• Journal of Chest Surgery
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• v.34 no.8
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• pp.630-633
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• 2001

Central anticholinergic syndrome is defined as an absolute or relative reduction in cholinergic activity in the central nervous system and has a wide variety of manifestations. It is associated with almost any drug given during anesthesia, except neuromuscular relaxants, and treated with the cholinesterase inhibitor physostigmine. The diagnosis of central anticholinergic syndrome is often made when symptoms resolve promptly after the administration of physostigmine. We present a case of a central anticholinergic syndrome diagnosed by treatment with physostigmine, in a patient who received closure of patent foramen ovale associated with stroke.

• 한국생물공학회:학술대회논문집
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• 2003.04a
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• pp.98-100
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• 2003

Synthetic polymers such as PET and ePTFE have widely been used for artificial vascular patches. However, these materials cannot function for a long term as blood vessel due to thrombotic occlusion and calcification. To overcome this limitation, a biocompatible vascular patch was developed using stem cell and tissue engineering approach. Autologous bone marrow mesenchymal stem cells were differentiated into vascular endothelial cells and smooth muscle cells. These cells were seeded onto collagen patch matrices. The matrices were anastomosed to abdominal arteries in canine models. Prior to implantation, histological and scanning electron microscopical examination revealed stem cell adhesion and growth on the matrices. At 3 weeks, the implanted vascular patches were patent. Histological examination showed the regeneration of endothelium, media and adventitia in the grafts. Cell tracing analysis using fluorescent reagent showed that labeled stem cells were present in the implanted grafts and contributed to the regeneration of vascular tissues. This study may help us develop a tissue-engineered vascular patch appropriate for clinical applications.

• Journal of the Korean Society of Radiology
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• v.85 no.2
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• pp.270-296
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• 2024

Coronary CT angiography (CCTA) is recognized for its role as a gatekeeper for invasive coronary angiography in patients suspected of coronary artery disease because it can detect significant coronary stenosis with high accuracy. However, heavy plaque in the coronary artery makes it difficult to visualize the lumen, which can lead to errors in the interpretation of the CCTA results. This is primarily due to the limited spatial resolution of CT scanners, resulting in blooming artifacts caused by calcium. However, coronary stenosis with high calcium scores often requires evaluation using CCTA. Technological methods to overcome these limitations include the introduction of high-resolution CT scanners, the development of reconstruction techniques, and the subtraction technique. Methods to improve reading ability, such as the setting of appropriate window width and height, and evaluation of the position of calcified plaque and residual visibility of the lumen in cross-sectional images, are also recommended.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.89-94
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• 2006

When the old schwannoma has the degenerative changes, it is named as the ancient schwannoma which was rarely reported. The degenerative changes are perivascular hyalinization, calcification, cystic necrosis, marked decrease of Antoni type A area, and degenerative nuclei and the ancient schwannoma may be misinterpreted as sarcomatous pleomorphisms. We experienced the ancient schwannoma which has massive hemorrhage and hematoma, cystic change, calcification, and marked decrease of Antoni A area in leg on 75 year old male patient, and report it.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.131-135
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• 2003

Bovine pericardium fixed in glutaraldehyde solution (GA) has been one of the most popular surgical bioprosthesis, however, late calcific degeneration after implantation remains to be solved. To mitigate calcific degeneration, we posttreated the bovine pericardium with amino acids after GA fixation. Material and Method: 40 small pieces of bovine pericardia were fixed in 0.625% GA solution with 4 g/L $MgCl_26H_2O$as a control group (group 1). 40 pieces fixed in the same GA solution were posttreated with 2% chitosan solution (group 2) and the other 40 pieces posttreated with 8% glutamate (group 3). These were implanted into the belly of forty Fisher 344 rats subdermally and extracted at f month, 2 months, 3 months and 4 months after implantation. Result: With atomic absorption spectrophotometry we measured the deposited calcium amount and the results were as follows; 2.01 $\pm$0.13 mg/g in group 1, 2.34$\pm$0.73 mg/g in group 2, 2.49$\pm$0.15 mg/g in group 3 at 1 month after implantation, and 3.57$\pm$0.15 mg/g in group 1, 3.52$\pm$0.92 mg/g in group 2, 3.46$\pm$0.12 mg/g in group 3 at the second month. But 5.45$\pm$0.42 mg/g in group 1, 3.22 $\pm$1.31 mg/g in group 2 and 4.20$\pm$0.55 mg/g in group 3 at the 3rd month, which have statistical significance in group 2 (p<0.05). Finally at 4th month, 6.01$\pm$1.21 mg/g in group 1, 3.78$\pm$1.82 mg/g in group 2, 3.92$\pm$0.92 mg/g in group 3, which also have statistical significance (p < 0.05). Conclusion: This means posttreatment with 2% chitosan shows meaningful calcium mitigation effects after 3rd month on subcutaneously implanted bovine pericardium in the rat models but 8% glutamate shows mitigation effect after 4months in this experiment.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.28-41
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• 2022

