혈관 조영술을 이용한 관동맥,말초혈관,경동맥의 동맥경화성 협착병변의 빈도

최동훈,편욱범,윤영섭,장양수,심원흠 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.9

혈관 질환 환자에서 복부 낭종의 빈도

노영남,박홍석,박광보,도영수,김영욱,이경복,박의준,김해솔,윤우성,김동익 대한혈관외과학회 2011 Vascular Specialist International Vol.27 No.1

Purpose: This study evaluated the prevalence of cystic disease in the intra-abdominal organs in a normal population and a group of patients with vascular disease. Methods: We reviewed the medical records and computed tomography scans of the vascular disease group and the control group. Vascular disease group (n=586) were patients who suffered with abdominal aortic aneurysm (AAA), aorto-iliac occlusive disease (AOD) and peripheral arterial occlusive disease (PAOD) and who were treated in our institute. The control group (n=424) were patients who visited the health promotion center in our institute during the same period. Results: The prevalence of abdominal cysts in the control group and the vascular disease group was 41.7%and 65.2%, respectively. The vascular disease group showed a higher prevalence of abdominal cystic lesion for all the specific vascular diseases. However, when the two groups were stratified according to age, the vascular disease group displayed no significant difference in the prevalence of abdominal cyst compared to that of the control group. Conclusion: Abdominal cystic lesions are common in patients with vascular disease, including AAA, AOD,and PAOD. But this high prevalence of abdominal cystic lesions seems to be associated with the advanced age of vascular disease patients. Further molecular-based research is needed to clarify the pathogenetic relationship between vascular disease and abdominal cystic lesions.

입원 치매환자에서 동반된 신체질환

조항석(Hang Suk Cho),오병훈(Byoung Hoon Oh),양성희(Seong Hee Yang),이혜리(Hye Ree Lee),유계준(Gye Joon Yoo) 대한노인정신의학회 1998 노인정신의학 Vol.2 No.2

Ojectives : Patients with dementia are accompanied with poor autonomy and multiple disability. Therefore moer cost and medical service are required than non-dementia patients. In order to insure comprehensive, systematic care for dementia patients, knowledge of the associated disease of different types of dementia is warranted. This study evaluate the characteristics of associated disease in inpatients with dementia, to be used as basic reference for effective treatment. Methods : The study popultion consist of 92 patients with dementia admitted between January 1, 1996 and September 30, 1997 to geriatric department, Yosei University Kwangju Severance Psychiatric Hospital. Diagnoses were based on DSM-IV and NINCDS. Severity of dementia was evaluated by GDS (Global Deterioration Scale). Associated diseases was recorded in separated checklist. χ-test, Fisher's exact test, ANOVA, T-test, Wilcoxon rank sum test, Kruskal-Wallis test were used to determine statistical differences among the dementia subgroup. Results : The mean age was 71.8±9.2 with 31 male (33.7%) subjects and 61 female subject (66.3%). The types of dementia among the 92 demented patients were as follows : 50 (54%) with Alzheimer's disease, 30 (33%) with vascular dementia, 12 (13%) with unclassified dementia. Mean GDS score was 5.4±1.1. The mean duration of admission was 66.9±88.9 days. Types of discharge were normal discharge 33 (35.9%), discharge against doctors' advice 28 (30.4%), transfer 23 (25.0%). The average number of diagnoses was 4.9±2.4. (4.5±2.4 in Alzheimer's disease, 6.1±2.4 in vascular dementia, 5.3±2.1 in unclassified dementia in respectively (p<0.05). The most common associated disease were gastrointestinal disorders (24.8%), cardiovascular disorders (11.8%), urinary tract infection (6.8%), musculoskeletal disorder (6.6%), diabetes mellitus (4.5%). Associated diseases that their frequency showed significant differences in different types of dementia were hypertension, diabetes mellitus, urinary incontinence, oral cavity disease, anemia (p<0.01). Conclusions : Associated disease are different in different type of dementia. Patients with vascular dementia had more associated disease and received more drugs for associated disease than Alzheimer's disease. Our data emphasize comprehensive and systematic treatment plan according to type of dementia.

