PURPOSE: Obesity is a significant health problem with medical and psychological consequences for children and adolescents. The purpose of this study was to assess the correlation between body fat percent using bioelectrical impedance(BI) and other variable methods. METHODS: We measured height, weight, body mass index(BMI) and body fat percent by skinfold thickness(ST) and BI in 1,035(496 male; 539 female) children from seven to 18 years of age. The correlation coefficients between BI and each of the other different methods were obtained. The sensitivity and specificity to predict obesity by these several methods were studied. RESULTS: Fat percent estimated by BI analysis and BMI showed a strong correlation(r=0.749). Fat percent estimated by BI analysis and ST showed a very strong correlation(r=0.835). At the 95th percentile cut-off point for BI, ST showed a sensitivity of 57.7%, and a specificity of 97.6% for estimating body fat. At the 95th percentile cut-off point for BI, BMI showed a sensitivity of 84.9%, and a specificity of 99.3% for estimating body fat. CONCLUSION: The fat percent estimated by BI analysis correlated strongly with ST or BMI. BI analysis is an objective and accurate method for estimating body fat in childhood obesity.
Adipose Tissue* ; Adolescent ; Body Mass Index ; Body Weight ; Child ; Electric Impedance* ; Humans ; Male ; Obesity ; Pediatric Obesity ; Sensitivity and Specificity ; Skinfold Thickness

BACKGROUND AND OBJECTIVES: Drug therapy to treat atrial fibrillation has been achieved unsatisfactory results due to the frequent failure to maintain a sinus rhythm as well as the occurrence of adverse side effects. This study investigated the efficacy of amiodarone for the treatment of tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation. SUBJECTS AND METHODS: We treated twenty-seven patients with tachycardia-induced cardiomyopathy due to non-valvular atrial fibrillation with amiodarone in order to convert to and maintain the sinus rhythm. We followed up and compared the functional status, electrocardiography and parameters of echocardiography before and after treatment with amiodarone. RESULTS: Patients treated with amiodarone showed cardiac functional improvement based on New York Heart Association classification. Eighteen patients (66.7%) out of the total 27 converted to sinus rhythm. The pulse rate decreased from 109.0+/-34 bpm (beats per min) before the administration of amiodarone to 70.3+/-13.0 bpm after medication. The size of the left atrium decreased from 50.7+/-6.7 (mm) to 46.9+/-5.6 (mm). The ejection fraction (EF) improved from 36.2+/-14.9 (%) to 51.2+/-17.7 (%). CONCLUSION: Amiodarone is effective in the conversion to sinus rhythm as well as ventricular rate control in patients with atrial fibrillation induced cardiomyopathy. The cardiac functional status and the echocardiographic parameters of left ventricular function in patients with tachycardia-induced cardiomyopathy due to atrial fibrillation improved with amiodarone therapy.
Amiodarone* ; Atrial Fibrillation* ; Cardiomyopathies* ; Classification ; Drug Therapy ; Echocardiography ; Electrocardiography ; Heart ; Heart Atria ; Heart Rate ; Humans ; Tachycardia* ; Ventricular Function, Left

Vitamin D is an important fat-soluble vitamin that functions as a prohormone and affects bone mineralization and calcium homeostasis. Vitamin D deficiency causesboth musculoskeletal manifestations, including rickets, and extra-musculoskeletal symptoms. Because vitamin D is naturally present in only some foods, intake of daily foods cannot meet the dietary reference intake for vitamin D. Sunlight is the main source of vitamin D in humans therefore, the lack of sunlight can easily cause vitamin D deficiency in children and adolescents. Vitamin D deficiency can be diagnosed on the basis ofits typical clinical manifestation, laboratory tests, and radiologic findings. Detection of vitamin D deficiency in children or adolescents necessitates the simultaneous administration of vitamin D and calcium supplements. To prevent vitamin D deficiency, 200 IU of daily vitamin D intake is recommended in infants, and 400 IU of daily vitamin D intake is recommended in Korean children and adolescents.
Adolescent ; Calcification, Physiologic ; Calcium ; Child ; Homeostasis ; Humans ; Infant ; Rickets ; Sunlight ; Vitamin D ; Vitamin D Deficiency ; Vitamins

