Yonsei Medical Journal最新文献

{"title":"Screening and Predictive Value of Thoracic Ossification Observed on Lateral Radiography for Myelopathy.","authors":"Hyun Jun Jang, Byung-Jou Lee, Kyung Hyun Kim, Jin Hoon Park, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Bong-Ju Moon","doi":"10.3349/ymj.2025.0100","DOIUrl":"10.3349/ymj.2025.0100","url":null,"abstract":"<p><strong>Purpose: </strong>Ossification of the ligamentum flavum (OLF) is known to compress neural structures, leading to myelopathy. Although computed tomography (CT) is a reliable diagnostic tool, thoracic OLF is often underdiagnosed due to the challenges of routinely performing thoracic imaging in clinical practice. Radiographs offer a more accessible option but lack established criteria for screening clinically significant thoracic OLF.</p><p><strong>Materials and methods: </strong>Retrospective study conducted at a single institution, evaluating radiographic and clinical data from patients with thoracic OLF. A total of 142 patients were included: 69 in the myelopathy group, who had myelopathy symptoms due to thoracic OLF, and 73 in the non-myelopathy group, who had OLF observed on CT but no myelopathy symptoms.</p><p><strong>Results: </strong>The OLF diameter (8.39±2.42 mm vs. 5.96±2.93 mm, <i>p</i><0.001) and OLF diameter ratio (0.63±0.15 vs. 0.42±0.33, <i>p</i><0.001) were significantly larger in the myelopathy group compared to the non-myelopathy group. Receiver operating characteristic analysis revealed that an OLF diameter ratio ≥0.58 on lateral radiographs had an area under the curve of 0.817, with 73% sensitivity and 82% specificity for predicting myelopathy.</p><p><strong>Conclusion: </strong>The OLF diameter ratio measured on lateral radiographs is an effective and non-invasive parameter for identifying thoracic OLF cases with myelopathy symptoms. When the OLF diameter ratio is ≥0.58, clinicians should consider the possibility of myelopathy and perform further diagnostic imaging, such as CT or magnetic resonance imaging, to guide treatment decisions.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 5","pages":"419-426"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell-Derived Nanocarriers for Monocyte-Mediated Therapeutic Delivery: Concept and Challenges.","authors":"Seung Eun Yu, Jueun Kim, Hak-Joon Sung","doi":"10.3349/ymj.2025.0286","DOIUrl":"10.3349/ymj.2025.0286","url":null,"abstract":"<p><p>Nano-delivery has been largely focused on ligand-based navigational targeting, but several common limitations have been recognized. First, the same targeting ligand can be sporadically expressed by unintended cells and tissues across different temporal and spatial contexts. Second, clearance from blood circulation via the liver, kidney, lung, and spleen is largely uncontrollable, in addition to nonspecific uptake by immune cells during circulation or tissue accumulation. Accordingly, inherent characteristics of cells have recently been utilized as alternative strategic points for delivery. Cell-derived nanocarriers utilize plasma membranes as modulators of targeting and delivery mechanisms, including cell hitchhiking to alter carrier behavior, reprogram phenotypes, and enable drug hand-over. The membrane mediates contact with target cells in a manner analogous to cell-cell interactions, thereby enabling physical bridging between cells and natural homing to peer cells, in addition to user-specified molecular display through mother cell expression or chemical conjugation. Here, cell-derived nanocarriers for therapeutic delivery (CDNTD) are reviewed with emphasis on their mechanistic basis, distinctions from synthetic nanoparticles, and therapeutic potential. We recently introduced spleen-mediated delivery strategies that employ resident monocytes as second therapeutic carriers following uptake of primary nanocarriers. In this way, the natural targeting behavior of monocytes in response to inflammatory cues enhances payload delivery efficiency to ischemic sites. Future directions of CDNTD research are also discussed with respect to clinical translation.