• Title/Summary/Keyword: ischemic disease

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Are There Hopeful Therapeutic Strategies to Regenerate the Infarcted Hearts?

  • Gyu-Chul Oh;Yeon-Jik Choi;Bong-Woo Park;Kiwon Ban;Hun-Jun Park
    • Korean Circulation Journal
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    • v.53 no.6
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    • pp.367-386
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    • 2023
  • Ischemic heart disease remains the primary cause of morbidity and mortality worldwide. Despite significant advancements in pharmacological and revascularization techniques in the late 20th century, heart failure prevalence after myocardial infarction has gradually increased over the last 2 decades. After ischemic injury, pathological remodeling results in cardiomyocytes (CMs) loss and fibrosis, which leads to impaired heart function. Unfortunately, there are no clinical therapies to regenerate CMs to date, and the adult heart's limited turnover rate of CMs hinders its ability to self-regenerate. In this review, we present novel therapeutic strategies to regenerate injured myocardium, including (1) reconstruction of cardiac niche microenvironment, (2) recruitment of functional CMs by promoting their proliferation or differentiation, and (3) organizing 3-dimensional tissue construct beyond the CMs. Additionally, we highlight recent mechanistic insights that govern these strategies and identify current challenges in translating these approaches to human patients.

Study on the Relationship between Polymorphisms in Glutathione S-transferase and Ischemic Cerebrovascular Disease

  • Han Sang-Hyuk;Park Sae-Wook;Shin Yong-Il;Cho Kwang-Ho;Moon Byung-Soon
    • The Journal of Korean Medicine
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    • v.25 no.4
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    • pp.36-42
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    • 2004
  • Objective : Glutathione S-transferase polymorphism (GST) were examined in 120 cases with ischemic cerebrovascular disease (ICVD) to test the hyperthesis that GST polymorphisms confer a risk to an individual to develop ICVD. Tobacco smoking is a major cause of both cancer and vascular disease. Methods : therefore We were stratified the subjects with ICVD for smoking status, and then examined whether polymorphisms in this detoxification enzyme gene, GST, influence risk of ICVD Results : Neither GSTM1 nor GSTT1 genotypes in the ICVD group was significantly different from the control group (n=207), even in smokers. We attempted the combined analyses for GSTM1 and GSTT1 genotypes in ICVD for smoking status. No significant association observed between the combined genotypes and ICVD Conclusion : Our observation do not confirm the effect of the GSTM1 and GSTT1 genotypes as a risk factor for ICVD, even in smokers.

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Utilities and Limitations of Cardiac Magnetic Resonance Imaging in Dilated Cardiomyopathy

  • Min Jae Cha;Yoo Jin Hong;Chan Ho Park;Yoon Jin Cha;Tae Hoon Kim;Cherry Kim;Chul Hwan Park
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1200-1220
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    • 2023
  • Dilated cardiomyopathy (DCM) is one of the most common types of non-ischemic cardiomyopathy. DCM is characterized by left ventricle (LV) dilatation and systolic dysfunction without coronary artery disease or abnormal loading conditions. DCM is not a single disease entity and has a complex historical background of revisions and updates to its definition because of its diverse etiology and clinical manifestations. In cases of LV dilatation and dysfunction, conditions with phenotypic overlap should be excluded before establishing a DCM diagnosis. The differential diagnoses of DCM include ischemic cardiomyopathy, valvular heart disease, burned-out hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, and non-compaction. Cardiac magnetic resonance (CMR) imaging is helpful for evaluating DCM because it provides precise measurements of cardiac size, function, mass, and tissue characterization. Comprehensive analyses using various sequences, including cine imaging, late gadolinium enhancement imaging, and T1 and T2 mapping, may help establish differential diagnoses, etiological work-up, disease stratification, prognostic determination, and follow-up procedures in patients with DCM phenotypes. This article aimed to review the utilities and limitations of CMR in the diagnosis and assessment of DCM.

