Harvard의대 장익경 교수님 BRIC 소개서
페이지 정보
- 작성자 : 김성수
- 작성일 : 2005-04-21
- 조회 : 1,171회
관련링크
본문
경희의대를 졸업하시고 현재 Harvard 의대 심장내과 교수로 계시는 장익경 교수님의 소개서가 BRIC에 있어 복사해 놓으니 경희의대 학생들도 참고하시고 휼륭한 의학자가 되도록 노력하여 주시기 바랍니다.
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Location : BRIC > 생물동향 > 한국을 빛내는 사람들
장익경 (Ik-Kyung Jang)
Massachusetts General Hospital
조회수 : 577 [2005년 3월]
Circulation, Published online before print March 21, 2005
In Vivo Characterization of Coronary Atherosclerotic Plaque by Use of Optical Coherence Tomography
Ik-Kyung Jang MD, PhD*, Guillermo J. Tearney MD, PhD, Briain MacNeill MD, Masamichi Takano MD, Fabian Moselewski BS, Nicusor Iftima PhD, Milen Shishkov PhD, Stuart Houser MD, H. Thomas Aretz MD, Elkan F. Halpern PhD, and Brett E. Bouma PhD
From the Cardiology Division (I.-K.J., B.M., M.T., F.M.), the Wellman Center for Photomedicine (G.J.T., M.T., N.I., M.S., B.E.B.), the Department of Radiology (E.F.H.), and the Department of Pathology (G.J.T., S.H., H.T.A.), Massachusetts General Hospital and Harvard Medical School, Boston, MA.
* To whom correspondence should be addressed.
Background--The current understanding of the pathophysiology of coronary artery disease is based largely on postmortem studies. Optical coherence tomography (OCT) is a high-resolution (10 µm), catheter-based imaging modality capable of investigating detailed coronary plaque morphology in vivo.
Methods and Results--Patients undergoing cardiac catheterization were enrolled and categorized according to their clinical presentation: recent acute myocardial infarction (AMI), acute coronary syndromes (ACS) constituting non-ST-segment elevation AMI and unstable angina, or stable angina pectoris (SAP). OCT imaging was performed with a 3.2F catheter. Two observers independently analyzed the images using the previously validated criteria for plaque characterization. Of 69 patients enrolled, 57 patients (20 with AMI, 20 with ACS, and 17 with SAP) had analyzable images. In the AMI, ACS, and SAP groups, lipid-rich plaque (defined by lipid occupying 2 quadrants of the cross-sectional area) was observed in 90%, 75%, and 59%, respectively (P=0.09). The median value of the minimum thickness of the fibrous cap was 47.0, 53.8, and 102.6 µm, respectively (P=0.034). The frequency of thin-cap fibroatheroma (defined by lipid-rich plaque with cap thickness 65 µm) was 72% in the AMI group, 50% in the ACS group, and 20% in the SAP group (P=0.012). No procedure-related complications occurred.
Conclusions--OCT is a safe and effective modality for characterizing coronary atherosclerotic plaques in vivo. Thin-cap fibroatheroma was more frequently observed in patients with AMI or ACS than SAP. This is the first study to compare detailed in vivo plaque morphology in patients with different clinical presentations.
Key words : arteriosclerosis, coronary disease, imaging, plaque
저자와의 연락을 원하시면 한빛사 담당자에게 연락주시기 바랍니다.
About the Author
Education
1980 M.D., Kyung-Hee University, Seoul, Korea
1987 Ph.D. in Physiology, Leuven University, Leuven, Belgium
Postdoctoral Training
1980-1983 Resident in Medicine, Leuven University Hospital, Leuven, Belgium
1983-1987 Fellow in Cardiology, Leuven University Hospital, Leuven, Belgium
1987-1992 Fellow in Cardiology, Massachusetts General Hospital, Boston, MA
Licensure and Certificate
1980 Korean License of Physician 1985 Belgian Board of Internal Medicine
1985 Belgian Board of Cardiology 1991 Licensed in Massachusetts
1997 American Board of Internal Medicine 1999 American Board of Internal Medicine, Cardiovascular Disease
2000 American Board of Internal Medicine, Interventional Cardiology
Academic Appointments
1980-1985 Assistant in Medicine, Leuven University, Leuven, Belgium
1985-1987 Assistant Professor of Medicine, Leuven University, Leuven, Belgium
1987-1989 Fellow in Medicine, Harvard Medical School, Boston, MA
1989-1992 Instructor in Medicine, Harvard Medical School, Boston, MA
1992-2002 Assistant Professor of Medicine, Harvard Medical School, Boston, MA
2002- Associate Professor of Medicine, Harvard Medical School, Boston, MA
Hospital Appointments
1980-1987 Assistant, Leuven University Hospital, Leuven, Belgium
1987-1992 Fellow, Massachusetts General Hospital, Boston, MA
1992-1994 Clinical Assistant in Medicine, Massachusetts General Hospital, Boston, MA
1994-1997 Assistant in Medicine, Massachusetts General Hospital, Boston, MA
1997-2000 Assistant Physician in Medicine, Massachusetts General Hospital, Boston, MA
2000- Associate Physician in Medicine, Massachusetts General Hospital, Boston, MA
Visiting Appointments
1991-1992 Visiting Scientist, Massachusetts Institute of Technology, Boston, MA
1997- Visiting Professor, Catholic University Medical School, Seoul, Korea
1997- Visiting Professor, Sung Kyun Kwan University (Samsung Medical Center), Seoul, Korea
1997- Visiting Professor, Kyung-Hee University, Seoul, Korea
6/2004 Visiting Professor, University of Bologna, Bologna, Italy
1/2005 Visiting Professor, Toho University, Chiba, Japan
Hospital Service Responsibilities
1994-1997 Member of Cardiac Unit Task Force on Research, Cardiology Division, Massachusetts General Hospital
1994-1997 Member of Cardiac Unit Task Force on Long Term Goals and Strategic Planning, Cardiology Division, Massachusetts General Hospital
1995- Member of Scientific Advisory Committee in General Clinical Research Center, Massachusetts General Hospital
2001- 2003 Director of QA in the Catheterization Laboratory, Massachusetts General Hospital
2002- Member, IRB Panel, Partners Healthcare (MGH/BWH)
2003- Director, Clinical Research, Cardiology Division, Massachusetts General Hospital
2003- Member of Mentored Scholarly Activity Program, Massachusetts General Hospital
2003- Co-Director, Cardiology Laboratory for Integrative Physiology and Imaging (C.L.I.P.I.)