울체피부염의 임상적 특징과 동반된 혈관 질환을 평가하기 위한 영상의학적 검사에 관한 연구

정서미곤 ( Seo Mi Gon Jeong ),김지연 ( Chi Yeon Kim ) 대한피부과학회 2021 大韓皮膚科學會誌 Vol.59 No.9

Background: Stasis dermatitis is an inflammatory skin disease that occurs in the lower legs of patients with chronic venous insufficiency; however, data on combined vascular disease and stasis dermatitis are limited. Objective: This study aimed to evaluate the clinical features of patients with stasis dermatitis and combined vascular diseases. Methods: We retrospectively reviewed the clinical features and combined vascular diseases of 37 patients clinically diagnosed with stasis dermatitis who visited the dermatology department from January 2017 to December 2020. Results: The average age of occurrence was 59.5 years, and the average duration of the disease was 3.2 years. Stasis dermatitis was more likely to occur in women than in men and more often in both lower legs. The major clinical features were erythematous patches. Asymptomatic symptoms were most common, followed by itching and tenderness. To evaluate vascular diseases, ultrasonography, venography computed tomography (CT), and angiography CT were performed. The most common combined vascular diseases were deep vein thrombosis, followed by varicose vein and thrombophlebitis. Most cases were treated with topical steroids and antihistamines, and anticoagulants/antiplatelet agents were used to treat vascular diseases. Conclusion: Stasis dermatitis is mainly associated with venous dysfunction in the lower legs. Early diagnosis and fundamental treatment of combined vascular diseases by evaluating vascular function in patients suspected of stasis dermatitis are important. This study will provide dermatologists with significant data on the clinical features of stasis dermatitis and combined vascular diseases. (Korean J Dermatol 2021;59(9):669∼675)

노인 우울증과 혈관질환과의 공통 위험인자

곽경필 동국대학교 의학연구소 2009 東國醫學 Vol.15 No.2

고혈압, 심혈관계질환, 뇌혈관질환과 같은 혈관 질환에서 우울증 병발하는 경우가 많으며, 우울증 환자에서 혈관성 질환을 가지는 경우가 많다. 우울증과 혈관성 질환은 다양한 환경인자를 공유한다. 이들 공통 혈관 위험인자로는 혈소판 과활성 기능, 혈관 내피의 기능이상, 사이토카인의 기능, 오메가 3 지방산의 기능, 유전학적 요인 등이 보고 되었다. 우울증과 혈관 질환의 단일 기전은 현재까지 알려진 바 없으나, 노인 우울중 환자의 치료에 있어 공존하는 혈관 질환에 대한 관심과 혈관 위험 인자의 지속적인 관리가 우울증의 치료와 예방에 필요하다. Depression may occur as a result of vascular disease. Support for vascular disease as an underlying etiology of depression includes the high rate of depression in patients with vascular disease. This paper examines possible mechanisms that may explain the bidirectional relationship between vascular disease and depression. Several vascular risk factors were considering including that were platelet activation, endothelial dysfunction, hypothalamic pituitary axis activation, cytokines, omega 3 fatty acids, homcysteine, autonomic dysfunction and genetics. The relationship between vascular disease and depression cannot soley be explained by current established risk factors or the effects of treatment for depression. Important areas for future study includes evaluation of the treatment of vascular risk factors on the course of depression, assessment of the relationship between vascular factor, depression and dementia.

