Dual chamber Pacemaker 의 임상경험

심원흠(Won Heum Shim),박승정(Seung Jung Park),이웅구(Woong Ku Lee),조승연(Seung Yun Cho),김성순(Sung Soon Kim) 대한내과학회 1989 대한내과학회지 Vol.36 No.2

N/A Since Furman and Robinson implanted a transvenous pacemaker (VOO) in 1958, Atricor (Cordis Co.), the first P-wave sensing dual chamber pacemaker (VAT) was introduced in 1963. Subsequently the atrioventricular seqeuential pacemaker (DVI), and universal automatic pacemaker (DDD) followed. Enetrex (Medtronic Co.), a VDD pacemaker, was first implanted after open heart surgery in a patient with a completed heart block in 1983. Sporadic case reports of dual chamber pacemaker implantation have been reported in Korean literature from our laboratory. We reviewed the clinical data of 51 dual pacer implantations in 48 patients performed in our laboratory during the period from September 1983 to November 1987. The following results were obtained: 1. The major indication was complete heart block in 32 cases (64.6%), high degree A-V block in 4(8,3%) and sick sinus syndrome in 11(20.8%) cases. 2. Main clinical symptoms were syncope and presyncope in 26(54.5%) cases. 3. The DDD pacer was most fregucently chosen in 44(86.3%) cases. 4. The route of entry of the leads was most commonly through a subclavian vein by the techique of percutaneous puncture in 44(91.7%)cases, cephalic vein cutdown in 1 cases, and epicardial screw in lead in 3 cases having open heart surgery. 5. The fixation of the atrial leads was the active form in 28 (58.3%) and the passive in 17 (35.4%) cases. The polarity of the leads was unlpolar in 38 (77.1%) and biopolar in 13 (22.9%) cases. 6. The complications wen various. The most fre- quent associated complications were pacemaker mediated tachycardia in 5 (10.9%) cases, infection in 5 (10.9 %), atrial lead displacement in 2, and atrial sensing and pacing problems in 4 cases. However, there were no serious complications such as death or other serious sequelae. In conclusion, dual chamber pacing is a more physilogically priented therapeutic measure for use in patients with symptomatic heart block or sick sinus syndrome and it can be implanted safely.

승모판협착증 환자에서의 풍선판막성형술의 작용기전

심원흠(Won Heum Shim),박승정(Seung Jung Park),탁승제(Seung Jae Tahk),조승연(Seung Yun Cho),김성순(Seung Soon Kim),이웅구(Woong Ku Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.1

N/A Preliminary reports have documented the utility of percutaneous balloon valvuloplasty of the mitral valve in adult patients with mitral stenosis, but the mechanism of successful valve dilation and the effect of mitral valvuloplasty on cardiac performance have not been studied in detail in our country, Accordingly, mitral valvuloplasty was performed in seven adult patients with rheumatic mitral stenosis, using either one (23 mm) or two (18 and 20 mm or 19 ´ 2 bifoil) dilation balloons intraoperatively or percutaneously, and in one in vitro status. Balloon dilation resulted in increased valve orifice area in all cases, secondary to separation of the fused commissures which were posteromedial in 4 cases, anterolateral in 2 and both in 2. Fracture of nodular calcium within the mitral leaflets occurred in one case. There was one ease of liberation of calcium embolic debris. In no case did balloon dilation result in tearing of the valve leaflets or disruption of the mitral ring. 1t is concluded that percutaneous mitral valvuloplasty can be performed in adult patients with mitral stenosis, including patients with calcific disease, and can result in significant improvement in valvular function. The major mechanisms of successful dilation include fused commissural separation and fracture of nodular calcium of the valve leaflets.

