PURPOSE: To construct new Korean reference curves for birth weight by sex and gestational age using contemporary Korean birth weight data and to compare them with the Lubchenco and the 2010 United States (US) intrauterine growth curves. METHODS: Data of 2,336,727 newborns by the Korean Statistical Information Service (2008-2012) were used. Smoothed percentile curves were created by the Lambda Mu Sigma method using subsample of singleton. The new Korean reference curves were compared with the Lubchenco and the 2010 US intrauterine growth curves. RESULTS: Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles birth weight by gestational age were made using 2,249,804 (male, 1,159,070) singleton newborns with gestational age 23-43 weeks. Separate birth weight curves were constructed for male and female. The Korean reference curves are similar to the 2010 US intrauterine growth curves. However, the cutoff values for small for gestational age (<10th percentile) of the new Korean curves differed from those of the Lubchenco curves for each gestational age. The Lubchenco curves underestimated the percentage of infants who were born small for gestational age. CONCLUSION: The new Korean reference curves for birth weight show a different pattern from the Lubchenco curves, which were made from white neonates more than 60 years ago. Further research on short-term and long-term health outcomes of small for gestational age babies based on the new Korean reference data is needed.
Asian Continental Ancestry Group ; Birth Weight* ; Female ; Gestational Age* ; Growth Charts ; Humans ; Infant ; Infant, Newborn ; Information Services* ; Male ; United States

BACKGROUND AND OBJECTIVES: According to the MADIT II criteria, a low left ventricular ejection fraction (LVEF) is one of the most important predicting factors for sudden cardiac death (SCD) in post myocardial infarction (PMI) patients, and it is a reasonable indication for ICD implantation. The aim of this study is to reveal the incidence and the prognostic value of the non-invasive parameters and whether the MADIT II criteria for ICD implantation can be applied to Korean PMI patients. SUBJECTS AND METHODS: During the period from January 2001 to June 2005, 640 PMI survivors were included in this study. The incidence of an abnormal SAECG, premature ventricular complex (PVC) counts > or = 10/hr, non-sustained ventricular tachycardia (NSVT) on ambulatory ECG and a low (< or = 30%) LVEF were studied and used as risk stratification markers for later adverse arrhythmic events. RESULTS: The incidence of PVCs > or = 10/hr and NSVT on the ambulatory ECG was 14.3% and 7.5%, respectively. 29 patients (4.9%) had a LVEF of less than 30%. Arrhythmic events occurred in 9 of the 29 patients (31%). SCD or adverse arrhythmic events occurred in 42 of the 640 patients. The percentage of patients who were using beta-blocker was lower than that in the MADIT II study group (55% vs 70%, respectively). In the adverse arrhythmic event (+) group, the percentage of beta-blocker use was significantly lower than that in the arrhythmic event (-) group (32.5% vs 58%, respectively). CONCLUSION: The MADIT II criteria and PVCs > or = 10/hr or NSVT on the ambulatory ECG can be suggested as the indications for implanting an ICD in Korean PMI patients. The use of beta-blocker is important for preventing adverse arrhythmic events.
Death, Sudden, Cardiac* ; Electrocardiography ; Humans ; Incidence ; Myocardial Infarction* ; Risk Assessment ; Stroke Volume* ; Survivors ; Tachycardia, Ventricular ; Ventricular Premature Complexes

A 52-year-old woman, who was suffering from aplastic anemia, presented with the clinical features of severe heart failure. The transthoracic echocardiogram showed a heterogeneous, huge mass on the base of the posterior mitral valve. We guessed that the mass would be a benign neoplasm and probably myxoma, and we decided upon surgical resection. After tumor resection, an unexpected result of the histopathology was a high grade osteosarcoma. The other studies that were done after we had the diagnosis could not reveal any evidence of metastatic malignancy.
Anemia, Aplastic ; Diagnosis ; Female ; Heart Failure ; Heart Neoplasms ; Humans ; Middle Aged ; Mitral Valve ; Myxoma ; Osteosarcoma*

