• Korean Circulation Journal
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• v.52 no.8
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• pp.563-575
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• 2022

Hypertrophic cardiomyopathy (HCM) is one of the most common inheritable cardiomyopathies. Contemporary management strategies, including the advent of implantable cardioverter-defibrillators and effective anticoagulation, have substantially improved the clinical course of HCM patients; however, the disease burden of HCM is still high in Korea. Sudden cardiac death (SCD), atrial fibrillation and thromboembolic risk, dynamic left ventricular outflow tract (LVOT) obstruction, and heart failure (HF) progression remain important issues in HCM. SCD in HCM can be effectively prevented with implantable cardioverter-defibrillators. However, appropriate patient selection is important for primary prevention, and the 5-year SCD risk score and the presence of major SCD risk factors should be considered. Anticoagulation should be initiated in all HCM patients with atrial fibrillation regardless of the CHA2DS2-VASc score, and non-vitamin K antagonist oral anticoagulants are the first option. Symptomatic dynamic LVOT obstruction is first treated medically with negative inotropes, and if symptoms persist, septal reduction therapy is considered. The recently approved myosin inhibitor mavacamten is promising. HF in HCM is usually related to diastolic dysfunction, while about 5% of HCM patients show reduced left ventricular ejection fraction <50%, also referred to as "end-stage" HCM. Myocardial fibrosis plays an important role in the progression to advanced HF in patients with HCM. Patients who do not respond to guideline-directed medical therapy can be considered for heart transplantation. The development of imaging techniques, such as myocardial deformation on echocardiography and late gadolinium enhancement on cardiac magnetic resonance, can provide better risk evaluation and decision-making for management strategies in HCM.

• Archives of Craniofacial Surgery
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• v.25 no.4
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• pp.179-186
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• 2024

Background: Auricle reconstruction is among the most challenging procedures in plastic and reconstructive surgery, and the choice of framework material is a critical decision for both surgeons and patients. This meta-analysis compared the outcomes of autologous auricle reconstruction using costal cartilage with those of alloplastic reconstruction using porous polyethylene implants. Methods: A literature review was conducted using the PubMed and Embase databases to retrieve articles published between January 2000 and June 2024. The outcomes analyzed included postoperative complications such as framework exposure, infection, skin necrosis, hematoma, and hypertrophic scars, as well as patient satisfaction. The proportions of reconstructive outcomes from each selected study were statistically analyzed using the "metaprop" function in R software. Results: Fourteen articles met our inclusion criteria. The group undergoing polyethylene implant reconstruction exhibited higher rates of framework exposure, infection, and skin necrosis, whereas the autologous reconstruction group experienced higher rates of hematoma and hypertrophic scars. Of all the complications, framework exposure was the only one to show a statistically significant difference between the two groups (p< 0.0001). In terms of patient satisfaction, those who underwent autologous cartilage reconstruction reported a higher rate of satisfaction, although this difference did not reach statistical significance in the meta-analysis (p= 0.076). Conclusion: There is no statistically significant difference in postoperative complications such as infection, hematoma, skin necrosis, and hypertrophic scars between auricle reconstructions using autologous costal cartilage and those using polyethylene implants. However, reconstructions with polyethylene implants show a significantly higher rate of framework exposure.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.269-276
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• 1997

Purpose : To evaluate the effects of surgical excision followed by radiation therapy for Prevention of keloids and hypertrophic scars. Materials and Methods : From October 1987 to April 1995, radiation therapy was applied to 167 sites in 106 patients with surgical excision in an attempt to prevention of recurrence against keloids and hypertrophic scars. The main etiology of the keloids and hypertrophic scars were surgery in $49.2\%,\;trauma\;in\;25.0\%,\;ear-piercing\;in\;5.4\%,\;and\;burn\;in\;5.4\%$, The Patients' ages ranged from 3 to 70 years with a median of 32 years. Radiation therapy used ranged from 6 to 8MeV electron beam. Radiation therapy was delivered within 24 hours of surgical excision. Several dose schedules were used, varing from 400cGy in 1 daily fraction to 1900cGy in 4 daily fractions. The average total dose was 1059cGy, and the average dose per fraction was 433cGy. All patients were followed up from 24 to 114 months with a median follow up of 49 months. Results : The overall recurrence rate was $12.6\%$ (21/167) The overall 1-year and 2-year recurrence rates were $10.2\%\;and\;11.4\%$, respectively Among 21 recurrent sites, seventeen sites $(81\%)$ were confirmed within 12 months after surgical excision. Period to recurrence ranged from 1 month to 47 months with a median recurrence time of 9.6 months, The history of previous therapy was only a significant factor in recurrence. Twenty-four patients had history of previous therapy recurrence rates was significantly higher in this group than those without history of Previous therapy $(22.6\%\;vs.\;11.0\%,\;p=0.04)$. There was no serious complication related to radiation therapy. Conclusion : This study suggests that surgical excision followed by radiation therapy is an effective method of preventing keloids and hypertrophic scars.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1389-1396
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• 2002

Purpose : This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. Methods : We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. Results : The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be $4.95{\pm}0.99mm$($mean{\pm}SD$), pyloric diameter $14.42{\pm}2.64mm$, and pyloric length $20.17{\pm}3.92mm$. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was $5.11{\pm}1.01mm$, pyloric diameter $15.01{\pm}2.47mm$, and pyloric length $22.32{\pm}3.43mm$. Conclusion : There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.

