• Korean Circulation Journal
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• 제54권8호
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• pp.468-481
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• 2024

Background and Objectives: Although the clinical consequences of advanced heart failure (HF) may be similar across different etiologies of cardiomyopathies, their proteomic expression may show substantial differences in relation to underlying pathophysiology. We aimed to identify myocardial tissue-based proteomic characteristics and the underlying molecular pathophysiology in non-ischemic cardiomyopathy with different etiologies. Methods: Comparative extensive proteomic analysis of the myocardium was performed in nine patients with biopsy-proven non-ischemic cardiomyopathies (3 dilated cardiomyopathy [DCM], 2 hypertrophic cardiomyopathy [HCM], and 4 myocarditis) as well as five controls using tandem mass tags combined with liquid chromatography-mass spectrometry. Differential protein expression analysis, Gene Ontology (GO) analysis, and Ingenuity Pathway Analysis (IPA) were performed to identify proteomic differences and molecular mechanisms in each cardiomyopathy type compared to the control. Proteomic characteristics were further evaluated in accordance with clinical and pathological findings. Results: The principal component analysis score plot showed that the controls, DCM, and HCM clustered well. However, myocarditis samples exhibited scattered distribution. IPA revealed the downregulation of oxidative phosphorylation and upregulation of the sirtuin signaling pathway in both DCM and HCM. Various inflammatory pathways were upregulated in myocarditis with the downregulation of Rho GDP dissociation inhibitors. The molecular pathophysiology identified by extensive proteomic analysis represented the clinical and pathological properties of each cardiomyopathy with abundant proteomes. Conclusions: Different etiologies of non-ischemic cardiomyopathies in advanced HF exhibit distinct proteomic expression despite shared pathologic findings. The benefit of tailored management strategies considering the different proteomic expressions in non-ischemic advanced HF requires further investigation.

• Korean Circulation Journal
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• 제52권8호
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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.

• Korean Circulation Journal
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• 제52권10호
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• pp.785-794
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• 2022

Background and Objectives: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Methods: Self-Monitoring of blood pressure and Feed-back using APP in Treatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. Conclusions: SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension.

• 대한한방부인과학회지
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• 제26권4호
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• pp.123-139
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• 2013

Purpose: Cold hypersensitivity is regarded to be associated with blood circulation. This study is aims to evaluate the effects and safety of oxygen chamber therapy on cold hypersensitivity by comparing the temperature and Visual Analogue Scale. Methods: 42 outpatients who visited ${\bigcirc}{\bigcirc}$ University Oriental Hospital from July 11th, 2013 to August 28th, 2013 were analyzed. Patients were subjected to thermometer, and those with thermal difference greater than $0.3^{\circ}C$ between upper arm and palm and also with more than VAS 4 of cold hypersensitivity were diagnosed with cold hypersensitivity. 42 outpatients diagnosed with cold hypersensitivity are divided into two groups, one is the experimental group consisted of 21 patients and other was control group consisted of 21 patients. The experimental group had oxygen chamber therapy 10 times for 4 weeks. Thereafter the effects of oxygen chamber therapy on cold hypersensitivity was analyzed with t-text using SPSS for Windows version 21. Results: After the oxygen chamber therapy, experimental group had considerable improvement on cold hypersensitivity, in consequence of decreasing rate of thermal difference and VAS of cold hypersensitivity. Ear deafness and hand numbness were reported as an adverse effects in experimental group, but there was no serious adverse effects. Conclusions: This clinical trial showed oxygen chamber therapy could be effective and safe to reduce cold hypersensitivity.

• 한국결정성장학회지
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• 제8권3호
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• pp.454-462
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• 1998

AUC 침전과정중 AUC 입차를 둥글게 제조하는 조건과 기구를 조사하였다. 둥근 AUC 제조는 교반기를 이용한 내부순환 시는 불가능했으나 펌프를 사용한 외부순환 시는 가능했다. 둥근 AUC 제조속도($dn_p$/dt)는 침전조건인 슬러리 밀도($M_t:U/l)$, 슬러리 회전율($T_o$:turn-over ratio), 임펠러 속도(U:Impelle tip velocity)에 비례하여 관계식을 $ dn_p/dt{\propto}M_t{\cdot}T_o{\cdot}U^2$로 표기할 수 있었으며, 이 속도식은 실험결과와 정성적으로 일치하였다. 그리고 두 개의 둥근 AUC 제조 기구가 제시되었는데, 하나는 균일형성기구이고 다른 하나는 etch-pit 형성기구이다. 전자는 AUC 침전과정에서 초기에 발생되고 후자는 침전과정 말기에 발생되는 것으로 확인되었다.

• 동의생리병리학회지
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• 제18권5호
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• pp.1285-1290
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• 2004

From a view point of Hyungsang medicine a study is made on depressive syndromes through 'Donguibogam(東醫寶鑑)' ,'Clinical lectures by Mr. Jeesan(芝山先生 臨床學特講)' and other literature. Depressed energy(?) originally meant the disorder of vital energy in the circulation of nature with the lapse of time. In later, it has been changed to mean the disease of man, especially related to the mind. Depressive syndromes come from the stagnation of the Ki or the abnormal circulation(rising, falling, coming and going), which happens when man cannot adjust oneself to the circumstances due to the disharmony between internal and external conditions. Depressive syndrome easily attacks the following types of persons; Dam type person with excessive Ki and deficient Hyung(形), manly woman, womanly man, Bird type person who shows a great variety of emotion, Turtle type person declined to melancholy, Ki type person apt to be depressive, and Shin type person with upward gush of the fire. It also attacks the persons who have smudgy face with the scar between eyebrows, those whose pulses are mixture of two different kinds and those whose pulses extend on two ranges in Jeesan's diagram. Depressive syndromes recorded in 'Donguibogam' are globus hystericus, chest congestion, gastric discomfort, cough and asthma caused by depressed Ki, abdominal mass, edema, and tympanites. The most effective prescriptions for depressive syndromes are Eajintang(二陳湯), Guibitang(歸脾湯), Hyangsosan(香蘇散), and Gamisachiltang(加味四七湯).

