• Title/Summary/Keyword: intima

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Multi-vessel intractable coronary spasm development in a patient with aborted sudden cardiac death: a case study with intravascular ultrasound findings

  • Cho, Sungsoo;Kang, Tae Soo
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.121-126
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    • 2018
  • Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.

Medicinal Herbs Effective Against Atherosclerosis: Classification According to Mechanism of Action

  • Kim, Jae-Yong;Shim, Sang Hee
    • Biomolecules & Therapeutics
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    • v.27 no.3
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    • pp.254-264
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    • 2019
  • Atherosclerosis is a widespread and chronic progressive arterial disease that has been regarded as one of the major causes of death worldwide. It is caused by the deposition of cholesterol, fats, and other substances in the tunica intima which leads to narrowing of the blood vessels, loss of elasticity, and arterial wall thickening, thus causing difficulty in blood flow. Natural products have been used as one of the most important strategies for the treatment and prevention of cardiovascular diseases for a long time. In recent decades, as interests in natural products including medicinal herbs have increased, many studies regarding natural compounds that are effective against atherosclerosis have been conducted. The purpose of this review is to provide a brief overview of the natural compounds that have been used for the treatment and prevention of atherosclerosis, and their mechanisms of action based on recent research.

Extraction of Intima and Adventitia using Bezier Curve on IVUS Image (IVUS 영상에서 베지어 곡선을 이용한 내막과 외막 추출)

  • Moon, A-Seong;Kim, Yeong-Wan;Kang, Yong Hoon;Kim, Kwang-Baek
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2020.01a
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    • pp.29-31
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    • 2020
  • 제안된 방법은 외막의 경계선을 추출하기 위해 Max-Min 이진화를 적용하여 외막을 추출 한 후에 삼각 함수의 각도 값을 이용하여 외막의 경계점을 추출한다. 추출한 경계점들을 Bezier Curve 기법을 적용하여 외막의 경계점들을 연결하여 외막의 경계선을 추출한다. 그리고 내막 영역을 추출하기 위해 외막 영역을 ROI 영역으로 추출한다. 추출된 ROI 영역을 오목 파라볼라 기법을 적용하여 내막의 영역을 강조한다. 내막영역이 강조된 ROI 영역에 평균 이진화를 적용하여 내막의 영역을 추출한다. 추출된 영역에서 잡음을 제거하기 위해 내막 영역만 Labeling 기법을 적용한다. 제안된 방법을 IVUS 영상을 대상으로 실험한 결과, 내막과 외막간의 포함관계의 정도에 따라 환자의 수술 여부 결정에 대한 외막과 내막의 각 넓이 정보를 개관적으로 제공할 수 있는 가능성을 확인하였다.

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Inter-Rater Reliability of Carotid Intima-Media Thickness Measurements in a Multicenter Cohort Study (다기관 코호트 연구에서 경동맥 내막-중막 두께 측정의 측정자간 신뢰도 평가)

  • Lee, Jung Hyun;Choi, Dong Phil;Shim, Jee-Seon;Kim, Dae Jung;Park, Sung-Ha;Kim, Hyeon Chang
    • Journal of health informatics and statistics
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    • v.41 no.1
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    • pp.49-56
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    • 2016
  • Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632- 0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ${\pm}1.96$ SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.

A Study on the Carotid Artery Ultrasonography for the Metabolic Syndrome (대사증후군에서 경동맥 초음파 검사에 대한 연구)

  • Kong, Hye-Jung;Kang, Young-Han;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.36 no.3
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    • pp.219-225
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    • 2013
  • The primary goal of this study was to ascertain the primary factors to the affect for the carotid artery intima-media thickness (IMT), the prevalence of metabolic syndrome and other risks can possibly influence the carotid artery IMT. All patients data (total specimens: 289, male: 197, female: 92) including the carotid artery ultrasonography examination. The all data were analyzed by the use of SPSS software, version 21.0 (SPSS, Chicago, IL USA), with the descriptive statistics method. The Results of this study was found to be highly increased in the males than the females. The prevalence of metabolic syndrome in all of the participants was 30.5 percentages. The carotid artery IMT in the subjects with metabolic syndrome was significantly high in both genders, compared to the rest, who were without metabolic syndrome. The Pearson's correlation coefficient of metabolic syndrome and CIMT was 0.378(p<0.01). In conclusions, the present study also supports the association between the carotid artery IMT and the metabolic syndromes with cardiovascular risk factors. Usage of B-mode ultrasonography to measure the carotid artery IMT was found to be highly effective in the current analysis.

