• Title, Summary, Keyword: 죽상경화증

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Surgical Treatment for Atherosclerosis of Aaortoiliac Artery (대동맥장골동맥의 죽상경화증에 대한 수술적치료)

  • 금동윤;정진악;신화균;이재원
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.34 no.2
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    • pp.133-137
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    • 2001
  • 배경: 하지에 영향을 미치는 죽상경화증은 복부대동맥과 이에 중요분지인 총장골동맥을 침범할 수 있다. 또한 국소분절을 침범할 수 있으나 다중분절은 침범할 수도 있다. 대상 및 방법: 을지의과대학교 흉부외과학 교실에서는 1995년 1월부터 1999년 12월까지 대동맥총장골동맥의 죽상경화증을 주소로 우회술을 시행받은 23례의 환자들을 후향적으로 조사하였다. 결과: 모든 환자는 남자였고 평균연령은 60.15$\pm$8.7세였다. 전 예에서 흡연의 과거력이 있었으며 동반질환으로 당뇨병 8례, 고혈합 7례, 관상동맥질환 6례, 그리고 판막질환 1례였다. 대동맥장골동맥 죽상경화증에 대한 수술방법으로는 대동맥양측대퇴동맥 우회술(7례), 대동맥양측동맥 우회술 및 대퇴동맥슬와동맥 우회술(8례), 대동맥양측대퇴동맥 우회술(2례), 액와대퇴동맥 및 고고동맥 우회술(3례), 고고동맥 우회술(3례)였다. 훌후 합병증으로 후복막상 출혈 3례, 마비성 장폐색 3례, 폐렴3례, 뇌졸중 1례, 급성신부전 2례, 창상감염 2례였다. 해부학적 우회술을 받은 환자중 3례에서 수술 사망이 발생하였다. 결론: 해부학적 우회술은 대동맥장골동맥의 폐쇄성질환에 표준적인 수술방법이지만 또한 해부학적 우회술 역시 술후 유병률 및 사망률이 낮은 좋은 수술법으로 사료된다.

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In Vitro Culture of Endothelial Cell and Smooth Muscle Cell for Studying Vascular Diseases

  • Kim, Joo-Young
    • Yeungnam University Journal of Medicine
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    • v.27 no.2
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    • pp.91-97
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    • 2010
  • Endothelial cells play a key role in pathological processes such as cancer cell metastasis, atherosclerosis, and diabetic retinopathy. Vascular smooth muscle cells directly involve in the formation of atheroma in atherosclerosis. Some kinds of the endothelial cells are simply harvested from the umbilical veins, the tunica intima of aortic walls, the retina using various enzymes solutions. Those purely isolated cells provide a powerful tool in vitro studies of the endothelial cell related diseases. In this context, the cultured smooth muscle cells after the isolation from the tunica media of aortic walls are also used for elucidating the pathogenesis of atherosclerosis. Here, I briefly introduce articles that include the isolation of human umbilical vein endothelial cells(HUVEC), aortic endothelial and smooth muscle cells, retinal microvascular endothelial cells(RMEC), as well as the diseases' applications of these cells.

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당뇨병과 비만

  • 김성래
    • The Monthly Diabetes
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    • pp.16-17
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    • 2002
  • 비만과 관련된 질환은 당뇨병, 고혈압, 고지혈증, 죽상경화증(동맥경화증), 심근경색증, 지방간, 담석증, 골 관절염, 통풍, 폐쇄성 수면 무호흡증, 대장암, 직장암, 전립선암, 유방암, 자궁내막암 등의 각종 암, 불안, 우울, 적응장애, 히스테리 등의 심리적 질환 등이 있다. 비만이 있을 때 우리 몸에서는 인슐린 자체에 대한 저항성이 생겨서 말초조직에서의 포도당 이용이 감소된다. 연구에 의하면 표준체중의 45$\%$ 이상을 초과한 비만환자는 당뇨병 발생의 위험도가 30배 증가된다고 알려져 있다. 비만이 있을 때 흔히 동반되는 질환들 중 특히 고혈압, 고지혈증, 죽상경화증 등의 질환은 당뇨가 있을 때 흔히 동반될 수 있는 질환들이고, 인슐린 저항성과 깊은 관계가 있는 질환들로 당뇨인들에게 비만은 매우 중요한 질환이라고 할 수 있겠다.

