• Title/Summary/Keyword: coronary artery diseases

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Analyzing association between low-density lipoprotein reduction by statin and adherence to medication using national health insurance service-national sample cohort (NHIS-NSC) (표본코호트기반 고지혈증 약제의 저밀도 콜레스테롤 감소량 및 투약순응도 분석)

  • Kim, Kyu-Jin;Jun, Chi-Hyuck;Lee, Hyeseon;Kim, Hun-Sung
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.5
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    • pp.1027-1041
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    • 2017
  • Hyperlipidemia, the status of blood with high level of low-density lipoprotein cholesterol (LDL-C), is known as a main cause of coronary artery diseases such as myocardiac infarction or brain infarct. Statin is the representative prescription to hyperlipidemia and the effects of it depend on the patient's individual conditions such as health-caring habits or adherence to medication. The main effect of statin is reducing LDL-C, which should reach the target range based on National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) guideline. In this research, the reduction of LDL-C and attainment to patient's target range are considered effects of statin. The association between factors - individual conditions and adherence to medication of patients - and the effects of statin is analyzed with National Health Insurance Service-National Sample Cohort (NHIS-NSC).

Kawasaki Disease with Influenza A Virus and Mycoplasma pneumoniae Infections: A Case Report and Review of Literature (인플루엔자 A 및 폐렴미코플라스마 감염과 병발한 가와사끼병 1례)

  • Moon, Hyeok Soo;Huh, Jae Seong;Kim, Mi Kyung;Lambert, Mulakwa Morisho
    • Pediatric Infection and Vaccine
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    • v.23 no.2
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    • pp.149-154
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    • 2016
  • Although an association of Kawasaki disease (KD) with infectious agents has been suggested, none have been proven to cause KD. In this case study, we present a case of KD with concurrent onset of influenza and Mycoplasma pneumoniae (MP) infections. A 27-month-old boy presented with prolonged fever, cough, and rhinorrhea. During the initial testing, influenza A infection was identified, and he was treated with oseltamivir. Despite the antiviral therapy, the fever persisted, and he had cervical lymph node enlargement, bilateral conjunctival injection, fissured red lips, strawberry tongue, and erythematous skin lesions on the Bacillus Calmette-$Gu{\acute{e}}rin$ vaccination site. Thus, the patient was diagnosed with KD and was treated with intravenous immunoglobulin (IVIG). The result of the initial antimycoplasma immunoglobulin M (IgM) antibody testing and was positive, and an increased IgM titer from baseline was found in a repeat test. We reviewed the hypotheses on pathogens known to be associated with KD and the etiology of KD. Based on our findings, we suspect that symptoms of KD and coronary artery lesions can occur from various infections besides those caused by Mycoplasma species and influenza viruses.

Association of Mannose Binding Lectin Gene Polymorphisms with the Development of Kawasaki Disease: A Pilot Study (Mannose Binding Lectin 유전자 다형성과 가와사끼병 발병의 연관성에 관한 Pilot 연구)

  • Choi, Eun Hwa;Kim, Hee Sup;Lee, Hoan Jong;Choi, Jung Yun
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.195-201
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    • 2008
  • Purpose : We hypothesized that the mannose binding lectin gene (MBL2), a key molecule of innate immunity may contribute to the development of Kawasaki disease (KD) in early childhood. This study was performed to investigate the polymorphisms of MBL2 and the risk of developing KD in Korean children. Methods : The study subjects were 112 children with KD who were admitted to the Seoul National University Bundang Hospital between October 2003 and March 2005. The control subjects consisted of 224 anonymous, healthy Korean blood donors. Extracted genomic DNA was amplified for codon 54 of MBL2 exon 1 and alleles (a and b) were assigned via sequencing analysis. The frequency of the alleles of the MBL2 exon 1 was compared between the case and control groups. Results : The median age of patients was 27 months (range, 3 months-7 years), 45.5% were <24 months of age and 54.5% were ${\geq}2$ years. The genotype distribution reached Hardy-Weinberg equilibrium in both cases and control subjects. In the cases with KD, the genotypic frequencies of codon 54 polymorphisms were 67.9% for aa, 29.5% for ab, and 2.6% for bb. There were no significant differences in the overall distribution of the polymorphisms between the cases and the control subjects. In addition, the genotype distribution was not different according to age. Conclusions : Our findings indicate that the codon 54 polymorphism of the MBL2 gene is not likely to contribute to the risk of developing KD in Korean children. Further studies on the development of coronary artery lesions with regard to MBL2 genotypes are warranted.

