• Journal of Chest Surgery
• /
• 제19권4호
• /
• pp.606-617
• /
• 1986

During the period from November 1981 through June 1986, 18 cases of coronary arterial bypass graft were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. They consisted of 13 males and 5 females with the mean age of 49 [range: 28-69 years]. History of myocardial infarction was noted in 50% of the patients and cardiomegaly on chest PA in 2 patients with preserved LV function. On resting EKG, except the evidences of old myocardial infarction, the findings of LVH were noted in 7 cases, acute myocardial infarction in 2, diffuse myocardial ischemia in 1, and significant ventricular arrhythmia in 2 cases. The angina by type of presentation is stable in 3 patients, unstable in 15 patients with resting, postinfarction and progressive angina as the criteria of unstability. The patterns of involvement of significant disease were single vessel involvement [5 cases] double vessel involvement [8 cases], and triple vessel involvement [5 cases] including 5 cases of left main coronary arterial diseases. The pattern of coronary arterial disease in individual patient was one or more stenosis of the proximal left coronary arterial system with or without right coronary involvement, in every case. We performed 9 cases of double bypass and 9 cases of triple bypass with great saphenous vein using single anastomosis technique except in 4 cases, One of the 4 cases is our first case, sequential anastomosis between LAD and diagonal was performed due to shortage of the prepared vein graft. In the other 3 cases, our latest experience, we adopted the left internal mammary artery for the left anterior descending coronary revascularization. The distribution of sites of distal anastomosis revealed more striking predilection to LAD, showing our attention on the significance of the revascularization of LAD system. The ischemic time was 35 minutes per graft and mean number of grafts per patient was 2.5. Of the 18 patients, 13 [77.2%] had complete revascularization, and incomplete in 5 cases with the causes of incompleteness as presented. The early results of operation were as followed: surgical death in 2 [11%], perioperative infarction 2 [11%], need of inotropic support 5 [28%], arrhythmia 2 [11%], wound problem, bleeding, and emotional dysfunction. The actuarial anginal free survival during the period of 6 months through 2 years was 85.2% with excellent symptomatic control according to the angina classification of Canadian Cardiovascular Society.

• Molecules and Cells
• /
• 제37권3호
• /
• pp.241-247
• /
• 2014

Sudden cardiac death (SCD), which is primarily caused by lethal heart disorders resulting in structural and arrhythmogenic abnormalities, is one of the prevalent modes of death in most developed countries. Myocardial ischemia, mainly due to coronary artery disease, is the most common type of heart disease leading to SCD. However, postmortem diagnosis of SCD is frequently complicated by obscure histological evidence. Here, we show that certain mRNA species, namely those encoding hemoglobin A1/2 and B (Hba1/2 and Hbb, respectively) as well as pyruvate dehydrogenase kinase 4 (Pdk4), exhibit distinct postmortem expression patterns in the left ventricular free wall of SCD subjects when compared with their expression patterns in the corresponding tissues from control subjects with non-cardiac causes of death. Hba1/2 and Hbb mRNA expression levels were higher in ischemic SCD cases with acute myocardial infarction or ischemic heart disease without recent infarction, and even in cardiac death subjects without apparent pathological signs of heart injuries, than control subjects. By contrast, Pdk4 mRNA was expressed at lower levels in SCD subjects. In conclusion, we found that altered myocardial Hba1/2, Hbb, and Pdk4 mRNA expression patterns can be employed as molecular signatures of fatal cardiac dysfunction to forensically implicate SCD as the primary cause of death.

