Under the assumption that people go through stages in making dietary behavior change, this study was attempted to apply the stages of a change model for fat intake by examining the associations of social psychological variables with stages of change in dietary fat reduction. Derived from social psychological theories, 10 social psychological variables on motivational beliefs(6), social influence(3) and self-efficacy(1) related specifically to selecting every day diets low in fat were constructed. Fat and energy intakes were assessed by a short form semi-quantitative food frequency questionnaire. The associations of stages of change with motivational beliefs, social influence, and self-efficacy variables and energy and fat intakes were assessed in 333 female adults from large cities in Korea. Dietary stage groups differed significantly on most of the social psychological variables in ways predicted by theory. Motivational factors that lead to a psychological state of readiness to take action were important in the early stages of the dietary change process. Social influences were more important in the stages as people decide to take action. Self efficacy and motivational beliefs, particularly, reduction of perceived barriers were important in maintaining fat reduction behavior. The results of our study indicate differences in stages of change in fat reduction behavior in terms of nutrient intakes and social psychological correlates and suggests that adding a time dimension to social psychological models increases our understanding of dietary change, which assist us in designing nutrition education interventions that are more appropriately targeted by stage of change.
Adult* ; Diet ; Dietary Fats ; Education ; Female* ; Humans ; Korea ; Models, Psychological ; Psychological Theory ; Self Efficacy ; Surveys and Questionnaires

During routine antenatal ultrasound examinations, an ovarian mass can be found incidentally. In clinical practice, the differential diagnosis between benign and malignant ovarian masses is essential for planning further management. Ultrasound imaging has become the most popular diagnostic tool during pregnancy, with the recent development of ultrasonography. In non-pregnant women, several methods have been used to predict malignant ovarian masses before surgery. The International Ovarian Tumor Analysis (IOTA) group reported several scoring systems, such as the IOTA simple rules, IOTA logistic regression models, and IOTA assessment of different NEoplasias in the adneXa. Other researchers have also evaluated the malignancy of ovarian masses before surgery using scoring systems such as the Sassone score, pelvic mass score, DePriest score, Lerner score, and Ovarian-Adnexal Reporting and Data System. These researchers suggested specific features of ovarian masses that can be used for differential diagnosis, including size, proportion of solid tissue, papillary projections, inner wall structure, locules, wall thickness, septa, echogenicity, acoustic shadows, and presence of ascites. Although these factors can also be measured in pregnant women using ultrasound, only a few studies have applied ovarian scoring systems in pregnant women. In this article, we reviewed various scoring systems for predicting malignant tumors of the ovary and determined whether they can be applied to pregnant women.

PURPOSE: To investigate the prevalence and related risk factors of infection with human papillomavirus(HPV) in young adults, and the interrelationships among the risk factors, school-based survey was conducted in Busan. METHODS: A total of 1,430 male and female students(aged 16~25) participated in the survey that included self-administered questionnaire and, for males, physician-performed collection of exfoliated genital cells, for females, self-collection of vaginal cells. The prevalences of 25 HPV types were evaluated by a polymerase chain reaction-based assay. RESULTS: HPV DNA detected more frequently in female students(15.2%) than in male students(8.7%). In female students, currently smoking cigarettes(OR=3.8, 95% CI=1.7~8.3) and having had penetrative sexual intercourse(OR=12.7, 95% CI=7.2~22.2) were the significant risk factors for HPV infection; in male students, there was nothing to show statistical significance. Smoking rate was 53.8% in males and 17.7% in females, and 55.6% of male students and 25.9% of female students reported having had a sexual intercourse. Smokers were more likely to have had a sexual intercourse than nonsmokers(OR=4.0, 95% CI=2.5~6.2, males; OR=9.1, 95% CI=5.6~14.7, females). CONCLUSIONS: According to the strong interrelationship between sexual intercourse and smoking, multilateral behavioral intervention is needed to prevent infection with HPV.
Adolescent* ; Busan ; Coitus ; DNA ; Female ; Humans* ; Male ; Papillomavirus Infections* ; Prevalence ; Risk Factors* ; Sexual Behavior ; Smoke ; Smoking ; Young Adult ; Surveys and Questionnaires