BACKGROUND: Leptin has been suggested as a possible cause of atherosclerotic disease. The small dense low-density lipoprotein cholesterol (LDL-C) has also been regarded as a new surrogate marker in atherosclerotic disease. The aim of this study was to evaluate the relationship between the leptin concentration and the small dense LDL-C concentration in Korean type 2 diabetic patients. METHODS: One hundred-ninety one type 2 diabetic patients, who did not use any medication that could affect the concentration of lipid such as statin, fibrate, thiazolidinediones and corticosteroid, were enrolled in this study. We analyzed the relationship between leptin, the small dense LDL-C and the other metabolic parameters. RESULTS: The small dense LDL-C concentrations were higher in the group with the highest tertile of the leptin value, both in males and females than those patients in the group with the lowest tertile of the leptin value. The small dense LDL-C concentrations were also higher in the group with the highest tertile of leptin divided by the BMI value both in males and females than those patients in the group with the lowest tertile of the leptin value. The leptin concentration was positively correlated with the small dense LDL-C, total cholesterol, triglyceride, LDL-C, insulin and HOMAIR values after adjusting for age, gender and BMI. CONCLUSION: The association between leptin and small dense LDL-C could be a factor that explains the association between leptin and cardiovascular disease.
Biomarkers ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, LDL* ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Insulin ; Leptin* ; Lipoproteins ; Male ; Thiazolidinediones ; Triglycerides

BACKGROUND: Leptin has been suggested as a possible cause of atherosclerotic disease. The small dense low-density lipoprotein cholesterol (LDL-C) has also been regarded as a new surrogate marker in atherosclerotic disease. The aim of this study was to evaluate the relationship between the leptin concentration and the small dense LDL-C concentration in Korean type 2 diabetic patients. METHODS: One hundred-ninety one type 2 diabetic patients, who did not use any medication that could affect the concentration of lipid such as statin, fibrate, thiazolidinediones and corticosteroid, were enrolled in this study. We analyzed the relationship between leptin, the small dense LDL-C and the other metabolic parameters. RESULTS: The small dense LDL-C concentrations were higher in the group with the highest tertile of the leptin value, both in males and females than those patients in the group with the lowest tertile of the leptin value. The small dense LDL-C concentrations were also higher in the group with the highest tertile of leptin divided by the BMI value both in males and females than those patients in the group with the lowest tertile of the leptin value. The leptin concentration was positively correlated with the small dense LDL-C, total cholesterol, triglyceride, LDL-C, insulin and HOMAIR values after adjusting for age, gender and BMI. CONCLUSION: The association between leptin and small dense LDL-C could be a factor that explains the association between leptin and cardiovascular disease.
Biomarkers ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, LDL* ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Insulin ; Leptin* ; Lipoproteins ; Male ; Thiazolidinediones ; Triglycerides

Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome, typically characterized by multiple colorectal adenomas and increased incidence of colorectal carcinomas if left untreated. It is caused by germline mutations of the adenomatous polyposis coli (APC) gene, which has been mapped on chromosome 5q21, and is accompanied by various benign and malignant extracolonic manifestations. The prevalence of thyroid tumors developing in patients with FAP is about 1~2%, are associated with FAP and have certain characteristics; mean age of tumor diagnosis at less than 30 years of age, the pathology is the papillary histiotype in more than 90% of cases, including a so-called cribriform- morular pattern, and multifocality is a frequent feature. In a genetic analysis, thyroid cancer in FAP usually has a mutation in the 5-portion of exon 15 between 778 and 1309, on chromosome 5q21. Also, the ret/PTC (especially ret/PTC1 and ret/PTC3) and p53 genes are thought probably to be associated with thyroid cancer in FAP patients. A case of familial adenomatous polyposis, accompanied by thyroid papillary cancer, was experienced in a 29 year-old female. She had hundreds of adenomas throughout the entire colon and congenital hypertrophy of the retinal pigment epithelium (CHRPE). The pathological finding of thyroid cancer was revealed as a mixture of cribriform, trabecular and papillary patterns. In a genetic analysis, she and her brother had a germline mutation of the APC gene at codon 1309. In Korea, there has been no previous case of cribriform-morular pattern and familial genetic analysis in FAP associated with thyroid cancer. Therefore, this case is reported, with a review of the literature
Adenoma ; Adenomatous Polyposis Coli* ; Adult ; Codon ; Colon ; Colorectal Neoplasms ; Diagnosis ; Exons ; Female ; Genes, APC ; Genes, p53 ; Germ-Line Mutation ; Humans ; Hypertrophy ; Incidence ; Korea ; Pathology ; Prevalence ; Retinal Pigment Epithelium ; Siblings ; Thyroid Gland* ; Thyroid Neoplasms