경피적 내심근 생검술의 임상 경험

심원흠(Won Heum Shim),김성순(Sung Soon Kim),탁승제(Seung Jae Tahk),박승정(Seung Jung Park),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung),조승연(Seung Yun Cho),이웅구(Woong Ku Lee) 대한내과학회 1988 대한내과학회지 Vol.35 No.6

N/A In 1962, Sakakibara and Konno reported doing endomyocardial biopsies in patients using a cartheter inserted into the right ventricle from a systemic vein. The right ventricular aspect of the ventricular septum was the portion of heart of heart biopsied, Although biopsy is not yet applicable in all cases of myocardial disease, many investigators have found this procedure valuable in specific circumstances, including cardiac allograft rejection, adriamycin-induced cardiomypathy and myocarditis. With this technique diagnoses can be made for various disorders including cardiac amyloidosis, sarcoidosis, hemochromatosis and endomyocardial fibrosis. Endomyocardial biopsy was done in 16 cases which consisted of dilated cardiomyopathy in 9(56.3%) cases, unexplained heart failure in 3(18.8%) cases, ventricular tachycardia in 3 cases and angina with normal coronary angiogram with thallium defects in 1 case. The route of entry of the biopsy porceps was through the right internal jugular vein in 12(75%) cases and right femoral vein in 4(25%) cases. There were no cases of left heart biopsy. There were no serious complications. The number of biopsy samples per patient was 2-7 pieces and these samples were examined by light microscope or electromicroscope or were used for special purposes such as culture or biochemical study. The biopsy yields were 100% and the material was satisfactory for pathologic study. A modified King's bioptome was selected for use in all cases. In conclusion, although of limited value from a diagnostic standpoint, the biopsy is safe and is likely to provide the most asistance as a research tool in the biochemical study of cardiomyopathy.

답차운동부하 검사에서 나타난 위정상화와 관동맥조영술 소견의 비교관찰

임세중(Se Joong Rim),심원흠(Won Heum Shim),양주영(Joo Young Yang),조승연(Seung Yun Cho),김성순(Sung Soon Kim),이웅구(Woong Ku Lee) 대한내과학회 1990 대한내과학회지 Vol.39 No.1

N/A There has been difficulty in interpreting the results of electrocardiographic exercise test in patients with abnormal T waves at rest. To investigate the significance of pseudonormalization of abnormal T waves during the treadmill test, 14 patients with pseudonormalization who underwent coronary angiography were studied. The following results were obtained: 1) The mean age was 57.4±9.6 (mean+SD) years. 2) There was one-vessel disease in eight patients, two-vessel disease in two patients, normal coronary vessels in four patients. 3) When T wave pseudonormalization and coronary angiography were matched to sites of involvement, 33% of T wave pseudonormafization in lead V2 and V5 was associated with significant lesions in the left anterior descending artery, and 71% of T wave normalization in II was associated with significant lesions in the right coronary artery. Overall, 71% of T wave pseudonormalization was associated with significant coronary lesions. 4) Nine out of 10 patients who complained of typical symptoms of angina had significant coronary diseases, but one out of four patients who had no complaints of symptoms had a significant coronary disease. These findings suggest that pseudonormalization of abnormal T waves in the treadmill test is highly predict- able for the presence of coronary arterial disease in patients with a clinical impression of angina.

급성 심근경색증 환자에서 혈전용해제 ( Urokinase ) 투여 및 경피적경혈관 관동맥확장성형술

이웅구(Woong Ku Lee),심원흠(Won Heum Shim),조승연(Seung Yun Cho),박승정(Seung Jung Park),정상만(Sang Man Chung),김성순(Sung Soon Kim) 대한내과학회 1988 대한내과학회지 Vol.34 No.2

N/A Since percutaneous transluminal coronary angiolplasty (PTCA) was introduced by Gruenzig in 1977, this procedure was extended to the multi-vessel lesion, unstable angina, acute myocardial infarction and old myocardial infarction. We performed coronary angiography and PTCA in 17 patients with evolving acute myocardial infarction for the last 21 months from February 1986 to November 1987 at Severance Hospital, Yonsei University. The result are followings: 1) Fifteen of 17 patients (88.2%) with total coronary occlusion underwent successful PTCA, including 15 patients with and 2 patients without previous intravenous or intracoronary urokinase infusion. 2) One patient (6.0%) died due to cardiogenic shock. 3) The delta area decreasing rate and left ventricular end diastolic pressure (LVEDP) were not improved in the left ventriculogram immediate after PTCA, but the LVEDP was significantly decreased in late follow-up left ventriculogram (Fig. 2,3). 4) In-hospital clinical course was stable in the 15 patients with successful PTCA, but 5 of them (33.3%) had angiographically restenosis during follow-up period of 2 days to 2 months. Two patients with angiographically restenosis and been performed repeat PTCA, one of them was successful. During follow-up period of 7 months (1-20 mos) in 15 patients with sucessful initial PTCA, 13 patients were in functional class I, two was functional class II and no death. 5) The patency rate of infarct-related coronary artery after urokinase infusion was 26.7%. The immediate urokinase effects was not remarkable in this study. These data suggest that successful PTCA with sustained patency of an infarct-related artery has a beneficial effect on the salvage of the jeopardized myocardium. In conclusion PTCA with or without thrombolytic therapy can be carried out with safety and is potentially useful therapeutic procedure in management of selected patients in evolving acute myocardial infarction.

