• 대한한의학회지
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• 제38권4호
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• pp.104-109
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• 2017

Objectives: Epicardial fat is true visceral fat that is known to be associated with metabolic syndrome, high abdominal fat, insulin resistance, coronary artery diseases, low coronary flow reserve and subclinical atherosclerosis. Dampness-Phlegm pattern is one of the pattern diagnosis of traditional Korean medicine. Previous studies showed that Dampness-Phlegm pattern is associated with hypertension, dyslipidemia, metabolic syndrome. This study is intended to find association between Dampness-Phlegm pattern and epicardial fat thickness. Methods: This study was a community-based single center trial. Ischemic stroke patients within 30 days after their ictus were enrolled. Epicardial fat thickness was measured using transthoracic echocardiography. Other measured and obtained variables are medical history, weight, height, body mass index, fasting blood glucose, cholesterol, triglycerol, high density lipoprotein, lipid and low density lipoprotein. Results: Three hundred sixty six were enlisted, and one hundred forty were diagnosed with the Dampness-Phlegm pattern. Dampness-Phlegm pattern group had significantly thicker epicardial fat. Binary logistic regression also showed statistically significant result. Conclusions: This study showed close association between epicardial fat and Dampness-Phlegm pattern. This result suggests a clue to standardization of pattern identification.

• 대한핵의학회지
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• 제39권2호
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• pp.69-74
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• 2005

Ever since it was first introduced as a method of scintigraphically measuring regional myocardial perfusion, myocardial perfusion study has been widely used in patients diagnosed or suspected with coronary artery diseases, and continuously improved upon. In addition to the technological enhancement of nuclear medicine equipments, the innovation of radiopharmaceuticals used in the cardiac exams were important contributors to such improvement. Besides the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. More information can be collected before diagnosing coronary vascular disease, evaluating the patient's condition, or assessing therapeutic effects. In this review article, the clinical efficacy and characteristics of radiopharmaceutical products tailored for cardiac SPECT that are commonly used in Korea currently, plus the ones not being used yet but have proven value are briefly described.

• Korean Journal of Radiology
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• 제23권10호
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• pp.939-948
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• 2022

Objective: Evidence supports the efficacy of coronary computed tomography angiography (CCTA)-based risk scores in cardiovascular risk stratification of patients with suspected coronary artery disease (CAD). We aimed to compare two CCTA-based risk score algorithms, Leiden and Confirm scores, in patients with diabetes mellitus (DM) and suspected CAD. Materials and Methods: This single-center prospective cohort study consecutively included 1241 DM patients (54.1% male, 60.2 ± 10.4 years) referred for CCTA for suspected CAD in 2015-2017. Leiden and Confirm scores were calculated and stratified as < 5 (reference), 5-20, and > 20 for Leiden and < 14.3 (reference), 14.3-19.5, and > 19.5 for Confirm. Major adverse cardiovascular events (MACE) were defined as the composite outcomes of cardiovascular death, nonfatal myocardial infarction (MI), stroke, and unstable angina requiring hospitalization. The Cox model and Kaplan-Meier method were used to evaluate the effect size of the risk scores on MACE. The area under the curve (AUC) at the median follow-up time was also compared between score algorithms. Results: During a median follow-up of 31 months (interquartile range, 27.6-37.3 months), 131 of MACE were recorded, including 17 cardiovascular deaths, 28 nonfatal MIs, 64 unstable anginas requiring hospitalization, and 22 strokes. An incremental incidence of MACE was observed in both Leiden and Confirm scores, with an increase in the scores (log-rank p < 0.001). In the multivariable analysis, compared with Leiden score < 5, the hazard ratios for Leiden scores of 5-20 and > 20 were 2.37 (95% confidence interval [CI]: 1.53-3.69; p < 0.001) and 4.39 (95% CI: 2.40-8.01; p < 0.001), respectively, while the Confirm score did not demonstrate a statistically significant association with the risk of MACE. The Leiden score showed a greater AUC of 0.840 compared to 0.777 for the Confirm score (p < 0.001). Conclusion: CCTA-based risk score algorithms could be used as reliable cardiovascular risk predictors in patients with DM and suspected CAD, among which the Leiden score outperformed the Confirm score in predicting MACE.

