• Journal of Chest Surgery
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• v.52 no.5
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• pp.376-379
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• 2019

Concomitant Loeys-Dietz syndrome (LDS) and hematologic malignancies are exceptionally rare. This is the first report of a patient operated on for aortic root dilation who had been previously diagnosed with LDS and B-cell-lymphoma. After completion of chemotherapy and complete remission, an elective valve-sparing aortic root replacement (using the David-V method) was performed. Due to the positive family history, preoperative genetic counseling was conducted, and revealed LDS with a TGFBR1 (transforming growth factor beta receptor type I) mutation in 6 probands of the family, albeit in 1 of them posthumously. This missense mutation has been previously described in relation to aortic dissection, but a causative relationship to malignancy has so far neither been proposed nor proven.

• BMB Reports
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• v.50 no.4
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• pp.208-213
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• 2017

Vascular endothelial growth factor (VEGF) is an essential cytokine that has functions in the formation of new blood vessels and regression of cardiac hypertrophy. VEGF/VEGF-receptor-1 (VEGFR1) signaling plays a key role in the regression of cardiac hypertrophy, whereas VEGF/VEGFR2 signaling leads to cardiac hypertrophy. In this study, we identified the prohypertrophic role of miR-374 using neonatal rat ventricular myocytes (NRVMs). Our results showed that overexpression of miR-374 activated G protein-coupled receptor-mediated prohypertrophic pathways by the inhibition of VEGFR1-dependent regression pathways. Luciferase assays revealed that miR-374 could directly target the 3'-untranslated regions of VEGFR1 and cGMP-dependent protein kinase-1. Collectively, these findings demonstrated that miR-374 was a novel pro-hypertrophic microRNA functioning to suppress the VEGFR1-mediated regression pathway.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.309-319
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• 2007

Chest pain is classified into two major categories of cardiac chest pain and non-cardiac chest pain. Cardiac chest pain is caused by cardiovascular disease, for example, myocardial infarction, angina pectoris, valvular heart disease, cardiac enlargement or hypertrophy, dissecting aortic aneurysm, pericarditis, myocarditis, etc. When the chest pain is not attributed to heart disease, it is termed non-cardiac chest pain. Non-cardiac chest pain is caused by pulmonary, gastrointestinal, musculoskeletal disease, psychiatric factor, etc. In tills case, we treated a 54-year old female patient who was diagnosed with dilated cardiomyopathy and suspicious sick sinus syndrome. She complained of chest pain, exertional dyspnea, dizziness and headache. For treatment, we made use of Yugultangami(六鬱湯加味) and Daejobwan(大造丸). Before and after treatment, we measured Heart rate variability(HRV). In result, the clinical symptoms were improved and there was a significant increase in assessmeut by Heart rate variability(HRV). Tills result suggests that Yugultaugami aud Daejowhan have a good effect on cardiac chest pain.

• BMB Reports
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• v.53 no.2
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• pp.118-123
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• 2020

Cardiac regeneration with adult stem-cell (ASC) therapy is a promising field to address advanced cardiovascular diseases. In addition, extracellular vesicles (EVs) from ASCs have been implicated in acting as paracrine factors to improve cardiac functions in ASC therapy. In our work, we isolated human cardiac mesenchymal stromal cells (h-CMSCs) by means of three-dimensional organ culture (3D culture) during ex vivo expansion of cardiac tissue, to compare the functional efficacy with human bone-marrow derived mesenchymal stem cells (h-BM-MSCs), one of the actively studied ASCs. We characterized the h-CMSCs as CD90^low, c-kit^negative, CD105^positive phenotype and these cells express NANOG, SOX2, and GATA4. To identify the more effective type of EVs for angiogenesis among the different sources of ASCs, we isolated EVs which were derived from CMSCs with either normoxic or hypoxic condition and BM-MSCs. Our in vitro tube-formation results demonstrated that the angiogenic effects of EVs from hypoxia-treated CMSCs (CMSC-Hpx EVs) were greater than the well-known effects of EVs from BM-MSCs (BM-MSC EVs), and these were even comparable to human vascular endothelial growth factor (hVEGF), a potent angiogenic factor. Therefore, we present here that CD90^lowc-kit^negativeCD105^positive CMSCs under hypoxic conditions secrete functionally superior EVs for in vitro angiogenesis. Our findings will allow more insights on understanding myocardial repair.

