• Korean Circulation Journal
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• v.52 no.6
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• pp.429-440
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• 2022

Background and Objectives: Endovascular therapy (EVT) first strategy has been widely adopted for the treatment of chronic limb threatening ischemia (CLTI) patients in real-world practice. This study aimed to investigate long-term outcomes of CLTI patients who underwent EVT and identify prognostic factors. Methods: From the retrospective cohorts of a Korean multicenter endovascular therapy registry, 1,036 patients with CLTI (792 men, 68.8 ± 9.5 years) were included. The primary endpoint was amputation-free survival (AFS) defined as the absence of major amputation or death. Secondary endpoints were major adverse limb events (MALE; a composite of major amputation, minor amputation, and reintervention). Results: Five-year AFS and freedom from MALE were 69.8% and 61%, respectively. After multivariate analysis, age (hazard ratio [HR], 1.476; p<0.001), end-stage renal disease (ESRD; HR, 2.340; p<0.001), Rutherford category (RC) 6 (HR, 1.456; p=0.036), and suboptimal EVT (HR, 1.798; p=0.005) were identified as predictors of major amputation or death, whereas smoking (HR, 0.594; p=0.007) was protective. Low body mass index (HR, 1.505; p=0.046), ESRD (HR, 1.648; p=0.001), femoropopliteal lesion (HR, 1.877; p=0.004), RC-6 (HR, 1.471; p=0.008), and suboptimal EVT (HR, 1.847; p=0.001) were predictors of MALE. The highest hazard rates were observed during the first 6 months for both major amputation or death and MALE. After that, the hazard rate decreased and rose again after 3-4 years. Conclusions: In CLTI patients, long-term outcomes of EVT were acceptable. ESRD, RC-6, and suboptimal EVT were common predictors for poor clinical outcomes.

• Korean Circulation Journal
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• v.52 no.4
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• pp.304-319
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• 2022

Background and Objectives: De-escalation of dual-antiplatelet therapy through dose reduction of prasugrel improved net adverse clinical events (NACEs) after acute coronary syndrome (ACS), mainly through the reduction of bleeding without an increase in ischemic outcomes. Whether the benefits of de-escalation are sustained in highly thrombotic conditions such as ST-elevation myocardial infarction (STEMI) is unknown. We aimed to assess the efficacy and safety of de-escalation therapy in patients with STEMI or non-ST-segment elevation ACS (NSTE-ACS). Methods: This is a pre-specified subgroup analysis of the HOST-REDUCE-POLYTECH-ACS trial. ACS patients were randomized to prasugrel de-escalation (5 mg daily) or conventional dose (10 mg daily) at 1-month post-percutaneous coronary intervention. The primary endpoint was a NACE, defined as a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, clinically driven revascularization, stroke, and bleeding events of grade ≥2 Bleeding Academic Research Consortium (BARC) criteria at 1 year. Results: Among 2,338 patients included in the randomization, 326 patients were diagnosed with STEMI. In patients with NSTE-ACS, the risk of the primary endpoint was significantly reduced with de-escalation (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.48-0.89; p=0.006 for de-escalation vs. conventional), mainly driven by a reduced bleeding. However, in those with STEMI, there was no difference in the occurrence of the primary outcome (HR, 1.04; 95% CI, 0.48-2.26; p=0.915; p for interaction=0.271). Conclusions: Prasugrel dose de-escalation reduced the rate of NACE and bleeding, without increasing the rate of ischemic events in NSTE-ACS patients but not in STEMI patients.