승모판협착증 환자에서의 경피적 풍선학장 판막성형술

박승정(Seung Jung Park),심원흠(Won Heum Shim),조승연(Seung Yun Cho),이웅구(Woong Ky Lee),김성순(Sung Soon Kim),탁승재(Seung Jea Tahk),백경권(Kyung Kwon Paik),정익모(Ik Mo Chung) 대한내과학회 1988 대한내과학회지 Vol.35 No.1

N/A Percutaneous mitral balloon valvuloplasty (PMV) using the double-balloon technique was performed in 28 symptomatic patients with mitral stenosis who were candidates for mitral valve commissurotomy. There were 21 women and 7 men with a mean age 38±10 years (range 23 to 57). PMV in 28 patients with moderate to severe mitral stenosis (including 3 with a fluoroscopic calcified valve) resulted in an increase mitral valve area (0.9±0.2 to 2.2±0,7cm, p<0.0001) by Gorlin`s formula, and a decrease in mean diastolic mitral pressure gradient (16.8±5.7 to 6.1±3.9mmHg, p<0.0001), and mean left atrial pressure (23.6±6.7 to 11.7±5.8mmHg, p<0. 0001). And also cardiac output increased (4.8±1.0 to 5. 8±1.5L/min, p<0.005) and mean pulmonary artery pressure decreased (32±12 to 24±9mmHg, p<0.05). Mitral regurgitation developed or increased in severity after PMV in 15 (53.6%) patients, grade 3mitral regurgitation in 2 and no mitral regurgitation in 12 patients. Oxymetric studies performed immediately after PMV demonstrated a small left-to-right shunt (pulmonary-to-systemic blood flow ratios>1.5) through the interatrial communication in 4 patients. Follow up echocardiography showed improvement in mitral valve area by 2-D and Doppler pressure half-time (0.9±0.2 to 1.8±0.5 and 0.8±0.2 to 1.7±0.4 cm, p<0.0001), increase of mitral EF slope (13±7 to 37±17mm/ sec, p<0.0001) and decrease peak E mitral velocity (209±32 to 142±32cm/sec, p<0.0001). Transient cerebral embolic phenomenon just after PMV was observed in 1 patient and cerebral embolic infarction with hemorrhage requiring surgery developed in 1 patient. PMV using the double-balloon technique is safe and effective procedure to relieve mitral valve obstruction and could be an alternative to surgical mitral commissurotomy in selected patients with mitral stenosis.

심장질환 11 예에 있어서 핵자기공명영상술 소견

정남식 ( Nam Sik Chung ),심원흠 ( Won Heum Shim ),장양수 ( Yang Soo Jang ),박금수 ( Kum Soo Park ),안창범 ( Chang Bum Ahn ),김윤수 ( Yoon Soo Kim ),조장희 ( Zang Hee Cho ) 대한내과학회 1985 대한내과학회지 Vol.29 No.4

삼첨판의 Ebstein 씨 기형에 대한 임상적 고찰

차홍도 ( Hong Do Cha ),노원식 ( Won Shick Loh ),심봉섭 ( Bong Sup Shim ),심원흠 ( Won Heum Shim ),윤견일 ( Kyun Ill Yoon ) 대한내과학회 1975 대한내과학회지 Vol.18 No.8

성장기 청소년의 혈압변화와 결정요인

서일,남정모,지선하,김석일,김영옥,김성순,심원흠,김춘배,이강희,하종원,강형곤,오경원,Suh, Il,Nam, Chung-Mo,Jee, Sun-Ha,Kim, Suk-Il,Kim, Young-Ok,Kim, Sung-Soon,Shim, Won-Heum,Kim, Chun-Bae,Lee, Kang-Hee,Ha, Jong-Won,Kang, Hyung-Gon,Oh, Ky 대한예방의학회 1997 예방의학회지 Vol.30 No.2

