1.A Spontaneous Coronary Artery Dissection Autopsy in a 64-Year-Old Male
Sang Won LEE ; Wooyoung JANG ; Tae Mo KANG ; So Youn IM ; Kyungmin LEE ; Kwang Soo KO ; Jinhyuk CHOI
Korean Journal of Legal Medicine 2025;49(2):51-55
Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.
2.A Spontaneous Coronary Artery Dissection Autopsy in a 64-Year-Old Male
Sang Won LEE ; Wooyoung JANG ; Tae Mo KANG ; So Youn IM ; Kyungmin LEE ; Kwang Soo KO ; Jinhyuk CHOI
Korean Journal of Legal Medicine 2025;49(2):51-55
Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.
3.A Spontaneous Coronary Artery Dissection Autopsy in a 64-Year-Old Male
Sang Won LEE ; Wooyoung JANG ; Tae Mo KANG ; So Youn IM ; Kyungmin LEE ; Kwang Soo KO ; Jinhyuk CHOI
Korean Journal of Legal Medicine 2025;49(2):51-55
Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.
4.A Spontaneous Coronary Artery Dissection Autopsy in a 64-Year-Old Male
Sang Won LEE ; Wooyoung JANG ; Tae Mo KANG ; So Youn IM ; Kyungmin LEE ; Kwang Soo KO ; Jinhyuk CHOI
Korean Journal of Legal Medicine 2025;49(2):51-55
Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.
5.Antimicrobial Peptides Targeting Oral Pathogens:Applicability as an Oral Disease Treatment and Dental Material
Sehyeok IM ; Jun Hyuck LEE ; Youn-Soo SHIM
Journal of Dental Hygiene Science 2024;24(4):231-248
Background:
Antimicrobial peptides (AMPs) are small, naturally occurring molecules that are integral components of the innateimmune system across many organisms. In humans, saliva is rich in various AMPs that play a pivotal role in maintaining oral health by serving as the primary line of defense in the oral cavity. These peptides are essential for protection against a broad spectrum of pathogens, including bacteria and fungi. Recently, active research has been conducted on both naturally occurring AMPs and modified or synthetic AMPs for the treatment of oral pathogens and their application in dental materials.
Methods:
We compiled previous studies on AMPs present in saliva and their target oral microorganisms. Additionally, wesummarized research on artificially created AMPs targeting oral pathogens. Furthermore, we analyzed recent trends in applied studies, such as the development of oral rinses, toothpaste, and implant coatings using AMPs.
Results:
Through a literature review, we identified 19 studies on AMPs present in the oral cavity and 40 studies testing AMPs derivedfrom other organisms or synthetically engineered against oral pathogens. Additionally, we reviewed seven studies on the development of implant coatings and oral hygiene material additives using AMPs. These findings suggest the potential for discovering or developing AMPs with activity against specific oral pathogens that can be applied to improve oral health.
Conclusion
AMPs exhibit broad antimicrobial activity against a wide range of pathogens. Their mechanisms of action primarilyinvolve attacking and disrupting the cell membranes of target microorganisms, making them effective against various pathogens.AMPs have the potential for use as coating materials for dental implants or restorative materials that require long-term use.Further research is needed to investigate the cytotoxicity, durability, and stability of AMPs in the oral environment to support their clinical use in dentistry.
6.Antimicrobial Peptides Targeting Oral Pathogens:Applicability as an Oral Disease Treatment and Dental Material
Sehyeok IM ; Jun Hyuck LEE ; Youn-Soo SHIM
Journal of Dental Hygiene Science 2024;24(4):231-248
Background:
Antimicrobial peptides (AMPs) are small, naturally occurring molecules that are integral components of the innateimmune system across many organisms. In humans, saliva is rich in various AMPs that play a pivotal role in maintaining oral health by serving as the primary line of defense in the oral cavity. These peptides are essential for protection against a broad spectrum of pathogens, including bacteria and fungi. Recently, active research has been conducted on both naturally occurring AMPs and modified or synthetic AMPs for the treatment of oral pathogens and their application in dental materials.
Methods:
We compiled previous studies on AMPs present in saliva and their target oral microorganisms. Additionally, wesummarized research on artificially created AMPs targeting oral pathogens. Furthermore, we analyzed recent trends in applied studies, such as the development of oral rinses, toothpaste, and implant coatings using AMPs.
Results:
Through a literature review, we identified 19 studies on AMPs present in the oral cavity and 40 studies testing AMPs derivedfrom other organisms or synthetically engineered against oral pathogens. Additionally, we reviewed seven studies on the development of implant coatings and oral hygiene material additives using AMPs. These findings suggest the potential for discovering or developing AMPs with activity against specific oral pathogens that can be applied to improve oral health.
Conclusion
AMPs exhibit broad antimicrobial activity against a wide range of pathogens. Their mechanisms of action primarilyinvolve attacking and disrupting the cell membranes of target microorganisms, making them effective against various pathogens.AMPs have the potential for use as coating materials for dental implants or restorative materials that require long-term use.Further research is needed to investigate the cytotoxicity, durability, and stability of AMPs in the oral environment to support their clinical use in dentistry.