코호트 연구를 통한 악성암과 심장 및 뇌혈관질환자의진료비 부담 추이 분석(2004~2016)

송혜숙,서정안 인문사회 21 2022 인문사회 21 Vol.13 No.3

Analysis of the Burden of Medical Expenses for Malignant Cancer and Patients with Heart and Cerebrovascular DiseaseThrough Cohort Study (2004-2016)Hyeasuk Song & Jeongan Seo Abstract: This study was conducted to analyze the rate of the mortality rate and the cost of medical expenses through cohort study of malignant neoplasms (cancer), heart and cerebrovascular disease patients, which are the main causes of death in Korea, and to use them as basic data for public health care and health insurance policies.,The data of the National Health Insurance Corporation's customized DB were used for the study, and as of 2004, the individual identification codes for 12 years were linked with the data of the death of the National Statistical Office and followed by the survival period of the subjects who were treated with malignant neoplasms (C00~C97, D45~47), heart disease (I21~I23) and cerebrovascular disease (I60~I64). The results of this study showed that 134,000 (0.27%) of malignant neoplasms, 18,000 (0.04%) of heart disease, and 105,000 (0.22%) of cerebrovascular disease were diagnosed as the three major diseases out of the total population of 48 million people in Korea. After 12 years, mortality rate was 68,000 (51.2%) of malignant neoplasms, 9,000 (48.2%) of heart disease, 52.2% of cerebrovascular disease The number of the subjects was 5,000 (49.5%), which was 50%.,As a result of analyzing the medical expenses, the amount of increase and decrease after the introduction of the protection policy decreased from 20% to 10% before the introduction of the burden rate, but the cerebrovascular disease was 20%.,Therefore, it is necessary to review the policy to strengthen the protection to lower the burden of cerebrovascular disease. Key Words: Cancer, Heart Disease, Cerebro Vascular Disease, Death Rate, Cost Analysis 코호트 연구를 통한 악성암과 심장 및 뇌혈관질환자의진료비 부담 추이 분석(2004~2016)송 혜 숙*ㆍ서 정 안** 요약: 본 연구는 우리나라 주요 사망원인인 악성신생물(암), 심장 및 뇌혈관질환자의 12년간 코호트 연구를 통해 사망률 및 진료비 본인부담금 비율 분석을 통해 국민의 건강관리와 건강보험 정책의 기초자료로 활용하고자 하였다. 연구방법은 국민건강보험공단의 맞춤형 DB 자료를 이용하였고, 2004년 기준으로 악성신생물(C00~C97, D45~47), 심장질환(I21~I23), 뇌혈관질환(I60~I64)을 주진단으로 진료받은 대상자들의 2016년까지 12년간의 개인별 식별코드를 통계청의 사망자료와 연동하여 생존기간을 추적관찰 하였다. 연구결과, 우리나라 전체인구수 약 4,800만명 중 3대 질환으로 진단받은 사람은 악성신생물 약 134,000명(0.27%), 심장질환 약 18,000명(0.04%), 뇌혈관질환 약 105,000명(0.22%)이었고, 이 중 12년 경과 후 사망률은 악성신생물이 68,000명(51.2%), 심장질환 9,000명(48.2%), 뇌혈관질환 52,000명(49.5%)으로서 대상자의 50% 수준으로 확인되었다. 진료비 분석결과는 보장성 강화정책 도입 전에 비해 후의 증감금액을 비교한 결과 악성신생물과 심장질환은 본인부담률 도입전 20%에서 약 10%로서 감소하였으나, 뇌혈관질환은 20%로 전 후 차이가 크지 않았다. 이에 뇌혈관질환의 본인부담률을 낮추는 보장성 강화정책을 재검토할 필요가 있다고 판단된다. 핵심어: 악성암, 심장질환, 뇌혈관질환, 사망률, 진료비분석 □ 접수일: 2022년 4월 20일, 수정일: 2022년 5월 27일, 게재확정일: 2022년 6월 20일* 주저자, 광주여자대학교 보건행정학과 교수(First Author, Professor, Kwangju Women’s Univ., Email: hyeasuk@kwu.ac.kr)** 교신저자, 인천재능대학교 보건의료행정과 교수(Corresponding Author, Professor, JEI Univ., Email: jeong91@jeiu.ac.kr)

Regional amyloid burden and lacune in pure subcortical vascular cognitive impairment

Hong, Yun Jeong,Kim, Chan-Mi,Kim, Ji Eun,Roh, Jee Hoon,Kim, Jae Seung,Seo, Sang Won,Na, Duk L.,Lee, Jae-Hong PERGAMON PRESS LTD 2017 NEUROBIOLOGY OF AGING Vol. No.

