BACKGROUND AND OBJECTIVES: Idiopathic restrictive cardiomyopathy is a very rare and poorly recognized disease in children. This study is performed to describe the clinical course and to define potential predictors of outcome. MATERIAL AND METHOD: We reviewed the medical records and diagnostic studies of 11 consecutive patients during the period from Jan.1991 to Aug. 2000. RESULTS: The age at diagnosis was 1.2-13 years (median 7 years) and the duration of follow up was 3-90 months (median 3.6 years). All except one were symptomatic (dyspnea in ten, chest pain in four). The chest pain was associated with significant ST depression on both resting and exercise ECG, suggesting myocardial ischemia. Two had complete heart block as either initial or terminal event. Cardiac catheterization was done in nine ( mean pulmonary arterial wedge pressure 23+/-6mmHg, systolic pulmonary arterial pressure 47+/-14mmHg, mean right atrial pressure 11+/-9mmHg). Echocardiographic dimensional ratio of left atrium and aorta (LA/Ao) was 2.41+/-0.58. Mitral E/A inflow ratio was 2.72+/-1.42, E wave deceleration time was 93.6+/-44.2ms. During follow up, six died. The 2 year and 5 year cumulative survival rates were 54.5% and 18.8% respectively. The predictor for nonsurvivor were pulmonary venous congestion and LA/Ao >2.5(p<0.05). Verapamil was tried in 6 cases without favorable effect in all. CONCLUSION: Considerable numbers of restrictive cardiomyopathy have myocardial ischemia associated with ST depression and chest pain. The patients with pulmonary venous congestion and severe left atrial enlargement (LA/Ao>2.5) were at risk for death, requiring prompt definitive treatment such as cardiac transplantation.
Aorta ; Arterial Pressure ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Restrictive* ; Chest Pain ; Child* ; Deceleration ; Depression ; Diagnosis ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Atria ; Heart Block ; Heart Transplantation ; Humans ; Hyperemia ; Medical Records ; Myocardial Ischemia ; Pulmonary Wedge Pressure ; Survival Rate ; Verapamil

We reviewed 26 cases of cardiac rhabdomyoma in children which were diagnosed between 1986 and 1991 in Seoul National University Children's Hospital. Twenty-two cases were associated with tuberous sclerosis. Total tumor count was 58 and mean tumor count per patient was "daehakgyo".23. Their cardiac rhabdomyomas were diagnosed from fetal period through 12 years after birth. Median age was 9."uiwon" months. Fifteen patients were males and rest 11 patients were females. Cardiac symtoms and signs at initial diagnosis were present in 12 cases. They consisted of cardiac murmur in "hakgyo", arrhythmia in 8 and congestive heart failure in "daehakgyo" cases (one with murmur and the other with arrhythmia). Cardiomegaly was seen in 9 cases on chest X-ray and other "byeongwon" case showed abnormal left cardiac border. Electrocardiography and 24 hour Holter monitorings showed arrhythmia in 15 cases. Clinically significant arrhythmias were found in 7 cases on 24 hour Holter monitorings. They consisted of 1with frequent premature ventricular contractions, "daehakgyo uigwadaehak" with frequent premature atrial contractions, "daehakgyo" with atrial tachycardia and "daehakgyo uigwadaehak" with atrio-ventricular block ("daehakgyo" cases of atrio-ventricular block had other arrhythmias also). The locations of tumors were left ventricle in 21, interventricular septum in 21, right ventricle in 13 and atrium in "daehakgyo uigwadaehak" tumors. Mean tumor count per patient in fetal period and infancy was "daehakgyo".86 and it was statistically much more than that after infancy which was "byeongwon".5. Mean tumor area which was calculated on two dimensional echocardiography was larger in fetal period and infancy(128.9 +/- 38.2mm2)than that after infancy(47.8 +/- 11.2mm2). Mean relative tumor area to aortic root dimension was also significantly larger in fetal period and infancy than that after infancy ("daehakgyo".07vs 0.30). In tuberous sclerosis, mean mass area and mean relartive tumor area to aortic root dimension in fetal period and infancy was significantly larger than those in patients after infancy. Of 26 cases, tumorectomy was done in "daehakgyo uigwadaehak" cases due to hemodynamic obstruction and arrhythmia. One case died immediately after operation and the other "daehakgyo" cases are still alive with the follow up period of 30 and 44 months each. Of the 7 patients with significant arrhythmia on 24 hour Holter monitorings, pacemaker insertion was done in "byeongwon" case who received tumorectomy and other 1 case was treated with anti-arrhythmic drugs. All the other patients did not need anti-arrhythmic drugs or other management.
Arrhythmias, Cardiac ; Atrial Premature Complexes ; Cardiomegaly ; Child* ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Failure ; Heart Murmurs ; Heart Ventricles ; Hemodynamics ; Humans ; Male ; Parturition ; Rhabdomyoma* ; Seoul ; Tachycardia ; Thorax ; Tuberous Sclerosis ; Ventricular Premature Complexes

