Background: The association between renal dysfunction and cardiovascular outcomes has yet to be determined in patients with hypertrophic cardiomyopathy (HCM). We aimed to investigate whether mildly reduced renal function is associated with the prognosis in patients with HCM. Methods: Patients with HCM were enrolled at two tertiary HCM centers. Patients who were on dialysis, or had a previous history of heart failure (HF) or stroke were excluded. Patients were categorized into 3 groups by estimated glomerular filtration rate (eGFR): stage I (eGFR ≥ 90 mL/min/1.73 m2 , n = 538), stage II (eGFR 60–89 mL/min/1.73 m2 , n = 953), and stage III–V (eGFR < 60 mL/min/1.73 m2 , n = 265). Major adverse cardiovascular events (MACEs) were defined as a composite of cardiovascular death, hospitalization for HF (HHF), or stroke during median 4.0-year follow-up. Multivariable Cox regression model was used to adjust for covariates. Results: Among 1,756 HCM patients (mean 61.0 ± 13.4 years; 68.1% men), patients with stage III–V renal function had a significantly higher risk of MACEs (adjusted hazard ratio [aHR], 2.71; 95% confidence interval [CI], 1.39–5.27; P = 0.003), which was largely driven by increased incidence of cardiovascular death and HHF compared to those with stage I renal function. Even in patients with stage II renal function, the risk of MACE (vs. stage I: aHR, 2.21’ 95% CI, 1.23–3.96; P = 0.008) and HHF (vs. stage I: aHR, 2.62; 95% CI, 1.23–5.58; P = 0.012) was significantly increased. Conclusion This real-world observation showed that even mildly reduced renal function (i.e., eGFR 60–89 mL/min/1.73 m2 ) in patients with HCM was associated with an increased risk of MACEs, especially for HHF.

Background and Objectives: Early diastolic mitral annular tissue (e’) velocity is a commonly used marker of left ventricular (LV) diastolic function. This study aimed to investigate the prognostic implications of e’ velocity in patients with mitral regurgitation (MR). Methods: This retrospective cohort study included 1,536 consecutive patients aged <65 years with moderate or severe chronic primary MR diagnosed between 2009 and 2018. The primary and secondary outcomes were all-cause and cardiovascular mortality, respectively.According to the current guidelines, the cut-off value of e’ velocity was defined as 7 cm/s. Results: A total of 404 individuals were enrolled (median age, 51.0 years; 64.1% male; 47.8% severe MR). During a median 6.0-year follow-up, there were 40 all-cause mortality and 16 cardiovascular deaths. Multivariate analysis revealed a significant association between e’ velocity and all-cause death (adjusted hazard ratio [aHR], 0.770; 95% confidence interval [CI], 0.634–0.935; p=0.008) and cardiovascular death (aHR, 0.690; 95% CI, 0.477–0.998;p=0.049). Abnormal e’ velocity (≤7 cm/s) independently predicted all-cause death (aHR, 2.467; 95% CI, 1.170–5.200; p=0.018) and cardiovascular death (aHR, 5.021; 95% CI, 1.189–21.211; p=0.028), regardless of symptoms, LV dimension and ejection fraction. Subgroup analysis according to sex, MR severity, mitral valve replacement/repair, and symptoms, showed no significant interactions. Including e’ velocity in the 10-year risk score improved reclassification for mortality (net reclassification improvement [NRI], 0.154; 95% CI, 0.308– 0.910; p<0.001) and cardiovascular death (NRI, 1.018; 95% CI, 0.680–1.356; p<0.001). Conclusions In patients aged <65 years with primary MR, e’ velocity served as an independent predictor of all-cause and cardiovascular deaths.