PURPOSE: Syncope appears to be common. However, the mechanism of syncope is not clear. Increased vagal activity and withdrawal of sympathetic stimulation cause hypotension, bradycardia and finally loss of consciousness. The purpose of this study was to evaluate changes of cerebral blood flow velocity, blood pressure, and heart rate during tilt test in children with vasovagal syncope. METHODS: Sixty four children with a past history of syncope were evaluated. The stand up test was performed for 15 minutes after a rest at supine position for 10 minutes, followed by an 80 degrees tilt test lasting 45 minutes. If presyncope(lightheadedness, nausea, blurred vision, or sweating) or syncope occurred, the study was discontinued. 12-lead electrocardiography, echocardiography, and electroencephalography were performed. Transcranial Doppler study was performed at the middle cerebral artery with 2 MHz continuous Doppler probe in 10 children with positive tilt test. Systolic, diastolic, mean cerebral blood flow velocity, integral, and pulsatility index were measured with blood pressure, heart rate, and O2 saturation. RESULTS: The positive rate of tilt test was 31.3%(20/64). Systolic, diastolic, and mean cerebral blood flow velocity decreased significantly in absence of hypotension or bradycardia during presyncope. Time velocity integral of cerebral artery also decreased significantly. CONCLUSION: Decreased cerebral blood flow velocity can predict the presyncope manifestation. Impairment of autoregulation of cerebral blood flow might play an important role in the pathophysiology of vasovagal syncope.
Blood Flow Velocity ; Blood Pressure ; Bradycardia ; Cerebral Arteries ; Child* ; Echocardiography ; Electrocardiography ; Electroencephalography ; Heart Rate ; Homeostasis ; Humans ; Hypotension ; Middle Cerebral Artery ; Nausea ; Supine Position ; Syncope ; Syncope, Vasovagal* ; Unconsciousness

Although dietary protein restriction may protect against progression of renal failure, it is important to consider whether protein restriction can be attained without inducing malnutrition. We assessed the calculated dietary protein intake(cDPI) by 24 hour urinary collection and food intake, biochemical nutritional indices and the results of anthropometric measurement in 83 predialysis patients with different stages of chronic renal failure(CRF) and 84 controls. Dietary interventions were minimal. We categorized patients into three groups according to whether their creatinine clearance(Ccr) was greater than 25(group A), 10 to 25(group B), or less than 10ml/min(group C). 1) The mean(+/-SD) cDPI was significantly lower in group C(0.77+/-0.17g/kg/day) and group B(0.84+/- 0.16g/kg/day) than in group A(1.04+/-0.21g/kg/day) and controls(1.14+/-0.22g/kg/day)(P<0.05). The mean (+/-SD) high biologic value protein intake was significantly lower in group C(0.29+/-0.25g/kg/day) and group B(0.39+/-0.27g/kg/day) than in group A (0.48+/-0.35g/kg/day)(P<0.05). The cDPI(r=0.50, P< 0.05), high biologic value protein intake(r=0.39, P< 0.05) were positively correlated with the Ccr. 2) The mean (SD) total lymphocyte count (TLC) was significantly lower in group C(1,554+/-368/mm3) and group B(1,972+/-470/mm3) than in group A(2,111+/-540/mm3) and controls(2,177+/-589/mm3)(P<0.05). The TLC was positively correlated with the Ccr(r= 0.28, P<0.05). The levels of albumin and transferrin were lower in patients with CRF than in controls (P<0.05). There was no difference in the levels of albumin, transferrin, prealbumin, insulin-like growth factor-1, cholesterol and anthropometric measurements among the different stages of CRF. CONCLUSION: In predialysis patients with CRF, the dietary protein and high biologic value protein intake spontaneously decreases as renal function declines. Several nutritional indices, such as TLC, albumin and transferrin were lower in predialysis patient with CRF than controls. Therefore objective measurement of DPI should be considered to educate a low protein diet in predialysis patients with CRF.
Cholesterol ; Creatinine ; Diet, Protein-Restricted ; Dietary Proteins* ; Eating ; Humans ; Kidney Failure, Chronic ; Lymphocyte Count ; Malnutrition ; Nutrition Assessment* ; Prealbumin ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Transferrin

The occurrence of disseminated tuberculosis in combination with acute leukemia is rare. A 28 year old male undergoing induction chemotherapy for AML presented with fever of unknown origin. Upon the studies to make the diagnosis this case turned out to be disseminated tuberculosis including meningitis. The chest CT showed multiple enlarged mediastinal lymphadenopathy. The Brain CT showed noncommunicating obstructive hydrocephalus. Disseminated tuberculosis was pathologically proven by theliver, bone marrow and mediastinal lymph node biopsies. As clinical course improved, radiological lesions were completely resolved after antituberculosis therapy. It is important to consider disseminated tuberculosis for the etiology of FUO inpatient with AML who had suffered from long standing fever.
Adult ; Biopsy ; Bone Marrow ; Brain ; Diagnosis ; Fever ; Fever of Unknown Origin ; Humans ; Hydrocephalus ; Induction Chemotherapy ; Inpatients ; Leukemia ; Leukemia, Myeloid, Acute* ; Lymph Nodes ; Lymphatic Diseases ; Male ; Meningitis ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Meningeal*