BACKGROUND: High sensitivity C-reactive protein (hsCRP) is more sensitive than standard CRP assay in evaluating a risk of coronary heart diseases and other atherosclerotic events. By this time, there are several reports that type 2 diabetic subjects have higher level of hsCRP than non-diabetic subjects. However, there are few reports about factors which have influence upon the level of serum hsCRP in type 2 diabetic subjects. We had evaluated the association of serum hsCRP level with risk factors of cardiovascular diseases, carotid intima-media thickness (IMT) and microvascular complications in type 2 diabetic subjects. METHODS: 105 patients (59 men and 46 women) with type 2 diabetes were recruited, and subjects with severe cardiovascular diseases were excluded. All subjects were undergone carotid ultrasonography for evaluation of carotid IMT. Serum hsCRP concentrations were measured. For evaluation of microvascular complications, fundus photography, nerve conduction velocity test were performed, and 24-hour urine protein/albumin excretion amounts were measured. RESULTS: Serum hsCRP level was correlated with mean left IMT (r=0.366, p=0.003), maximal left IMT (r=0.370, p=0.002), mean right IMT (r=0.281, p=0.023) and maximal right IMT (r=0.370, p=0.002). Body mass index (r=0.377, p<0.001), waist circumference (r=0.342, p<0.001), waist-hip ratio (r=0.229, p=0.020), serum total cholesterol (r=0.202, p=0.024), serum triglyceride (r=0.292, p=0.022) and serum low density lipoprotein (r=0.133, p=0.044). There was no difference of serum hsCRP level between groups with or without retinopathy (1.26+/-0.83 vs 1.13+/-1.13 mg/L, p=0.704), neuropathy (1.30+/-1.27 vs 0.88+/-0.80 mg/L, p=0.203) or nephropathy (1.10+/-0.93 vs 1.06+/-1.06 mg/L, p=0.863). CONCLUSION: We conclude that serum hsCRP level is correlated with carotid IMT and the risk factors of cardiovascular diseases, and may be useful to predict accelerated atherosclerotic process in type 2 diabetic subjects. But, diabetic microvascular complications do not effect on the level of serum hsCRP.
Body Mass Index ; C-Reactive Protein* ; Cardiovascular Diseases ; Carotid Intima-Media Thickness* ; Cholesterol ; Coronary Disease ; Diabetes Mellitus, Type 2 ; Humans ; Lipoproteins ; Male ; Neural Conduction ; Photography ; Risk Factors ; Triglycerides ; Ultrasonography ; Waist Circumference ; Waist-Hip Ratio

Primary hyperparathyroidism is rarely encountered during pregnancy but its prompt diagnosis and treatment if encountered during pregnancy is important because it can carry considerable morbidity not only for the mother but also for the fetus. It tends to remain undiagnosed because 50~80% of the patients are asymptomatic. Even if they do demonstrate symptoms, those are often nonspecific. The other reason for non-diagnosis is masking of hypercalcemia due to the change of calcium homeostasis during pregnancy. Neonatal tetany can be a clue for the presence and diagnosis maternal hyperparathyroidism. The asymptomatic patient who is diagnosed postpartum when her newborn is symptomatic should undergo elective parathyroidectomy to avoid future complication. We experienced a woman with undiagnosed primary hyperparathyroidism during pregnancy whose two children suffered neonatal tetany. We report this case along with a review of literature on primary hyperparathyroidism in pregnancy and calcium homeostasis during pregnancy.
Calcium ; Child ; Diagnosis ; Female ; Fetus ; Homeostasis ; Humans ; Hypercalcemia ; Hyperparathyroidism* ; Hyperparathyroidism, Primary ; Infant, Newborn ; Masks ; Mothers ; Parathyroidectomy ; Postpartum Period ; Pregnancy* ; Tetany*