Background and Objectives: The prognostic or safety implication of renin-angiotensinaldosterone system inhibitors (RASi) in hypertrophic cardiomyopathy (HCM) are not well established, mainly due to concerns regarding left ventricular outflow tract (LVOT) obstruction aggravation. We investigated the implications of RASi in a sizable number of HCM patients. Methods: We enrolled 2,104 consecutive patients diagnosed with HCM in 2 tertiary university hospitals and followed up for five years. RASi use was defined as the administration of RASi after diagnostic confirmation of HCM. The primary and secondary outcomes were all-cause mortality and hospitalization for heart failure (HHF). Results: RASi were prescribed to 762 patients (36.2%). During a median follow-up of 48.1months, 112 patients (5.3%) died, and 94 patients (4.5%) experienced HHF. Patients using RASi had less favorable baseline characteristics than those not using RASi, such as older age, more frequent history of comorbidities, and lower ejection fraction. Nonetheless, there was no difference in clinical outcomes between patients with and without RASi use (log-rank p=0.368 for all-cause mortality and log-rank p=0.443 for HHF). In multivariable analysis, patients taking RASi showed a comparable risk of all-cause mortality (hazard ratio [HR], 0.70, 95% confidence interval [CI], 0.43–1.14, p=0.150) and HHF (HR, 1.03, 95% CI, 0.63–1.70, p=0.900). In the subgroup analysis, there was no significant interaction of RASi use between subgroups stratified by LVOT obstruction, left ventricular (LV) ejection fraction, or maximal LV wall thickness. Conclusions RASi use was not associated with worse clinical outcomes. It might be safely administered in patients with HCM if clinically indicated.

Two new species, Thelopsis ullungdoensis and Phylloblastia gyeongsangbukensis are described from Ullung-Do (Island), South Korea. The closest relatives from Europe and Korea are epiphytic Thelopsis flaveola which differs by their immersed or semi-immersed yellow ascomata, ascospores without halo and their habitat of smooth bark (mainly Fagus) in humid and cold climates. Thelopsis gangwondoensis differs by its bigger semi-immersed ascomata (600–700 µm in diam.), oblong halonate ascospores (8–12 × 6–8 µm) and its habitat of smooth bark of deciduous trees. P. gyeongsangbukensis differs from its relatives within the genus in having 5-septate ascospores (22–26 × 6–8 µm), semi-immersed, subglobose ascomata with a flattened top (250–400 µm) and a thin, matt, uneven gray-brown to gray-green continuous thallus without isidia.

Two new species, Thelopsis ullungdoensis and Phylloblastia gyeongsangbukensis are described from Ullung-Do (Island), South Korea. The closest relatives from Europe and Korea are epiphytic Thelopsis flaveola which differs by their immersed or semi-immersed yellow ascomata, ascospores without halo and their habitat of smooth bark (mainly Fagus) in humid and cold climates. Thelopsis gangwondoensis differs by its bigger semi-immersed ascomata (600–700 µm in diam.), oblong halonate ascospores (8–12 × 6–8 µm) and its habitat of smooth bark of deciduous trees. P. gyeongsangbukensis differs from its relatives within the genus in having 5-septate ascospores (22–26 × 6–8 µm), semi-immersed, subglobose ascomata with a flattened top (250–400 µm) and a thin, matt, uneven gray-brown to gray-green continuous thallus without isidia.

PURPOSE: The objective of this study was to measure secondhand smoke (SHS) exposure in personal computer (PC) rooms with the purpose of determining the strength of scientific evidence supporting the legislative ban on smoking in PC rooms located in the Republic of Korea. MATERIALS AND METHODS: From June to September 2012, particulate matter (PM2.5) and air nicotine concentration (ANC) were measured in the smoking and non-smoking areas of PC rooms in Goyang City, Korea. In 28 randomly sampled PC rooms, field investigators completed an observational questionnaire on building characteristics, smoking policies, and evidence of smoking. The geometric means (GM) of PM2.5 and ANC in smoking and non-smoking areas were compared. RESULTS: Evidence of smoking was identified in both the smoking and non-smoking areas of all PC rooms. The GMs of PM2.5 and ANC in both areas were high and did not differ significantly (174.77 μg/m3 and 48.95 μg/m3 in smoking areas; 93.38 μg/m3 and 41.30 μg/m3 in non-smoking areas). Overall PM2.5 concentrations were 5.5-fold higher than those listed in the World Health Organization guidelines. CONCLUSION: This study supported previous reports that a partial smoking ban did not protect individuals from SHS exposure. Furthermore, the results from our study suggest how research can support policy. Countries in which smoke-free policies are not yet comprehensive may find our results useful.
Humans ; Korea* ; Microcomputers ; Nicotine ; Particulate Matter ; Republic of Korea ; Research Personnel ; Smoke ; Smoke-Free Policy ; Smoking ; Tobacco Smoke Pollution* ; World Health Organization

