• Journal of Korean Neurosurgical Society
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• v.65 no.3
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• pp.422-429
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• 2022

Objective : Extracranial supra-aortic dissections (ESADs) with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke. Endovascular stenting to reconstruct non acute phase ESADs (NAP-ESADs) is an alternative to anticoagulant or antiplatelet therapy. However, its feasibility, safety and efficacy of stenting in NAP-ESADs is unclear. This study aims to investigate the long-term outcomes of the feasibility, safety and efficacy of stenting in NAP-ESADs. Methods : Seventy-four patients with 91 NAP-ESAD vessels with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke who underwent stent remodeling were enrolled into this respective study from December 2008 to March 2020. Technical success rate, complications, clinical and angiographic results were harvested and analyzed. Results : Success rate of stent deployment was 99% (90/91) with no procedural mortality or morbidity. Transient ischemic attack occurred in three patients during operation (4.1%, 3/74). Asymptomatic embolisms of distal intracranial vessels were found in two patients (2.7%, 2/74). One hundred and forty-two stents deployed at 85 carotid (135 stents) and six vertebral (seven stents) vessels. Six stent types (Wingspan, 28/135, 20.7%; Solitaire, 10/135, 7.4%; Neuroform, 8/135, 5.9%; LVIS, 2/135, 1.5%; Precise, 75/135, 55.6%; Acculink, 12/135, 8.9%) were deployed at carotid arterial dissection while two types (Wingspan, 5/7, 71.4%; Solitaire 2/7, 28.6%) at vertebral arterial dissection. Digital subtracted angiography (56%, 51/91), computational tomography angiography (41.8%, 38/91) and high resolution magnetic resonance imaging (2.2%, 2/91) were adopted for follow up, with a mean time of 17.2±15.4 months (5-77). All patient modified Rankin Scale scores showed no increase at discharge or follow-up. Angiographically, dissections in 86 vessels in 69 patients (94.5%, 86/91) were completely reconstructed with only minor remnant dissections in four vessels in four patients (4.4%, 4/91). Severe re-stenosis in the stented segment required re-stenting in one patient (1.1%, 1/91). Conclusion : Stent remodeling technique provides feasible, safe and efficacious treatment of ESADs patients with severe stenosis, occlusion and/or pseudoaneurysm.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.51-61
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• 2023

BACKGROUND: Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS: In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS: The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS: This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.24 no.1
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• pp.17-25
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• 2024

Fabry disease (FD) is an X-linked lysosomal storage disorder. It is caused by mutations in the α-galactosidase A gene, which results in deficient or absent activity of α-galactosidase A (α-Gal A). This leads to a progressive accumulation of globotriaosylceramide (Gb3) in various tissues. Manifestations of Fabry disease include serious and progressive impairment of renal and cardiac function. In addition, patients experience pain, gastrointestinal disturbance, transient ischaemic attacks, and strokes. Additional effects on the skin, eyes, ears, lungs, and bones are often seen. Reduced life expectancy and deadly consequences are being caused by cardiac involvement. Chaperone therapy or enzyme replacement therapy (ERT) are two disease-specific treatments for FD. Thus, early detection of FD is critical for decreasing morbidity and mortality. Globotriaosysphingosine (lyso-Gb3) for identifying atypical FD variants and highly sensitive troponin T (hsTNT) for detecting cardiac involvement are both significant diagnostic indicators. This review aimed to offer a basic resource for the early diagnosis and update on the diagnosis of having FD. We will also provide a general diagnostic algorithm and information on ERT and its accompanying treatments.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.283-289
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• 2002