No abstract available.
Child* ; Heart Neoplasms* ; Humans

The purpose of this study was to evaluate nutrient intake and meal variety with breakfast eating in Korean adolescents using data from the 2008-2009 National Health and Nutrition Examination Survey. The analysis included 1245 adolescents aged 12 to 18 years. The subjects were divided into two groups according to breakfast skipping (BS: breakfast skipping, n = 235, BE: breakfast eating, n = 1110). The BS group was significantly higher in its frequency of eating soda drinks, instant noodle, and ice cream than the BE group. The BS group consumed significantly lower quantities of plant calcium and plant protein per 1,000 kcal compared to the BE group. Also the intake of cereal and vegetables in the BS group was significantly lower than those in the BE group, however, the intake of beverage in the BS group was significantly higher than that in the BE group. The average number of foods of the BE and BS groups were 29.50 and 25.85, respectively and revealed a statistical significance (p < 0.0001). The snack intake and % energy from snack intake of the BS group were significantly higher than those of the BE group. Also, the fasting blood glucose concentrations were significantly higher in the BS group compared to the BE group. In conclusion, adolescents who skip breakfast may have lower meal variety and higher blood glucose concentrations. Therefore, in support of proper dietary management, it is necessary to promote and encourage breakfast eating.
Adolescent ; Aged ; Beverages ; Blood Glucose ; Breakfast ; Calcium ; Edible Grain ; Eating ; Fasting ; Humans ; Ice Cream ; Meals ; Nutrition Surveys ; Plants ; Snacks ; Vegetables

The purpose of this study was to evaluate nutrient intake and anthropometric parameters related to obesity in Korean female adolescents according to dietary diversity score. We analyzed data from the combined 2007-2009 Korean National Health and Nutrition Examination Survey (KNHANES). The subjects were 770 female adolescents. Nutrient intakes, Dietary Diversity Score (DDS) ) and Dietary Variety Score (DVS) were derived by using the data from the 24-recall method. The DDS was defined as the number of six food groups (cereals, meats, fruits, vegetables, dairy, fats and oils) consumed. The DVS was defined as the number of food items consumed. The average age of the subjects of the study was 15.02 years and the average height, weight, and BMI were 159.50 cm, 52.58 kg, 20.62 kg/m2, respectively. The energy and nutrients intakes, percent of the recommended intake for nutrients in DDS = 5~6 group were significantly higher than those of the other groups. Calcium and vitamin C INQ in DDS = 5~6 group were significantly higher than those of the other groups. The average DVS of the subjects was 29.33. The most frequent style of food pattern was CMDFVO (cereals, meats, dairy, fruits, vegetables, fats and oils) = 111011. In conclusion, in healthy Korean female adolescents, food diversity intake variety did beneficially affect the intakes of calcium and vitamin C. Further studies are needed to confirm these findings.
Adolescent ; Ascorbic Acid ; Calcium ; Fats ; Female ; Fruit ; Humans ; Meat ; Nutrition Surveys ; Obesity ; Vegetables