OBJECTIVE: Human immunodeficiency virus (HIV) infection has been known to damage the microstructural integrity of white matter (WM). However, only a few studies have assessed the brain regions in HIV-associated neurocognitive disorders (HAND) with diffusion tensor imaging (DTI). Therefore, we sought to compare the DTI data between HIV patients with and without HAND using tract-based spatial statistics (TBSS). MATERIALS AND METHODS: Twenty-two HIV-infected patients (10 with HAND and 12 without HAND) and 11 healthy controls (HC) were enrolled in this study. A whole-brain analysis of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity was performed with TBSS and a subsequent 20 tract-specific region-of-interest (ROI)-based analysis to localize and compare altered WM integrity in all group contrasts. RESULTS: Compared with HC, patients with HAND showed decreased FA in the right frontoparietal WM including the upper corticospinal tract (CST) and increased MD and RD in the bilateral frontoparietal WM, corpus callosum, bilateral CSTs and bilateral cerebellar peduncles. The DTI values did not significantly differ between HIV patients with and without HAND or between HIV patients without HAND and HC. In the ROI-based analysis, decreased FA was observed in the right superior longitudinal fasciculus and was significantly correlated with decreased information processing speed, memory, executive function, and fine motor function in HIV patients. CONCLUSION: These results suggest that altered integrity of the frontoparietal WM contributes to cognitive dysfunction in HIV patients.
Anisotropy ; Automatic Data Processing ; Brain ; Corpus Callosum ; Diffusion Tensor Imaging ; Executive Function ; Hand ; HIV ; Humans* ; Memory ; Neurocognitive Disorders* ; Pyramidal Tracts ; White Matter*

BACKGROUDN: The ratio of mitral inflow (E) and annular velocity (E') to stroke volume (E/E'/SV) has been used as an index of diastolic elastance (Ed). However, its change during exercise has not been evaluated. We hypothesized that Ed values obtained during exercise would be abnormal in patients with apical hypertrophic cardiomyopathy (ApHCM). METHODS: Ed was measured at rest and during graded supine bicycle exercise (25 Watts, 3 minute increments) in 15 patients with ApHCM (12 male; mean age, 57 years) and in 15 age- and gender-matched control subjects. RESULTS: Ed was not significantly different at rest and during 25 W of exercise. However, Ed was significantly higher at 50 W of exercise in patients with ApHCM compared to control subjects (0.21+/-0.05 vs. 0.15+/-0.04 cm/s, p=0.0059). There was significant positive correlation between the magnitude of change in proBNP levels during exercise and the change of Ed from rest to 50 W of exercise (r2=0.69, p<0.0001). CONCLUSION: Noninvasively-determined Ed was similar at rest and during mild exercise between patients with ApHCM and control subjects. However, Ed was significantly higher during moderate exercise in ApHCM patients, suggesting a dynamic change in LV stiffness during exercise in these patients.
Cardiomyopathy, Hypertrophic* ; Humans ; Male ; Stroke Volume

BACKGROUDN: The ratio of mitral inflow (E) and annular velocity (E') to stroke volume (E/E'/SV) has been used as an index of diastolic elastance (Ed). However, its change during exercise has not been evaluated. We hypothesized that Ed values obtained during exercise would be abnormal in patients with apical hypertrophic cardiomyopathy (ApHCM). METHODS: Ed was measured at rest and during graded supine bicycle exercise (25 Watts, 3 minute increments) in 15 patients with ApHCM (12 male; mean age, 57 years) and in 15 age- and gender-matched control subjects. RESULTS: Ed was not significantly different at rest and during 25 W of exercise. However, Ed was significantly higher at 50 W of exercise in patients with ApHCM compared to control subjects (0.21+/-0.05 vs. 0.15+/-0.04 cm/s, p=0.0059). There was significant positive correlation between the magnitude of change in proBNP levels during exercise and the change of Ed from rest to 50 W of exercise (r2=0.69, p<0.0001). CONCLUSION: Noninvasively-determined Ed was similar at rest and during mild exercise between patients with ApHCM and control subjects. However, Ed was significantly higher during moderate exercise in ApHCM patients, suggesting a dynamic change in LV stiffness during exercise in these patients.
Cardiomyopathy, Hypertrophic* ; Humans ; Male ; Stroke Volume