• Korean Circulation Journal
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• v.52 no.4
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• pp.324-337
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• 2022

Background and Objectives: Identifying patients with high bleeding risk (HBR) is important when making decisions for antiplatelet therapy strategy. This study evaluated the impact of ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) according to HBR in acute coronary syndrome (ACS) patients treated with drug eluting stents (DESs). Methods: In this post-hoc analysis of the TICO trial, HBR was defined by 2 approaches: meeting Academic Research Consortium for HBR (ARC-HBR) criteria or Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent DAPT (PRECISE-DAPT) score ≥25. The primary outcome was a 3-12 months net adverse clinical event (composite of major bleeding and adverse cardiac and cerebrovascular events). Results: Of the 2,980 patients without adverse events during the first 3 months after DES implantation, 453 (15.2%) were HBR by ARC-HBR criteria and 504 (16.9%) were HBR by PRECISE-DAPT score. The primary outcome rate was higher in HBR versus non-HBR patients (by ARC-HBR criteria: hazard ratio [HR], 2.87; 95% confidence interval [CI], 1.76-4.69; p<0.001; by PRECISE-DAPT score: HR, 3.09; 95% CI, 1.92-4.98; p<0.001). Ticagrelor monotherapy after 3-month DAPT was associated with lower primary outcome rate than ticagrelor-based 12-month DAPT regardless of HBR by ARC-HBR criteria, with similar magnitudes of therapy effect for HBR and non-HBR patients (p-interaction=0.400). Results were consistent by PRECISE-DAPT score (p-interaction=0.178). Conclusions: In ACS patients treated with DESs, ticagrelor monotherapy after 3-month DAPT was associated with lower rate of adverse clinical outcomes regardless of HBR, with similar magnitudes of therapy effect between HBR and non-HBR.

• Korean Circulation Journal
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• v.52 no.3
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• pp.205-217
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• 2022

Background and Objectives: The prognostic value of left atrial (LA) function in terms of long-term clinical outcomes after mitral regurgitation (MR) surgery remains unclear. Therefore, we investigated the impact of preoperative LA global longitudinal strain (LAGLS) on the long-term postoperative clinical outcomes in chronic severe MR patients who underwent mitral valve (MV) repair surgery. Methods: From January 2012 to December 2017, we analyzed 338 patients (mean age, 51.9±12.5 years; 218 males [64.5%]) treated with MV repair surgery for severe MR. The primary outcome was cardiovascular events, defined as the composite of all-cause death, newly developed atrial fibrillation (AF), and re-hospitalization for cardiovascular causes. Results: During a median follow-up of 45 months (interquartile range, 26-65), 30 (8.9%) cardiovascular events, 5 (1.5%) all-cause death, 8 (2.4%) newly developed AF, and 26 (7.7%) re-hospitalizations occurred. On multivariable analysis, baseline LAGLS was an independent predictor of cardiovascular events (adjusted hazard ratio [HR], 0.91; 95% confidential interval [CI], 0.85-0.97; p=0.004) and re-hospitalization (adjusted HR, 0.93; 95% CI, 0.86-1.00; p=0.037). According to the optimal cutoff value of LAGLS, patients with low LAGLS (<23.6%) had a significantly higher risk of cardiovascular events (adjusted HR, 2.70; 95% CI, 1.04-7.00; p=0.041) than those with high LAGLS (≥23.6%). In a subgroup analysis, patients with high LAGLS had better clinical outcomes regardless of whether the patient had a LA volume index <60 mL/m². Conclusions: In patients with chronic severe MR who received successful MV repair surgery, preoperative LAGLS is an independent predictor of long-term postoperative outcomes.

• Korean Circulation Journal
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• v.52 no.7
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• pp.544-555
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• 2022

Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0-3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63-1.24), all-cause death (HR, 0.87; 95% CI, 0.60-1.25), and MI (HR, 1.25; 95% CI, 0.49-3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14-0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

• Journal of the Korean Society of Environmental Restoration Technology
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• v.2 no.1
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• pp.1-9
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• 1999