<P><B>Abstract</B></P> <P>We investigated the amyloid and vascular burden in Pittsburgh compound B (PiB)–negative subcortical vascular mild cognitive impairment (svMCI) and PiB-negative subcortical ischemic vascular dementia (SIVD) to elucidate the potential roles of amyloid deposition and small vessel disease (SVD). Thirty-eight svMCI patients and 42 SIVD patients were enrolled. The regional PiB uptake values and SVD markers were obtained and compared between groups. Additionally, correlations among amyloid burden, SVD, and cognition were made. Patients with PiB-negative SIVD showed more amyloid deposition than those with PiB-negative svMCI, particularly in the cuneus, lingual gyrus, supramarginal, and angular gyri. Despite subthreshold levels for amyloid deposition, our findings showed a marked regional difference in amyloid uptake between svMCI and SIVD, particularly in posteriorly located brain areas. However, lacune, a proxy for vascular burden, showed a broader association with cognition and had more impacts on developing dementia than amyloid burden. The topographical pattern of amyloid deposition and its impact on clinical status in pure subcortical vascular cognitive impairment were different from those in Alzheimer's disease.</P>

Vascular loop graft 술식을 이용한 $Kienb\"{o}ck$씨 질환의 치료

한정수,정덕환,박보연,남기운,한현수,Han, Chung-Soo,Chung, Duke-Whan,Park, Bo-Yeon,Nam, Gi-Un,Han, Hyun-Soo 대한미세수술학회 1993 Archives of reconstructive microsurgery Vol.2 No.1

Although the etiology of $Kienb\"{o}ck's$ disease is clearly related to avascular changes in the lunate, but the actual cause leading to this vascular impairment has remained elusive. Therefore, a great many different surgical procedures have been proposed for the correction of the multiple factors leading to lunate collapse or for the treatment of the lunatomalacia. The treatment modalities includes lunate excision, intercarpal arthrodesis, lunate implant resection arthroplasty, joint levelling operation(e.g ulnar lengthening & radial shortening), pronater quadratus pedicle graft and vascular loop graft. In the period from Jan. 1981 to Dec. 1992, we performed operative treatment in 19 cases of $Kienb\"{o}ck's$ disease. Among them, 6 cases were treated with vascular loop graft. We analysed all patients who were treated with vascular loop graft after followed up of 4 year 6 months, on an average(range from 1 year to 8 year 10 months). The results analysed are as follows, 1. All cases were stage III according to Lichtman's classification. 2. Ulnar variance was -1.5(range$-2{\sim}0$), on an average. 3. The average age of patients were 37.7years old(range 31-41). 4. Postoperatively, there were considerable restoration of range of motion and complete relief of pain in all cases, but continued decrease of grip power in one case. 5. Decreased sclerosis, loss of fragmentation and new bone formation were appeared in the last follow up film, in all cases. The vascular loop graft considered as a useful method for the treatment of the $Kienb\"{o}ck's$ disease.