Professional Societies
1988- Massachusetts Medical Society, Member
1988- Paul Dudley White Society, Member
1992- American Heart Association, Member
1992- American College of Cardiology, Fellow
1993-1999 European Society of Cardiology, Fellow
2003- The Society for Cardiac Angiography and Interventions, Fellow
Editorial Board
1996- Member, Journal of Thrombosis and Thrombolysis
1996- Ad hoc reviewer for: New England Journal of Medicine, Lancet, Circulation, Journal of American College of Cardiology, European Heart Journal, American Journal of Cardiology, American Heart Journal, American Journal of Medicine, Thrombosis and Haemostasis, Catheterization and Cardiovascular Intervention, Invasive Cardiology.
2000- Member, Acta Cardiologica
Awards and Honors
1990 American College of Cardiology/Merck Corporation Research Award
1999 Medical School Grant, Merck Research Laboratories
2000 Fast Forward Grant, Center of Innovative Minimally Invasive Therapy
2000 Partners in Excellence Award for Research
2002 Advisory Board, Cardiovascular Research Foundation Asan Medical Center, Seoul, Korea
2002 Recipient, Distinguished Alumnus Award, Kyung Hee University, Seoul, Korea
2005 Euwhang Grand Award. Kyung Hee University, School of Medicine, Seoul, Korea
Bibliography
1. Collen D, Stump D, Van de Werf F, Jang IK, Nobuhara M, Lijnen HR. Coronary thrombolysis in dogs with intravenously administered human pro-urokinase. Circulation 1985;72:384-388.
2. Jang IK, Vanhaecke J, De Geest H, Verstraete M, Collen D, Van de Werf F. Coronary thrombolysis with recombinant tissue-type plasminogen activator: patency rate and regional wall motion after 3 months. J Am Coll Cardiol 1986;8:455-460.
3. Van de Werf F, Jang IK, Collen D. Thrombolysis with recombinant human single-chain urokinase-type plasminogen activator (rscu-PA): Dose-response in dogs with coronary artery thrombosis. J Cardiovasc Pharmacol 1987;9:91-93.
4. Van de Werf F, Vanhaecke J, Jang IK, Flameng W, Collen D, De Geest H. Reduction in infarct size and enhanced recovery of systolic function combined with Β-adrenergic blockade with metoprolol. Circulation 1987;75:830-836.
5. Jang IK, Van de Werf F, Vanhaecke J, Flameng W, De Geest H. Long-term spontaneous evolution of left ventricular function after experimental coronary occlusion. Cardiovasc Research 1988;22:501-504.
6. Jang IK, Gold HK, Ziskind AA, Fallon JT, Holt RE, Leinbach RC, May JW, Collen D. Differential sensitivity of erythrocyte-rich and platelet-rich thrombi to lysis with recombinant tissue-type plasminogen activator: A possible explanation for resistance to coronary thrombolysis. Circulation 1989;79:920-928.
7. Jang IK, Van de Werf F, Vanhaecke J, De Geesst H. Coronary reperfusion and early Β-adrenergic blockade in acute experimental myocardial infarction. J Am Coll Cardiol 1989;14:1816-1823
8. Jang IK, Gold HK, Ziskind AA, Leinbach RC, Fallon JT, Collen D. Prevention of platelet-rich arterial thrombosis by thrombin inhibition. Circulation 1990;81:219-225.
9. Jang IK, Van de Werf F, Vanhaecke J, Aubert A, De Geest H. Comparison of angiographic methods for the assessment of the extent of experimental anterior myocardial infarction in dog hearts. Intern J Cardiol 1990;28:179-190.
10. Yasuda T, Gold HK, Yaoita H, Leinbach RC, Guerrero JL, Jang IK, Holt RC, Fallon JT, Collen D. Comparative effects of aspirin, a synthetic thrombin inhibitor and a monoclonal antiplatelet glycoprotein IIb/IIIa antibody on coronary artery reperfusion, reocclusion and bleeding with recombinant tissue-type plasminogen activator in a canine preparation. J Am Coll Cardiol 1990;16:714-722.
11. Vanhaecke J, Flameng W, Borgers M, Jang IK, Van de Werf F, De Geest H. Evidence for decreased coronary flow reserve in viable postischemic myocardium. Cir Res 1990;67:1201-1210.
12. Jang IK, Gold HK, Leinbach RC, Fallon JT, Collen D. In vivo thrombin inhibition enhances and sustains arterial recanalization with recombinant tissue-type plasminogen activator. Cir Res 1990;67:1552-1561.
13. Yasuda T, Gold HK, Leinbach RC, Saito T, Guerrero JL, Jang IK, Fallon JT, Holt RE, Collen D. Lysis of plasminogen activator-resistant platelet-rich coronary artery thrombus with combined bolus injection of recombinant tissue-type plasminogen activator (rt-PA) and antiplatelet IIb/IIIa antibody. J Am Coll Cardiol 1990;16:1728-1735.
14. Lu HR, Gold HK, Wu Z, De Cock F, Jang IK, Pauwels P, Collen D. Acceleration and persistence of recombinant tissue plasminogen activator-induced arterial eversion graft recanalization with a single bolus injection of F(ab’)2 fragments of the antiplatelet glycoprotein IIb/IIIa antibody 7E3. Coronary Artery Disease 1991;2:1039-1046.
15. Jang IK, Gold HK, Leinbach RC, Rivera AG, Fallon JT, Bunting S, Collen D. Persistent inhibition of arterial thrombosis by a one hour intravenous infusion of argatroban, a selective thrombin inhibitor. Coronary Artery Disease 1992;3:407-414.
16. Jang IK, Gold HK, Leinbach RC, Fallon JT, Bunting S, Collen D, Wilcox JN. Antithrombotic effect of a monoclonal antibody against tissue factor in a rabbit model of platelet-mediated arterial thrombosis. Arteriosclerosis and Thrombosis 1992;12:948-954.
17. Gold HK, Torres FW, Garabedian HD, Werner W, Jang IK, Khan A, Hagstrom JN, Yasuda T, Leinbach RC, Newell JB, Bovill EG, Stump DC, Collen D. Evidence for a rebound coagulation phenomenon following cessation of a 4-hour infusion of a specific thrombin inhibitor in patients with unstable angina pectoris. J Am Coll Cardiol 1993;21:1039-1047.