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 5","pages":"377-389"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Prediction System for Surgical Difficulty in Rectal Cancer Patients Using MRI Pelvimetry.","authors":"Yena Christina Kang, Tae Sik Hwang, Young Jae Kim, Youngbae Jeon, Kwang Gi Kim, Jeong-Heum Baek","doi":"10.3349/ymj.2024.0293","DOIUrl":"10.3349/ymj.2024.0293","url":null,"abstract":"<p><strong>Purpose: </strong>This study presents a system that automatically predicts the difficulty of laparoscopic total mesorectal excision (TME) using magnetic resonance imaging (MRI) pelvimetry and the clinical characteristics of the patients with rectal cancer, using deep learning (DL) technology and statistical analysis.</p><p><strong>Materials and methods: </strong>Colorectal MRI data were collected from patients with rectal cancer and input into to the segmentation model for DL training, followed by automatic measurement of pelvimetry parameters from the segmentation results. The measured parameters and preoperative clinical data of the patients were statistically analyzed to identify clinically correlated predictors of surgical difficulty. Finally, using the selected predictors, a logistic nomogram was generated for the prediction of surgical difficulty.</p><p><strong>Results: </strong>The segmentation models yielded Dice similarity coefficients (DSC) of 92.7%-95.7%, and the automatic measurement results exhibited high correlation with the manual measurement results. The identified predictors were age, tumor location from the anal verge, interspinous distance, angle Δ, and mesorectal fat area. The C-index of the generated nomogram was 0.852.</p><p><strong>Conclusion: </strong>The system provides standard guidance for the examination of the difficulty of TME that could potentially be used in clinical settings. A follow-up study could develop this idea to fully automate the entire process with a simple user interface to provide objective predictions and explanations.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 5","pages":"436-447"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Trends in Inflammatory Bowel Disease in Korea: Age-Related Shifts and Urban-Rural Disparities in a Nationwide Study, 2004-2015.","authors":"Joonki Lee, Daye Park, Jihye Park, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Jae Jun Park, Aesun Shin","doi":"10.3349/ymj.2025.0327","DOIUrl":"10.3349/ymj.2025.0327","url":null,"abstract":"<p><strong>Purpose: </strong>The incidence of inflammatory bowel disease (IBD) is rapidly increasing in newly industrialized Asian countries. However, nationwide epidemiological shifts, especially age-specific trends and urbanization effects, remain unclear in Korea. This study aimed to define recent secular trends in IBD incidence by age and residential area using the Korean National Health Insurance database.</p><p><strong>Materials and methods: </strong>We conducted a nationwide, population-based study using claims data from the National Health Insurance Service from 2004 to 2015. IBD cases were defined by a combination of diagnostic codes for Crohn's disease (CD) or ulcerative colitis (UC) and relevant prescription records. Age-standardized incidence rates (ASRs) were calculated, and joinpoint regression was used to estimate annual percent changes (APCs). Standardized incidence ratios (SIRs) compared incidence between metropolitan and non-metropolitan areas.</p><p><strong>Results: </strong>A total of 15241 CD and 39028 UC patients were identified. ASRs for both CD and UC steadily increased during the study period, with APCs of 6.8% [95% confidence interval (CI): 5.8-7.8] for CD and 3.2% (95% CI: 2.6-3.8) for UC. CD incidence was highest among adolescents aged 15-19 years. For UC, the peak age of onset shifted from 55-69 years in 2004 to 20-39 years by 2015. The most dramatic rise in UC incidence occurred in the 10-19 age group. Metropolitan areas had higher incidence rates than non-metropolitan areas for both diseases.</p><p><strong>Conclusion: </strong>The epidemiology of IBD in Korea is rapidly evolving, with increasing incidence, younger onset, and an urban-rural divide. Targeted strategies for adolescents and urban populations are needed.