본 연구는 1992년 당시 경기도 강화군 강화읍내에 거주하는 중학교 1학년에 재학중인 남자 335명과 여자 375명을 대상으로 5년간 혈압수준 및 변화에 대한 분포를 제시하고 혈압수준 및 변화의 결정 요인을 밝히고자 하였다. 혈압의 수준 및 변화와 관련된 요인으로는 신체적 요인, 혈청학적 요인 및 영양소 섭취요인을 조사하였다. 주요 연구결과는 다음과 같다. 1. 12세부터 16세까지 5년간 남자의 수축기혈압의 평균은 108.7mmHg에서 118.1mmHg로, 이완기혈압의 평균은 69.5mmHg에서 73.4mmHg로 증가하였으며 15세에 가장 높은 혈압수준을 보였다. 그러나 동기간 동안 여자의 수축기혈압의 평균은 114.4mmHg에서 113.5mmHg로, 이완기혈압의 평균은 75.2mmHg에서 72.1mmHg로 감소하였으며 13-14세 때에 가장 높은 혈압 수준을 보였다. 2. 남자의 5년간 신장, 체중, 신체비만지수 등은 계속 성장하였으나 여자는 15세를 기점으로 신체적 성장이 둔화되는 경향을 보였다. 한편 연령이 증가할 수록 남자의 혈청 총 콜레스테롤은 감소하고 중성지방은 증가하는 경향을 보였으나 여자에서는 특별한 변화가 없었다. 식이섭취에서는 지질의 섭취가 연령에 따라 약간 증가하는 경향을 보였으나 전반적으로 남녀 모두 에너지의 20% 정도였다. 3. 혈압수준과 체중, 신체비만지수, 피부두께 등은 남녀 모두 각 연령에서 통계학적으로 유의한 관련성이 있었다. 신체비만지수의 영향을 통제하였을 때 혈청 총 콜레스테롤은 남자에서 연령의 증가에 따라 수축기혈압과 음의 관계에서 양의 관계로, 여자의 경우에는 이완기혈압과 15-16세에서 양의 관련성을 보였다. 그리고 중성지방과 크레아티닌은 남자에서는 혈압과 양의 관련성을 보였으나 여자의 경우에는 관련성이 없었다. 한편 영양소 섭취와 혈압과의 관계는 성별-연령별로 일관성 있는 결과가 없었으나 남자의 이완기혈압과 단백질 섭취가 양의 관련성이 있었고 여자의 14세 때 수축기혈압과 비타민 A 섭취가 음의 관련성이 있었다. 4. 혈압변화와 신체비만지수의 변화, 혈청 총 콜레스테롤의 변화는 남녀 모두 양의 관련성을 보였으며 크레아티닌의 변화는 남자에서는 양의 관계를, 여자에서는 음의 관계를 보였다. 또한 남자에서 소디움 섭취가 높은 군이 계속해서 높은 혈압수준을 유지하였으며 여자의 경우에는 에너지에 대한 지질 섭취비율이 높은 군이 계속해서 낮은 혈압수준을 유지하여 성별에 따른 차이를 보였다. 전체적으로 성장기 혈압변화에 가장 큰 영향을 미치는 요인은 남녀 모두 신체비만 지수이었다. Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.

강화지역 청소년의 4년간 혈청 지질의 변화와 지속성

이강희,서일,지선하,남정모,김성순,심원흠,하종원,김석일,강형곤,Lee, Kang-Hee,Suh, Il,Jee, Sun-Ha,Nam, Chung-Mo,Kim, Sung-Soon,Shim, Won-Heum,Ha, Jong-Won,Kim, Suk-Il,Kang, Hyung-Gon 대한예방의학회 1997 Journal of Preventive Medicine and Public Health Vol.30 No.1