18. Moreno PR, Jang IK, Newell JB, Block PC, Palacios IF. The role of percutaneous aortic balloon valvuloplasty in patients with cardiogenic shock and critical aortic stenosis. J Am Coll Cardiol 1994;23:1071-1075.
19. Kiss RG, Lu HR, Roskams T, Jang IK, Plow EF, Gold HK, Collen D. Time course of the effects of a single bolus injection of F(ab’2) fragments of the antiplatelet GP IIb/IIIa antibody 7E3, on arterial eversion graft occlusion, platelet aggregation and bleeding time in dogs. Arterioscl Thromb 1994;14:367-374.
20. Grabowski EF, Head C, Michail HA, Jang IK, Gold HK, Benoit SE, Michelson AD. Effects of contrast media on platelet activation using flowing whole blood aggregometry and flow cytometry of platelet membrane glycoproteins. Invest Radiol 1994;29 Suppl 2:S198-200.
21. Grabowski EF, Jang IK, Gold HK, Head C, Benoit SE, Michelson AD. Variability of platelet degranulation by different contrast media. Acad Radiol 1995;2:S1-S3.
22. Jang IK, Block PC, Newell JB, Tuzcu EM, Palacios IF. Percutaneous mitral balloon valvotomy in patients with recurrent mitral stenosis following surgical commissurotomy. Am J Cardiol 1995;75:601-605.
23. Aubert AE, Jang IK, Brzostek T, Van de Werf F, De Geest H. Determinants of transmitral inflow pattern 10-14 days after acute myocardial infarction. Coronary Artery Disease. 1995;6:137-145.
24. Moreu J, Siver M, Palacios IF, Jang IK. Morphologic characteristics of restenotic lesions following coronary intervention: Angioplasty versus directional atherectomy. Can we speculate the mechanism of restenosis from morphologic analysis? Cath Cardiovasc Diag 1995;36:103-109.
25. Smith AJC, Holt RE, Fitzpatrick K, Palacios IF, Gold H, Werner W, Bovill EG, Fuster V, Jang IK. Transient thrombotic state after abrupt discontinuation of heparin in patients undergoing percutaneous coronary angioplasty. Am Heart J 1996;131:434-439.
26. Butte A, Houng A, Jang IK, Reed RL. Alpha 2-antiplasmin causes thrombus resistance to tissue plasminogen activator in experimental pulmonary embolism. Circulation 1997;95:1886-1891.
27. Jang IK, Giugliano PR, Massey TJ, Schwarz RP. A randomized blinded study of two doses of Novastan(brand of argatroban) versus heparin as adjunctive therapy to recombinant tissue plasminogen activator (accelerated administration) in acute myocardial infarction: rationale and design of the myocardial infarction using Novastan and TPA (MINT) study. J Thromb Thromboly 1998;5:49-52.
28. Seckler J, Butte A, Harrell L, Palacios IF, Jang IK. Acute occlusion during coronary interventions: The changing pattern in the era of stents. Massachusetts General Hospital Experience. J Invasive Cardiology 1998;10:208-212.
29. Toussaint Jean-Francois, Southern JF, Kantor HL, Jang IK, Fuster V. Behavior of atherosclerotic plaque components after in vitro angioplasty and atherectomy studied by high field MR imaging. Magnetic Resonance Imaging 1998;16:175-183.
30. Mahdi N, Lopez J, Leon M, Pathan A, Harrell L, Jang IK, Palacios IF. Comparison of primary coronary stenting to primary balloon angioplasty with stent bailout for the treatment of patients with acute myocardial infarction. Am J Cardiol 1998;81:957-963.
31. Boeve TJ, Reed RL, Carias de Oliveira N, Titus J, Janssens S, J,Guigliano RP, Torchiana D, Daggett W, Schwarz RP, Jang IK. Comparison of argatroban or hirudin for the reperfusion of thrombotic arterial occlusion by tissue plasminogen activator. J Thromb Thromboly 1998;6:103-108.
32. Jang IK, Brown DFM., Giugliano R, Anderson HV, Losordo D, Nicolau J, Dutra O, Bazzino O, Viamonte VM, Norbady R, Liprandi AS, Massey T, Dinsmore R, Schwarz R.P. A multicenter, randomized study of argatroban versus heparin as adjunct to tissue plasminogen activator (TPA) in acute myocardial infarction: Myocardial infarction with Novastan and TPA (MINT) study J Am Coll Cardiol 1999;33:1879-1885.
33. Kathiresan S, Jordan MK, Gimelli G, Lopez-Cuellar J, Madhi N, Jang IK. Frequency of silent myocardial ischemia following coronary stenting. Am J Card 1999;84:930-932.
34. Gimelli G, Kalra A, Sabatine MS, Jang IK. Primary versus rescue percutaneous coronary intervention in patients with acute myocardial infarction. Acta Cardiol 2000;55:187-192.
35. Sabatine M, Tu T, Jang IK. Combination of a direct thrombin inhibitor and a platelet glycoprotein IIb/IIIa blocking peptide facilitates and maintains reperfusion of platelet-rich thrombus with tissue plasminogen activator. J Thromb Thromboly 2000;10:189-196.
36. Kalra A, Jang IK. Prevalence of early left ventricular thrombus after primary stenting for acute myocardial infarction. J Thromb Thromboly, 2000;10:133-136. 37. Januzzi JL, Jr, Hahn SS, Chae CU, Giugliano RP, Coulter S, Lewandrowski K, Theroux P, Jang IK. Effects of Tirofiban plus heparin versus heparin alone on troponin I levels in patients with acute coronary syndromes. Am J Cardiol 2000;86:713-717.
38. Tearney GJ, Jang IK, Kang DH, Aretz HT, Houser SL, Brady TJ, Schlendorf K, Shishkov M, Bouma BE. In-vivo porcine coronary artery imaging by optical coherence tomography. Acta Cardiol 2000;55:233-237.
39. Abernethy WB, Choo JK, Oesterle SN, Jang IK. Balloon deflection technique: A method to facilitate entry of a balloon catheter into a deployed stent. Cathet Cardiovasc Intervent 2000;51:312-313.