BACKGROUND: The results and restenosis after long stent implantation for diffuse long coronary lesion has not been fully evaluated. We evaluated immediate and follow-up results of single long coronary stenting for long coronary disease. METHODS: This study report on the use of follow-up examination is possible 48 patients with 50 lesions after stenting in total 70 patients with 72 lesions with long lesion. Diffuse long coronary lesion was defined as a lesion length longer than 20mm. Mean follow-up duration was 8.7+/-2.9 months and mean patients age was 58+/-10 years. Total patients was infused 8000-10000IU heparin and added bolus 3000-5000IU heparin for activating clotting time(ACT) was over 250 seconds during procedure. Restenosis was defined over 50% diameter stenosis in 6 months follow-up angiographic study. RESULTS: Angiographic success was achieved 68/70 patients(97.1%) in this study. Mean reference diameter was 3.14+/-0.1mm and baseline, final, follow-up minimal luminal diameter(MLD) was 0.6+/-0.4mm, 3.0+/-0.4mm, 1.6+/-0.3mm on each occasion and each % diameter stenosis(% DS) was 78.7+/-0.4%, 4.9+/-0.4%, 47.4%+/-0.5% present. The overall significantly increased in diabetics patients(7/21 vs 3/29 p=0.04) and in long lesion length patients(33.9+/-4mm vs 30.4+/-0.4mm p=0.02) but, clinical diagnosis and indication of stenting, lesional location, stent length, stent size, reference diameter size were not associated with restenosis rate. CONCLUSION: Single long stent implantation for diffuse long coronary lesion shown excellent success rate but high restenosis rate present. The restenosis rate was significantly associated with diabetics and lesion length Some further study for improving restenosis rate is needed.
Constriction, Pathologic ; Coronary Disease ; Diagnosis ; Follow-Up Studies* ; Heparin ; Humans ; Phenobarbital ; Stents*

BACKGROUNG AND OBJECTIVES: To evaluate the clinical and prognostic significance of precordial ST segment depression in precordial leads on admission electrocardiogram (ECG) in acute inferior myocardial infarction treated with intravenous thrombolytic therapy. We analysed about clinical and angiographic characters. MATERIALS AND METHOD: ECG findings in 50 patients with acute inferior myocardial infarction were retrospectively studied with results of coronary angiography and clinical informations. We classified all patients in two group according to the admissional ECG. Twenty nine patients (Group A) had no or <1.0 mm ST depression in precordial lead and Twenty one patients (Group B) had > or =1.0 mm ST depression in two or more precordial (V1-V6) leads were included in this group. RESULTS: In precordial ST segment depression in acute inferior myocardial infarction patients had higher plasma peak mean CK levels (1945+/-1419 vs 3547+/-2728 IU/L, p=0.027) and lower LV ejection fraction (62+/-10% vs 53+/-11%, p=0.008) and lower left ventricle global chordal shortening (0.89+/-0.71 vs -1.39+/-0.94, p=0.046) and inferior wall chordal shortening (-1.68+/-1.11 vs -2.43+/-0.74, p=0.014) and higher Killip class (1.3+/-0.8 vs 2.4+/-1.4, p=0.002) than without precordial ST segment depression patients. CONCLUSION: In conclusion acute inferior myocardial infarction with precordial ST depression patients had more extensive myocardial damage with global and inferior left ventricle severe wall motion dysfunction. Therefore, this suggests a worse prognosis in acute inferior myocardial infarction with precordial ST depression than without precordial ST depression patients. We need more aggressive diagnosis and treatment in this patients to prevent extending myocardial damage.
Coronary Angiography ; Depression* ; Diagnosis ; Electrocardiography ; Heart Ventricles ; Humans ; Inferior Wall Myocardial Infarction* ; Plasma ; Prognosis ; Retrospective Studies ; Thrombolytic Therapy