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

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

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

It is important to predict the prognosis of patient with cancer. Well known parameters predicting the prognosis are staged and degree of differentiation. Recently, the prognostic and diagnostic significance of silver-stained nucleolar organizer regions(Ag-NORs) and flow cytometric DNA analysis are introduced. This study aims to detect the diagnostic significance of Ag-NORs in breast lesions, and to correlate the number of Ag-NORs and cellular ploidies in breast carcinoma. In addition, the existence of heterogeneity according to the sample in the same patient is studied Sixty six paraffin blocks(two primary lesions and the two metastatic lymph nodes in 13 patients, and one primary lesion and one metastatic lymph node I 10 patients) of breast carcinoma, 30 paraffin blocks of fibroadenoma and 23 paraffin blocks of normal breast are studied. The numbe of Ag-NORs increase from normal breast(mean 1.45) through fibroadenoma(mean 1.60) to carcinoma(mean 2.43). It was significantly different between each lsions(P<0.0005). The number of Ag-NORs increased in the aneuploidy carcinoma than that in the euploidy one(P<0.05). But, there was difference between the number of Ag-NORs and DNA index according to the sample area in the same patient with carcinoma. In conclusion, the number of Ag-NORs is diagnostically significant in breast lesions and is correlated with cellular ploidies in breast carcinoma. In addition, Ag-NORs and cellular ploidies are heterogenous in the same patient.
Neoplasm Metastasis

It is thought that calcium (Ca) and magnesium (Mg) may be related to mental disorders such as depression; however, there have been few studies investigating the association between Ca and Mg nutrition status with depression in middle-aged female adults. Study subjects in this study included 105 women between the ages of 41 and 57 years. The subjects were divided into three groups according to the Zung Self-rating Depression Scale (SDS) score: Group I (SDS score < 33 percentile; n = 32), Group II (33 percentile < or = SDS score < 67 percentile; n = 37), and Group III (67 percentile < or = SDS score; n = 36). Anthropometric measurements, dietary intake survey using 3-day dietary records, SDS questionnaire and measurement of serum Ca and Mg were obtained and analyzed. No differences were observed in Ca, plant Ca, and Mg intake among the three groups. However, animal Ca intake by Group III was 141.3 mg, which was significantly lower than 207.6 mg by Group I and 198.3 mg by Group II (P = 0.0345). There were no significant differences in serum levels of Ca, and Mg among the three groups. Correlation analysis indicated that the SDS score had negative correlations with Ca intake (r = -0.2927, P < 0.01) and animal Ca (r = -0.3411, P < 0.001) after adjusting for age, menopause and energy intake. In conclusion, dietary Ca and animal Ca had negative associations with SDS score among middle-aged Korean female adults. Additional analysis of factors related to the association of calcium and magnesium nutritional status and depression is necessary.
Adult ; Animals ; Calcium ; Calcium, Dietary ; Depression ; Diet Records ; Energy Intake ; Female ; Humans ; Magnesium ; Menopause ; Mental Disorders ; Nutritional Status ; Plants ; Surveys and Questionnaires

PURPOSE: The objective of the present study was to evaluate nutrient and food group intakes in Korean adults according to energy intake from eating-out. METHODS: This study was a cross-sectional study based on the 2013~2014 Korea National Health and Nutritional Examination Survey, and study subjects were 5,186 males (2,151) and females (3,035) aged 19~64 years. Energy intake from eating-out was analyzed using the 24-hour dietary recall method, and groups were classified by quartile according to energy intake from eating-out. RESULTS: Subjects who had more energy intake from eating-out tended to be younger, highly educated, have a higher income, and have higher alcohol consumption. Total energy intake and fat intake density of the highest quartile group of energy intake from eating-out were higher than those of the other groups. However, fiber, vitamin B1, calcium, phosphorus, potassium, and iron intake density levels were significantly lower in the highest quartile group of energy intake from eating-out. The highest quartile group of energy intake from eating-out consumed significantly more meat and beverages compared to the other groups. In addition, regarding diet quality (Index of nutritional quality), significantly lower vitamin B1, calcium, phosphorus, and iron levels were observed in the highest quartile group of energy intake from eating-out compared to those in the other groups. CONCLUSION: In conclusion, in Korean adults, consumption of eating-out decreased dietary quality, including vitamin B1, calcium, phosphorus, and iron levels. Further studies are needed to confirm these findings.
Adult* ; Alcohol Drinking ; Beverages ; Calcium ; Cross-Sectional Studies ; Diet ; Energy Intake* ; Female ; Humans ; Iron ; Korea* ; Male ; Meat ; Methods ; Nutrition Surveys* ; Phosphorus ; Potassium ; Thiamine