40. Lewis BE, Wallis DE, Berkowitz SD, Matthai WH, Fareed J, Walenga JM, Bartholomew J, Sham R, Lerner RG, Zeigler ZR, Rustagi PK, Jang IK, Rifkin SD, Moran J, Hursting MJ, Kelton JG. Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation 2001;103:1838-1843.
41. Januzzi J, Jr. Chae CU, Sabatine MS, Jang IK. Elevation in serum troponin predicts the benefit of tirofiban. J Thromb Thromboly 2001; 11:211-215
42. Sabatine MS, Januzzi JL, Snappin S, Theroux P, Jang IK. A risk score system for predicting adverse outcomes and magnitude of benefit with glycoprotein IIb/IIIa inhibitor therapy in patients with unstable angina. Am J Cardiol 2001; 88:488-492.
43. Wong P, Harding S, Walters D, Hull ML, Jang IK. Vascular complications after hemostatic puncture closure device (AngioSeal™) are not higher in overweight patients. J Invas Cardiol 2001; 13:623-625
44. Sheynberg B, Jang IK, Han RO, Sabatine MS, Brown D, Dinsmore R. Comparison of two different methods of quantitative coronary angiography in patients with acute coronary syndromes. Cathet Cardiovasc Intervent 2002;55:442-449
45. Jang,IK, Tearney G, Bouma B. Visualization of tissue prolapse between coronary stent struts by Optical Coherence Tomography (OCT): Comparison with Intravascular Ultrasound (IVUS). Circulation 2001;104:2754.
46. Jang IK, Bouma B, Kang DH, Park SJ, Park SW, Seung KB, Choi KB, Shishkov M, Schlendorf K, Pomerantsev E, Houser SL, Artez HT, Tearney GJ. Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: Comparison with Intravascular Ultrasound. J Am Coll Cardiol 2002;39:604-609
47. Walters DL, Harding SA, Walsh CR, Wong P, Pomerantsev E, Jang IK. Acute coronary syndrome is a common clinical presentation of in-stent restenosis. Am J Cardiology 2002;89:491-494.
48. Januzzi J. Jr., Snappin S, DiBattiste P, Jang IK, Theroux P. Benefits and safety of Tirofiban among acute coronary syndrome patients with mild to moderate renal insufficiency. Circulation 2002;105:2361-2366.
49. Yabushita H, Bouma BE, Houser SL, Aretz HT, Jang IK, Schlendorf KH, Kauffman CR, Shishkov, M, Kang DH, Halpern, EF, Tearney GJ. Characterization of human atherosclerosis by optical coherence tomography. Circulation 2002;106:1640-1645.
50. Tearney GJ, Yabushita H, Houser SL, Aretz T, Jang IK, Schlendorf KH, Kauffman CR, Shishkov M, Halpern, EF, Bouma BE. Quantification of macrophage content in atherosclerotic plaques by optical coherence tomography. Circulation 2003;207:113-119.
51. Bouma BE, Tearney GJ, Yabushita H, Shishkov M, Kauffman CR, DeJoseph Gauthier D, MacNeill BD, Houser SL, Aretz HT, Halpern EF, Jang IK. Evaluation of intracoronary stenting by intravascular optical coherence tomography. Heart 2003;89:317-321.
52. Grossman SA, Brown DE, Change YC, Chung WG, Cranmer H, Dan L, Fisher J, Tedrow U, Lewandrowski K, Jang IK, Nagurney JT. Predictors of delay in presentation to the ED in patients with suspected acute coronary syndromes. The American Journal of Emergency Medicine 2003;21:425-428.
53. MacNeill BD, Harding SA, Bazari H, Patton KK, Colon-Hernandez P, DeJoseph D, Jang IK. Prophylaxis of contrast-induced nephropathy in patients undergoing coronary angiography. Cathet Cardovsc Intervent 2003;60:000-000.
54. Achenbach S, Moselewski F, Ropers D, Ferencik M, Hoffmann U, MacNeill B, Pohle K, Baum U, Anders K, Jang IK, Daniel WG, Brady TJ. Detection of calcified and non-calcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral CT: a segment-based comparison to IVUS. Circulation 2004;109:14-17.
55. Achenbach S, Ropers D, Hoffman U, MacNeill B, Baum U, Pohle K, Brady T, Pomerantsev E, Ludwig J, Flachskampf F, Wicky S, Jang IK, Daniel W. Assessment of coronary remodeling in stenotic and nonstenotic coronary atherosclerotic lesions by multidetector spiral CT. J Am Coll Cardiol 2004;43
56. Wong P, Harding S, Inglessis I, Choi C, Walters D, Chang Y, Gimelli G, Jang IK. The effect of glycoprotein IIb/IIIa receptor inhibitor on the microcirculation in patients undergoing high-risk coronary stenting; a prospective, randomized study. J Thromb Thromboly 2003;16:163-166.
57. MacNeill B, Harding S, Bazari H, Patton K, Colon-Hernandez P, DeJoseph D, Jang IK. Prophylaxis of contrast-induced nephropathy in patients undergoing coronary angiography. Cathet Cardovasc Intervent 2003;60:458-461. 58. Hoffman U, Moselewski F, Cury R, Ferencik M, Jang IK, Diaz L, Abbara S, Brady T, Achenbach S. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease. Patient-versus segment based analysis. Circulation 2004;110:2638-2643.
59. MacNeill B, Jang, IK, Bouma B, Iftimia N, Takano M, Yabushita H, Shishkov M, Kauffman C, Houser S, Aretz H, Dejoseph, D, Halpern E, Tearney G. Focal and multi-focal plaque macrophage distributions in patients with acute and stable presentations of coronary artery disease. J Am Coll Cardiol 2004;44:972-979.
60. Jang IK, Lewis B, Matthai W, Kleiman N. Argatroban anticoagulation in conjunction with glycoprotein IIb/IIIa inhibition in patients undergoing percutaneous coronary intervention: An open-label, nonrandomized pilot study. J Thromb Thromboly 2004;18:31-37.
61. Diaz-Sandoval LJ, Bouma BE, Tearney GJ, Jang, IK. Optical coherence tomography as a tool for percutaneous coronary intervention. Cathet Cariovasc Intervet 2005; In Press.