• 대한한의학방제학회지
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• 제21권1호
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• pp.1-15
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• 2013

Objectives : This article is a study on to which categories of modern diseases blood stasis patterns are assigned and the meaning of blood stasis interpreted with perspectives of Korean Medicine and modern medicine. Methods : We reviewed "Neijing", "Shanghanlun", "Yilingaicuo", "Xuezhenglun" and other books and modern clinical papers related with blood stasis. Results : 1. Blood stasis patterns are related with disorders of hemorrheology, hemodynamics, platelet function, microcirculation, microelements and endothelial damage. 2. From the types of syndrome differentiation, diverse diseases classified in type of qi deficiency with blood stasis and type of blood stasis due to qi stagnation are reported, which reflects qi and blood are closely connected. And many diseases are classified in type of kidney deficiency with blood stasis, which has something in common with chronic diseases can achieve effect from treatment considering blood stasis. 3. Diseases related with kidney involve menopausal disorder, mazoplasia, prostatitis, erectile dysfunction, chronic nephritis, renal calculus, osteoporosis and bursitis. Diseases related with heart involve coronary artery disease, arrhythmia and cerebral thrombosis. Diseases related with spleen involve gastritis, colonitis and digestive organ ulcer. Diseases related with liver involve hepatitis, hyperthyroidism and stroke. Diseases related with lung involve neurodermatitis, bronchitis and paranasal sinusitis. Conclusions : Blood stasis pattern which is one of the areas to draw medicine's attention has broad clinical application.

• 대한임상검사과학회지
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• 제37권3호
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• pp.185-189
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• 2005

Lipids such as total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C) and high sensitivity C-reactive protein (hs-CRP) are known as good risk factors for coronary artery diseases caused by arthrosclerosis. We measured the serum concentrations of hs-CRP, TC, and HDL-C of 6,128 persons who underwent medical examinations in the Health Screening Center at Kangbuk Samsung Hospital. We classified the subjects into normotensive and hypertensive groups according to the blood pressure measured. We investigated whether there was a difference of hs-CRP and lipids between the normotensive and hypertensive groups. There was significant difference of TC, TC/HDL-C ratio, and hs-CRP concentration between the normotensive and hypertensive groups in both men and women, but there was no significant difference of HDL-C concentration between two groups. Our results indicated that the concentrations of hs-CRP and lipids were higher in patients with hypertension and confirmed the usefulness of lipids and hs-CRP in predicting the risk for coronary artery diseases.

• Pediatric Infection and Vaccine
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• 제24권2호
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• pp.102-107
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• 2017

목적: 가와사키병의 환아뿐만 아니라, 다른 전신 염증 질병의 환아들에 관상동맥 병변(coronary arterial lesion [CAL])의 발생이 보고되었다. 본 연구에서는 전형적인 전신염증반응증후군(systemic inflammatory response syndrome [SIRS])의 소견을 보이는 패혈증 마우스 모델에서 가와사키병 환아에게 관찰되는 CAL이 발생하는지 확인하고자 하였다. 방법: 생후 6주 C57BL/6 마우스에 내독소를 복강내주사하여 SIRS를 보이는 패혈증 모델을 유도하였다. 대조군과 패혈증군의 주요 장기의 조직학적 소견을 비교하였고 패혈증 마우스에서 CAL을 찾기 위한 시도를 하였다. 결과: 대조군과 비교하여, 염증세포의 침윤이 패혈증 마우스의 심장, 간, 신장에 상대적으로 증가하였다. 패혈증 마우스의 심장에서 심근(심근염)과 심장 주위 연조직에 림프구 침윤을 확인하였다. 또한, 패혈증 마우스의 관상동맥을 관찰하였지만, CAL을 확인할 수는 없었다. 결론: 본 연구에서 패혈증 마우스 모델에서 CAL의 존재를 확인하는 것은 실패하였다. 하지만, SIRS를 유발하는 많은 종류의 원인 질병에서 CAL이 발생한다는 것은 잘 알려져 있다. 가와사키병을 포함한 다양한 전신 염증 질병에 나타나는 CAL의 임상적 의미에 대한 연구가 필요할 것이다.

• Journal of Chest Surgery
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• 제39권8호
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• pp.619-625
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• 2006

