea. The mean plasma total cholesterol level was 212${\pm}$43 mg/dL, and 25.3% of the subjects was diagnosed as HC and 39.3% as nomorcholesterolemia(NC〈200 mg/dL). The prevalence of HC seemed to increase with age. The subjects with HC were highly overweighted and had higher body mass index(BMI) than the NC subjects. The incidence of overweight(25$\leq$BMI〈30) and obesity(BMI$\geq$30) among the HC subjects were 44.5%, and 1.8%, respectively. The HC subjects had higher systolic(SBP) and diastolic blood pressure(DBP) than the NC subjects. The incidence of borderline hypertension (160/95〉SBP/DBP$\geq$140/90) and hypertension(SBP/DBP$\geq$160/95) among the HC subjects were 18.3%, and 9.1%, respectively. However, there was no difference in blood glucose level between the HC and NC subjects. The plasma total cholesterol level had positive relationships with BMI(P〈0.001), weight(P〈0.001), DBP(P〈0.001), SBP(P〈0.01), and age(P〈0.01), whereas inverse relationships with height/weight ratio(P〈0.001), and height(P〈0.01). The relative risks on HC were 1.99 for obesity, 1.53 for overweight, 1.82 for hypertension, 1.44 for borderline hypertension and 1.08 for hyperglycemia. Attributable risks on HC were 0.25 for obesity, 0.11 for overweight, 0.20 for hypertension, 0.10 for borderline hypertension and 0.02 for hyperglycemia. The results indicate that the level of plasma total cholesterol was closely associated with the incidences of obesity and hypertension. (Korean J of Human Ecology 2(1) : 80-88, 1999)

• Journal of Chest Surgery
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• v.35 no.7
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• pp.517-522
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• 2002

Background: Congenital heart surgery may lead to myocardial swelling and hemodynamic instability. Delayed sternal closure may be beneficial in this setting. The purpose of this study was to assess mortality and mediastinal infection rate associated with delayed sternal closure after congenital heart surgery and to evaluate the risk factors which affect mortality and mediastinal infection rate. Material and Method: We retrospectively reviewed 40 patients who underwent delayed sternal closure after repair of congenital heart disease at Yonsei Cardiovascular Hospital, from January 1994 to May 2001. In these patients, we assessed the mortality and mediastinal infection rate, and evaluated their risk factors including operation time, bypass time, aortic cross clamp time, duration to sternal closure and postoperative artificial ventilation time. Mediastinal infection was defined to have positive culture in mediastinum. Result: Hemodynamic instability was the most common indication for delayed sternal closure(n=36) and other indications included postoperative bleeding(n=2) and conduit compression(n=2). The median age at operation was $14.4{\pm}33.4$months old(range, 2days-12years). The patients with postoperative bleeding and conduit compression were much older than the others. The sternum was left open for $4.5{\pm}3.4$ days(range, 1-20days). Overall mortality was 25%(10/40) and mediastinal infection occured in 24.3%(9/37) (3 patients were excluded in mediastinal infection for early death). In risk factor analyses, only aortic cross clamp time had statistical significance for mortality in univariate analyses. However, multivariate analyses revealed that there were no significant predictors for risk of mortality and mediastinal infection. Conclusion: Delayed sternal closure after repair of congenital cardiac disease had relatively high mortality and mediastinal infection rate. But, in patients with hemodynamic instability, postoperative bleeding and conduit compression after repair of congenital cardiac disease, delayed sternal closure may be an effective life saving method.

• Biomedical Science Letters
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• v.3 no.1
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• pp.29-35
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• 1997

Cardiovascular disease has been the leading cause of death among patients with chronic renal failure. Many reports have been described that homocysteine is one of the independent risk factor to the occulsive vascular disease. In this study, HPLC/FLD (high performance liquid chromatography-fluorescence detector) technique was used to measure homocysteine level in patients with chronic renal failure and normal control group. The detection limit and recovery of total plasma homocysteine using HPLC/FLD were 98.6$\pm$5.8% and 0.2 nmol/ml, respectively. The linearity of this method was established in concentration range of 2~50 nmol/ml (correlation coefficient=0.9997). The concentrations of total plasma homocysteine were 6.81$\pm$1.54 nmol/ml and 27.28$\pm$14.94 nmol/ml in normal control (n=20) and patient group (n=90), respectively (p<0.05). In this study, the HPLC/FLD method showed high sensitivity and reproducibility for a routine clinical laboratory testing. Moreover determination of homocysteine level in plasma might be useful for a biochemical marker for predicting the cardiovascular diseases and for monitoring of therapeutic effect of lowering homocysteine in patients with chronic renal failure.

• Journal of the Korea Convergence Society
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• v.9 no.11
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• pp.203-208
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• 2018

The purpose of this study was to investigate whether there is a relationship between pulmonary function, serum lipid and pulse pressure, which is a risk factor of cardiovascular disease, in subjects with 109 office workers(51 males and 58 females) be at Seoul, Korea. The mean age of the subjects was $43.44{\pm}7.23$ years old (male $43.44{\pm}7.27$, fenale $49.1{\pm}11.5$). The subjects' height, weight, BMI, systolic and diastolic blood pressures were measured and there was statistical difference between men and women.The mean pulse pressure of the subjects was $47.82{\pm}9.02mmHg$, and the mean of FVC was $84.26{\pm}9.91%$. There was no difference between men and women in both. There was a positive correlation between pulse pressure and systolic blood pressure in males (p<0.01) and females (p<0.01), and FVC and HDL in males were positively correlated (p<0.05). Pulse pressure and %FVC were negatively correlated (r =-0.267, P<0.01). Pulse pressure and %FVC were negatively correlated (r =-0.267, P<0.01). Regression analysis showed that PP was the independent affected %FVC. Therefore, pulse pressure and %FVC may be useful as a predictor of cardiovascular disease in middle-aged subjects with normal, suggest a long-term convergence follow-up is warranted to elucidate the incidence of cardiovascular disease.