Relationship of Thickness of Carotid Artery according to Smoking and Drinking in University Students (대학생들의 흡연 및 음주에 따른 목동맥 두께의 상관성)

  • Kim, Dae-Sik;Sung, Hyun-Ho;Cho, Eun-Kyung;Lee, Jong-Woo
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.345-353
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    • 2018
  • This study examined the associations of smoking, alcohol drinking habits and both with the carotid intima-media thickness (CIMT) in university students. This study was performed using a CAGE (test for alcohol: cutting down, annoyance by criticism, guilty feeling, and eye-openers) questionnaire, FTND (the Fagerstrom test for nicotine dependence) questionnaire, and CIMT of university students. No statistically significant differences were observed among the CIMT results according to each CAGE level classified into 3 groups. The results of CIMT according to the FTND smoking categorization showed that the smoking group was higher than nonsmoking group (P<0.01). A statistically significant difference was observed between the left and right CIMT regarding smoking and drinking (P<0.01). In the only drink risk group, the left CIMT (19.84 rank) showed a low-ranking. The CIMT on the left (42.38 rank) and right (42.81 rank) showed high scores in the group with only the risk of smoking (P<0.01). These results suggested that there are distinct differences in CIMT and relevant risk factors between smokers and drinkers, particularly among those with a high smoking status. This study had several limitations: the study population was small; the relatively young age of the study subjects; and limited of focus on smoking, drinking and CIMT. In conclusion, cigarette smoking significantly exacerbates the adverse effects and higher CIMT on the subclinical atherosclerosis risk in young adults, which underscores the importance of prevention and cessation of cigarette smoking in young adults.

Age and Gender Differences in the Relationship of Cognitive Impairment, Vascular Risk Factors, and Subclinical Carotid Atherosclerosis from Community-based Elderly (나이와 성별에 따른 지역사회 거주 노인에서 무증상 경동맥 죽상경화증에 대한 혈관위험인자 및 인지장애와의 관련성)

  • Kim, Ji-Hee;Park, Hyun-Young;Kim, Dae-Won;Byun, Seung-Jae;Moon, Hyo-Jeong;Lee, In;Yang, Chung-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.3
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    • pp.399-407
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    • 2012
  • To evaluate age and gender differences in the relation of cardiovascular risk factors, cognitive impairment, and subclinical carotid atherosclerosis from aged people using by a cross sectional method. Sixty-nine healthy elders living in the community who had not previously undergone carotid ultrasonography were included. We conducted life style surveys, and cognitive function tests including Korean-mini-mental state examination (K-MMSE) and clinical dementia rating-Korean. Various biomarkers from blood were assessed; fasting insulin-like growth factor-1, lipid-profile, high sensitivity C-reactive protein, total homocysteine, glucose, insulin, Homeostasis model assessment (HOMA) for insulin resistance index, vitamin B12, and folate level. Carotid intima-media thickness (C-IMT), and plaques were measured using carotid ultrasonography and aortic ultrasonography, a valid index of atherosclerosis. For the elderly subjects (aged 65-82 years), cognition impairment was more prevalent in females while subclinical atherosclerosis was more prevalentin males. Increased C-IMT has been kept in males, and C-IMT shows increasing trend and the peak at about 80 year-old in females with increasing age. The significant correlations between C-IMT and many vascular risk factors including age, triglyceride, abnormal homocysteinein male, and K-MMSE, insulin, HOMA index and abnormal aortic ultrasonography in female were different in each gender, with the exception of homocysteine (p<0.05). This data suggests that there were differences of age and gender characteristics in terms of subclinical atherosclerosis, cognitive impairment and vascular risk factors in community-living elders. Further larger and longitudinal studies across entire age are required to better understand the effects of risk factors on subclinical atherosclerosis.