62. Jang IK, Tearney GJ, MacNeill B, Takano M, Moselewski F, Iftima N, Shishkov M, Houser S, Aretz HT, Halpern EF, Bouma BE. In vivo characterization of coronary atherosclerotic plaque using optical coherence tomography. Circulation 2005; In press.
Copyright(c) 2003 BRIC, All rights reserved. Contact to part@bric.postech.ac.kr
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Location : BRIC > 생물동향 > 한국을 빛내는 사람들
장익경 (Ik-Kyung Jang)
Massachusetts General Hospital
조회수 : 577 [2005년 3월]
Circulation, Published online before print March 21, 2005
In Vivo Characterization of Coronary Atherosclerotic Plaque by Use of Optical Coherence Tomography
Ik-Kyung Jang MD, PhD*, Guillermo J. Tearney MD, PhD, Briain MacNeill MD, Masamichi Takano MD, Fabian Moselewski BS, Nicusor Iftima PhD, Milen Shishkov PhD, Stuart Houser MD, H. Thomas Aretz MD, Elkan F. Halpern PhD, and Brett E. Bouma PhD
From the Cardiology Division (I.-K.J., B.M., M.T., F.M.), the Wellman Center for Photomedicine (G.J.T., M.T., N.I., M.S., B.E.B.), the Department of Radiology (E.F.H.), and the Department of Pathology (G.J.T., S.H., H.T.A.), Massachusetts General Hospital and Harvard Medical School, Boston, MA.
* To whom correspondence should be addressed.
Background--The current understanding of the pathophysiology of coronary artery disease is based largely on postmortem studies. Optical coherence tomography (OCT) is a high-resolution (10 µm), catheter-based imaging modality capable of investigating detailed coronary plaque morphology in vivo.
Methods and Results--Patients undergoing cardiac catheterization were enrolled and categorized according to their clinical presentation: recent acute myocardial infarction (AMI), acute coronary syndromes (ACS) constituting non-ST-segment elevation AMI and unstable angina, or stable angina pectoris (SAP). OCT imaging was performed with a 3.2F catheter. Two observers independently analyzed the images using the previously validated criteria for plaque characterization. Of 69 patients enrolled, 57 patients (20 with AMI, 20 with ACS, and 17 with SAP) had analyzable images. In the AMI, ACS, and SAP groups, lipid-rich plaque (defined by lipid occupying 2 quadrants of the cross-sectional area) was observed in 90%, 75%, and 59%, respectively (P=0.09). The median value of the minimum thickness of the fibrous cap was 47.0, 53.8, and 102.6 µm, respectively (P=0.034). The frequency of thin-cap fibroatheroma (defined by lipid-rich plaque with cap thickness 65 µm) was 72% in the AMI group, 50% in the ACS group, and 20% in the SAP group (P=0.012). No procedure-related complications occurred.
Conclusions--OCT is a safe and effective modality for characterizing coronary atherosclerotic plaques in vivo. Thin-cap fibroatheroma was more frequently observed in patients with AMI or ACS than SAP. This is the first study to compare detailed in vivo plaque morphology in patients with different clinical presentations.
Key words : arteriosclerosis, coronary disease, imaging, plaque
저자와의 연락을 원하시면 한빛사 담당자에게 연락주시기 바랍니다.
About the Author
Education
1980 M.D., Kyung-Hee University, Seoul, Korea
1987 Ph.D. in Physiology, Leuven University, Leuven, Belgium
Postdoctoral Training
1980-1983 Resident in Medicine, Leuven University Hospital, Leuven, Belgium
1983-1987 Fellow in Cardiology, Leuven University Hospital, Leuven, Belgium
1987-1992 Fellow in Cardiology, Massachusetts General Hospital, Boston, MA
Licensure and Certificate
1980 Korean License of Physician 1985 Belgian Board of Internal Medicine
1985 Belgian Board of Cardiology 1991 Licensed in Massachusetts
1997 American Board of Internal Medicine 1999 American Board of Internal Medicine, Cardiovascular Disease
2000 American Board of Internal Medicine, Interventional Cardiology
Academic Appointments
1980-1985 Assistant in Medicine, Leuven University, Leuven, Belgium
1985-1987 Assistant Professor of Medicine, Leuven University, Leuven, Belgium
1987-1989 Fellow in Medicine, Harvard Medical School, Boston, MA
1989-1992 Instructor in Medicine, Harvard Medical School, Boston, MA
1992-2002 Assistant Professor of Medicine, Harvard Medical School, Boston, MA
2002- Associate Professor of Medicine, Harvard Medical School, Boston, MA
Hospital Appointments
1980-1987 Assistant, Leuven University Hospital, Leuven, Belgium
1987-1992 Fellow, Massachusetts General Hospital, Boston, MA
1992-1994 Clinical Assistant in Medicine, Massachusetts General Hospital, Boston, MA
1994-1997 Assistant in Medicine, Massachusetts General Hospital, Boston, MA
1997-2000 Assistant Physician in Medicine, Massachusetts General Hospital, Boston, MA
2000- Associate Physician in Medicine, Massachusetts General Hospital, Boston, MA
Visiting Appointments
1991-1992 Visiting Scientist, Massachusetts Institute of Technology, Boston, MA
1997- Visiting Professor, Catholic University Medical School, Seoul, Korea
1997- Visiting Professor, Sung Kyun Kwan University (Samsung Medical Center), Seoul, Korea
1997- Visiting Professor, Kyung-Hee University, Seoul, Korea
6/2004 Visiting Professor, University of Bologna, Bologna, Italy
1/2005 Visiting Professor, Toho University, Chiba, Japan
Hospital Service Responsibilities
1994-1997 Member of Cardiac Unit Task Force on Research, Cardiology Division, Massachusetts General Hospital
1994-1997 Member of Cardiac Unit Task Force on Long Term Goals and Strategic Planning, Cardiology Division, Massachusetts General Hospital
1995- Member of Scientific Advisory Committee in General Clinical Research Center, Massachusetts General Hospital
2001- 2003 Director of QA in the Catheterization Laboratory, Massachusetts General Hospital
2002- Member, IRB Panel, Partners Healthcare (MGH/BWH)
2003- Director, Clinical Research, Cardiology Division, Massachusetts General Hospital
2003- Member of Mentored Scholarly Activity Program, Massachusetts General Hospital
2003- Co-Director, Cardiology Laboratory for Integrative Physiology and Imaging (C.L.I.P.I.)
