• Korean Journal of Community Nutrition
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• v.4 no.2
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• pp.186-193
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• 1999

Recent epidemiologic and clinical students have shown that plasma cholesterol and triglyceride levels are independent risk factors for coronary heart disease. However, there is not much data on the characteristics of anthropometry and lipid profiles of hypercholesterolemia patients with hypertiglyceridemia. In this study, 112 hypercholesterolemic subjects$(T.C{\ge}240mg/dl)$ were divided into two groups by their plasma triglyceride levels. We compared the anthropometric measurements and lipid profiles of the subjects between the two groups : the simples hypercholesterolemic group(SHC, TG<200mg/dl) and the combined hypercholesterolemic group$(CHC, TG{\ge}250mg/dl)$. The distribution of the subjects into the SHC and CHC groups was 36.6% and 47.3%, respectively. The frequency of the CHC patients decreased with age. The subjects in this group had higher weight, BMI, HWR, cricumferences of mid arm, waist, hip and thigh, and skinfold thicknesses of biceps and triceps than those of the SHC subjects. The difference of plasma total cholesterol level was mainly due to the difference of VLDL-C levels. These differences resulted in the CHC subjects having higher atherogenic indexes and T-C/HDL-C ratios than those of the SHC subjects. Also, the former had higher Apo-B and insulin levels than those the latter. However, blood pressure, fasting blood glucose and HDL-C levels were not significantly different between the two groups. These results suggest that hypercholesterolemic patients with hypertriglyceridemia have riskier lipid profiles for CHD than those of patients with normal triglyceridemia. They also indicate that CHC is closely associated with glucose resistance syndrome(obesity, hyperglycemia, hyperinsulinemia and hypertriglyceridemia), and more prevalent in young people.

• Journal of the Korean Dietetic Association
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• v.7 no.4
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• pp.331-348
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• 2001

The purpose of this study was to obtain basic data for nutrition education of the children in a health promoting elementry school. The data was collected by a questionaire of food habits, and anthropometric measurement and biochemical test in comparison with obesity index. The study subjects were boys and girls aged 10 to 12 years who participated in the “99 Children Nutrition Camp”. The average obesity index was 1.7$\pm$21.6% in boys and -11.4$\pm$12.6% in girls. After school, major leisure items were significnatly different by gender but both boys and girls played mainly computer game. In concern for body image and eating habits, girls had more concern and girls had attempted weight control more than boys. 80.2% of subjects had prejudice for special food, especially, all subjects in the severely underweight group had prejudice. But this tendency was significantly decreased with the increasing obesity index. The lowest preferency was for vegetables(64.4%). The tendency of prejudice of subjects was higher whose mother are thirties than those of subjects whose mother are in fourties. The serum GOT and GPT values were significantly higher in overweight and obese group than the other groups. The only serum T-chol was significantly higher in boys than in girls. The number of risk factors related to coronary heart disease(CHD) based on coresponding criteria of TG, T-chol, HDL-chol, and LDL-chol was not increased significantly with the degree of obesity index. The results indicated the need of nutritional management for the children. At a point of view, to educate children early who are able to change food habits and life-styles means to help heathy growth and to deliver up heathy adults. Active nutrition education for both children and mothers will be recommended with joint participation of nutritionists in community public health center and elementary school.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.299-304
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• 2009

Background: Although the results of the surgical management for complete atrioventricular septal defect (c-AVSD) have improved, the optimal surgical strategy is still controversial. The aims of this study are to evaluate the outcome of c-AVSD repair and to define the risk factors related to reoperation. Material and Method: We retrospectively reviewed the medical records of 35 patients (8 males and 27 females) who underwent the total correction of c-AVSD from August 1996 to March 2008. The median age at repair was 5.2 months (range: 3 days$\sim$82 months). Sixteen patients (45.7%) were associated with Down syndrome. Prior palliative operations were performed in 4 patients. The one-patch techniques were performed in 3 patients, and the two-patch techniques were done in 32 patients. Result: There was 1 early death (2.9%). The median follow-up period was 68 months (range: $2\sim134$ months) for 34 survivors. There was no late death. Reoperations were performed in 5 patients (14.3%) for severe left atrioventricular valvular regurgitation (AVVR). Nine patients (25.7%) showed left an AVVR of more than grade III. Associated major cardiac anomalies and the use of Gore-Tex patch for ventricular septal closure were the risk factors for postoperative left atrioventricular valve failure and reoperation. Conclusion: In this study, we found that surgical repair of c-AVSD was safe and effective. However, the high reoperation rate after repair remains a problem to be solved.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.364-374
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• 2010

Background: We assessed the early and mid-term results of the modified Norwood procedure for first-stage palliation of hypoplastic left heart syndrome (HLHS) and its variants to identify the risk factors for hospital mortality. Material and Method: Between March, 2003, and December, 2009, 23 patients (18 males and 5 females) with HLHS or variants underwent the modified Norwood procedure. The age at operation ranged from 3 to 60 days (mean, $11.7{\pm}13.2days$) and weight at operation ranged from 2.2 to 4.8 kg (mean, $3.17{\pm}0.52kg$). We used a modified technique that spared the anterior wall of the main pulmonary artery in 20 patients. The sources of pulmonary blood flow were RV-PA conduit in 15 patients (group I) and RMBTS in 8 (group II). Follow-up was completed in 19 patients (19/20, 95%) in our hospital (mean $26.0{\pm}22.8months$). Result: Early death occurred in 3 patients (3/23, 13%), of whom 2 had TAPVC. Fourteen patients underwent subsequent bidirectional cavopulmonary connection (BCPC, stage 2) and seven underwent the Fontan operation (stage 3). Three patients died between stages, 2 before stage 2 and one before stage 3. The estimated 1-year and 5-year survival rates were 78% and 69%, respectively. On multivariate regression analysis, aberrant right subclavian artery (RSCA) and associated total anomalous pulmonary venous connection (TAPVC) were risk factors for hospital mortality after stage 1 Norwood procedure. Conclusion: HLHS and its variants can be palliated by the modified Norwood procedure with low operative mortality. Total anomalous pulmonary venous connection adversely affects the survival after a stage 1 Norwood procedure, and interstage mortality rates need to be improved.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.1-11
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• 2008

Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.