대사증후군에 따른 혈관 내피세포 기능 부전과 운동

황문현,심영제 대한비만학회 2015 The Korean journal of obesity Vol.24 No.3

심혈관 질환 위험 인자의 결집체인 대사증후군은 전 세계적으로 전염병처럼 만연하고 있으며, 우리나라를 포함한 서구 발전된 국가들의 경우 성인 인구의 약 30% 정도가 대사증후군으로 분류되고 있다. 혈관 내피세포 기능은 동맥 경화성 심장 질환을 예측하는 예후인자이며, 타당도와 신뢰도가 기 입증된 초음파를 이용한 혈류매개 혈관확장 반응을 통해 측정 및 평가가 가능하다. 대사증후군에 따른 혈관 내피세포 기능 부전에 관련된 생리학적 기전은 아직까지 명확히 밝혀지지 않았으나, 동물 연구를 통해 인슐린 저항성 증가와 고혈당으로 인한 혈관 내피세포 내 산화 스트레스 증가에 따른 일산화질소 생이용성 감소가 주된 원인으로 추측되고 있다. 국외 문헌을 바탕으로 장기간의 유산소 운동은 대사증후군 환자의 혈관 내피세포 기능에 긍정적인 영향을 미치는 것으로 나타나고 있으나 과학적 증거의 양이 미흡하고 관련 생리학적 기전은 아직까지 명확하게 밝혀지지 않고 있다. 따라서 앞으로 다양한 운동 종류와 강도를 적용하여 대사증후군에 따른 혈관 내피세포 기능 부전을 개선시키는 데 가장 효과적인 운동 방법을 찾아내고 관련 생리학적 기전을 밝히는 것이 요구되며, 이는 비만, 당뇨, 대사증후군 환자의 심혈관 건강을 개선시키기 위한 운동처방 및 운동치료 프로그램의 개발 및 발전을 유도하여 대사증후군 환자의 심혈관 질환 위험을 감소시키는 데 기여할 것이다. Metabolic syndrome, a constellation of cardiovascular disease risk factors, is a global pandemic. Over 30% of the adult population in both South Korea and the United States are currently classified as having metabolic syndrome. Vascular endothelial function is a precursor of future atherosclerotic cardiovascular disease. Conduit artery flow-mediated dilation using ultrasonography is considered the non-invasive, gold standard for assessing nitric oxide-mediated vascular endothelial function. Patients with metabolic syndrome commonly exhibit increased insulin resistance and hyperglycemia, which are thought to impair vascular endothelial function by increasing oxidative stress and reducing nitric oxide bioavailability in the vascular endothelium and in smooth muscle cells. Previous findings have indicated that long-term aerobic exercise has a positive effect on impaired vascular endothelial function in metabolic syndrome patients, but the underlying mechanisms have not been fully elucidated. Therefore, further studies are needed that will apply different exercise modalities and intensities with the goal of improving vascular endothelial function in patients with metabolic syndrome, as well as investigation of the associated mechanisms. Ultimately, well-designed future studies will help to establish and develop exercise prescription and/or exercise therapy programs that can reduce cardiovascular disease risk and improve cardiovascular health in metabolic syndrome patients.

Recent Updates on Subcortical Ischemic Vascular Dementia

노지훈,이재홍 대한뇌졸중학회 2014 Journal of stroke Vol.16 No.1

Vascular dementia (VaD) is a history-laden disease entity that dates back to the 19th century when arteriosclerotic brain atrophy due to hardening of the arteries was perceived as the major cause of senile dementia. Its existence had been overshadowed by the emergence of Alzheimer’s disease (AD) in the past century and research on AD dominated the field of dementia. Interest in VaD has been revived in recent years as vascular lesions have been shown to make great contributions to the development of dementia, particularly in the elderly. VaD has now evolved into the concept of vascular cognitive impairment (VCI), which encompasses not only VaD but also AD with cerebrovascular disorder and VCI with no dementia. The concept of VCI is intended to maximize the therapeutic potential in dementia management because the vascular component may be amenable to therapeutic intervention particularly in the early stages of cognitive impairment. Subcortical ischemic vascular dementia (SIVD) is pathologically driven by severe stenosis and the occlusion of small vessels that culminate into white matter ischemia and multiple lacunar infarctions in the subcortical structures. The relatively slow progression of symptoms and clinical manifestations associated with cholinergic deficits often make the differentiation of SIVD from AD difficult. The recent development of in vivo amyloid imaging enabled further pathological breakdown of SIVD into pure SIVD and mixed dementia with subcortical ischemia based on the absence or existence of amyloid pathology in the brain. In this article, the authors reviewed the emerging concepts of VaD/VCI and the clinical manifestations, biomarkers, treatments, and preclinical models of SIVD based on the pathophysiologic mechanisms of the disease.