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Expressions of Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-2 with Changes of Interleukin-6 and Interleukin-18 in Atherosclerotic Lesions of Hypercholesterolemic Rabbits (고콜레스테롤혈증 가토의 죽상경화성 병변에서 Interleukin-6와 Interleukin-18의 변화 및 Matrix Metalloproteinase-9과 Tissue Inhibitor of Metalloproteinase-2의 발현)

  • 권영무;김성숙;장봉현
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.35 no.6
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    • pp.407-419
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    • 2002
  • Atherosclerosis is a chronic inflammatory disease of the arterial wall characterized by progressive accumulation of lipids, cells, and extracellular matrix. Matrix metalloproteinases(MMPs) and tissue inhibitor of metalloproteinases(TIMPS) contribute to vascular matrix remodeling in atherosclerosis, and some cytokines may play role in the synthesis or activation of MMPs or TIMPs. Material and Method: We produced experimental atherosclerotic plaques in 9 rabbits by atherogenic hypercholesterol diet for 12 weeks, and 10 other rabbits were used as control group with standard laboratory chow, At that time, 19 rabbits were sacrificed and aorta, coronary arteries and blood specimens were prepared. The expressions of MMP-9, TIMP-2 and interleukin(IL)-18, and the bioactivity of IL-6 were investigated with H&E stain, immunohistochemical stain, immunoblotting(Western blot analysis), and bioassay. Result: Serum cholesterol in the experimental group increased up to 1258$\pm$262 mg/dL(control group: 41$\pm$7 mg/dL). All experimental group showed well-developed atherosclerotic plaques in aorta and coronary artery. The expression of MMP-9 in aorta and coronary artery of the experimental group showed significant increase than that of the control group by immunohistochemistry. Among the experimental group, complicated lesions with intimal rupture or complete luminal occlusion, demonstrated stronger expression of MMP-9. Interestingly, there was no difference in expression of TIMP-2 between the experimental and the control group. These findings were confirmed by Western blot analysis. The bioassay revealed significant up-regulation of serum bioactivity of IL-6 in the experimental group(4819.60$\pm$2021.25 IU/$m\ell$) compared to that of IL-6 in the control group(27.20 $\pm$ 12.19 IU/$m\ell$). IL-18 was expressed in all atherosclerotic plaques, whereas little or no expression was detected in the control group. Conclusion: The increased MMP-9 expression along with the unchanged TIMP-2 expression seem to be contributory factors in extracellular matrix degradation in atherosclerosis. Focal overexpression of MMP-9 may promote plaque destabilization and cause complications of atherosclerotic plaques such as thrombosis with/without acute coronary syndrome. Elevation of IL-6 and IL-18 may be more than just markers of atherosclerosis but actual participants in lesion development. Identification of critical regulatory pathway is important to improve the understanding of the cellular and molecular basis of atherosclerosis and may open the way for novel therapeutic strategies.

Association between intakes of minerals (potassium, magnesium, and calcium) and diet quality and risk of cerebral atherosclerosis in ischemic stroke patients (뇌졸중 환자들의 무기질 (칼륨, 마그네슘, 칼슘) 섭취와 식사의 질 및 대뇌 죽상경화증과의 상관성 연구)