Pulmonary edema is a major cause of mortality due to acute lung injury (ALI). The involvement of protein kinase C-delta (PKC-delta) in ALI has been a controversial topic. Here we investigated PKC-delta function in ALI using PKC-delta knockout (KO) mice and PKC inhibitors. Our results indicated that although the ability to produce proinflammatory mediators in response to LPS injury in PKC-delta KO mice was similar to that of control mice, they showed enhanced recruitment of neutrophils to the lung and more severe pulmonary edema. PKC-delta inhibition promoted barrier dysfunction in an endothelial cell layer in vitro, and administration of a PKC-delta-specific inhibitor significantly increased steady state vascular permeability. A neutrophil transmigration assay indicated that the PKC-delta inhibition increased neutrophil transmigration through an endothelial monolayer. This suggests that PKC-delta inhibition induces structural changes in endothelial cells, allowing extravasation of proteins and neutrophils.
Acute Lung Injury* ; Animals ; Capillary Permeability* ; Endothelial Cells ; Lung ; Mice ; Mortality ; Neutrophils ; Protein Kinase C-delta* ; Protein Kinases* ; Pulmonary Edema

PURPOSE: The purpose of this study was to compare smoking prevalence and risk factors of smoking between Korean and Korean-Chinese middle school students. METHODS: Data was collected from seventh and eighth grade students from 12 schools in Korea and 6 schools in China. Descriptive statistics, Chi-square test, and t test were performed. RESULTS: For data analysis 10,002 usable surveys were utilized. The smoking prevalence was higher in Korean-Chinese students than in Korean students. Risk factors, such as father smoking, friends smoking, gender, grade, academic achievement, alcohol use, and family income were associated with current smoking, and the differences in the two samples were significant. Korean-Chinese students were more likely than Korean students to have friends who smoked and a father who smoked. Smokers had a significantly higher rate of friends smoking, father smoking, and alcohol use. Korean-Chinese male students smoking prevalence was more than three times higher than Korean students. Korean students could sense a more anti-tobacco atmosphere in their environment. Korean-Chinese students were more likely than Korean students to perceive that it was easy to buy cigarettes and to smoke cigarettes in a public computer room. CONCLUSION: These results highlight the differences of smoking prevalence and risk factors between Korean-Chinese students and Korean students. The findings may help health educators and researchers to better understand adolescent smoking and risk factors cross culturally and aid in the development of more effective education programs, which could lead to preventing tobacco use among these populations.
Achievement ; Adolescent ; Atmosphere ; China ; Cross-Cultural Comparison ; Fathers ; Friends ; Health Educators ; Humans ; Korea ; Male ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Statistics as Topic ; Tobacco ; Tobacco Products