배경: 죽상동맥경화성 하지동맥폐쇄증은 대부분의 경우에 전신 동맥 경화증이 동반되며 사망의 원인으로는 주로 반 이상이 관상동맥질환에 의하여 발생한다. 또한 만성 동맥폐쇄증 수술 후 수술 사망 원인은 심장 합병증에 의한 사망이 가장 빈번한 것으로 알려져 있다. 특히 죽상동맥경화성 하지동맥폐쇄증 환자에게 과거에 심질환이 없거나 허혈성 심질환의 주증상이 없던 경우에 수술 후 높은 사망률을 보이는데 이런 이유로 이 환자군에 대한 관상동맥질환의 동반 여부에 대한 수술 전 검사의 필요성이 제기되는 바이다. 대상 및 방법: 2001년 2월부터 2004년 10월까지 죽상동맥경화성 하지동맥폐쇄증으로 입원한 환자 중 과거력상 심질환이 있었거나 허혈성 심질환이 주증상이었던 환자를 제외한 52명의 환자를 대상으로 관상동맥조영술과 하지동맥조영술을 동시에 시행하여 죽상동맥경화성 하지동맥폐쇄증에서 관상동맥질환의 동반 빈도를 파악하였다. 또한 죽상동맥경화성 하지동맥폐쇄증의 중증도를 나타내는 AVO score와 동반된 관상동맥질환과의 상관관계를 비교하였다. 결과: 죽상동맥경화성 하지동맥폐쇄증에서 관상동맥질환을 동반한 경우는 63%(33명)였고, 고령, 당뇨, 고혈압, 흡연력, 고콜레스테롤혈증 등의 동맥 경화증의 위험인자 중 고령과 고혈압이 관상동맥 질환을 동반하는 죽상동맥경화성 하지동맥폐쇄증의 중증도와 통계학적인 의미를 보였다. AVO score가 높을수록 관상동맥 질환의 동반이 흔하였고 관상동맥질환의 중증도 역시 증가되는 소견을 보였다. 관상동맥질환이 동반된 죽상동맥경화성 하지동맥폐쇄증 환자에서 관상동맥 우회술 및 관상동맥 중재적 시술을 병합하여 하지동맥 우회술을 시행한 경우, 하지동맥 우회술의 단독시행에 비해 사망률이 현저히 감소하였다. 결론: 과거력상 심질환이 없거나 허혈성 심질환의 주증상이 없는 죽상동맥경화성 하지동맥폐쇄증 환자에서 특히, 고령, 고혈압, AVO score가 높은 환자군에서는 수술 전 관상동맥조영술을 시행하여 동반되는 관상동맥 질환을 파악한 뒤 이에 대한 적극적인 치료를 시행하여야 한다.

• 생명과학회지
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• 제20권9호
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• pp.1299-1305
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• 2010

심혈관질환 진단을 위해 여러 가지 표지자들이 이용되고 있으며 그와 같은 표지자로 cardiac troponin-I (cTNI), creatine kinase-MB (CK-MB), C-reative protein (CRP)이 있다. 최근, 심장기능부전의 표지자로서 brain natriuretic peptide (BNP)에 대한 관심이 집중되고 있다. 이 연구는 심폐바이패스(cardiopulmonary bypass) 비적용 관상동맥우회수술을 시행한 74명의 성인환자를 대상으로 수술 전 BNP 농도와 다른 심장 표지자들 농도, 그리고 수술 전후 표지자들 간의 상관관계를 규명하기 위해 시행하였다. 수술 전 시기의 BNP, cTNI, CK-MB, CRP 각각의 농도는 수술 전 심초음파 변수와 양 또는 음의 상관성을 보였다. 수술 전 BNP 농도와 수술 전 cTNI, CK-MB, CRP 농도 각각과 높은 양의 상관관계가 있었다. 수술 전 BNP, cTNI, CK-MB, CRP 농도 각각은 수술 후 기계호흡보조시간, 중환자실치료기간과 유의한 양의 상관관계를 보였다. 이 연구의 결과들은 수술 전 BNP, cTNI, CK-MB, CR과 같은 심장 표지자들의 측정 및 병용은 심혈관질환자들의 진단, 환자들의 등급화, 수술 후 예후평가에 매우 유용한 방법임을 시사하고 있다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.153-161
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• 2013

Polyunsaturated fatty acids (PUFAs) are the major components of brain and retina, and are the essential fatty acids with important physiologically active functions. Thus, PUFAs should be provided to children, and are very important in the brain growth and development for fetuses, newborn infants, and children. Omega-3 fatty acids decrease coronary artery disease and improve blood flow. PUFAs have been known to have anti-inflammatory action and improved the chronic inflammation such as auto-immune diseases or degenerative neurologic diseases. PUFAs are used for metabolic syndrome related with obesity or diabetes. However, there are several considerations related with intake of PUFAs. Obsession with the intake of unsaturated fatty acids could bring about the shortage of essential fatty acids that are crucial for our body, weaken the immune system, and increase the risk of heart disease, arrhythmia, and stroke. In this review, we discuss types, physiologic mechanism of action of PUFAs, intake of PUFAs for children, recommended intake of PUFAs, and considerations for the intake of PUFAs.

• Endocrinology and Metabolism
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• 제33권4호
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• pp.429-434
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• 2018

As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.