  • Son, Jihyun;Choe, Han-Saem;Hwang, Ji-Yun;Song, Tae-Jin;Chang, Yoonkyung;Kim, Yong-Jae;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.48 no.2
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    • pp.167-179
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    • 2015
  • Purpose: This study was conducted to evaluate the association between intakes of potassium, magnesium, and calcium and diet quality in ischemic stroke patients. Methods: This study analyzed data from 285 subjects recruited from February 2011 to August 2014 in Seoul, Korea. Nutrition intakes were obtained from a semi-quantitative food frequency questionnaire composed of 111 food items. The subjects were divided into 4 groups by quartiles according to intakes of potassium, magnesium, and calcium. Index of Nutritional Quality (INQ), Mean Adequacy Ratio (MAR), and DQI-International (DQI-I) were analyzed for assessment of diet quality. Results: We found a positive association of intakes of these three minerals with MAR and DQI-I after adjustment for age, sex, education level, smoking, atrial fibrillation, and total energy intake. However, total moderation of DQI-I score in the Q4 group was significantly lower than that of the Q1 group. The age, sex, education level, and smoking, atrial fibrillation, and total energy intake-adjusted odds ratios of extensive cerebral atherosclerosis were inversely associated with intake of magnesium (Ptrend = 0.0204). However, this association did not exist with intakes of potassium and calcium. Conclusion: Potassium, magnesium, and calcium rich and high quality diet could be associated with decreased risk of ischemic stroke, in part, via effect on extensive cerebral atherosclerosis.

특집 - 당뇨가 혈관에 주는 영향

  • Son, Seok-Man
    • The Monthly Diabetes
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    • pp.8-10
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    • 2007
  • 대혈관 합병증은 중간크기 이상의 혈관(동맥 및 정맥)에서 동맥경화증이나 죽상경화증에 의한 변화로 발생하는 질환으로 관상동맥, 뇌혈관 및 말초혈관에 주로 발생하며 당뇨병환자의 주된 사망원인과 관련이 있기 때문에 매우 중요합니다. 당뇨병환자에서 대혈관 합병증인 죽상경화증은 가장 흔하고 중대한 만성합병증으로 관상동맥질환에 의한 관상동맥질환, 말초혈관질환 및 뇌혈관질환이 발생합니다. 발생률은 당뇨병이 없는 사람에 비해 2$\sim$5배 높으며 제 2형 당뇨병뿐만 아니라 제 1형 당뇨병환자의 주된 사망원인이 됩니다. 대혈관 합병증과 관련된 질환은 유병기간이 오래된 당뇨병환자에서 이환율, 장애 정도, 사망률 및 치료비용에 심각한 영향을 미칩니다. 당뇨병환자의 사망은 대부분이 대혈관 합병증과 관련이 있으며, 이중에서도 관상동맥질환으로 인한 사망률이 2$\sim$4배 증가합니다. 당뇨병성 만성합병증은 건강관리를 위한 지출에 상당히 영향을 미칩니다. 총 의료관리 예산의 약 25%가 당뇨병 및 당뇨병성 만성합병증의 치료에 지출됩니다. 위험요소를 감소시키거나 제거하면 만성합병증의 85%가 지연되거나 진행을 늦출 수 있습니다. 이것으로 미국의 경우 매년 170억 달러의 의료관리 예산을 절감할 수 있다고 합니다.

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GENE EXPRESSION OF HUMAN CORONARY ARTERY ENDOTHELIAL CELLS IN RESPONSE TO PORPHYROMONAS ENDODONTALIS INVASION (Porphyromonas endodontalis의 침투에 따른 혈관 내피세포의 유전자 발현)

  • Kong, Hee-Joung;Choi, Kyoung-Kyu;Park, Sang-Hyuk;Lee, Jin-Yong;Choi, Gi-Woon
    • Restorative Dentistry and Endodontics
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    • v.34 no.6
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    • pp.537-550
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    • 2009
  • During the last two decades, there has been an increasing interest in the impact of oral health on atherosclerosis and subsequent cardiovascular disease (CVD). To date, some periodontal pathogens including Porphyromonas gingivalis (P. gingivalis) have been reported to be relevant to CVD. Porphyromonas endodontalis (P. endodontalis), which shares approximately 87% sequence homology with P. gingivalis, is mostly found within infected root canals. However, recent studies reveal that this pathogen also resides in the dental plaque or periodontal pocket in patients with periodontitis. It has been shown that P. endodontalis invades human coronary artery endothelial cells (HCAEC) and coronary artery smooth muscle cells (CASMC). To evaluate whether P. endodontalis can participate in the progression of atherosclerosis and CVD, we examined the changes in transcriptional gene expression profiles of HCAEC responding to invaion by P. endodontalis in this study. The following results were obtained. 1. Porphyromonas endodontalis was invasive of HCAEC. 2. According to the microarray analysis, there were 625 genes upregulated more than two-folds, while there were 154 genes downregulated by half. 3. Upregulated genes were relevant to inflammatory cytokines, apoptosis, coagulation and immune response. Enhanced expression of MMP-1 was also noticeable. 4. The transcription profiles of the 10 selected genes examined by real-time PCR agreed well with those observed in the microarray analysis. Thus, these results show that P. endodontalis presents the potential to trigger and augment atherosclerosis leading to CVD.