The aims of this study were to evaluate obesity-related dietary behaviors and to determine long-term exercise effects on obesity and blood lipid profiles in elderly Korean subjects. A total of 120 subjects, aged 60-75 yr, were recruited, and obesity-related dietary behaviors were determined. An exercise intervention was conducted with 35 qualified elderly females for 6 months, and body composition and blood lipids were measured 6 times at 4 week intervals. At baseline, mean BMI (kg/m2) was 24.8 for males and 23.1 for females. The females had better eating habits than the males and were more concerned with reading nutrition labels on food products (P < 0.001); they also preferred convenience foods less than the male subjects (P < 0.05). Obese individuals were more likely than overweight or normal weight individuals to misperceive their weight (P < 0.001). Those with a high BMI responded feeling more depressed (P < 0.01), lacking self-confidence (P < 0.01), and feeling isolated (P < 0.01), as well as having more difficulty doing outdoor activities (P < 0.01). After exercise, body fat (%) and WHR were significantly reduced (P < 0.05), while body weight and BMI were also decreased without statistical significance. Total cholesterol and blood HDL were significantly improved (207.1 mg/dl vs. 182.6 mg/dl, HDL: 45.6 mg/dl vs. 50.6 mg/dl, P < 0.05). Other benefits obtained from exercise were improvements in self-confidence (26.4%), movement (22.6%), stress-relief (18.9%), and depression (13.2%). In conclusion, elderly females had better eating habits and were more concerned with nutrition information and healthy diets compared to elderly males. However, misperceptions of weight and obesity-related stress tended to be very high in females who were overweight and obese, which can be a barrier to maintain normal weight. Long-term Danhak practice, a traditional Korean exercise, was effective at reducing body fat (%) and abdominal obesity, and improved lipid profiles, self-confidence, and stress.
Adipose Tissue ; Aged ; Body Composition ; Body Weight ; Cholesterol ; Depression ; Diet ; Eating ; Fast Foods ; Female ; Humans ; Male ; Obesity ; Obesity, Abdominal ; Overweight

OBJECTIVE: The aim of our study was to define the prevalence, demographic data, selection of the medical services and disability of the patients with self-reported arthritis which were based on the data of National Health and Nutrition Survey (NHNS) conducted by Korea Institute for Health and Social Affairs (KIHASA) and Ministry of Health and Welfare in 1998. MEHTODS: By a stratified multistage probability sampling method, 200 sample districts which consisted of total 13,523 households were selected all over the country. The investigation started with a basic household survey which was completed in 12,189 households with exclusion of non-kinship family. The Health Interview Survey was subdivided to 5 parts including the basic household survey (n=39,060), the diseases survey (n=26,448), and the disability survey (n=694). RESULTS: An estimated 8.0% of Koreans had some form of self-reported arthritis in 1998 and this proportion was higher than that of other chronic medical conditions such as peptic ulcer disease, hypertension, and diabetes mellitus (DM) -7.0%, 4.5%, and 2.2%, respectively. Arthritis was more prevalent among people with female, increasing age, lower income (less than 500 thousand \ per month), lower educational attainment (less than 9 years), and lower standard of living. Especially, arthritis ranked first in prevalence as the cause of the chronic disease in the population aged over 45 years, with the prevalence rate of 22.6%. People with arthritis were more likely to report functional limitations such as activities of daily living (ADL) and instrumental activities of daily living (IADL) (5.4%), compared with people who had other musculoskeletal diseases, such as low back pain (3.8%), and herniated intervertebral disc (2.8%). The loss of productivity from arthritis was estimated to reach 0.25% of gross domestic product (GDP) amounts to won 1,133 billion per year which was remarkably higher than that of cardiovascular diseases or cancers. CONCLUSION: Arthritis has a major impact on the health profile of our population. High burden of arthritis in our society should be considered as an important factor in planning health care services and setting research priorities.
Activities of Daily Living ; Arthritis* ; Cardiovascular Diseases ; Chronic Disease ; Delivery of Health Care ; Diabetes Mellitus ; Efficiency ; Epidemiology ; Family Characteristics ; Female ; Gross Domestic Product ; Humans ; Hypertension ; Intervertebral Disc ; Korea* ; Low Back Pain ; Musculoskeletal Diseases ; Nutrition Surveys ; Peptic Ulcer ; Prevalence* ; Socioeconomic Factors