7.Antimicrobial Peptides Targeting Oral Pathogens:Applicability as an Oral Disease Treatment and Dental Material
Sehyeok IM ; Jun Hyuck LEE ; Youn-Soo SHIM
Journal of Dental Hygiene Science 2024;24(4):231-248
Background:
Antimicrobial peptides (AMPs) are small, naturally occurring molecules that are integral components of the innateimmune system across many organisms. In humans, saliva is rich in various AMPs that play a pivotal role in maintaining oral health by serving as the primary line of defense in the oral cavity. These peptides are essential for protection against a broad spectrum of pathogens, including bacteria and fungi. Recently, active research has been conducted on both naturally occurring AMPs and modified or synthetic AMPs for the treatment of oral pathogens and their application in dental materials.
Methods:
We compiled previous studies on AMPs present in saliva and their target oral microorganisms. Additionally, wesummarized research on artificially created AMPs targeting oral pathogens. Furthermore, we analyzed recent trends in applied studies, such as the development of oral rinses, toothpaste, and implant coatings using AMPs.
Results:
Through a literature review, we identified 19 studies on AMPs present in the oral cavity and 40 studies testing AMPs derivedfrom other organisms or synthetically engineered against oral pathogens. Additionally, we reviewed seven studies on the development of implant coatings and oral hygiene material additives using AMPs. These findings suggest the potential for discovering or developing AMPs with activity against specific oral pathogens that can be applied to improve oral health.
Conclusion
AMPs exhibit broad antimicrobial activity against a wide range of pathogens. Their mechanisms of action primarilyinvolve attacking and disrupting the cell membranes of target microorganisms, making them effective against various pathogens.AMPs have the potential for use as coating materials for dental implants or restorative materials that require long-term use.Further research is needed to investigate the cytotoxicity, durability, and stability of AMPs in the oral environment to support their clinical use in dentistry.
8.Oral Pathogens and Their Antibiotics from Marine Organisms: A Systematic Review of New Drugs for Novel Drug Targets
Sehyeok IM ; Jun Hyuck LEE ; Youn-Soo SHIM
Journal of Dental Hygiene Science 2024;24(2):84-96
Background:
Recent studies have elucidated the quorum-sensing mechanisms, biofilm formation, inter-pathogen interactions,and genes related to oral pathogens. This review aims to explore the recent expansion of drug targets against oral pathogens and summarize the current research on novel antibiotic substances derived from marine organisms that target oral pathogens.
Methods:
A comprehensive literature review summarized the novel mechanisms pertaining to quorum-sensing signal transmission systems, biofilm formation, and metabolite exchange in oral pathogens. The amino acid sequences of the 16 proteins identified as potential drug targets were systematically classified and compared across various oral microorganisms.
Results:
Through a literature review, we identified nine studies researching quorum sensing signaling inhibitors targeting oral pathogens. A comparison of the amino acid sequences of 16 potential drug targets in oral microorganisms revealed significant differences between oral pathogens and beneficial oral symbiotic microorganisms. These findings imply that it is possible to design drugs that can bind more selectively to oral pathogens.
Conclusion
By summarizing the results of recent research on the signaling mechanisms that cause pathogenicity, new drug targets against oral pathogens were proposed. Additionally, the current status of developing new antibiotics for oral pathogens using recently developed quorum sensing inhibitors and natural products derived from marine organisms was introduced.Consequently, marine natural products can be used to develop drugs targeting new proteins in oral pathogens.
9.Feasibility of the Threshold-Based Quantification of Myocardial Fibrosis on Cardiac CT as a Prognostic Marker in Nonischemic Dilated Cardiomyopathy
Na Young KIM ; Dong Jin IM ; Yoo Jin HONG ; Byoung Wook CHOI ; Seok-Min KANG ; Jong-Chan YOUN ; Hye-Jeong LEE
Korean Journal of Radiology 2024;25(6):540-549
Objective:
This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM).
Materials and Methods:
Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan–Meier method was used to estimate event-free survival according to MDE levels.
Results:
Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712–1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005).
Conclusion
The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.
10.Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach
Tae-Han KIM ; In-Ho KIM ; Seung Joo KANG ; Miyoung CHOI ; Baek-Hui KIM ; Bang Wool EOM ; Bum Jun KIM ; Byung-Hoon MIN ; Chang In CHOI ; Cheol Min SHIN ; Chung Hyun TAE ; Chung sik GONG ; Dong Jin KIM ; Arthur Eung-Hyuck CHO ; Eun Jeong GONG ; Geum Jong SONG ; Hyeon-Su IM ; Hye Seong AHN ; Hyun LIM ; Hyung-Don KIM ; Jae-Joon KIM ; Jeong Il YU ; Jeong Won LEE ; Ji Yeon PARK ; Jwa Hoon KIM ; Kyoung Doo SONG ; Minkyu JUNG ; Mi Ran JUNG ; Sang-Yong SON ; Shin-Hoo PARK ; Soo Jin KIM ; Sung Hak LEE ; Tae-Yong KIM ; Woo Kyun BAE ; Woong Sub KOOM ; Yeseob JEE ; Yoo Min KIM ; Yoonjin KWAK ; Young Suk PARK ; Hye Sook HAN ; Su Youn NAM ; Seong-Ho KONG ;
Journal of Gastric Cancer 2023;23(1):3-106
Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

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