Disease-related Knowledge Level and Compliance of Health Behavior in Patients with Myocardial Infarction According to the Atherosclerotic Risk Factors (심근 경색증 환자의 죽상경화증 위험요인별 질병관련 지식과 건강행위 이행)

  • Jeong, Hey-Sun
    • Korean Journal of Adult Nursing
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    • v.13 no.4
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    • pp.529-538
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    • 2001
  • Purpose: This study purposed to examine the disease-related knowledge level and compliance with good health behavior in patients with myocardial infarction according to the atherosclerotic risk factors. Method: The subjects consisted of 72 patients with myocardial infarction and the data were collected by interviewing the subjects with questionnaires and reviewing their medical records from September, 15, 1999 to July 31, 2000. Data were analyzed using the SAS program. Results: 1) With regard to atherosclerotic risk factors: of the subjects, 91.7% lacked regular exercise, followed by smoking (61.1%). 2) The average knowledge score of the patients was 19.7 and the average compliance score was 53.9. 3) There were no significant differences in the total knowledge scores according to the patients' atherosclerotic risk factors. 4) Non-diabetics were significantly higher in knowledge scores on domain of risk factors than the diabetics. 5) The overweight patients were significantly higher in knowledge score on domain of nature of disease than the normalweight patients. 6) The total compliance scores of the non-smokers were significantly higher than those of the smokers. 7) The total compliance scores of the patients who do regular exercise were significantly higher than those of the patients who forgo regular exercise. 8) The non-smokers were significantly higher in compliance scores on domain of diet than the smokers. 9) The diabetic patients were significantly higher in compliance scores on domain of smoking cessation than the non-diabetics. 10) Patients who do regular exercise were significantly higher in compliance scores on other domains than the patients who forgo regular exercise. Conclusion: According to the above findings, it can be concluded that intensive nursing care and education should be provided to patients who have atherosclerotic risk factors such as smoking, hypertension, diabetes mellitus, lack of exercise, over weight, or hypercholesterolemia to increase disease related knowledge level and to improve compliance with good health behavior.

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Association between cardiovascular disease and periodontal disease prevalence (치주질환에 의한 심장질환 발생의 관련성)

  • Jeong, Mi-Ae;Kim, Jee-Hee
    • Journal of the Korea Convergence Society
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    • v.2 no.4
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    • pp.47-52
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    • 2011
  • Periodontal disease is a common inflammatory disorder that is being considered as a risk factor for atherosclerotic complication. Recent epidemiological evidence also supports that its potential association with increased blood pressure levels and hypertensive prevalence. Data from cross-sectional studies suggest that in hypertensive patients periodontal disease may enhance the risk and degree of target organ damage. So dental infections have been associated with cardiovascular diseases. There are potential pathophysiologic links between hypertension and periodontits. The role of the inflammatory pathway include C-reactive protein(CRP). CRP is an inflammatory mediator that has been shown to predict the development of hypertension independently of baseline BP and traditional risk factors, has been consistently reported as at least mildly elevated in patients with periodontal disease. Reactive oxygen species produced by locally infiltrating neutrophils participate in periodontal tissue destruction. Periodontits can lead to inflammatory responses in the atrial myocardium, which disturbs the structural and electrophysiologic properties of the atrium and facilitates atrial fibrillation in the animal experiment.