• Korean Journal of Radiology
• /
• 제19권6호
• /
• pp.1007-1020
• /
• 2018

Objective: To compare the diagnostic performance of cardiovascular magnetic resonance (CMR) myocardial perfusion at 1.5- and 3-tesla (T) for detecting significant coronary artery disease (CAD), with invasive coronary angiography (ICA) as the reference method. Materials and Methods: We prospectively enrolled 281 patients (age $62.4{\pm}8.3$ years, 193 men) with suspected or known CAD who had undergone 1.5T or 3T CMR and ICA. Two independent radiologists interpreted perfusion defects. With ICA as the reference standard, the diagnostic performance of 1.5T and 3T CMR for identifying significant CAD (${\geq}50%$ diameter reduction of the left main and ${\geq}70%$ diameter reduction of other epicardial arteries) was determined. Results: No differences were observed in baseline characteristics or prevalence of CAD and old myocardial infarction (MI) using 1.5T (n = 135) or 3T (n = 146) systems. Sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) for detecting significant CAD were similar between the 1.5T (84%, 64%, 74%, 76%, and 0.75 per patient and 68%, 83%, 66%, 84%, and 0.76 per vessel) and 3T (80%, 71%, 71%, 80%, and 0.76 per patient and 75%, 86%, 64%, 91%, and 0.81 per vessel) systems. In patients with multi-vessel CAD without old MI, the sensitivity, specificity, and AUC with 3T were greater than those with 1.5T on a per-vessel basis (71% vs. 36%, 92% vs. 69%, and 0.82 vs. 0.53, respectively). Conclusion: 3T CMR has similar diagnostic performance to 1.5T CMR in detecting significant CAD, except for higher diagnostic performance in patients with multi-vessel CAD without old MI.

• Genomics & Informatics
• /
• 제12권3호
• /
• pp.127-133
• /
• 2014

Gastritis is a major disease that has the potential to grow as gastric cancer. Gastric cancer is a very common cancer, and it is related to a very high mortality rate in Korea. This disease is known to have various reasons, including infection with Helicobacter pylori, dietary habits, tobacco, and alcohol. The incidence rate of gastritis has reported to differ between age, population, and gender. However, unlike other factors, there has been no analysis based on gender. So, we examined the high risk factors of gastritis in each gender in the Korean population by focusing on sex. We performed an analysis of 120 clinical characteristics and genome-wide association studies (GWAS) using 349,184 single-nucleotide polymorphisms from the results of Anseong and Ansan cohort study in the Korea Association Resource (KARE) project. As the result, we could not prove a strong relation with these factors and gastritis or gastric ulcer in the GWAS. However, we confirmed several already-known risk factors and also found some differences of clinical characteristics in each gender using logistic regression. As a result of the logistic regression, a relation with hyperlipidemia, coronary artery disease, myocardial infarction, hyperlipidemia therapy, hypotensive or antihypotensive drug, diastolic blood pressure, and gastritis was seen in males; the results of this study suggest that vascular disease has a potential association with gastritis in males.

• 한국방사선학회논문지
• /
• 제3권2호
• /
• pp.5-10
• /
• 2009

심근영상의 SPECT(Single Photon Emission Computed tomography)검사는 감마선을 방출하는 방사성의약품을 환자에게 정맥주사한 후 이 의약품이 심장에 고루 퍼지면 관심부위를 촬영하여 질병으로 인한 변화를 컴퓨터를 이용하여 진단하는 검사법이다. 기능적인 정보를 담고 있는 심근관류 영상은 비침습적인 심근질환 검사에 유용한 방법이지만, 물리적 인자들에 의해 잡음과 낮은 해상도는 판도하는데 어려움을 주게 된다. 본 논문은 심근영상을 레벨 셋 알고리즘을 이용하여 영상을 분할하고 분할된 영역을 3차원으로 구현하여 판독에 도움을 주는 방안을 제안하였다. 판독의 어려움을 해결하기 위하여 레벨 셋을 이용하여 관심부위인 좌심실 영역을 분할하였고 분할된 영역을 3차원영상으로 모델링하였다.

• 한국산학기술학회논문지
• /
• 제11권6호
• /
• pp.2240-2245
• /
• 2010

심근영상의 SPECT(Single Photon Emission Computed tomography)검사는 감마선을 방출하는 방사성의약품을 환자에게 정맥주사한 후 이 의약품이 심장에 고루 퍼지면 관심부위를 촬영하여 질병으로 인한 변화를 컴퓨터를 이용하여 진단하는 검사법이다. 기능적인 정보를 담고 있는 심근관류 영상은 비침습적인 심근질환 검사에 유용한 방법이지만, 물리적 인자들에 의해 잡음과 낮은 해상도는 판도하는데 어려움을 주게 된다. 본 논문은 심근영상을 레벨 셋 알고리즘을 이용하여 영상을 분할하고 분할된 영역을 3차원으로 구현하여 판독에 도움을 주는 방안을 제안하였다. 판독의 어려움을 해결하기 위하여 레벨 셋을 이용하여 관심부위인 좌심실 영역을 분할하였고 분할된 영역을 3차원영상으로 모델링 하였다.