To find pertinent soil type and maintenance method for artificial planting ground, the effects of soil compositions{sandy loam(S), vermiculite(V), sandy loam+vermiculite+sand(SVS), sandy loam+ carbonized rice husk+sand(SCS), sandy loam+humus sawdust+sand(SHS)}, and fertilizers (organic, chemical) on plant(kentuckyblue grass) growth were measured and compared from the field experiment. The results are summarized as follows 1. the highest germination rate is found from "vermiculite(V)" and the lowest from "sandy loam(S)" among tested 5 soil compositions. 2. "sandy loam+vermiculite+sand(SVS)" composition shows the highest plant height growth effect (5cm growth during tested 3 months) comparing to other 4 compositions. 3. "sandy loam+vermiculite+sand(SYS)" composition shows the highest ground covering rate after first two months, but it concede its order to "sandy loam+humus sawdust+sand(SHS)" composition after next one month growing. 4. the effects of fertilizers are follows 1) Among the blocks where no fertilizer was tried, the predominant height growth was obvious in "sandy loam+carbonized rice husk+sand(SCS)" and "sandy loam+humus sawdust+sand(SHS)" composition. 2) Among the blocks where chemical fertilizer was tried, relatively positive results were found from "vermiculite(V)" and "sandy loam+vermiculite+sand(SYS)" blocks on germination and growth rate. But on the ground coverage ratio, the effect of "sandy loam+carbonized rice husk+sand(SCS)" composite precede that of those 2 composites. 3) Among the blocks where organic fertilizer was tried, "sandy loam+humus sawdust+sand(SHS)" and "vermiculite(V)" blocks show relatively high ground coverage rate, growth rate than others. 4) When compositional differences were not considered, the block where organic fertilizer was tried shows most positive effects on all 3 measurements-germination ratio, height growth and ground covering.

• Composites Research
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• v.12 no.4
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• pp.71-78
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• 1999

To determine the effect of chemical structure of linear amine curing agents on thermal and mechanical properties, standard epoxy resin DGEBA was cured with diaminodiphenyl methane (DDM), diaminodiphenyl sulphone (DDS) in a stoichiometrically equivalent ratio. From this work, the effect of aromatic amine curing agents. In contrast, the results show that the DGEBA/DDS cure system having the sulfone structure between the benzene rings had higher values in the conversion of epoxide, density, shrinkage (%), glass transition temperature, tensile modulus and strength, flexural modulus and strength than the DGEBA/DDM cure system having methylene structure between the benzene rings, whereas the DGEBA/DDM cure system presented higher values in the maximum exothermic temperature, thermal expansion coefficient, and thermal stability. These results are caused by the relative effects of sulfone group having strong electronegativity and methylene group having (+) repulsive property and stem from the effect of the conversion ratio of epoxide group. The result of fractography shows that the each grain size of the DDM/DGEBA system with feather-like structure is larger than that of the DDS/DGEBA system.

• Korean Journal of Food Science and Technology
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• v.41 no.2
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• pp.173-178
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• 2009

Epidemiological studies showed that high trans-fat consumption is closely associated with getting the risks of cardiovascular disease. The objective of this study was to produce trans-free fat through lipase-catalyzed interesterification, as a substitute for the cream margarine commonly used in industry. Optimum conditions for interesterification in a packed bed enzyme bioreactor (PBEB) were determined using response surface methodology (RSM) based on central composite design. Three kinds of reaction variables were chosen, such as substrate flow rate (0.4-1.2 mL/min), reaction temperature (60-70$^{\circ}C$), and ratio of fully hydrogenated canola oil (FHCO, 35-45%) to evaluate their effects on the degree of interesterification. Optimum conditions from the standpoint of solid fat content (SFC) were found to be as follows: 0.4 mL/min flow rate, 64.7$^{\circ}C$ reaction temperate, and 42.8% (w/w) ratio of FHCO, respectively. The half-life of immobilized lipase in PBEB with two stages at 60$^{\circ}C$ ($1^{st}$ stage) and 55$^{\circ}C$ ($2^{nd}$ stage) was about more than 30 days as estimated by extrapolating the incubation time course of tristearoyl glycerol (TS) conversion, whereas the half-life of the enzyme in PBEB with single stage at 65$^{\circ}C$ was only about 15 days. Finally, the results from SFC analysis suggest that trans-free fat produced in this study seems to be a suitable substitute for the cream margarine commonly used in industry.