• Journal of the Institute of Convergence Signal Processing
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• v.21 no.1
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• pp.49-54
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• 2020

Cardiovascular disease is the leading cause of death worldwide and is caused by a variety of causes. The highest risk factor for cardiovascular disease is high blood pressure, which has no obvious symptoms, but if left untreated, it causes several complications. In order to treat hypertension, medication and regular exercise are required. In people with high blood pressure, excessive physical activity can put a great strain on the heart and lead to cardiovascular disease. Therefore, there is a need for an exercise intensity monitoring system through PTT measurement that can perform exercise at an appropriate intensity. In this study, we implemented a PTT change monitoring system according to exercise intensity by calculating PTT through ECG and PPG measurement. The implemented system differentiates the R-peak of the ECG and P-peak of the PPG, and calculates the PTT using the time difference between R-peak and P-peak. A running experiment was conducted to monitoring PTT change according to exercise intensity. As a result of the experiment, low intensity PTT is 0.313s, moderate is 0.220s, high is 0.188s, it was confirmed that the PTT decreased as the exercise increase increased.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2219-2231
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• 2012

This study conducted to investigate incidence rate and association of serum lipid profiles with incidence of ischemic heart disease. Study subjects consisted of 417,642 adults aged 30 years and over, who underwent physical examination and responded to questionnaire from health examination center of 19 university general hospitals. Hazard ratio of risk factor for ischemic heart disease (IHD) were calculated by Cox's proportional hazard regression model adjusted for ages, BMI and lifestyle (drinking, smoking and exercising). For TC/HDL ratio, hazard ratio of IHD in male increased from 1.21 times to 1.84 times increase with TC/HDL ratio, and that in female also increased from 1.26 times to 1.86 times. For TG/HDL ratio, hazard ratio of IHD in male increased from 1.17 times to 1.49 times increase with TG/HDL ratio, and that in female also increased from 1.42 times to 1.97 times. For LDL/HDL ratio, hazard ratio of IHD in male increased from 1.26 times to 1.82 times increase with LDL/HDL ratio, and that in female also increased from 1.26 times to 1.68 times. In conclusion serum lipid indexes are the significant risk factors for cardiovascular diseases. The higher the concentration of TC, LDL and TG is, the lower the concentration of HDL is, hazard ratio for IHD increased. Ratio of TC/HDL, TG/HDL and LDL/HDL were also verified to be significant risk factors for IHD.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.127-132
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• 2010

Background: Femoropopliteal artery bypss grafting is an effective form of treatment for infrainguinal artery occlusive disease in those patients who have either intermittent claudication or resting critical ischemia. The objective of this analysis was to evaluate the long-term patency of a femoropopliteal bypass graft that is classified as an above-the-knee saphenous vein graft or an above-the-knee PTFE (polytetrafluoroethylene) graft. Material and Method:From January 1998 to February 2005, 103 above-the-knee femoro-popliteal bypasses were performed on 87 patients. There were 74 male and 13 female patients with a mean age of $65.7{\pm}9.69$ (range: 31~82). The surgical indications were intermittent claudication in 65 cases (74.7%), foot ulceration in 2 cases (2.3%), foot necrosis in 10 ases (11.5%) and toe necrosis in 10 cases (11.5%). For the bypass graft, a reversed saphenous vein was used in 31 limbs and a polytetrafluoroethylene (PTFE) prosthesis was used in 72 limbs (6 mm: 27 limbs, 8 mm: 45 limbs). The perioperative risk factors were diabetes mellitus in 33 cases (37.9%), hypertension in 47 cases (54.0%), a history of ischemic heart disease in 13 cases (14.9%) and smoking in 72 cases (82.8%). Result:There were three perioperative deaths (3.4%) and seven late deaths (8.3%). Major leg amputation was necessary in 12 patients (13.8%) during the entire course of the study. The primary patency rate at 5 years for the vein grafts, the 8 mm-PTFE grafts and the 6 mm-PTFE grafts were 84.7%, 77.4% and 74.2%, respectively and the overall primary patency rate was 78.7%, and there were no significant statistical differences among the graft groups. By using multivariate analysis, the number of patent tibial arteries was determined to be a significant factor that influenced the primary graft patency rate (p<0.005), but risk factors such as diabetes mellitus, ischemic heart disease, smoking and age had no statistically significant affect on the primary graft patency rates. Conclusion: The great saphenous vein is considered the most durable conduit for infrainguinal revascularization, but the overall results of this study show that saphenous vein and PTFE grafts have comparable patency rates when used above the knee in patients with claudication or critical ischemia. The use of PTFE above the knee is a reasonable alternative for a femoro-poplitael bypass and it is associated with acceptable long term patency rates.