• 기본간호학회지
• /
• 제8권2호
• /
• pp.259-269
• /
• 2001

Purpose: The purpose of this study was to investigate the effects of an intensive teaching program on the knowledge level of MI in patients with a myocardial infarction. Method: The subjects were 47 patients with a myocardial infarction. Of the subjects 23 were assigned to the experimental group and 24 to the control group. The data were collected through a questionnaire (Lee, 1992; Nam, 1998) survey of knowledge level. The data collection was done about MI between September 15, 1999 and December 31, 2000 after hospital discharge. Data were analyzed using the SAS program and the results are as follows. Results: 1. There were no significant difference in knowledge level of the MI (P=0.621) between the two groups before the teaching program was given. 2. After 4 weeks the knowledge level about MI was significantly higher in the experimental group compared to the control group (P = 0.000). 3. After 12 weeks the knowledge level about MI was significantly higher in the experimental group compared to the control group (P= 0.000). 4. After 4 weeks the experimental group was at a higher scores of knowledge category about MI for nature of disease (P=0.000). risk factors, (P=0.000), diet (P=0.000), medication (P=0.000) exercise and daily activities (P=0.000) as compared to the control group. 5. After 12 weeks the experimental group was at a higher scores of knowledge category about MI for nature of disease (P=0.000). risk factors (P=0.001). diet (P=0.000), medication (P=0.000) exercise and daily activities (P=0.000) as compared to the control group. Conclusion: The above findings indicate that the intensive teaching program used for the experimental group in this study was effective in increasing the knowledge level about MI of the patients with a myocardial infarction.

• 대한한의학회지
• /
• 제40권3호
• /
• pp.1-20
• /
• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• Journal of Veterinary Science
• /
• 제24권1호
• /
• pp.2.1-2.14
• /
• 2023

Background: Hypothermia is a crucial environmental factor that elevates the risk of cardiovascular disease, but the underlying effect is unclear. Objectives: This study examined the role of cold stress (CS) in cardiac injury and its underlying mechanisms. Methods: In this study, a chronic CS-induced myocardial injury model was used; mice were subjected to chronic CS (4℃) for three hours per day for three weeks. Results: CS could result in myocardial injury by inducing the levels of heat shock proteins 70 (HSP70), enhancing the generation of creatine phosphokinase-isoenzyme (CKMB) and malondialdehyde (MDA), increasing the contents of tumor necrosis factor-α (TNF-α), high mobility group box 1 (HMGB1) interleukin1b (IL-1β), IL-18, IL-6, and triggering the depletion of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). Multiple signaling pathways were activated by cold exposure, including pyroptosis-associated NOD-like receptor 3 (NLRP3)-regulated caspase-1-dependent/Gasdermin D (GSDMD), inflammation-related toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)-mediated nuclear factor kappa B (NF-κB), and mitogen-activated protein kinase (MAPK), as well as oxidative stressinvolved thioredoxin-1/thioredoxin-interacting protein (Txnip) signaling pathways, which play a pivotal role in myocardial injury resulting from hypothermia. Conclusions: These findings provide new insights into the increased risk of cardiovascular disease at extremely low temperatures.

• 대한핵의학회지
• /
• 제23권1호
• /
• pp.13-18
• /
• 1989

To evaluate diagnostic accuracy of $^{99m}Tc-pyrophosphate$ (PYP) myocardial scan, we analysed 160 $^{99m}Tc-PYP$ scans (acute transmural myocardial infarction 87 cases, acute subendocardial infarction; 20 cases, unstable angina pectoris; 7 cases, other disease; 46 cases). These scans were requested by the physician in Seoul National University Hospital from Sep. 1982 to Oct. 1987. And the diagnosis was confirmed by clinical course and laboratory examinations. 1) The diagnostic sensitivity of $^{99m}Tc-PYP$ scan in acute transmural myocardial infarction was 91.2% (62/68) if scintigraphy was performed within 7 days after infarction, 57.1% (8/14) between 8th and 14th day, 20% (1/5) and after 15 days. 2) The diagnostic sensitivity of $^{99m}Tc-PYP$ scan in acute subendocardial infarction was 75% (12/16) if scintigraphy was performed within 7 days after infarction and 0% after 8 days. 3) The diagnostic specificity of $^{99m}Tc-PYP$ scan in acute myocardial infarction was 94.3% (5/53). Among 5 cases of false positive scans, 1 case was unstable angina pectoris, 2 cases were old myocardial infarction with left ventricular aneurysm, 1 case was old myocardial infarction and the remaining 1 case was cardiomyopathy.