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 5","pages":"400-407"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Glucose Monitoring-Driven Personalization of Cornstarch Therapy in Glycogen Storage Disease: A Retrospective Analysis.","authors":"Jang Hoon Ru, Ji Seung Ryu, Yunkoo Kang, Sejung Yang","doi":"10.3349/ymj.2025.0468","DOIUrl":"10.3349/ymj.2025.0468","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatic glycogen storage diseases (GSD), including types Ia, Ib, and IXa, are rare inherited disorders characterized by impaired hepatic glucose homeostasis. In GSD Ia, deficiency of glucose-6-phosphatase results in recurrent hypoglycemia and metabolic disturbances. Uncooked cornstarch (UCCS) is the standard therapy due to its slow digestion and sustained glucose release; however, dosing requirements vary according to age, digestion rate, metabolic demand, and lifestyle. Despite the central role of UCCS in long-term management, real-world data describing extended continuous glucose monitoring (CGM) patterns in hepatic GSD are extremely limited, and objective evidence guiding individualized dose adjustment remains scarce. This study examined CGM profiles in patients with hepatic GSD receiving long-term UCCS therapy and assessed the clinical utility of CGM in guiding individualized dosing adjustments.</p><p><strong>Materials and methods: </strong>We performed a retrospective, multi-year analysis of CGM data from 32 patients with hepatic GSD treated with UCCS. CGM traces were processed using 15-minute resampling, constrained interpolation, and physiologic clipping (40-400 mg/dL). Data were segmented into non-overlapping, calendar-anchored 7- and 14-day windows (anchor at 00:00) and retained when coverage was ≥70%. Per window, we calculated time in range (TIR, 70-150 mg/dL), time below range (TBR, <70 mg/dL), time above range (≥150 mg/dL), coefficient of variation, nocturnal TBR (00:00-06:00), and hypoglycemia burden [area under the curve (AUC) <70 mg/dL].</p><p><strong>Results: </strong>During routine clinic follow-up, CGM-informed, patient-specific UCCS and dietary adjustments maintained high TIR and low glycemic variability. Growth parameters and liver enzyme levels remained within normal limits. Episodes of recurrent nocturnal hypoglycemia identified on CGM prompted targeted modifications of UCCS dosing.</p><p><strong>Conclusion: </strong>A CGM-guided approach facilitates personalized UCCS management in hepatic GSD. Systematic review of TIR, nocturnal TBR, and AUC <70 mg/dL, alongside growth and liver assessments, provides a practical framework for optimizing long-term metabolic stability.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 5","pages":"390-399"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Clinical Trial of Imagery Stabilization and Rescripting Therapy for Psychiatric Outpatients with Posttraumatic Stress Disorder.","authors":"Daeho Kim, Soorack Ryu, Ji Young Min, Hyunji Lee, Eunkyung Kim","doi":"10.3349/ymj.2025.0167","DOIUrl":"10.3349/ymj.2025.0167","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the safety and effectiveness of a novel psychotherapy based on imagery techniques, we conducted a randomized clinical trial comparing imagery stabilization and rescripting therapy (ISRT) with non-trauma-focused cognitive behavioral therapy (CBT) for adults with posttraumatic stress disorder (PTSD).</p><p><strong>Materials and methods: </strong>Eight sessions of 60-minute ISRT were conducted for the treatment condition (n=59), while the control group received eight sessions of 60 minutes of CBT (n=27). The Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale were administered by clinicians, while self-questionnaires were administered at pretreatment, posttreatment, and the 6-month follow-up.</p><p><strong>Results: </strong>Forty-two participants in the ISRT group and 20 participants in the CBT group completed more than six sessions; thus, dropout rates were not significantly different between the groups (17/59, 28.8% vs. 7/27, 25.9%, respectively). Although no statistical differences were found between conditions, both completer and intention-to-treatment analyses revealed that clinical status, PTSD symptoms, and quality of life favored ISRT after treatment and 6 months later.</p><p><strong>Conclusion: </strong>Our findings suggest that ISRT is a safe and effective treatment option for PTSD.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 5","pages":"408-418"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin-Associated Hepatotoxicity Linked to <i>CASP8</i> Polymorphisms: Mechanistic Insights from Proteomic Analysis.","authors":"Da Hoon Lee, Yoon-A Park, Seo-A Choi, Yubin Song, Jung Sun Kim, Jeong Yee, Ji Min Han, Yoonkyung Chang, Tae-Jin Song, Hye Sun Gwak","doi":"10.3349/ymj.2025.0181","DOIUrl":"10.3349/ymj.2025.0181","url":null,"abstract":"<p><strong>Purpose: </strong>Statins are widely used for cardiovascular diseases, but statin-associated hepatotoxicity remains a concern. Apoptotic caspases, including caspase-8 (CASP8) and caspase-3 (CASP3), are crucial in hepatotoxicity and may affect statin-associated hepatotoxicity. We examined how these gene variants affect hepatotoxicity risk and protein expression in statin users.