Professional Societies
1988- Massachusetts Medical Society, Member
1988- Paul Dudley White Society, Member
1992- American Heart Association, Member
1992- American College of Cardiology, Fellow
1993-1999 European Society of Cardiology, Fellow
2003- The Society for Cardiac Angiography and Interventions, Fellow
Editorial Board
1996- Member, Journal of Thrombosis and Thrombolysis
1996- Ad hoc reviewer for: New England Journal of Medicine, Lancet, Circulation, Journal of American College of Cardiology, European Heart Journal, American Journal of Cardiology, American Heart Journal, American Journal of Medicine, Thrombosis and Haemostasis, Catheterization and Cardiovascular Intervention, Invasive Cardiology.
2000- Member, Acta Cardiologica
Awards and Honors
1990 American College of Cardiology/Merck Corporation Research Award
1999 Medical School Grant, Merck Research Laboratories
2000 Fast Forward Grant, Center of Innovative Minimally Invasive Therapy
2000 Partners in Excellence Award for Research
2002 Advisory Board, Cardiovascular Research Foundation Asan Medical Center, Seoul, Korea
2002 Recipient, Distinguished Alumnus Award, Kyung Hee University, Seoul, Korea
2005 Euwhang Grand Award. Kyung Hee University, School of Medicine, Seoul, Korea
Bibliography
1. Collen D, Stump D, Van de Werf F, Jang IK, Nobuhara M, Lijnen HR. Coronary thrombolysis in dogs with intravenously administered human pro-urokinase. Circulation 1985;72:384-388.
2. Jang IK, Vanhaecke J, De Geest H, Verstraete M, Collen D, Van de Werf F. Coronary thrombolysis with recombinant tissue-type plasminogen activator: patency rate and regional wall motion after 3 months. J Am Coll Cardiol 1986;8:455-460.
3. Van de Werf F, Jang IK, Collen D. Thrombolysis with recombinant human single-chain urokinase-type plasminogen activator (rscu-PA): Dose-response in dogs with coronary artery thrombosis. J Cardiovasc Pharmacol 1987;9:91-93.
4. Van de Werf F, Vanhaecke J, Jang IK, Flameng W, Collen D, De Geest H. Reduction in infarct size and enhanced recovery of systolic function combined with Β-adrenergic blockade with metoprolol. Circulation 1987;75:830-836.
5. Jang IK, Van de Werf F, Vanhaecke J, Flameng W, De Geest H. Long-term spontaneous evolution of left ventricular function after experimental coronary occlusion. Cardiovasc Research 1988;22:501-504.
6. Jang IK, Gold HK, Ziskind AA, Fallon JT, Holt RE, Leinbach RC, May JW, Collen D. Differential sensitivity of erythrocyte-rich and platelet-rich thrombi to lysis with recombinant tissue-type plasminogen activator: A possible explanation for resistance to coronary thrombolysis. Circulation 1989;79:920-928.
7. Jang IK, Van de Werf F, Vanhaecke J, De Geesst H. Coronary reperfusion and early Β-adrenergic blockade in acute experimental myocardial infarction. J Am Coll Cardiol 1989;14:1816-1823
8. Jang IK, Gold HK, Ziskind AA, Leinbach RC, Fallon JT, Collen D. Prevention of platelet-rich arterial thrombosis by thrombin inhibition. Circulation 1990;81:219-225.
9. Jang IK, Van de Werf F, Vanhaecke J, Aubert A, De Geest H. Comparison of angiographic methods for the assessment of the extent of experimental anterior myocardial infarction in dog hearts. Intern J Cardiol 1990;28:179-190.
10. Yasuda T, Gold HK, Yaoita H, Leinbach RC, Guerrero JL, Jang IK, Holt RC, Fallon JT, Collen D. Comparative effects of aspirin, a synthetic thrombin inhibitor and a monoclonal antiplatelet glycoprotein IIb/IIIa antibody on coronary artery reperfusion, reocclusion and bleeding with recombinant tissue-type plasminogen activator in a canine preparation. J Am Coll Cardiol 1990;16:714-722.
11. Vanhaecke J, Flameng W, Borgers M, Jang IK, Van de Werf F, De Geest H. Evidence for decreased coronary flow reserve in viable postischemic myocardium. Cir Res 1990;67:1201-1210.
12. Jang IK, Gold HK, Leinbach RC, Fallon JT, Collen D. In vivo thrombin inhibition enhances and sustains arterial recanalization with recombinant tissue-type plasminogen activator. Cir Res 1990;67:1552-1561.
13. Yasuda T, Gold HK, Leinbach RC, Saito T, Guerrero JL, Jang IK, Fallon JT, Holt RE, Collen D. Lysis of plasminogen activator-resistant platelet-rich coronary artery thrombus with combined bolus injection of recombinant tissue-type plasminogen activator (rt-PA) and antiplatelet IIb/IIIa antibody. J Am Coll Cardiol 1990;16:1728-1735.
14. Lu HR, Gold HK, Wu Z, De Cock F, Jang IK, Pauwels P, Collen D. Acceleration and persistence of recombinant tissue plasminogen activator-induced arterial eversion graft recanalization with a single bolus injection of F(ab’)2 fragments of the antiplatelet glycoprotein IIb/IIIa antibody 7E3. Coronary Artery Disease 1991;2:1039-1046.
15. Jang IK, Gold HK, Leinbach RC, Rivera AG, Fallon JT, Bunting S, Collen D. Persistent inhibition of arterial thrombosis by a one hour intravenous infusion of argatroban, a selective thrombin inhibitor. Coronary Artery Disease 1992;3:407-414.
16. Jang IK, Gold HK, Leinbach RC, Fallon JT, Bunting S, Collen D, Wilcox JN. Antithrombotic effect of a monoclonal antibody against tissue factor in a rabbit model of platelet-mediated arterial thrombosis. Arteriosclerosis and Thrombosis 1992;12:948-954.
17. Gold HK, Torres FW, Garabedian HD, Werner W, Jang IK, Khan A, Hagstrom JN, Yasuda T, Leinbach RC, Newell JB, Bovill EG, Stump DC, Collen D. Evidence for a rebound coagulation phenomenon following cessation of a 4-hour infusion of a specific thrombin inhibitor in patients with unstable angina pectoris. J Am Coll Cardiol 1993;21:1039-1047.