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Cardioprotective Potential of Gracilaria Verrucosa Extract in Myocardial Infarction-Induced Heart Failure Model (심근 경색 유발 심부전 모델에서 강리 추출물의 심장 보호 가능성)

  • Youn Jae Jang;Hye Yoom Kim;Jung Joo Yoon;Byung Hyuk Han;Je Kuk Yu;Nam Geun Cho;Ho Sub Lee;Dae Gill Kang
    • Herbal Formula Science
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    • v.31 no.3
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    • pp.157-169
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    • 2023
  • Gracilaria Verrucosa (GV), a seaweed used in traditional Korean medicine, was studied for its effects on MI-induced heart failure in rats. MI is caused by a blocked coronary artery, leading to severe cardiac dysfunction. The study used a rat model to assess cardiac changes over time and evaluate the impact of GV on heart failure. Ischemia was induced through LAD ligation surgery, and the extent of ischemic area was measured as a prognostic factor. GV extract administration significantly improved cardiac morphology and reduced cardiac weight compared to the MI group. GV treatment also improved cardiac function, as evidenced by positive effects on chamber dilation during MI-induced heart failure. Parameters such as ejection fraction (EF) and fractional shortening (FS) were measured. The MI group showed decreased EF and FS compared to the sham group, while these parameters improved in the GV group. GV treatment also reduced levels of LDH, CPK, and CK-MB in the serum, indicating reduced myocardial damage. Histological analysis revealed that GV treatment attenuated cardiac hypertrophy and fibrosis, with reduced collagen deposition in the myocardium. Immunohistochemistry analysis showed suppressed expression of TGF-β1 and collagen 1, involved in fibrosis. In conclusion, GV showed potential in improving cardiac function in a rat model of MI-induced heart failure. It alleviated myocardial damage, attenuated cardiac hypertrophy and fibrosis, and suppressed fibrotic markers. Further studies are needed to explore its clinical efficacy and underlying mechanisms in cardiac diseases beyond animal models.

20(S)-ginsenoside Rg3 exerts anti-fibrotic effect after myocardial infarction by alleviation of fibroblasts proliferation and collagen deposition through TGFBR1 signaling pathways

  • Honglin Xu;Haifeng Miao;Guanghong Chen;Guoyong Zhang;Yue Hua;Yuting Wu;Tong Xu;Xin Han;Changlei Hu;Mingjie Pang;Leyi Tan;Bin Liu;Yingchun Zhou
    • Journal of Ginseng Research
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    • v.47 no.6
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    • pp.743-754
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    • 2023
  • Background: Myocardial fibrosis post-myocardial infarction (MI) can induce maladaptive cardiac remodeling as well as heart failure. Although 20(S)-ginsenoside Rg3 (Rg3) has been applied to cardiovascular diseases, its efficacy and specific molecular mechanism in myocardial fibrosis are largely unknown. Herein, we aimed to explore whether TGFBR1 signaling was involved in Rg3's anti-fibrotic effect post-MI. Methods: Left anterior descending (LAD) coronary artery ligation-induced MI mice and TGF-β1-stimulated primary cardiac fibroblasts (CFs) were adopted. Echocardiography, hematoxlin-eosin and Masson staining, Western-blot and immunohistochemistry, CCK8 and Edu were used to study the effects of Rg3 on myocardial fibrosis and TGFBR1 signaling. The combination mechanism of Rg3 and TGFBR1 was explored by surface plasmon resonance imaging (SPRi). Moreover, myocardial Tgfbr1-deficient mice and TGFBR1 adenovirus were adopted to confirm the pharmacological mechanism of Rg3. Results: In vivo experiments, Rg3 ameliorated myocardial fibrosis and hypertrophy and enhanced cardiac function. Rg3-TGFBR1 had the 1.78×10-7 M equilibrium dissociation constant based on SPRi analysis, and Rg3 inhibited the activation of TGFBR1/Smads signaling dose-dependently. Cardiac-specific Tgfbr1 knockdown abolished Rg3's protection against myocardial fibrosis post-MI. In addition, Rg3 downregulated the TGF-β1-mediated CFs growth together with collagen production in vitro through TGFBR1 signaling. Moreover, TGFBR1 adenovirus partially blocked the inhibitory effect of Rg3. Conclusion: Rg3 improves myocardial fibrosis and cardiac function through suppressing CFs proliferation along with collagen deposition by inactivation of TGFBR1 pathway.