Acute coronary syndrome involves three types of coronary artery disease associated with sudden rupture of coronary artery plaque, and has a clinical presentation ranging from ST-segment elevation myocardial infarction (STEMI) to non-ST-segment elevation myocardial infarction (NSTEMI) or unstable angina. Cardiac CT can help quantify and characterize atherosclerotic plaques. According to a previous study, low-attenuation plaque, napkin ring sign, positive remodeling, spotty calcification, and increased perivascular fat attenuation are associated with plaque ruptures on cardiac CT. Therefore, coronary artery stenosis, as well as acute coronary artery syndrome, can be diagnosed using cardiac CT.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.94-101
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• 2002

All kinds of tissue valves must be pretreated for the inactivation of immunologic properties and the strengthening of tissue before implantation. However, the tissue valves are gradually denatured with the calcification process and they eventually lose their functions. Recent reports have shown the existence of specific calcium binding non collagenous proteins in the calcified area of implanted biomaterials. This experiment was intended to confirm the effect of pretreatment with RGDS(Arg-Gly-Asp-Ser) tetrapeptide on the calcification of subcutaneously implanted bovine pericardium in rats. RGDS tetrapeptide has the same amino acid sequence of attachment site of specific calcium binding non collagenous proteins. Material and Method: All bovine pericardial pieces were fixed with 0.6% glutaraldehyde. The pretreatments were done using 5 different methods, groupI, with normal saline for 60 minutes, groupII, with 0.5% GRSD(Gly-Arg-Scr-Asp) tetrapeptide solution for 60 minutes, group III : with 0.5% RGDS(Arg-Gly-Asp-Ser) tctrapeptide for 30 minutes, group IV ; with 0.5% RGDS for 60 minutes, and group V : with 0.5% RGDS for 120 minutes. The pretreated bovine pericardial pieces were implanted subcutaneously at the abdominal sites of rats. 30 days after the implantation, the implanted bovine pericardial tissue were examined radiologically, biochemically, and histologically to measure the severity of calcification. Result: On the radiological examination, group I ; 68.42$\pm$3.06, group II , 64.25$\pm$5.58 showed significant difference with group III: 48.00$\pm$3.57, group IV; 43.67$\pm$2.31, and group V ; 2.58$\pm$2.47(p<0.05). There was no difference between group I and II(p=0.105). On the biochemical examination, the amount of calcium in group I was , 33.09$\pm$6.59 mg, in group II ; 28.12$\pm$5.50mg, in group III ; 25.42$\pm$7.67mg, in group Ⅵ ; 20.51$\pm$5.11mg, and in group V : 15.43$\pm$4.25mg.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.560-566
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• 1998

Background: Bovine pericardial bioprosthesis treated with glutaraldehyde (GA) is one of the most popular prosthetic materials, but late calcific degeneration after implantation is a problem that remains unsolved. For the purpose of mitigating the calcific degeneration, we added MgCl2 into the 0.625% GA solution to compete with calcium for binding to the free aldehyde from GA and pretreated with the surfactants like sodium dodecyl sulfate (SDS) and Triton X-100 before GA fixation for preventing the phospholipid infiltration into the pericardial tissue, the first step of the calcific degeneration. Material and Method: 40 square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4g/L MgCl2 6H2O as a control group (group 1). 40 pieces pretreated with 1% SDS were also fixed in the same GA solution (group 2) and other 40 pieces pretreated with 1% Triton X-100 were prepared with the same method (group 3). After 1 month of fixation these were implanted into the belly of 40 Sprague-Dawley subdermally and extracted 1 month, 2 months, 3 months and 6 months after implantation. With atomic absorption spectrophotometry we measured the deposited calcium amount. Result: 1 month after implantation we could not find any differences between the three groups, but by the 2nd month calcium deposition was 0.921$\pm$0.121 mg/g in group 1, 0.481$\pm$0.037 mg/g in group 2 and 1.369$\pm$0.200 mg/g in group 3. By the 3rd month it was 0.786$\pm$0.080 mg/g in group 1, 0.584$\pm$0.054 mg/g in group 2 and 1.139$\pm$0.188 mg/g in group 3, and on the 6th month 1.623$\pm$0.601 mg/g in group 1,0.501$\pm$0.043 mg/g in group 2 and 1.625$\pm$0.382 mg/g in group 3, with statistical significance in group 2(p<0.05). Conclusion: Pretreatment with SDS showed meaningful calcium mitigation effects on subcutaneously implanted bovine pericardium in the rat models but the neutral type surfactant, Triton X-100, had no positive mitigation effect in this experiment.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.858-861
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• 2003

The main cause of ischemic heart disease combined with aortic valve disease is the systemic atherosclerotic process. Coronary artery embolism by a particle from the calcified aortic valvular tissue is very rare. A 73-year-old female patient was admitted due to chest tightness of recent onset. Two dimensional echocardiogram showed severe calcific aortic valve stenosis. Preoperative coronary angiogram exhibited a stenotic lesion at the distal right coronary artery, which seemed to be embolic in origin. The coronary embolus was removed through the coronary arteriotomy and then the arteriotomy site was repaired by onlay patch angioplasty technique. Aortic valve was replaced by a bioprosthetic valve. The embolus was reported as a fibrocalcified particle of diseased valve.