Objectives: . We, herein, report two novel USH2A variants from two unrelated Korean families and their clinical phenotypes, with attention to severe or more than severe sensorineural hearing loss (SNHL). Methods: . Two postlingually deafened subjects (SB237-461, M/46 and SB354-692, F/34) with more than severe SNHL and also with suspicion of Usher syndrome type II (USH2) were enrolled. A comprehensive audiological and ophthalmological assessments were evaluated. We conducted the whole exome sequencing and subsequent pathogenicity prediction analysis. Results: . We identified the following variants of USH2A from the two probands manifesting more than severe SNHL and retinitis pigmentosa (RP): compound heterozygosity for a nonsense (c.8176C>T: p.R2723X) and a missense variant (c.1823G>A: p.C608Y) in SB237, and compound heterozygosity for two frameshift variants (c.14835delT: p.S4945fs & c.13112_13115delAAAT: p.G4371fs) in SB354. Based on the American College of Medical Genetics and Genomics/Association for Molecular Pathology guidelines, two novel variants, c.1823G>A: p.C608Y and c.14835delT: p.Ser4945fs, can be classified as “uncertain significance” and “pathogenic,” respectively. The audiogram exhibited more than severe SNHL and a down-sloping configuration, necessitating cochlear implantation. The ophthalmic examinations revealed typical features of RP. Interestingly, one proband (SB 354-692) carrying two truncating compound heterozygous variants exhibited more severe hearing loss than the other proband (SB 237-461), carrying one truncation with one missense variant. Conclusion . Our results provide insight on the expansion of audiological spectrum encompassing more than severe SNHL in Korean subjects harboring USH2A variants, suggesting that USH2A should also be included in the candidate gene of cochlear implantation. A specific combination of USH2A variants causing truncating proteins in both alleles could demonstrate more severe audiological phenotype than that of USH2A variants carrying one truncating mutation and one missense mutation, suggesting a possible genotype-phenotype correlation. The understanding of audiological complexity associated with USH2A will be helpful for genetic counseling and treatment starategy.

Of the congenital coronary artery fistulae, the multiple coronary artery microfistulae, arising from the left and right coronary artery emptying into the left ventricle, are very rare. Little is known about their anatomic and clinical features, especially in apical hypertrophic cardiomyopathy. The clinical findings are heterogeneous, but include, in most cases, a history of typical or atypical angina pectoris. A 67 year old woman was referred for evaluation of chest pain on exertion, and a shortness of breath. The electrocardiographic and echocardiographic findings were typical of apical hypertrophic cardiomyopathy. Coronary arteriography showed normal epicardial coronary arteries, but multiple coronary artery-left ventricular microfistulae arising from the left and right coronary arteries. Transthoracic Doppler echocardiography, using a high frequency transducer, with a low Nyquist limit, demonstrated multiple coronary artery-left ventricular microfistulae just beneath the apical impulse window.
Aged ; Angina Pectoris ; Angiography ; Cardiomyopathy, Hypertrophic ; Chest Pain ; Coronary Vessels ; Dyspnea ; Echocardiography ; Echocardiography, Doppler* ; Electrocardiography ; Female ; Fistula ; Heart Ventricles ; Humans ; Transducers ; Vascular Fistula

Intestinal epithelial cells (IECs) have been known to produce galactose-alpha1,4-galactose-beta1,4-glucose ceramide (Gb3) that play an important role in the mucosal immune response. The regulation of Gb3 is important to prevent tissue damage causing shiga like toxin. Epigallocatechin-3-gallate (EGCG) has been studied as anti-carcinogenic, anti-oxidant, anti-angiogenic, and anti-viral activities, and anti-diabetic. However, little is known between the expressions of Gb3 on IECs. The aim of this study was to examine the inhibitory effect of EGCG, a major ingredient of green tea, on Gb3 production via mitogen-activated protein kinases (MAPKs) and nuclear factor-kappa B (NF-kappa B) in the TNF-alpha stimulated human colon epithelial cells, HT29. To investigate how Gb3 is regulated, ceramide glucosyltransferase (CGT), lactosylceramide synthase (GalT2), and Gb3 synthase (GalT6) were analyzed by RT-PCR in HT 29 cells exposed to TNF-alpha in the presence or absence of EGCG. EGCG dose-dependently manner, inhibits TNF-alpha induced Gb3 expression by blocking in both the MAPKs and NF-kappaB pathways in HT29 cells. TNF-alpha enhanced CGT, GalT2 and GalT6 mRNA levels and EGCG suppressed the level of these enzymes enhanced by TNF-alpha treatment.
Apoptosis/drug effects ; Blotting, Western ; Catechin/*analogs & derivatives/pharmacology ; Cell Nucleus/drug effects/metabolism ; Cell Proliferation/drug effects ; Dose-Response Relationship, Drug ; Epithelial Cells/drug effects/metabolism/pathology ; Flow Cytometry ; Galactosyltransferases/genetics ; Gene Expression Regulation, Enzymologic/drug effects ; Glucosyltransferases/genetics ; HT29 Cells ; Humans ; Intestinal Mucosa/drug effects/metabolism/pathology ; Mitogen-Activated Protein Kinases/antagonists & inhibitors/*metabolism ; NF-kappa B/antagonists & inhibitors/*metabolism ; Phosphorylation/drug effects ; Protein Transport/drug effects ; RNA, Messenger/genetics/metabolism ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Trihexosylceramides/*biosynthesis ; Tumor Necrosis Factor-alpha/*pharmacology