Quantitative Vertebral Bone Density Seen on Chest CT in Chronic Obstructive Pulmonary Disease Patients: Association with Mortality in the Korean Obstructive Lung Disease Cohort

  • Hye Jeon Hwang;Sang Min Lee;Joon Beom Seo;Ji-Eun Kim;Hye Young Choi;Namkug Kim;Jae Seung Lee;Sei Won Lee;Yeon-Mok Oh
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.880-890
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    • 2020
  • Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (DThorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. DThorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between DThorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. DThorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. DThorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV1) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DLCO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower DThorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower DThorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV1, and lower DLCO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

Preliminary Study on the Standardization of Korean Version of Type D Personality Scale 14 : Internal Consistency and Construct Validity (D형 인격 척도의 표준화 예비연구 : 내적일치도 및 구성타당도)

  • Lee, Moon-Soo;Park, Young-Min;Lim, Hong-Euy;Song, Woo-Hyuk;Ahn, Jung-Chun;Kim, Seong-Hwan;Lee, Bun-Hee;Han, Chang-Su;Kim, Yong-Ku;Joe, Sook-Haeng;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.81-87
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    • 2007
  • Objectives : The distressed personality (type-D) pattern, consisting of negative affectivity and social inhibition, has been shown by Denollet et al. For measuring the Type D characteristics, Denollet has devised the 14 item Type D scale (DS14). In the present study, this instrument was translated into Korean. The reliability and validity of the Korean DS14 was pilot tested. Methods : Preliminary version of the total 17-item DS14 scale was translated into Korean. 372 controls that did not have any coronary heart diseases (CHD) were randomly sampled in Seoul and Gyeonggi province. Preliminary Korean version was applied to controls and 14 items were finally selected to maximize reliability of the scale. We compared the distribution of type-D personality among the normal controls, hypertensive patients, and the CHD patients. Results : 7 of 10 items in social inhibition were selected and final 14-item version was made. The internal consistency of negative affectivity (0.817) and social inhibition (0.797) were high. In addition, the prevalence of type-D personality in the CHD patients group was significantly higher than normal controls. Conclusion : These findings suggest that Korean version of DS14 is a valid tool for measuring the type D characteristics. Type-D characteristics can be suggested to predict adverse prognosis in patients with CHD.

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NT-pro BNP : A new diagnostic screening tool for Kawasaki disease (가와사끼병에서 진단적 지표로서의 NT-proBNP)

  • Lee, Hyunju;Kim, Heejung;Kim, Hae Soon;Sohn, Sejung
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.539-544
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    • 2006
  • Purpose : The purpose of this study was to determine whether N-terminal fragment of B-type natriuretic peptide(NT-proBNP) may be used to differentiate acute Kawasaki disease(KD) from other clinically similar diseases. Methods : Using electrochemiluminescence immunoassay, NT-proBNP concentrations were measured in the acute phase within 10 days after the onset of KD(n=58) and in the convalescent phase, 60 to 81 days after the onset(n=51), and also in patients with acute febrile disease as a control(n=34). Echocardiography was performed to detect pericardial effusion(PE) and coronary artery lesions(CAL), and to measure the left ventricular dimension at diastole(LVIDd) and ejection fraction(LVEF). The cutoff value of NT-proBNP for separating KD from other diseases was determined. Results : NT-proBNP concentration in the acute phases of KD was significantly higher than that in the control group($1,501.6{\pm}2,132.6$ vs. $139.0{\pm}88.8pg/mL$, P<0.0001). In KD patients, NT-proBNP was elevated in the acute phase and was lowered in the convalescent phase($1,466.0{\pm}2,173.2$ vs. $117.5{\pm}95.5pg/mL$, P<0.0001). The cutoff value of 260 pg/mL discriminated KD patients from other patients, with a sensitivity of 93 percent and a specificity of 88 percent. The NT-proBNP was higher in patients with PE(n=17) compared with those without PE(n=41)($1,784.2{\pm}1,903.1$ vs. $1,384.4{\pm}2,232.6pg/mL$, P=0.52). Comparison of NT-proBNP could not be done between patients with CAL and those without, owing to a small number of patients with CAL(n=3). There was no correlation between NT-proBNP and LVEF index(r=0.104, P=0.46) or LVIDd index(r=0.171, P=0.22). Conclusion : NT-proBNP increases in the acute phase of KD and decreases to within normal range in the convalescent phase. NT-proBNP >260 pg/mL may be highly suggestive of acute KD. NT-proBNP may be used as a diagnostic tool for KD.