Backgrouds: It is almost universally accepted that occlusive vascular diseases are best managed by anatomical reconstruction. However, the mortality and the morbidity have limited this operation for patients with high operation risks. In these patients, palliative operations such as extra-anatomic bypass and lumbar sympathectomy, are accepted as useful treatment. Material and Method: A retrospective study was conducted in 38 patients who underwent palliative operations for occlusive vascular disease at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 60.37 $\pm$ 17.65 years, and preoperative diagnoses were atherosclerosis in 32 patients, Buerger's disease in 4 patients, Raynaud's syndrome in 1 patient and SVC syndrome in 1 patient. Result: Extra-anatomic bypass(40procedures), lumbar sympathectomy(17), thromboembolectomy(7) and femoral artery graft interposition(1) were performed. Six patients were required reoperation due to graft flow failure or fistula. Three year primary patency rate of entire operations was 78.29 $\pm$ 8.81%, and the correlation between type of operation and patency rate was not statistically significant. Conclusion: Palliative operations for occlusive vascular disease are useful treatment in limited patients with high operation risks or limited life expectancy.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.87-94
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• 2003

Purpose : Respiratory viruses are one of the most infectious agent in human. Acute lower respiratory tract infection(ALRTIs) is associated with significant morbidity and mortality in children. This study is performed to investigate the etiologic organism, age and sex distribution, clinical manifestations and seasonal occurrence of ALRTIs in children. Methods : Viral agent was evaluated with nasopharyngeal aspirates, rhinorrhea and saliva collected from 568 patients. We confirmed viral agents in 54 patients who were younger than 15 year old. They had visited Maryknoll Hospital, Busan in Korea from January, 2002 to December, 2002 for ALRTIs. Results : The viral pathogens identified were Influenza A virus(59.3%), Enterovirus(33.3%), Adenovirus(5.6%), and Influenza B virus(1.9%). Parainfluenza virus and Respiratory syncytial virus were not detected. The occurrence of acute lower respiratory infections was high between 3 & 6 years old. The clinical patterns include pneumonia(51.9%), bronchitis(31.5%), croup(9.3%), bronchiolitis(7.4%). The respiratory viral agents had their characteristic seasonal patterns. Conclusion : Influenza A virus was the most common cause of acute lower respiratory tract infections in Busan area during the 2002. ALRTIs had high occurrence between 3 to 6 years old. And the most common clinical patterns were pneumonia and bronchitis.

• Journal of the Korean Dietetic Association
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• v.6 no.2
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• pp.125-135
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• 2000

Hypertension is a well-known degenerative disease whose prevalence rate increases with age. Management of high blood pressure is a critical concern in preventive strategies to reduce the morbidity and mortality for cardiovascular disease. The purpose of this study was to examine the dietary characteristics of hypertensive program participants, and to establish strategies based on their nutritional needs. Hypertensive patients were enrolled in the program in a public health center or in a local elderly center, at Suwon, in 1999-2000. Trained dietitians interviewed 62 enrollees(24-hour recall) and related variables. Mean body mass index of the subjects was 25.0kg/m². 30.7% of the subjects had a family history of hypertension. The majority of them ate regularly and partook of all available side dishes. They consumed grains and vegetables regularly, but seldom ate dairy products or food prepared with oil. Male enrollees frequently consumed more processed food and animal fat than did female enrollees(p<0.05). An analysis of the percentage of RDA(Recommended Dietary Allowances of Korea 1995) showed that but for ascorbic acid, enrollees consumed nutrients below the RDA. The food group intake pattern was not diverse, thus only 8.1% of enrollees consumed all food groups in a day. An analysis of eating attitude showed that 64.5% of enrollees always added salt to beef soup. Male enrollees showed low food-related self-efficacy compared to female enrollees, especially with reference to reduction of instant food intake(p<0.01), increase in vegetable intake(p<0.01), reduction of monosodium glutamate(MSG) intake(p<0.01). and not overeating(p<0.05). Their perceived barriers for participating in hypertension nutrition programs included lack of time, program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education programs for community hypertensive patients should focus on increasing participant consumption of foods, expecially dairy products, and desirable eating attitudes. It also suggests that the program should consider should consider encouraging self-efficacy in changing eating behavior.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.250-256
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• 2004