A Quantitative Analysis on Clinical Course of Acute Ischemic Stroke with National Institute of Health Stroke Scale (National Institutes of Health Stroke Scale을 이용한 급성기 허혈성 뇌졸중의 증상 경과에 대한 정량적 고찰)

  • Choi, Jin-Young;Cho, Gwon-Il;Shin, Hak-Soo;Shin, Sun-Ho;Kim, Dong-Woung;Han, Myoung-Ah
    • The Journal of Internal Korean Medicine
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    • v.23 no.1
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    • pp.5-13
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    • 2002
  • Purpose : Studies on stroke were conducted by using the scaling system to estimate, compare severity and to predict prognosis. National Institute of Health Stroke Scale is widely used for this purpose due to its accuracy in predicting clinical symptoms. According to previous studies, neurologic symptoms in acute stage of ischemic stroke did not disappear, and approximately 27% to 43% of them were aggravated, We conducted this study to define clinical aggravation and to improve ischemic stroke in its acute stage by using NIHSS. Methods and Subjects : Due to their acute ischemic stroke, twenty five patients visited Wonkwang Oriental Medicine in Cheonju within forty eight hours from its beginning stage. Two oriental medicine doctors checked NIHSS every six hours during the first ninety six hours and later every twenty four hours for twelve days from the beginning of the disease. Results : The Aggravated group consisted of nineteen out of twenty five cases, which is seventy six % and NIHSS on admissions were $5.88{\pm}0.63$ and it increased linearly over time by the equation of NIHSS on admissions was $8.50{\pm}2.02$ and it decreased linearly over time by the equation of NIHSS=-0.01 one hour+7.91. Conclusion : During the study, we defined the clinical courses of acute ischemic stroke. There have been no reports on this so far. Therefore, we hope that this study will be beneficial to expand the scope of oriental medicine in dealing with aggravating ischemic stroke in the acute stage.

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Ischemic Infarcion Model by Middle Cerebral Artery Occlusion using Allogenic Blood Clot in Beagle Dogs (비글견에서 동종혈전 색전술을 이용한 중간대뇌동맥의 허혈성 뇌경색 모델)

  • Kim, Younghwan;Choi, Sooyoung;Lee, Kija;Han, Woosok;Choi, Hojung;Lee, Youngwon
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.10-15
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    • 2016
  • The purpose of this study was to establish reproducible ischemic infarction model using allogenic blood clot in beagle dogs and identify induced ischemic lesion after middle cerebral artery occlusion using magnetic resonance imaging (MRI) and histopathologic findings. Twenty eight male beagle dogs with no evidence of neurologic disease were experimented. Allogenic embolus was made using a healthy beagle dog. After internal carotid artery (ICA) was exposure, 16G catheter was introduced through the ICA. The dog was administered 0.3 ml blood clot for 15 seconds followed by 3 ml of saline for 15 seconds. MRI scans were performed with 1.5T to evaluate ischemic lesion at 7 days after middle cerebral artery occlusion procedure. Evaluation parameters of MRI include location, distribution, infarction type, margin, shape, mass effect and intensity of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid attenuated inversion recovery (FLAIR) sequence, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC). On MRI, all dogs (28/28) showed focal or multifocal lesion including telencephalon and thalamus lesions, especially caudate nucleus (24/28). These lesions had well-defined margin from adjacent brain parenchyma, none or mild mass effect and various shape. Most of dogs appeared hyperintensity on T1WI, T2WI, FLAIR, and DWI/ADC, corresponding to chronic infarction. These lesions were histopathologically confirmed atrophic changes and unstained lesion. In conclusion, MRI is the useful method to provide information about ischemic infarction in dogs and the best reproducible ischemic infarction model was developed by using allogenic blood clot.