PURPOSE: The purpose of the present study is to identify the relationship between practicing healthy diet and metabolic syndrome indicators in Koreans. METHODS: This research is a cross-sectional study based on the 2013~2014 Korea National Health and Nutritional Examination Survey. This study investigated 6,748 adults aged 19 to 64 yr (19~49 yr: n = 4,230, 50~64 yr: n = 2,518) to examine practice of healthy diet and metabolic syndrome indicators. In this study, according to practicing healthy diet, we classified subjects into the “Practicing healthy diet (PHD)” group (19~49 yr: n = 1,782, 50~64 yr: n = 937) and “Non-practicing healthy diet (NPHD)” group (19~49 yr: n = 2,448, 50~64 yr: n = 1,581). PHD score was determined by adding the number of practicing factors: adequate fat intake, sodium intake ≤ 2,000 mg/day, fruit & vegetable intake ≥ 500 g/day, and using nutrition label information in food selection. RESULTS: Female adults had a larger proportion of subjects who practiced a healthy diet compared to male adults (p < 0.001), and the percentages of 19~49 yr and 50~64 yr were 40.46% and 37.07%, respectively. The PHD group consumed significantly more calcium, vitamin B1, B2, and vitamin C density compared to the NPHD group. In 50~64 yr females, the subjects practicing healthy diet (PHD score ≥ 2) was inversely associated with risk of abdominal obesity (OR: 0.71, 95% CI: 0.54~0.93, p value = 0.0131) and metabolic syndrome (OR: 0.70, 95% CI: 0.52~0.94, p value = 0.0166) after adjustments for multiple confounding factors, compared with the lower PHD score (PHD score ≤ 1). CONCLUSION: Good dietary practice such as adequate fat intake, sodium intake ≤ 2,000 mg/day, sufficient fruit & vegetable intake, and using nutrition label information in food selection could be useful in decreasing metabolic syndrome risk of Korean adults.
Adult* ; Ascorbic Acid ; Calcium ; Cross-Sectional Studies ; Diet* ; Female ; Food Preferences ; Fruit ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Obesity, Abdominal ; Sodium ; Thiamine ; Vegetables

PURPOSE: This study was conducted to evaluate nutrition intake and diet quality according to carbonated drink consumption in male adolescents (middle-school students = 480, high-school students = 417). METHODS: We analyzed data from the combined 2007~2009 KNHANES (Korean National Health and Nutrition Examination Survey). Subjects were divided into two groups, the LCDI (low carbonated drink intake (< 1 time/week), n = 362) group and the HCDI (high carbonated drink intake (> or = 1 time/week), n = 535) group, according to carbonated beverage consumption. Nutrient and food group intake, NAR (nutrient adequacy ratio), and MAR (mean adequacy ratio) were analyzed using data from the 24-recall method. RESULTS: Intake of plant protein, vitamin C, plant calcium, phosphorous, and potassium was significantly lower in the HCDI group, compared with the LCDI group. Percent of RNI (recommended nutrient intake) of vitamin C and phosphorous was significantly lower in the HCDI group, compared with the LCDI group. Percentage of subjects who consumed under EAR (estimated average requirement) of protein and vitamin C was significantly higher in the HCDI group, compared with the LCDI group. The NAR of phosphorous was significantly lower in the HCDI group, compared with the LCDI group. Food intakes from potato and starches, pulses and vegetables were significantly lower in the HCDI group, compared with the LCDI group. CONCLUSION: Consumption of carbonated drinks decreased the diet quality, including calcium, potassium, protein, and vitamin C. Therefore, nutrition education relating to consumption of carbonated drinks is required for male adolescents in order to maintain healthy dietary habits.
Adolescent* ; Ascorbic Acid ; Calcium ; Carbon* ; Carbonated Beverages* ; Diet ; Ear ; Education ; Food Habits ; Humans ; Male* ; Nutrition Surveys* ; Nutritional Status* ; Plants ; Potassium ; Solanum tuberosum ; Starch ; Vegetables

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

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*