• 혜화의학회지
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• 제8권2호
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• pp.317-327
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• 2000

Through the study about Che-Qi-Jung(諸氣證) concerned with phenomenon of stress, we concluded as fallow. 1. Stressors are recognized three parts, internal cause, external cause, non-interexternal cause, in the oriental medicine. And the reaction of the body about stressors, was expressed change of Qi(氣). 2. The vascular system and autonomic nervous system are tensed or relexed. Because the etiology of Yuk-Em(六淫), Chil-Jeong(七情) make lose up and down, in and out, circulation of Gi(氣). The symtom caused with stress are explained, divided into Chil-Qi(七氣), Gu-Qi(九氣), Joong-Qi(中氣), Qi-Tong(氣痛), Qi-Yuk(氣逆), Qi-Wool(氣鬱). 3. The symtom of Chil-Qi is recognized into psycholoQical stress and Mae-Haek-Qi(梅核氣). The symtom of Gu-Qi is composed of Chil-Qi and Han(寒), Youl(熱), Ro(勞). 4. The symtoms of Qi-Yuk and Joong-Qi are caused by the ascent of Hwa-Qi(火氣). And Hwa-Qi is made by rage and depression. Qi-Yuk is chronic symtom that the ascent of Hwa-Qi is made by out of function in up and down mechanism of Qi. Joong-Qi is acute symtom that patholoQical state of Qi-Yuk take place for a while by sudden psycholoQical shock. 5. The symtom of Qi-Wool is loss of funtion made by depressed state in physioloQical mechanism, and Qi-Wool is observed in depressive psychosis and hypochondriasis and psychogenic. 6. The symtom of Qi-Tong is the pain caused by interference of circulation of Qi-Hyul(氣血). PsycholoQical stimulation such as rage and depression, tense autonomic nervous system. This make convulsion in gastro-intestine or vascular circuluation or abdominal muscles, and the pain is caused by convulsion.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.116-123
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• 2008

Objective : The objective of this study is to investigate clinical characteristics, management methods and possible causes of intracranial fusiform aneurysm. Methods : Out of a series of 2,458 intracranial aneurysms treated surgically or endovascularly, 22 patients were identified who had discrete fusiform aneurysms. Clinical presentations, locations, treatment methods and possible causes of these aneurysms were analyzed. Results : Ten patients of fusiform aneurysm were presented with hemorrhage, 5 patients with dizziness with/without headache, 4 with ischemic neurologic deficit, and 1 with 6th nerve palsy from mass effect of aneurysm. Two aneurysms were discovered incidentally. Seventeen aneurysms were located in the anterior circulation, other five in the posterior circulation. The most frequent site of fusiform aneurysm was a middle cerebral artery. The aneurysms were treated with clip, and/or wrapping in 7, resection with/without extracranial-intracranial (EC-IC) bypass in 6, proximal occlusion with coils with/without EC-IC bypass in 5, EC-IC bypass only in 1 and conservative treatment in 3 patient. We obtained good outcome in 20 out of 22 patients. The possible causes of fusiform aneurysms were regard as dissection in 16, atherosclerosis in 4 and collagen disease or uncertain in 2 cases. Conclusion : There is a subset of cerebral aneurysms with discrete fusiform morphology. Although the dissection or injury of internal elastic lamina of the cerebral vessel is proposed as the underlying cause for most of fusiform aneurysm, more study about pathogenesis of these lesions is required.

• 대기
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• 제24권2호
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• pp.131-140
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• 2014

The "Barents Oscillation (BO)", first designated by Paul Skeie (2000), is an anomalous recurring atmospheric circulation pattern of high relevance for the climate of the Nordic Seas and Siberia, which is defined as the second Emperical Orthogonal Function (EOF) of monthly winter sea level pressure (SLP) anomalies, where the leading EOF is the Arctic Oscillation (AO). BO, however, did not attracted much interest. In recent two decades, variability of BO tends to increase. In this study, we analyzed the spatio-temporal structures of Atmospheric internal modes such as Arctic Oscillation (AO) and Barents Oscillation (BO) and examined how these are related with Arctic warming in recent decade. We identified various aspects of BO, not dealt in Skeie (2000), such as upper-level circulation and surface characteristics for extended period including recent decade and examined link with other surface variables such as sea-ice and sea surface temperature. From the results, it was shown that the BO showed more regionally confined spatial pattern compared to AO and has intensified during recent decade. The regional dipolelar structure centered at Barents sea and Siberia was revealed in both sea-level pressure and 500 hPa geopotential height. Also, BO showed a stronger link (correlation) with sea-ice and sea surface temperature especially over Barents-Kara seas suggesting it is playing an important role for recent Arctic amplification. BO also showed high correlation with Ural Blocking Index (UBI), which measures seasonal activity of Ural blocking. Since Ural blocking is known as a major component of Eurasian winter monsoon and can be linked to extreme weathers, we suggest deeper understanding of BO can provide a missing link between recent Arctic amplification and increase in extreme weathers in midlatitude in recent decades.

• Korean Circulation Journal
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• 제52권6호
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• pp.460-474
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• 2022

Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05-1.24) but not in those by the 2017 ACC/AHA definition. Elevated on-treatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18-1.70) and stroke (aHR, 1.19; 95% CI, 1.08-1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10; 95% CI, 1.04-1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion: Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.