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed prospectively collected samples from 851 South Korean statin users to assess associations between <i>CASP8</i> and <i>CASP3</i> polymorphisms and hepatotoxicity, defined as grade II or higher according to the Common Terminology Criteria for Adverse Events. Nine single nucleotide polymorphisms were genotyped using a TaqMan assay. Multivariable logistic regression included clinical variables alone (Model 1) or combined with genetic variants (Model 2). To evaluate functional relevance, we examined 8995 participants from the UK Biobank, assessing associations between genetic variants and protein expression levels using the Olink proteomics platform.</p><p><strong>Results: </strong>Among 851 patients, 66 experienced hepatotoxicity. In Model 1, lipophilic statins, atrial fibrillation, and diabetes mellitus were significantly associated with hepatotoxicity. In Model 2, three <i>CASP8</i> polymorphisms-rs1045487 (GG genotype), rs3769825 (G allele carriers), and rs6745051 (CC genotype)-were independently associated with increased risk, with adjusted odds ratios of 1.93 [95% confidence interval (CI): 1.04-3.60], 2.38 (95% CI: 1.33-4.24), and 3.00 (95% CI: 1.31-6.84), respectively. Incorporating genetic data improved the model's predictive performance (area under the receiver operating characteristic curve: 0.720 vs. 0.622). In the UK Biobank, risk-associated CASP8 variants showed suggestive trends toward elevated <i>CASP8</i> protein expression, directionally consistent with the primary findings.</p><p><strong>Conclusion: </strong><i>CASP8</i> gene polymorphisms are associated with an increased risk of hepatotoxicity in statin users.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 5","pages":"427-435"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Post-Induction Hypotension in Diverse Surgical Populations: A Multiclass Classification Universal Model Using Machine Learning Techniques.","authors":"Sang-Wook Lee, Donghee Lee, Sung-Hoon Kim","doi":"10.3349/ymj.2025.0105","DOIUrl":"10.3349/ymj.2025.0105","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aims to develop a machine learning model that not only predicts the occurrence of post-induction hypotension (PIH) but also assesses its severity, addressing a broader patient population than previous studies which mostly focused on a single population.</p><p><strong>Materials and methods: </strong>In our study, we extracted data from 71473 patients aged 18 years and older who underwent general anesthesia for non-cardiac surgery at a tertiary care hospital, using the electronic medical record system for modeling. We used patient demographics, baseline and pre-induction blood pressure, preoperative laboratory tests, surgical details, and anesthetics data, focusing on predicting PIH. The severity of hypotension was assessed by integrating and calculating the integral value of hypotensive periods. We employed several machine learning techniques and evaluated their performance using accuracy, precision, F1-scores, and macro-averaged area under the curve. Additionally, SHapley Additive exPlanation values were used to determine the key factors influencing the predictions.</p><p><strong>Results: </strong>A multiclass classification model, which assesses hypotension severity through the area of hypotension, surpassed the binary model with an F1-score of 0.664. Among various machine learning techniques, the eXtreme Gradient Boosting (XGBoost) model exhibited superior prediction performance, achieving an accuracy of 0.755 and an F1-score of 0.664. Models using preoperative blood pressure and demographic data outperformed those using other datasets.</p><p><strong>Conclusion: </strong>We found that using the XGBoost ensemble machine learning technique aids in predicting PIH before surgery, and introducing a multiclass classification model that indicates the severity of hypotension to clinicians leads to an overall enhancement in prediction performance, thereby increasing its clinical utility for real-world applications.