Clinical EPS was performed in 16 normal adults without evidence of conduction disease on the surface standard 12 lead electrocardiogram in order to provide normal electrophysiological values of the sinus node function and AV conduction. EPS was also performed in 15 patients with sick sinus syndrome and 10 patients with AV conduction disturbance to evaluate the clinical usefulness of EPS in detecting sinus node dysfunction and AV conduction disturbance. The results were as follows. 1) The results of sinus node function test in the normal group were m-SNRT 853+/-198msec(range 800-1,560msec), c-SNRT 230+/-66msec(range 120-370msec), and %m -SNRT/SCL 127+/-11%(range 114-149%). 2) In 15 patients with SSS, the M-SNRT were ranged from 1,270 to 12,330msec and 10 patients(66%) had significantly increased m-SNRT exceeding 1,560msec. The c-SNRT were ranged from 230 to 10,730msec and 13 patients(83%) had significantly increased c-SNRT exceeding 370msec. The % m-SNRT/SCL were ranged from 136 to 770% and 12 patients(80%) had significantly increased % m-SNRT/SCL exceeding 150%. 3) The SACT in normal group were 84+/-14msec(range 70-105msec) measured by continuous atrial pacing method and 80+/-19 msec(range 60-115msec) measured by atrial extrastimulation method. 4) In SSS, the SACT measured by continuous atrial pacing method was ranged from 80 to 1,050msec and 11/12 patients(92%) had significantly increased SACT exceeding 112 msec. The SACT measured by atrial extrastimulation method was ranged from 90 to 310msec and 7/8 patients(88%) had significantly increased SACT exceeding 118 msec. 5) C-SNRT, % m-SNRT/SCL, and SACT were more useful in detecting sinus node dysfunction than m-SNRT. 6) The AV conduction intervals in normal group were PA interval 17+/-6(range 5-25msec), AH interval 96+/-18 msec(range 70-135msec), and HV interval 46+/-7msec(range 35-55msec). 7) Rapid atrial pacing induced Wenckebach type second degree AV block proximal to H at pacing rate of 90 to 190/min in 14/16 normal adults. 2 patients maintained intact AV conduction upto maximum pacing rate of 200/min. 8) His bundle electrogram showed the site of AV block in 9 of 10 patients with AV conduction disturbances. The sites of AV block were AV nodal area 1 case, intraHis bundle 4 cases, and infraHis bundle 4 cases. 9) EPS provided a good supportive information that was useful in selecting pacemaker therapy in a patient with chronic bifascicular block who revealed prolonged HV interval and infraHis bundle block at a pacing rate of 70min. 10) The refractory periods of AV conduction system in normal group were AERP 274+/-54msec (range 170-410msec), AVN-FRp 467+/-74msec(range 285-600msec), AVN-ERP 341+76msec(range 190-460), and V-ERP 280+/-25msec(range 240-320msec).
Adult ; Atrioventricular Block ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Humans ; Sick Sinus Syndrome ; Sinoatrial Node*

BACKGROUND/OBJECTIVES: Observational studies suggest that an association between vegetable consumption and coronary heart disease (CHD). However, the results are inconsistent. This study aimed to investigate the daily intake of vegetables on a national level and its effect on the risk of CHD risk, as determined by the Framingham Risk Score (FRS). SUBJECTS/METHODS: This study was conducted a cross-sectional design of 2,510 male adults 40-64y of age who participated in the 2007-2009 Korean National Health and Nutrition Examination Survey. Daily intake of vegetable was assessed by 24-h recall, and the consumption frequency of vegetables was determined using a food frequency questionnaire. The odd ratio of CHD risk according to daily intake and frequency of vegetables was analyzed. RESULTS: Total vegetable intake was inversely and significantly associated with the risk of CHD (Model 1: 4th vs. 1st quartile, OR = 0.74, 95% CI = 0.58-0.96, P for trend = 0.0015), and the significant relationship with CHD risk remained even after adjusting for potential confounders (Model 3: 4th vs. 1st quartile, adjusted OR [aOR] = 0.69, 95% CI = 0.49-0.95, P for trend = 0.0492). Subjects in the higher quartiles of non-salted vegetable intake had 31% lower odds of the risk of CHD compared to those in the lowest quartile after adjusting for various potential confounders in model 3 (aOR = 0.69; 95% CI = 0.49-0.97, P for trend = 0.0478). No significant associations between the frequency of vegetable intake (total, green, white and red vegetable) and the risk of CHD were found. CONCLUSIONS: The major results of this study indicate that higher vegetable intake may help prevent CHD in Korean men.
Adult ; Coronary Disease ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Vegetables*