• Proceedings of the KSAR Conference
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• 2003.06a
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• pp.76-76
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• 2003

Pluripotent embryonic stem cells can differentiate into beating cardiomyocytes with proper culture conditions and stimulants via embryo-like aggregates. We describe here the use of mouse embryonic stem (mES03) cells as a reproducible differentiation system for cardiomyocyte. mES03 cells growing in colonies were dissociated and allowed to re-aggregated in suspension [embryoid body (EB) formation〕. To induce cardiomyocytic differentiation, cells were exposed to 0.75% dimethyl sulfoxide (DMSO) during EB formation for 4 days and then another 4 days without DMSO (4+/4-). Thus treated EB was plated onto gelatin-coated dishes for differentiation. Spontaneously contracting colonies which appeared in approximately 4~5 days upon differentiation were mechanically dissected, enzymatically dispersed, plated onto coverslips, and then incubated for another 48~72 hrs. By RT-PCR, robust expression of cardiac myosin heavy chain $\alpha$, cardiac muscle heavy polypeptide 7 $\beta$($\beta$-MHC), cardiac transcription factor GATA4, and skeletal muscle-specific $\alpha$$_1$-subunit of the L-type calcium channel ($\alpha$$_1$CaC $h_{sm}$ ) were detected as early as 8 days after EB formation, but message of cardiac muscle-specific $\alpha$$_1$-subunit of the L-type calcium channel ($\alpha$$_1$CaCh) were reveled at a low level. In contrast, expression of myosin light chain (MLC-2V) and atrial natriuretic factor (ANF) were not detected during EB formation for 8 days. However, a strong expression of the atrial-specific ANF gene was expressed from day 8 onward, which were remained constant in EB. (cardiac specialization and terminal differentiation stage). Electrophysiological examination of spontaneously contracting cells showed ventricle-like action potential 17 days after the EB formation. This study indicates that mES03 cell-derived cardiomyocytes via 4+/4- protocol displayed biochemical and electrophysiological properties of subpopulation of cardiomyocytes.

• Biomedical Science Letters
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• v.19 no.1
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• pp.61-69
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• 2013

The aim of this study was to evaluate the effect of exercise-based cardiac rehabilitation on pro- and anti-inflammatory markers in patients with acute coronary syndrome (ACS). ACS patients who underwent percutaneous coronary intervention (PCI) and took medicine during phase II of rehabilitation were recruited for study. Subjects were divided into two groups; exercise group (EX, n=21) and a non-exercise group (non-EX, n=13). Supervised exercise program in hospital consisted of treadmill and bicycle exercise was performed three times per week for 6 weeks. Patients of EX received individual counseling, including knowledge of heart disease, risk factor modification, and physical training. Cardiopulmonary fitness, body composition, and biochemical blood factors were analyzed before and after experiment. There was no significant difference in serum levels of hs-CRP and TGF-${\beta}1$ between groups, and between time intervals. But there was a significant decrease in serum levels of IL-18 (P<.001). And there was a significant increase in ratio of IL-18 to IL-10 (P<.01) and serum levels of IL-10 (P<.001). After cardiac rehabilitation, there was significant increase in exercise duration (P<.001), maximal oxygen uptake ($VO_{2peak}$; P<.001) and decrease in submaximal rate-pressure product (sRPP; P<.05) in EX. In conclusion, exercise-based cardiac rehabilitation during phase II in patients with ACS after PCI decreased serum IL-18 (pro-inflammatory) content and ratio of IL-18 to IL-10 in serum (highly related with disease recurrence), and increased serum IL-10 (anti-inflammatory) content. In addition, it led to improved cardiopulmonary fitness.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.463-475
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• 2000