• Journal of Ecology and Environment
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• v.40 no.1
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• pp.66-74
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• 2016

Background: When developing water quality improvement strategies for eutrophic lakes, questions may arise about the relative importance of point sources and nonpoint sources of phosphorus. For example, there is some skepticism regarding the effectiveness of partial reductions in phosphorus loading; because phosphorus concentrations are too high in hypertrophic lakes, in-lake phosphorus concentrations might still remain within typical range for eutrophic lakes even after the reduction of phosphorus loading. For this study, water quality and the phytoplankton and zooplankton communities were monitored in a hypertrophic reservoir (Lake Wangsong) before and after the reduction of phosphorus loading from a point source (a sewage treatment plant) by the installation of a chemical phosphorus-removal process. Results: Before phosphorus removal, Lake Wangsong was classified as hypertrophic with a median phosphorus concentration of $0.232mg\;L^{-1}$ and a median chlorophyll-a concentration of $112mg\;L^{-1}$. The dominant phytoplankton were filamentous cyanobacteria for the most of the ice-free season. Following the installation of the advanced treatment process, phosphorus concentrations were reduced to $81mg\;L^{-1}$, and the N/P atomic ratio increased from 42 to 102. Chlorophyll-a concentrations decreased to $42{\mu}g\;L^{-1}$, and the duration of cyanobacterial dominance was confined to the summer season. Cyanobacteria in spring and autumn were replaced by diatoms and cryptomonads. Filamentous cyanobacteria in summer were replaced by colony-forming unicellular Microcystis spp. It was remarkable that zooplankton biomass increased despite the decrease in phytoplankton biomass, and especially cladoceran zooplankton which increased drastically. These responses to the reduction of point source P loading to Lake Wangsong imply that reducing the point source P loading can have a big impact even when nonpoint sources account for a large fraction of the total annual phosphorus loading. Conclusions: Our results also show that the phytoplankton community can shift to decreased cyanobacterial dominance and the zooplankton community can shift to higher cladoceran dominance, even when phosphorus concentrations remain within the typical range for eutrophic lakes following the reduction of phosphorus loading.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.775-778
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• 2006

Hypertrophic cardiomyopathy is characterized by inappropriate hypertrophy of the myocardium and is associated with various clinical presentations ranging from complete absence of symptoms to sudden, unexpected death. These are caused by dynamic obstruction of the left ventricular outflow tract and surgical approaches were initiated. But, the complete resection of hypertrophied midventricular septum is impossible by standard, transaortic approach, because of narrow vision and limited approach. And it leads to inadequate excision, will leave residual left ventricular out-flow tract obstruction or systolic anterior motion of mitral leaflet, and limit symptomatic improvement and patient's survival. We report a case of extended septal myectomy for hypertrophic cardiomyopathy of mid-septum in a child. The extended septal myectomy was performed by aortotomy and left ventricular apical incision, and made possible the complete resection of mid-ventricular septum, abnormal papillary muscles and chordae. The patient's symptom was improved and the postoperative course was uneventful.

• The korean journal of orthodontics
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• v.34 no.2 s.103
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• pp.143-152
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• 2004

It has not been elucidated whether the initiation of condylar development of the mandible is related with the periosteum of the mandible, or if it derives from a separate programmed blastema not related with the mandible. Also, although the mandibular condylar cartilage is known to promote growth, few studies have dealt with molecular-biologic mechanisms such as the expression of specific genes according to the differentiation of the mandibular condyle. To elucidate the unique cellular characteristics, development, and differentiation process of the mandibular condyle, an examination of expressions of genes characteristic of cartilage and bone were carried out using RT-PCR and mRNA in situ hybridization. 1. Type? collagen mRNA was detected with type II collagen mRNA in the differentiation and growth process of the cartilage of the mandibular condyle. TypeII collagen mRNA was demonstrated in the whole resting md upper part of the poliferative zone, whereas type II collagen mRNA was observed in the resting, proliferative and upper hypertrophic cartilage zone of the mandibular condyle. 2. The condylar cartilage rapidly increased in size due to the accumulation of hypertrophic chondrocytes as characterized by the expression of type II collagen mRNA during postnatal development. 3. BMP-4 mRNA was present in the anlage of the future condylar process and also in the ossifying mandibular body. 4. IHH mRNA was limited exclusively to the lower part of the proliferative zone and the upper part of the hypertrophic cartilage zone during condylar development. These findings were different from those in the growth-plate cartilage of the long bone, indicating a characteristic feature of the differentiation of the chondrocytes in the condylar cartilage present in prenatal and postnatal development. Furthermore, it was also suggested that chondroblasts of condylar cartilage rapidly differentiate into hypertrophic chondrocytes with increased functional Load force such as muscle activity and mastication.

• Proceedings of the Zoological Society Korea Conference
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• 1996.10a
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• pp.125.2-125
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• 1996

No Abstract, See Full Text

• Journal of Cardiovascular Imaging
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• v.31 no.4
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• pp.217-219
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• 2023

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.641-646
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• 2007

Purpose: Lateral canthoplasty is utilized in aesthetic surgery to lengthen the lateral palpebral fissure of the lateral canthal area. However, complication such as recurrence, contour deformity or hypertrophic scar make its results doubtful. Therefore, we developed lateral canthoplasty with lateral canthotomy and Y-V advancement to effectively lengthen the palpebral fissure without recurrence. Methods: A total number of 117 patients were reviewed from March 1991 to April 2005. The operative procedure was lateral canthoplasty with lateral canthotomy and Y-V advancement. To prevent recurrence, we dissected lateral conjunctiva of lower eyelid. The author believes that by this procedure, V flap would be able to advance laterally without tension. Results: We performed lateral canthoplasty in 117 patients. There were no recurrence and patients were satisfied with the results. There were 12 patients who presented with complication. Complication included hypertrophic scar in 4 patients, web formation in 3 patients and over-correction in 5 patients. Conclusion: Lateral canthoplasty with lateral canthotomy and simple Y-V advancement may be used as an effective method to lengthen palpebral fissure without recurrence.