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 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*

PURPOSE: This study was conducted to evaluate the risk of metabolic factors in adults consuming 3-in-1 coffee from the 2012~2015 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 5,872 subjects (male = 2,253, female = 3,619) aged 19~64 yrs were presented with food frequency questionnaires, and they were classified according to coffee consumption level and types of coffee consumed (black coffee, ≤1 time/day of 3-in-1 coffee, > 1 and ≤2 times/day of 3-in-1 coffee, > 2 times/day of 3-in-1 coffee). Analysis was conducted by gender for age-stratified groups: 19~39 (male = 968 and female = 1,285) and 40~64 (male = 1,468, female = 2,151) yrs old. RESULTS: Black coffee consumption was associated with a significantly higher education level and household income compared to 3-in-1 coffee consumption in both males and females. The > 2 times/day group had significantly more smokers compared to other patterns of coffee consumption in both males and females. In the 40~64 yrs age group, males and females in the > 2 times/day group had significantly lower density of micronutrients such as fiber, niacin, vitamin C, calcium, phosphorus,and potassium compared with black coffee consumption. In the 40~64 yrs age group, males (OR: 2.03, 95% CI: 1.13~3.64) in the > 2 times/day group were at a higher risk of metabolic syndrome compared with black coffee consumption after multivariable adjustment. CONCLUSION: We found that frequency of 3-in-1 coffee consumption may be associated with prevalence of metabolic syndrome in males aged 40~64 yrs.
Adult* ; Ascorbic Acid ; Calcium ; Coffee* ; Education ; Family Characteristics ; Female ; Humans ; Korea* ; Male ; Micronutrients ; Niacin ; Nutrition Surveys* ; Potassium ; Prevalence

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 is suggested that evaluation of diet quality may be a great indicator of nutritional assessment. The aim of this study was to evaluate the diet quality of children and adolescents based on nutrient and food group intake and Diet Quality Index-International (DQI-I). This survey was conducted through questionnaires and diet record survey to 477 students (elementary school students; n = 131, middle school students; n = 136, and high school students; n = 210). The results showed that high school students were significantly more often to skip breakfast compared with the other groups. The middle and high school students consumed significantly higher intakes of food and energy compared to the elementary school students. Also the number of nutrients in Index of Nutritional Quality (INQ) < 1.0 of high school students were significantly higher than that of elementary and middle school students. The Korean's dietary diversity score (KDDS) of elementary school, middle school and high school students were 4.1, 4.4 and 4.3 respectively. The average DQI-I of elementary school, middle school and high school students were 66.7, 65.5, and 63.7, respectively and there was significant difference. Also, middle school students showed to have higher score in variety and adequacy category compared with the other groups, and elementary school students appeared to have higher score in moderation category. In conclusion, high school students appeared to have unhealthy dietary habits in terms of high frequency of skipping breakfast and lower INQ and DQI-I score compared to the elementary school and middle school students. Therefore, the proper dietary management should be needed for high school students.
Adolescent ; Breakfast ; Child ; Diet ; Diet Records ; Food Habits ; Humans ; Nutrition Assessment ; Nutritive Value ; Surveys and Questionnaires

PURPOSE: The aim of this study was to investigate the relationship between instant noodle intake and metabolic factors in Korean adults. METHODS: Study subjects were 5,894 (male 2,293, female 3,601) aged 19~64 years who participated in the 2013~2014 KNHANES. Information on frequency and consumption of instant noodles was obtained by the food frequency questionnaires method in KNHANES (Korean National Health and Nutrition Examination Survey), and subjects were classified according to age, sex, and instant noodle consumption (INC). RESULTS: The frequency and consumption of instant noodles was 1.2 times/week and 1.2 servings in subjects. High INC group (≥ 1 serving/week) was significantly younger in age compared with the low INC group (< 1 serving/week). However, the high INC group had significantly higher waist circumference, metabolic factors (triglyceride, cholesterol, and HDL-cholesterol), and dietary intake (energy intake, fat, and sodium density) compared with the low INC group. Hyperglycemia showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors, including age, gender, household income, education, smoking, and alcohol compared with the lowest quartile (OR: 1.4, 95% CI: 1.1-1.8). In female, abdominal obesity showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors compared with the lowest quartile (OR: 1.6, 95% CI: 1.2-2.2). CONCLUSION: Consumption of instant noodles was associated with increased prevalence of abdominal obesity and hyperglycemia in women. These findings suggest an association of instant noodle consumption status with metabolic risk
Adult ; Cholesterol ; Education ; Family Characteristics ; Female ; Humans ; Hyperglycemia ; Korea* ; Methods ; Nutrition Surveys* ; Obesity, Abdominal ; Prevalence ; Smoke ; Smoking ; Sodium ; Waist Circumference

Epstein-Barr virus (EBV) has been known to be associated with a wide variety of neoplastic conditions including nasopharyngeal carcinoma, Hodgkin's disease, and non-Hodgkin's lymphoma. Recent studies reveal the presence of EBV in certain subtypes of gastric carcinoma in which EBV appears to be pathogenetically related. To evaluate the relationship between EBV and gastric adenocarcinoma, we examined EBV DNA using direct in situ polymerase chain reaction, and expression of p53 protein and bcl-2 protein using immunohistochemical staining method on paraffin embedded tissues. The materials consisted of one hundred twenty-eight gastric adenocarcinomas and twenty benign peptic ulcers. EBV DNA was detected in 14 of 128 gastric adenocarcinomas (10.9%). p53 protein was positive in 10 of 14 EBV positive adenocarcinomas (71.4%) and in 61 of 114 EBV negative adenocarcinomas (53.5%). Bcl-2 protein was positive in 2 of 14 EBV positive adenocarcinomas (14.3%) and in 19 of 114 EBV negative adenocarcinomas (16.7%). The above results indicate that EBV is associated with gastric adenocarcinoma, and p53 protein may play a role in carcinogenesis of EBV in gastric adenocarcinoma.
Adenocarcinoma* ; Carcinogenesis ; DNA ; Herpesvirus 4, Human* ; Hodgkin Disease ; Lymphoma, Non-Hodgkin ; Paraffin ; Peptic Ulcer ; Polymerase Chain Reaction