The purpose of the study was to identify the effects of inpatient cardiac rehabilitation programs on motivation, the performance of health behavior, and quality of life in patients with coronary artery disease. The subjects consisted of 31 patients who participated in the rehabilitation program during their hospital stay, and were compared with 34 patients who did not participate. The study results are as follows: 1. The mean of cardiac risk factor scores for the subjects was 22.5 (SD = 5.5) at the level of low to moderate risk with some possibility to improve. The physiological and behavioral risk factors for the subjects were also in the normal range or slightly above the normal range. 2. The motivation level to preform health behaviors for both groups was improved after discharge. Also, perceived self-efficacy was significantly higher for the program participants than for the comparison group at the post-test. 3. The performance of cardiac related health behaviors improved for both groups after discharge, but there were no significant differences between the two groups. The program participants reported better performance in most health behaviors at the post-test, but the results failed to reach a statistical significant level. 4. As for motivation and health behavior, the subjects in the both groups showed an improved quality of life after the discharge. In addition, the program participants produced significantly higher scores in health and functioning dimension than the comparison group during the post-test. In conclusion, the study partially supported the effects of the inpatient cardiac rehabilitation program to motivate and improve the quality of life, and provide the need to apply early rehabilitation interventions for the patients after cardiac events. Further study with a longitudinal design is also suggested to verify the effect of cardiac rehabilitation program from hospitalization to discharge and subsequently to fully recover to the level of pre-hospitalized state.

• Journal of Korean Academy of Nursing
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• v.50 no.2
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• pp.159-177
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• 2020

Purpose: This study aimed at identifying factors related to persistent postoperative pain after cardiac surgery and estimating their effect sizes. Methods: The literature search and selection was conducted in four different databases (CINAHL, Cochrane Library, PubMed, and PQDT) using the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. A total of 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, R was used to analyze 30 effect sizes of for both individual and operative factors as well as publication biases from a total of nine studies. Results: The meta-analysis revealed that persistent postoperative pain after cardiac surgery was related to one individual factor (gender) and two operative factors (acute postoperative pain and use of the internal mammary artery). Operative factors (OR=5.26) had a larger effect size than individual factors (OR=1.53). Conclusion: Female gender, acute pain after surgery, and use of the internal mammary artery are related factors to persistent postoperative pain. The development of interventions focusing on modifiable related factors, such as acute postoperative pain, may help to minimize or prevent PPP after cardiac surgery.

• Molecules and Cells
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• v.40 no.1
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• pp.66-72
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• 2017

Pathological hypertrophy of the heart is closely associated with endoplasmic reticulum stress (ERS), leading to maladaptations such as myocardial fibrosis, induction of apoptosis, and cardiac dysfunctions. Salubrinal is a known selective inhibitor of protein phosphatase 1 (PP1) complex involving dephosphorylation of phospho-eukaryotic translation initiation factor 2 subunit $(p-eIF2)-{\alpha}$, the key signaling process in the ERS pathway. In this study, the effects of salubrinal were examined on cardiac hypertrophy using the mouse model of transverse aortic constriction (TAC) and cell model of neonatal rat ventricular myocytes (NRVMs). Treatment of TAC-induced mice with salubrinal ($0.5mg{\cdot}kg^{-1}{\cdot}day^{-1}$) alleviated cardiac hypertrophy and tissue fibrosis. Salubrinal also alleviated hypertrophic growth in endothelin 1 (ET1)-treated NRVMs. Therefore, the present results suggest that salubrinal may be a potentially efficacious drug for treating pathological cardiac remodeling.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.451-457
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• 2014

Background: The balance of the risks and the benefits of cardiac surgery in the elderly remains a major concern. We evaluated the early and mid-term clinical results of patients aged over 75 years who underwent major cardiovascular surgery. Methods: Two hundred and fifty-one consecutive patients, who underwent cardiac surgery at Seoul National University Bundang Hospital between July 2003 and June 2011, were included in this study (mean age, $78.7{\pm}3.4$ years; male:female=130:121). Elective surgery was performed in 112 patients, urgent in 90, and emergency in 49. Results: Early mortality was 12.7% (32/251). Follow-up completion was 100%, and the mean follow-up duration was $2.8{\pm}2.2$ years. Late mortality was 24.2% (53/219). There were 283 readmissions in a total of 109 patients after discharge. However, the reason for readmission was related more to non-cardiac factors (71.3%) than to cardiac factors. The overall survival estimates were 79.2% at the 1-year follow-up and 58.4% at the 5-year follow-up. Patients who underwent elective surgery had a lower early mortality rate (elective, 4.5%; urgent, 13.3%; emergency, 30.6%) and better overall survival rate than those that underwent urgent or emergency surgery (p<0.001). Conclusion: The timing of cardiac surgery was found to be an independent risk factor for early and late mortality. Thus, earlier referral and intervention may improve operative results. Further, comprehensive coordinated postoperative care is needed for other comorbid problems in aged patients.