18. Moreno PR, Jang IK, Newell JB, Block PC, Palacios IF. The role of percutaneous aortic balloon valvuloplasty in patients with cardiogenic shock and critical aortic stenosis. J Am Coll Cardiol 1994;23:1071-1075.
19. Kiss RG, Lu HR, Roskams T, Jang IK, Plow EF, Gold HK, Collen D. Time course of the effects of a single bolus injection of F(ab’2) fragments of the antiplatelet GP IIb/IIIa antibody 7E3, on arterial eversion graft occlusion, platelet aggregation and bleeding time in dogs. Arterioscl Thromb 1994;14:367-374.
20. Grabowski EF, Head C, Michail HA, Jang IK, Gold HK, Benoit SE, Michelson AD. Effects of contrast media on platelet activation using flowing whole blood aggregometry and flow cytometry of platelet membrane glycoproteins. Invest Radiol 1994;29 Suppl 2:S198-200.
21. Grabowski EF, Jang IK, Gold HK, Head C, Benoit SE, Michelson AD. Variability of platelet degranulation by different contrast media. Acad Radiol 1995;2:S1-S3.
22. Jang IK, Block PC, Newell JB, Tuzcu EM, Palacios IF. Percutaneous mitral balloon valvotomy in patients with recurrent mitral stenosis following surgical commissurotomy. Am J Cardiol 1995;75:601-605.
23. Aubert AE, Jang IK, Brzostek T, Van de Werf F, De Geest H. Determinants of transmitral inflow pattern 10-14 days after acute myocardial infarction. Coronary Artery Disease. 1995;6:137-145.
24. Moreu J, Siver M, Palacios IF, Jang IK. Morphologic characteristics of restenotic lesions following coronary intervention: Angioplasty versus directional atherectomy. Can we speculate the mechanism of restenosis from morphologic analysis? Cath Cardiovasc Diag 1995;36:103-109.
25. Smith AJC, Holt RE, Fitzpatrick K, Palacios IF, Gold H, Werner W, Bovill EG, Fuster V, Jang IK. Transient thrombotic state after abrupt discontinuation of heparin in patients undergoing percutaneous coronary angioplasty. Am Heart J 1996;131:434-439.
26. Butte A, Houng A, Jang IK, Reed RL. Alpha 2-antiplasmin causes thrombus resistance to tissue plasminogen activator in experimental pulmonary embolism. Circulation 1997;95:1886-1891.
27. Jang IK, Giugliano PR, Massey TJ, Schwarz RP. A randomized blinded study of two doses of Novastan(brand of argatroban) versus heparin as adjunctive therapy to recombinant tissue plasminogen activator (accelerated administration) in acute myocardial infarction: rationale and design of the myocardial infarction using Novastan and TPA (MINT) study. J Thromb Thromboly 1998;5:49-52.
28. Seckler J, Butte A, Harrell L, Palacios IF, Jang IK. Acute occlusion during coronary interventions: The changing pattern in the era of stents. Massachusetts General Hospital Experience. J Invasive Cardiology 1998;10:208-212.
29. Toussaint Jean-Francois, Southern JF, Kantor HL, Jang IK, Fuster V. Behavior of atherosclerotic plaque components after in vitro angioplasty and atherectomy studied by high field MR imaging. Magnetic Resonance Imaging 1998;16:175-183.
30. Mahdi N, Lopez J, Leon M, Pathan A, Harrell L, Jang IK, Palacios IF. Comparison of primary coronary stenting to primary balloon angioplasty with stent bailout for the treatment of patients with acute myocardial infarction. Am J Cardiol 1998;81:957-963.
31. Boeve TJ, Reed RL, Carias de Oliveira N, Titus J, Janssens S, J,Guigliano RP, Torchiana D, Daggett W, Schwarz RP, Jang IK. Comparison of argatroban or hirudin for the reperfusion of thrombotic arterial occlusion by tissue plasminogen activator. J Thromb Thromboly 1998;6:103-108.
32. Jang IK, Brown DFM., Giugliano R, Anderson HV, Losordo D, Nicolau J, Dutra O, Bazzino O, Viamonte VM, Norbady R, Liprandi AS, Massey T, Dinsmore R, Schwarz R.P. A multicenter, randomized study of argatroban versus heparin as adjunct to tissue plasminogen activator (TPA) in acute myocardial infarction: Myocardial infarction with Novastan and TPA (MINT) study J Am Coll Cardiol 1999;33:1879-1885.
33. Kathiresan S, Jordan MK, Gimelli G, Lopez-Cuellar J, Madhi N, Jang IK. Frequency of silent myocardial ischemia following coronary stenting. Am J Card 1999;84:930-932.
34. Gimelli G, Kalra A, Sabatine MS, Jang IK. Primary versus rescue percutaneous coronary intervention in patients with acute myocardial infarction. Acta Cardiol 2000;55:187-192.
35. Sabatine M, Tu T, Jang IK. Combination of a direct thrombin inhibitor and a platelet glycoprotein IIb/IIIa blocking peptide facilitates and maintains reperfusion of platelet-rich thrombus with tissue plasminogen activator. J Thromb Thromboly 2000;10:189-196.
36. Kalra A, Jang IK. Prevalence of early left ventricular thrombus after primary stenting for acute myocardial infarction. J Thromb Thromboly, 2000;10:133-136. 37. Januzzi JL, Jr, Hahn SS, Chae CU, Giugliano RP, Coulter S, Lewandrowski K, Theroux P, Jang IK. Effects of Tirofiban plus heparin versus heparin alone on troponin I levels in patients with acute coronary syndromes. Am J Cardiol 2000;86:713-717.
38. Tearney GJ, Jang IK, Kang DH, Aretz HT, Houser SL, Brady TJ, Schlendorf K, Shishkov M, Bouma BE. In-vivo porcine coronary artery imaging by optical coherence tomography. Acta Cardiol 2000;55:233-237.
39. Abernethy WB, Choo JK, Oesterle SN, Jang IK. Balloon deflection technique: A method to facilitate entry of a balloon catheter into a deployed stent. Cathet Cardiovasc Intervent 2000;51:312-313.
40. Lewis BE, Wallis DE, Berkowitz SD, Matthai WH, Fareed J, Walenga JM, Bartholomew J, Sham R, Lerner RG, Zeigler ZR, Rustagi PK, Jang IK, Rifkin SD, Moran J, Hursting MJ, Kelton JG. Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation 2001;103:1838-1843.