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 4","pages":"349-357"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Donor Lung Resection Technique on Bronchopleural Fistula in Transplantation: Pulmonary Tailoring Versus Hilar Dissection.","authors":"Young Ho Yang, Ruari Krueger Lee, Zhu Jing Jun, Nguyen Minh Dung, Tae Hee Hong, Ha Eun Kim, Byung Jo Park, Chang Young Lee, Dae Joon Kim, Jin Gu Lee","doi":"10.3349/ymj.2025.0153","DOIUrl":"10.3349/ymj.2025.0153","url":null,"abstract":"<p><strong>Purpose: </strong>Donor shortages in many countries necessitate the use of marginal donor lungs despite challenges such as size mismatch, and donor lung pathologies requiring resection, such as consolidation or anatomical abnormalities. One way to address these challenges is through major pulmonary resection of the donor lung, which can be in the form of hilar dissection (HD), an anatomical resection, or pulmonary tailoring (PT), a non-anatomical resection. No studies have compared these two techniques; hence, we aimed to compare their intraoperative and postoperative outcomes.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 40 lung transplant recipients who underwent major pulmonary resection of donor lungs between January 2014 and May 2023. The patients were divided into HD (n=18) and PT (n=22) groups, and their intraoperative and postoperative outcomes were compared.</p><p><strong>Results: </strong>Postoperative bronchopleural fistula (BPF) occurred in 22.2% of patients in the HD group but was absent in the PT group (<i>p</i>=0.033). There were no significant differences between the two groups in terms of total operative time, ischemic time for each lung, occurrence of primary graft dysfunction, bronchial anastomotic dehiscence, bronchial stenosis, or pneumothorax. The survival curves were also similar between the two groups.</p><p><strong>Conclusion: </strong>The PT technique significantly reduced the risk of BPF compared with the HD technique, suggesting its potential as a safer technique for managing oversized donor lungs and addressing other pathologies requiring resection.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 4","pages":"334-340"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydrodynamic Characteristics of Bovine Pericardial and Porcine Valves Using a Mock Circulatory System Mimicking the Aortic and Pulmonary Positions.","authors":"Yu Rim Shin, Seung-Hyun Lee, Jae-Kwang Shim, Yongwoo Kim, Sak Lee","doi":"10.3349/ymj.2025.0174","DOIUrl":"10.3349/ymj.2025.0174","url":null,"abstract":"<p><strong>Purpose: </strong>Aortic prostheses are used in pulmonary positions due to structural similarities between the pulmonary and aortic valves. However, there are no available studies that have comprehensively evaluated the mechanism of bioprosthetic aortic valves under pulmonary conditions.</p><p><strong>Materials and methods: </strong>Using a mock circulatory system, we evaluated the hydrodynamic characteristics of bovine pericardial and porcine valves. Geometric orifice area, regurgitant and leakage volume, regurgitant fraction, peak pressure gradient, and forward flow volume were evaluated in different pulmonary pressure conditions (from 15/5 mm Hg to 75/35 mm Hg) and normal aortic pressure (110/80 mm Hg).</p><p><strong>Results: </strong>Bovine pericardial valves were associated with larger opening area (0.93±0.01 vs.1.70±0.01 for 23-mm valve; 0.99±0.01 vs.1.75±0.01 for 25-mm valve; 1.58±0.01 vs. 2.25±0.02 for 27-mm valve; all <i>p</i><0.01) and forward flow volume (42.27±0.05 vs. 64.79±0.14 for 23-mm valve; 46.41±0.06 vs. 64.28±0.18 for 25-mm valve; 72.64±0.17 vs.73.25±0.07 for 27-mm valve; all <i>p</i><0.01). Porcine valves were associated with incomplete opening, smaller opening area, and lower regurgitant fraction. Bovine pericardial valves demonstrated lower peak pressure gradients (15.75±0.14 vs. 12.57±0.47 for 23-mm valve; 14.85±0.05 vs. 12.87±0.28 for 25-mm valve; 15.72±0.32 vs. 7.91±0.03 for 27-mm valve).</p><p><strong>Conclusion: </strong>Bovine pericardial and porcine bioprosthetic valves has different hydrodynamic characteristics under various pulmonary pressure conditions.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"67 4","pages":"297-305"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}