• Korean Chemical Engineering Research
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• v.44 no.6
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• pp.650-658
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• 2006

The recycling of TDA from solid waste of TDI plant(TDI-R) by near-critical hydrolysis reaction had been studied by means of a statistical design of experiment. The main and interaction effects of process variables had been defined from the experiments in a batch reactor and the correlation equation with process variables for TDA yield had been obtained from the experiments in a continuous pilot plant. It was confirmed that the effects of reaction temperature, catalyst type and concentration, and the weight ratio of water to TDI-R(WR) on TDA yield were significant. TDA yield decreased with increases in reaction temperature and catalyst concentration, and increased with an increase in WR. As a catalyst, NaOH was more effective than $Na_2CO_3$ for TDA yield. The interaction effects between catalyst concentration and temperature, WR and temperature, catalyst type and reaction time on TDA yield had been defined as significant. Although the effect of catalyst concentration on TDA yield at $300^{\circ}C$ as subcritical water was insignificant, the TDA yield decreased with increasing catalyst concentration at $400^{\circ}C$ as supercritical water. On the other hand, the yield increased with an increase in WR at $300^{\circ}C$ but showed negligible effect with WR at $400^{\circ}C$. The optimization of process variables for TDA yield has been explored with a pilot plant for scale-up. The catalyst concentration and WR were selected as process variables with respect to economic feasibility and efficiency. The effects of process variables on TDA yield had been explored by means of central composite design. The TDA yield increased with an increase in catalyst concentration. It showed maximum value at below 2.5 of WR and then decreased with an increase in WR. However, the ratio at which the TDA yield showed a maximum value increased with increasing catalyst concentration. The correlation equation of a quadratic model with catalyst concentration and WR had been obtained by the regression analysis of experimental results in a pilot plant.

• Composites Research
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• v.34 no.3
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• pp.192-198
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• 2021

Due to enormous market growing of electric vehicles without combustion engine, reducing unwanted BSR (buzz, squeak, and rattle) noise is highly demanded for vehicle quality and performance. Particularly, innerbelt weatherstrips which not only block wind noise, rain, and dust from outside, but also reduce noise and vibration of door glass and vehicle are required to exhibit high damping properties for improved BSR performance of the vehicle. Thermoplastic elastomers (TPEs), which can be recycled and have lighter weight than thermoset elastomers, are receiving much attention for weatherstrip material, but TPEs exhibit low material damping and compression set causing frictional noise and vibration between the door glass and the weatherstrip. In this study, high damping EPDM (ethylene-propylene-diene monomer)/PP (polypropylene) thermoplastic vulcanizates (TPV) were investigated by varying EPDM/PP ratio and ENB (ethylidene norbornene) fraction in EPDM. Viscoelastic properties of TPV materials were characterized by assuming that the material damping is directly related to the viscoelasticity. The optimum material damping factor (tanδ peak 0.611) was achieved with low PP ratio (14 wt%) and high ENB fraction (8.9 wt%), which was increased by 140% compared to the reference (tanδ 0.254). The improved damping is believed due to high fraction of flexible EPDM chains and higher interfacial slippage area of EPDM particles generated by increasing ENB fraction in EPDM. The stick-slip test was conducted to characterize frictional noise and vibration of the TPV weatherstrip. With improved TPV material damping, the acceleration peak of frictional vibration decreased by about 57.9%. This finding can not only improve BSR performance of electric vehicles by designing material damping of weatherstrips but also contribute to various structural applications such as urban air mobility or aircrafts, which require lightweight and high damping properties.