Blood Vessel Strain Imaging Using Linear Array Transducer (선형 트랜스듀서를 이용한 혈관 변형률 영상법)

  • Ahn, Dong-Ki;Jeong, Mok-Kun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.3
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    • pp.880-890
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    • 2010
  • The intrasvascular ultrasound (IVUS) imaging technique is used to diagnose cerebrovascular diseases such as stroke. Recently, elasticity imaging methods have been investigated to diagnose blood clots attached to blood vessel intima. However, the IVUS imaging technique is an invasive method that requires a transducer to be inserted into blood vessel. In this paper, strain images are obtained of blood clots attached to blood vessel intima with data acquired from outside the blood vessel using a linear array transducer. In order to measure the displacement of blood vessel accurately, experimental data are acquired by steering ultrasound beams so that they can intersect the blood vessel wall at right angles. The acquired rf data are demodulated to the baseband. The resulting complex baseband signals are then processed by an autocorrelation algorithm to compute the blood vessel movement and thereby produce strain image. This proposed method is verified by experiments on a plastic blood vessel mimicking phantom. The efficacy of the proposed method was verified using a home-made blood vessel mimicking phantom. The blood vessel mimicking phantom was constructed by making a 6 mm diameter hollow cylinder inside it to simulate a blood vessel and adhering 2 mm thick soft plaque to the inner wall of the hollow cylinder. The RF data were acquired using a clinical ultrasound scanner (Accuvix XQ, Medison, Seoul. Korea) with a 7.5 MHz linear array transducer by steering ultrasound beams in steps of $1^{\circ}$ from $-40^{\circ}$ to $40^{\circ}$ for a total of 81 angles. Experimental results show that the plaque region near the blood vessel wall is softer than background tissue. Although the imaging region is restricted due to the limited range of angles for which scan lines are perpendicular to the wall, the feasibility of strain imaging is demonstrated.

False Aneurysm of Common Carotid Artery by Trauma (외상에 의한 가경동맥루 1례 보고)

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.67-70
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    • 1981
  • Aneurysms of the extracranial carotid artery are rare. This is a case report of the rapidly expanding false carotid aneurysm at left common carotid artery, which was repaired surgically with internal shunt This 20 year old male patient had a large pulsatile mass on left lateral aspect of neck at the time of admission. About 1 month before admission, he had received a trauma on left neck by glass piece and noted massive blood loss. And its skin of lesion was sutured simply at local clinic and well healed. 10 days before the admission, he had the sudden onset of the adult thumb sized and pulsatile mass and the mass had been enlarged more and more to the adult first-sized one. The cervical film showed a egg-sized and soft tissue mass. There was systolic bruit on the mass. The diagnosis was confirmed with the angiogram of left carotid artery and this showed the man`s thumb tip-sized extravasation at the point 2 Cm below the bifurcation of Internal and external carotid arteries. The emergency operation was performed by the internal shunt with carotid artery. The aneurysm was enclosed with the adventitia and carotid sheath, and the intima and media were Intact and had the opening of 0.5 cm in diameter. The opening was sutured by the one-hand mattress suture method and firmed with the Aron Alpha-A "Sankyo." The postoperative course was uneventful and the patient was discharged with good general condition.

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Review of silent lacunar infarct and cerebral microbleeds : in the aspect of insurance medicine and independent medical examiners (보험 및 장애평가 대상으로서 무증상 뇌경색과 뇌미세출혈의 의미)

  • Joung, Jae-hoon
    • The Journal of the Korean life insurance medical association
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    • v.28 no.1_2
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    • pp.11-14
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    • 2009
  • It is common to find cerebral infarct and hemorrhage without definite neurologic signs but with lesions on neuroimaging. These lesions are called silent lacunar infarct and cerebral microbleed. Silent lacunar infarct are frequently seen in the elderly and are associated with clinically apparent stroke and vascular dementia. Known stroke risk factors, such as hypertension, diabetes mellitus, smoking, hypercholesterolemia and heart problems may increase the risk of silent lacunar infarct. Metabolic syndrome, homocysteinemia, renal failure and intima media thickness(IMT) are also other risk factors of the silent lacunar infarct. Cerebral microbleed, lacunar infarct and intracerebral hemorrhage(ICH) have similar pathology and pathogenesis. So, cerebral microbleed are coexisted with lacunar infarct, leukoaraiosis, hypertensive ICH and vascular dementia. Cerebral microbleed are associated with volume and recurrence of ICH. Also cerebral microbleed may reflect baseline status of blood brain barrior disruption. Silent lacunar infarct and cerebral microbleed are very important to clinical management, but in the aspect of insurance medicine and independent medical examiners, these lesions are not subject of evaluation for handicap.

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