Background : Bacterial infections in diabetic patients are an important cause of increased morbidity and mortality. It has been reported that bacterial infections in diabetics showed more impaired PMN functions such as reduced PMN respiratory burst and decreased microbicidal activity in inflammed tissues. Also, apoptosis(programmed cell death) is postulated to be a key mechanism for neutrophil elimination. It is very important that PMN apoptosis keeps the balance from an area of inflammation. Actuallly, as little was known about PMN apoptosis and respiratory burst in diabetes, we investigated PMN apoptosis and hydrogen peroxide production after endotoxin exposure. Methods : Peripheral venous blood samples were collected by routine venipuncture from healthy volunteers and diabetics to harvest neutrophils. We respectively measured the PMN apoptosis, the production of hydrogen peroxide, and the cell viability. Results : Normal neutrophils showed a tendency to decreased apoptosis after endotoxin treatment. In patients with diabetes, PMN apoptosis was significantly decreased compared with healthy controls. In addition, the LPS-induced neutrophils in diabetics demonstrated more decreased apoptosis. However, the production of hydrogen peroxide was not different between groups. Conclusion : These observations suggest that the decreased PMN apoptosis in diabetics with endotoxin exposure may also affect the increased susceptibility and severity of infections.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.515-523
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• 2001

Background: More than 70% of morbidity and mortality of diabetes mellitus is due to macrovascular complications. These complications may be associated with defect of endothelium-dependent vascular relaxation. There have been suggestions that this defect might be due to direct toxicities of oxygen-free radical. So in this study ascorbic acid was used as a dietary supplement in streptozotocin induced diabetic rats to correct this defect. Material and Method: Sixty male Sprague-Dawley rats were used in this study. They were divided into control and experimental groups. Streptozotocin was injected to the 33 rats of experimental group and then divided into two the other receiving subgroups; one receiving ascorbic acid supplement(1 g/l in drinking water); and nosupplements. At 6, 9 and 12 weeks, abdominal aortic rings were obtained to make tissue preparations for evaluation of vascular smooth muscle contractility. Result: While control group showed good response to acetylcholine induced relaxation, diabetic group showed decreased relaxation regardless of ascorbic acid supplement at the experiments 6 weeks after streptozotocin treatment. This abnormal endothelium-dependent vascular relaxation was markedly reversed at 9 and 12 weeks into the diabetic group with ascorbic acid supplement. There were no differences in sodium nitroprusside induced relaxation responses between control and experimental groups; also, norepinephrine induced contractile responses did not show any remarkable effects. Conclusion: These results strongly suggest that the endothelial cells have defects in diabetic rats. Dietary supplement of ascorbic acid can reverse the defects of diabetic endothelial cells through its antioxidant effects and it may further protect against vascular disease in diabetic patients.

• Korean Journal of Clinical Laboratory Science
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• v.56 no.1
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• pp.66-72
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• 2024

Lipid metabolic disorders are commonly encountered in clinical practice. Dyslipidemia and its prevalence rate are strongly associated with the morbidity and mortality of cardiovascular disease worldwide. We conducted a genetic analysis to determine the association between genetic polymorphisms of the ABO gene in adults middle-aged (40~69 years) with dyslipidemia in the Korean population. A total of 6,750 subjects from the Korea Association REsource (KARE) were selected for this study. Using the genetic and epidemiologic data of 4,403 dyslipidemia cases and 2,347 normal controls from the KARE, single nucleotide polymorphisms (SNPs) in ABO gene were analyzed for their genetic correlation. Eleven SNPs out of the ABO gene demonstrated a statistically significant association with dyslipidemia. Among them, rs8176707 in ABO gene statistically showed the most significant correlation with dyslipidemia (P-value=0.002, odds ratio=0.82, 95% confidence interval=0.78~0.86). The minor allele of T polymorphism within the ABO intron genetic region was associated with a decreased risk of dyslipidemia. This study uncovered a significant association between genetic polymorphism in the ABO gene and dyslipidemia. This finding suggest that ABO SNPs markers have a genetic correlation with the etiology of dyslipidemia.