BACKGROUND: Wolff-Parkinson-White syndrome(WPW syndrome) is well known and somtimes causes life-threatening arrhythmias.To date,the clinical and electrophysiologic charicteristics of patients with WPW syndrome in Korea has not been available,though results of catheter ablation treatment for atrioventricular reentrant tachycardia(AVRT) including WPW syndrome were reported. METHOD: Clinical and electrocardiographic(ECG) characteristics and results of electrophysiologic study of consecutive 400 patients with WPW syndrome who underwent electrophsiologic study between December 1986 and September 1995 were analyzed. RESULTS: Mean age of the patients was 35 years and male patients were more common(262male patients,65.5%).Mean duration and frequency of palpitation episodes were 8.1 years and 4.2 times per month,respectively.Thirty six patients(9.0%) experienced syncopal episodes and the half of them were associated with atrial fibrillation.Two cases of aborted sudden cardiac death were associated with atrial fibrillation.Twenty four cases of congenital heart diseases and 13 cases of acquired heart diseases were found.The most commonly associated cardiac disease was Ebstein's anomaly(8 cases,2,0%).Clinically,368 patients(92,0%) had ECG-documented tachycardias and 46 patients had two or more types of tachycardia.Orthodromic AVRT was the most common tachcardia (227 patients including 44 cases with coexisting atrial fibrillation).Atrial fibrillation was documented in 115 patients(31.1%) and antidromic AVRT in 23 patients(6.2%).Patients with antidromic AVRT were more likely to have multiple accessory pathways compared to those with orthodromic AVRT (30.4% versus 4.3%).On electrophysiologic study,the most commonly inducible tachcardia was also orthodromic AVRT (334/389 cases,89.8%).Antidromic AVRT was induced in 23 cases(6.0%).Atrial fibrillation was present in 104 patients(27.2%),especially in those with clinically documented atrial fibrillation(71.3% vs 12.3%).In 17 patients without inducible tachycardias,ventriculoatrial conduction was absent or had long effective refractory period.Finally,396 patients(99.0%) had clinically documented or inducible tachycardias.Eight patients with Ebstein's anomaly had right-sided accessory pathway(87.5%)exept one case.Twenty four patients had secondary accessory pathway.The most common site of accessory pathway including secondary accessory pathway was left free wall(204 cases,48.1%).Other accessory pathways were found at right free wall(123 cases,29.0%),posteroseptal(54 cases,17.5%)and anteroseptal site(15 cases,3.5%)in order. CONCLUSIONS: The clinical and electrophysiologic characteristics of patients in this series were similar with those of previous reports of other countries.Because certain types of tachyarrhythmia were associated with characteristic electrophysiologic findings such as the relationships between antidromic AVRT and presence of secondary accessory pathways or clinical atrial fibrillation and higher occurrence rate of atrial fibrillation during electrophysiologic study,it is important to document clinical tachyarrhythmias with ECG.And electrophysiologic study can have important clinical implications in diagnosis and especially in curative treatment.
Atrial Fibrillation ; Catheter Ablation ; Death, Sudden, Cardiac ; Diagnosis ; Ebstein Anomaly ; Heart Diseases ; Humans ; Korea ; Male ; Syncope ; Tachycardia ; Wolff-Parkinson-White Syndrome*