41. Januzzi J, Jr. Chae CU, Sabatine MS, Jang IK. Elevation in serum troponin predicts the benefit of tirofiban. J Thromb Thromboly 2001; 11:211-215
42. Sabatine MS, Januzzi JL, Snappin S, Theroux P, Jang IK. A risk score system for predicting adverse outcomes and magnitude of benefit with glycoprotein IIb/IIIa inhibitor therapy in patients with unstable angina. Am J Cardiol 2001; 88:488-492.
43. Wong P, Harding S, Walters D, Hull ML, Jang IK. Vascular complications after hemostatic puncture closure device (AngioSeal™) are not higher in overweight patients. J Invas Cardiol 2001; 13:623-625
44. Sheynberg B, Jang IK, Han RO, Sabatine MS, Brown D, Dinsmore R. Comparison of two different methods of quantitative coronary angiography in patients with acute coronary syndromes. Cathet Cardiovasc Intervent 2002;55:442-449
45. Jang,IK, Tearney G, Bouma B. Visualization of tissue prolapse between coronary stent struts by Optical Coherence Tomography (OCT): Comparison with Intravascular Ultrasound (IVUS). Circulation 2001;104:2754.
46. Jang IK, Bouma B, Kang DH, Park SJ, Park SW, Seung KB, Choi KB, Shishkov M, Schlendorf K, Pomerantsev E, Houser SL, Artez HT, Tearney GJ. Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: Comparison with Intravascular Ultrasound. J Am Coll Cardiol 2002;39:604-609
47. Walters DL, Harding SA, Walsh CR, Wong P, Pomerantsev E, Jang IK. Acute coronary syndrome is a common clinical presentation of in-stent restenosis. Am J Cardiology 2002;89:491-494.
48. Januzzi J. Jr., Snappin S, DiBattiste P, Jang IK, Theroux P. Benefits and safety of Tirofiban among acute coronary syndrome patients with mild to moderate renal insufficiency. Circulation 2002;105:2361-2366.
49. Yabushita H, Bouma BE, Houser SL, Aretz HT, Jang IK, Schlendorf KH, Kauffman CR, Shishkov, M, Kang DH, Halpern, EF, Tearney GJ. Characterization of human atherosclerosis by optical coherence tomography. Circulation 2002;106:1640-1645.
50. Tearney GJ, Yabushita H, Houser SL, Aretz T, Jang IK, Schlendorf KH, Kauffman CR, Shishkov M, Halpern, EF, Bouma BE. Quantification of macrophage content in atherosclerotic plaques by optical coherence tomography. Circulation 2003;207:113-119.
51. Bouma BE, Tearney GJ, Yabushita H, Shishkov M, Kauffman CR, DeJoseph Gauthier D, MacNeill BD, Houser SL, Aretz HT, Halpern EF, Jang IK. Evaluation of intracoronary stenting by intravascular optical coherence tomography. Heart 2003;89:317-321.
52. Grossman SA, Brown DE, Change YC, Chung WG, Cranmer H, Dan L, Fisher J, Tedrow U, Lewandrowski K, Jang IK, Nagurney JT. Predictors of delay in presentation to the ED in patients with suspected acute coronary syndromes. The American Journal of Emergency Medicine 2003;21:425-428.
53. MacNeill BD, Harding SA, Bazari H, Patton KK, Colon-Hernandez P, DeJoseph D, Jang IK. Prophylaxis of contrast-induced nephropathy in patients undergoing coronary angiography. Cathet Cardovsc Intervent 2003;60:000-000.
54. Achenbach S, Moselewski F, Ropers D, Ferencik M, Hoffmann U, MacNeill B, Pohle K, Baum U, Anders K, Jang IK, Daniel WG, Brady TJ. Detection of calcified and non-calcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral CT: a segment-based comparison to IVUS. Circulation 2004;109:14-17.
55. Achenbach S, Ropers D, Hoffman U, MacNeill B, Baum U, Pohle K, Brady T, Pomerantsev E, Ludwig J, Flachskampf F, Wicky S, Jang IK, Daniel W. Assessment of coronary remodeling in stenotic and nonstenotic coronary atherosclerotic lesions by multidetector spiral CT. J Am Coll Cardiol 2004;43
56. Wong P, Harding S, Inglessis I, Choi C, Walters D, Chang Y, Gimelli G, Jang IK. The effect of glycoprotein IIb/IIIa receptor inhibitor on the microcirculation in patients undergoing high-risk coronary stenting; a prospective, randomized study. J Thromb Thromboly 2003;16:163-166.
57. MacNeill B, Harding S, Bazari H, Patton K, Colon-Hernandez P, DeJoseph D, Jang IK. Prophylaxis of contrast-induced nephropathy in patients undergoing coronary angiography. Cathet Cardovasc Intervent 2003;60:458-461. 58. Hoffman U, Moselewski F, Cury R, Ferencik M, Jang IK, Diaz L, Abbara S, Brady T, Achenbach S. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease. Patient-versus segment based analysis. Circulation 2004;110:2638-2643.
59. MacNeill B, Jang, IK, Bouma B, Iftimia N, Takano M, Yabushita H, Shishkov M, Kauffman C, Houser S, Aretz H, Dejoseph, D, Halpern E, Tearney G. Focal and multi-focal plaque macrophage distributions in patients with acute and stable presentations of coronary artery disease. J Am Coll Cardiol 2004;44:972-979.
60. Jang IK, Lewis B, Matthai W, Kleiman N. Argatroban anticoagulation in conjunction with glycoprotein IIb/IIIa inhibition in patients undergoing percutaneous coronary intervention: An open-label, nonrandomized pilot study. J Thromb Thromboly 2004;18:31-37.
61. Diaz-Sandoval LJ, Bouma BE, Tearney GJ, Jang, IK. Optical coherence tomography as a tool for percutaneous coronary intervention. Cathet Cariovasc Intervet 2005; In Press.
62. Jang IK, Tearney GJ, MacNeill B, Takano M, Moselewski F, Iftima N, Shishkov M, Houser S, Aretz HT, Halpern EF, Bouma BE. In vivo characterization of coronary atherosclerotic plaque using optical coherence tomography. Circulation 2005; In press.
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