The Surgical Treatment of Atrial Fibrillation in Patients Undergoing Simultaneous Open Heart Surgery (심장세동의 수술요법)

  • Kim, Gi-Bong;Lee, Chang-Ha;Son, Dae-Won
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.287-292
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    • 1997
  • .Itrial fibrillation is one of the most common cardiac arrhythmias requiring treatment. About 60% of patients with mitral valvular disease have atrial fibrillation and one third of patients with atrial fibrillation may have the past history of thromboembolic events. Between April 1994 and June 1995, 20 patients with organic heart diseases combined with atrial fibrillation underwent open heart surgery including Cox-maze 111 procedure. There were 6 men and 14 women with an average age of 48 years (range, 31 to 66 years). Nineteen patients had valvular heart diseases and 1 ventricular septal defEct (VSD). Mean duration of atrial fibrillation was 36 months (:42 months) (range, 1 to 132 months). T e past medical history of thromboembolic events was positive in 7 patients (35%) and left atrial thrombus was detected in 9 patients (45%). The concomitant procedures were mitral valve replacement (MVR) and aortic valve replacement (AVR) in 5 patients, MVR in 4, MVd and tricuspid annuloplasty(TAP) in 4, mitral valvuloplasty(Mln) in 3, Mln and Tln in 1, MIW and coronary artery bypass surgery in 1, AVR in 1, and patch closure of VSD in 1. Mean aortic cross-clamping time was 175 minutes (range, 116 to 270 minutes). Atrial fibrillation recurred in 16 patients (80%) during the early postoperative period, but, recurrent atrial fibrillation was converted to regular rhythm at postoperative forty-first day in average. There was no early or late death in this series of 20 patients and postoperative complications were inappropriate tachycardia in 5 patients (25%), low cardiac output syndrome in 3 (15%), aggravated hemiplegic in 1, and acute renal failure in 1. Mean follow-up interval of patient was 16.5 months (range, 10.5 to 24 months) and all patients are currently in regular rhythm. Seventeen patients (85%) are in sinus rhythm and 3 (15%) in junctional rhythm. Right atrial contraction was detected in 95% of patients and left atrial contraction in 63% on postoperative transthoracic echocardiogram. The surgical treatment of atrial fibrillation concomitant with open heart surgery is warranted in the recent clinical setting of improved myocardial protection technique, considering the untoward side-effects of atrial fibrillation.

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Analysis of Trans Fatty Acid Content in Processed Foods and Meat Products (가공식품과 육가공품의 트랜스 지방산 함량 조사)

  • Park, Jung-Min;Ji, Won-Gu;Kim, Eun-Jung;Park, Da-Jung;Shin, Jin-Ho;Shim, Soon-Mi;Suh, Hyung-Joo;Chang, Un-Jae;Kang, Duk-Ho;Kim, Jin-Man
    • Food Science of Animal Resources
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    • v.27 no.4
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    • pp.531-537
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    • 2007
  • Small amounts of trans fatty acids exist naturally in beef and dairy foods. Also, they can be produced in the process of partial hydrogenation to manufacture shortning or margarine. They can provide a better palatability and shelf life. According to the recently studies, trans fatty acids can raise health risk such as heart diseases and coronary artery diseases. They can also increase low-density lipoprotein (LDL) cholesterol and decrease high-density lipoprotein (HDL) cholesterol in the blood plasma, therefore increasing the risk of atherosclerosis and diabetes. The aim of this study was to determine total lipids and trans fatty acids (TFAs) content in processed foods and meat products. The analysis of trans fatty acids was performed in 28 samples of donuts, 18 samples of bakeries, 4 samples of frozen doughs, 2 samples of popcorns, and 4 samples of meat products (ham, sausage, nuget, and bacon). Total lipids in processed foods and meat products were extracted by chloroform-Methanol method and acid digestion, respectively. They were analyzed by gas chromatography using a SP-2560 column and flame ionization detector. The amounts of TFAs per 100 g of foods were 0-3.3% (0.74% on average) in donuts, 0.2-5.8% (1.18% on average) in bakeries, 0.2-6.3% (1.93% on average) in frozen doughs, and 0-5.8% in popcorns. Meat products such as ham, sausage, and nuget analyzed 0.1% of TFAs, respectively and trans fatty acids in bacon were not detected. As a result, the distribution of TFAs in processed foods was widely ranged from O% to 6.3% according to manufacturers and types of products, whereas the content of TFAs in meat products ranged from 0% to 0.1%.