Application of Transfer Insensitive Labeling Technique (TILT) in Ischemic Cerebrovascular Diseases

  • 이승구;김동익;김상흠;김시연;인연권
    • Proceedings of the KSMRM Conference
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    • 2001.11a
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    • pp.169-169
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    • 2001
  • Purpose: To assess the clinical usefulness of Transfer Insensitive Labeling Technique (TILT) in t evaluation of ischemic cerebrovascular disease. Method: Arterial spin labeling (ASL) is a method of perfusion weighted imaging usin endogenous water as a tracer. To avoid MT-related artifacts, which is common in usual A technique, a transfer insensitive labeling technique (TILT) was used, which globall manipulate macromolecular spins in the same way by both labeling and reference preparatio while free water is labeled in one case and left unchanged in the other. Philips Interal 1.5 T system was used. 40cm FOV and 32 repeated measurements were done because of the wea perfusion signal. 5 slices of supratentorial brain were obtained in 5 patients {MCA infar (n=3), moyamoya disease (n=2)}. We simultaneously obtained contrast enhanced T2*-weighted perfusion MRI and correlate to TILT images.

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A Study of Prescription Analysis on Patients with Ischemic Heart Disease and Evaluation of Antihypertensive Drug Use in General Hospital (종합병원 허혈성 심장질환 환자의 항고혈압약제 사용 현황 및 평가)

  • Moon, Kyoung-Sil;Song, Hyun-Ju;Sohn, Uy-Dong
    • YAKHAK HOEJI
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    • v.51 no.5
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    • pp.336-342
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    • 2007
  • Treatment of hypertension is important in reducing death and attack rates by Ischemic heart disease (IHD). The purposes of this study are to investigate recent prescriptions for patients with IHD and to evaluate antihypertensive drug use. On the basis of the guidelines proposed by Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure, we analyzed prescriptions of antihypertensive drugs for patients with IHD. It is necessary to set up new guideline for appropriate treatment to lower death and attack rates for patients with IHD.

A Posterior Annuloplasty, Papillary Muscle Plication and Left Ventricle Reduction Through Left Ventriculotomy in Severe Ischemic Cardiomyopathy with Mitral Regurgitation (승모판 폐쇄 부전을 동반한 허혈성 심근병증에서 좌심실 절개를 통한 승모판 성형술 및 유두근 단축술과 좌심실 용적 축소술)

  • Jung Jong-Pil;Cho Won-Chul;Kim Joon-Bum;Lee Jae-Won
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.549-552
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    • 2006
  • In the mitral regurgitation (MR) accompanied with a serious ischemic cardiomyopathy (ICMP), coronary revascularization to viable myocardium, LV reduction and mitral reconstruction become the main surgery under the bad conditions that the cardiac transplantation is not so easy. The MR in ischemic cardiomyopathy appears as various pathologic factors, among them, the papillary muscle displacement in addition to the annular dilatation is pointed out as the important cause. Our hospital would like to report the experience of the surgery about coronary revascularization to the left main with 3-vessel coronary disease, severe ICMP patients accompanied with the MR, posterior mitral annuloplasty and papillary muscle plication through the LVtomy.

Loss of Integrity: Impairment of the Blood-brain Barrier in Heavy Metal-associated Ischemic Stroke

  • Kim, Jeong-Hyeon;Byun, Hyeong-Min;Chung, Eui-Cheol;Chung, Han-Young;Bae, Ok-Nam
    • Toxicological Research
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    • v.29 no.3
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    • pp.157-164
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    • 2013
  • Although stroke is one of the leading causes of death and disability worldwide, preventive or therapeutic options are still limited. Therefore, a better understanding of the pathophysiological characteristics of this life-threatening disease is urgently needed. The incidence and prevalence of ischemic stroke are increased by exposure to certain types of xenobiotics, including heavy metals, suggesting the possible toxicological contribution of these compounds to the onset or aggravation of stroke. Among the potential targets, we have focused on alterations to cerebral endothelial cells (CECs), which play important roles in maintaining the functional integrity of brain tissue.