소아에서부터 청소년기까지 혈청 지질의 지속성(tracking)은 서구에서 행해진 연구들에 의해서 이미 잘 알려져 있으나 국내에서는 이에 관한 연구가 거의 이루어지지 않았다. 본 연구는 우리나라 청소년의 혈청 지질치의 변화를 조사하고 지속성이 있는지를 분석하였다. 연구대상은 경기도 강화군에서 진행하고 있는 강화 아동 혈압 코호트(719명)의 청소년들로 12세, 14세, 16세 세 번에 걸쳐서 공복 후 혈액검사(혈청 총 콜레스테롤, 중성지방, LDL 콜레스테롤, HDL 콜레스테롤을 포함)와 신체계측을 시행하였다. 이 중 3번의 혈액 검사에서 10시간 이상의 공복이 확인된 청소년 309명 (남자 162명, 여자 147명)을 최종 연구대상으로 선정하였다. 연구대상이 된 청소년들과 연구대상에서 제외한 청소년들의 12세때 초기 검사치들을 t 검정을 이용하여 서로 비교한 결과 통계학적으로 유의한 차이는 없었다. 연구방법은 우선 혈청 지질치의 변화양상을 보기 위하여 각 검사 년도간에 반복 측정된 분산분석을 시행하였다. 각 혈청지질의 지속성을 보기 위해서는 첫께, 초기값을 바탕으로 사분위 집단으로 나누어 각 사분위 집단의 혈청지질치가 매 검사 연도마다 어떻게 변하는 지를 그림으로 나타내었다. 둘째, 혈청지질치의 검사 시기사이의 스피어맨 상관계수를 구하였다. 그리고 마지막으로 각 검사 년도의 혈청지질치를 사분위 집단으로 구분하여 초기검사에서 가장 위험도가 큰 집단에 속한 사람들이 지속적으로 위험도가 큰 집단에 속하는 백분율을 계산하였다. 연구결과 남녀 모두 4년간 세 번의 검사에서 혈청 총 콜레스테롤은 남자가 초기검사에서 $160.7{\pm}25.3mg/dl$, 최종 추적검사에서 $150.0{\pm}27.8mg/dl$, 여자가 초기검사에서 $168.8{\pm}29.7mg/dl$, 최종 추적검사에서 $168.8{\pm}29.7mg/dl$, 중성지방은 남자가 $98.0{\pm}45.7mg/dl$에서, $114.1{\pm}67.9/mg/dl$로, 여자가 $109.9\geq37.1mg/dl$에서, $104.9{\pm}47.6mg/dl$로, LDL 콜레스테롤은 남자가 $93.6{\pm}21.2mg/dl$에서, $83.0{\pm}25.0mg/dl$로 여자가 $83.0{\pm}25.0mg/dl$에서, $94.7{\pm}24.4mg/dl$로, HDL 콜레스테롤은 남자가 $47.6{\pm}9.1mg/dl$에서, $44.2{\pm}9.4mg/dl$로, 여자가 $48.8{\pm}10.0mg/dl$에서, $47.8{\pm}11.3mg/dl$ 변화하였다. 반복 측정한 분산분석 결과 남녀 모두 4년 동안 혈청 총 콜레스테롤, LDL 콜레스테롤, HDL콜레스테롤이 통계적으로 유의하게 감소하였다. 특히 남자 LDL 콜레스테롤은 두 번의 추적검사에서 모두 감소한 것으로 나타났다. 중성지방은 남자에서는 지속적으로 증가하였고 여자에서는 변화가 없었다. 같은 연령에서 남녀간의 각 혈청지질치를 비교해보면 중성지방을 제외하고는 모두 여자가 남자보다 더 컸다. 혈청 지질의 초기 검사와 최종 검사간의 스피어맨 상관분석과 각 혈청 지질치의 위험도가 가장 큰 사분위집단에 잔류하는 백분율을 보면 지속성이 존재하였다. 혈청 총 콜레스테롤과 HDL 콜레스테롤에서 각 시기의 검사치들의 상관계수는 남자가 0.6 이상, 여자가 약 0.7 이상이었으며 통계적으로 유의하였다. 첫 번께 검사에서 위험도가 가장 큰 사분위 집단에 속한 사람 중 두 번째 검사에서도 위험도가 가장 큰 사분위 집단에 속한 백분율은 여자의 중성지방(42.9%)을 제외하고는 모두 50%이상이었다. 이들이 세 번째 검사에서도 같은 사분위 집단에 잔류한 백분율은 It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.