It has been suggested that vegetables protect the cardiovascular system in part by attenuating blood pressure. The purpose of the present research was to examine blood lipids according to vegetable intakes. Anthropometric measurements, blood pressures, nutrient intakes using the 24-hour recall method, and serum lipids of < 50th percentile vegetable intake group (< 50th percentile VIG; men = 66, women = 111) and > or = 50th percentile vegetable intake group (> or = 50th percentile VIG; men = 83, women = 94) were estimated. The average age, height, and BMI were 54.7 years, 158.2 cm, 62.2 kg, and 24.9 kg/m2 for < 50th percentile VIG and 53.7 years, 159.6 cm, 63.0 kg, and 24.7 kg/m2 for > or =50th percentile VIG, respectively. The daily food intake of the > or = 50th percentile VIG was significantly higher than that of the < 50th percentile VIG (p < 0.001). Also, daily intakes of cereals (p < 0.001), legumes (p < 0.05), nuts (p < 0.05), vegetables (p < 0.001), and fruits (p < 0.05) of the > or = 50th percentile VIG were significantly higher than those of the < 50th percentile VIG. The daily energy intakes of > or = 50th percentile VIG and< 50th percentile VIG were 1342.7 kcal and 1782.0 kcal (p < 0.001), and most nutrient intakes of the > or = 50th percentile VIG was significantly higher than that of the < 50th percentile VIG. Serum cholesterol of the > or = 50th percentile VIG were significantly lower than that of the < 50th percentile VIG (p < 0.01). Also, vegetable intake showed significantly negative correlations with total cholesterol (p < 0.05) and LDL-cholesterol (p < 0.05). Based on these results, it should be emphasized that increase of vegetable intake improves the blood lipid profile.
Adult* ; Blood Pressure* ; Cardiovascular System ; Edible Grain ; Cholesterol ; Eating ; Fabaceae ; Female ; Fruit ; Humans ; Male ; Nuts ; Vegetables*

The purpose of this study was to compare the nutrient intake and diet quality of postmenopausal osteoporotic women to those of control subjects, and to investigate the relationship among diet quality and bone mineral density in postmenopausal women. In this study, we classified the subjects into the postmenopausal osteoporotic women (n = 38) and control (n = 43) according to their lumbar spine bone mineral density and age. Dietary intakes, anthropometric measurements and dietary quality indices were measured and evaluated. The average age of osteoporotic and control group were 60.4 yrs and 58.3 yrs, respectively and there was no significant difference. Body weight, body mass index of osteoporotic group were significantly lower than those of control group. The average energy intake of osteoporotic and control group were 1243.3 kcal and 1475.8 kcal, respectively and there was a significant difference. The osteoporotic group consumed significantly lower quantities of protein, plant protein, vitamin A, vitamin B1, vitamin B2, folate, vitamin C, calcium, animal calcium, plant calcium, iron and zinc compared to the control group. The osteoporotic group consumed significantly lower of food, vegetables, mushrooms, fruits intakes compared to the control group. In the diet quality, protein, vitamin A, vitamin B1, vitamin B2, folate, vitamin C, calcium, iron, Zinc nutrient adequacy ratio (NAR) of osteoporotic group were significantly lower than that of control group. Mean adequacy ratio (MAR) of osteoporotic and control group were 0.63 and 0.78, respectively and there was significant difference. To evaluate nutrient density, Index of nutritional quality (INQ) was calculated by dividing nutrient content per 1,000 kcal of diet with RDA per 1,000 kcal. The average dietary variety score (DVS) of osteoporotic and control group were 22.4 and 33.2, respectively and there was significant difference. DVSs of pulses (p < 0.01), seeds (p < 0.01) and vegetables (p < 0.05) in osteoporotic group were significantly lower than those of the control. In conclusion, postmenopausal osteoporotic women had lower protein, vitamin A, folate, vitamin C, calcium, iron zinc intake quality and vegetables, mushrooms, fruits DVSs than those of the control. Therefore, to promote skeletal health enough energy and food should be consumed, and the maintenance of vitamin and mineral balance by increasing of vitamin A, folate, vitamin C, calcium, iron of intakes are very important.
Agaricales ; Animals ; Ascorbic Acid ; Body Mass Index ; Body Weight ; Bone Density ; Calcium ; Diet* ; Energy Intake ; Female ; Folic Acid ; Fruit ; Humans ; Iron ; Nutritive Value ; Plants ; Riboflavin ; Spine ; Thiamine ; Vegetables ; Vitamin A ; Vitamins ; Zinc

Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.
Abdominal Pain ; Adult ; Female ; Humans ; Incidence ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Reproduction