We observed the levels of serum cholesterol, triglyceride and HDL-cholesterol in 28-hyperlipidemic patients after treatment with procetofene(Lipanthyl(R)), a new hypolipidemic agent. The results were as follows. 1. The hyperlipidemic patients were 7 cases of pure hypercholesterolemia, 12 cases of mixed hyperlipidemia and 9 cases of pure hypertriglyceridemia. 2. All the patients were treated with daily dose of 200 to 400mg, usually 300mg, and duration of more than 12 weeks. 3. The serum cholesterol decreased significantly at the rate of 29% in pure hypercholes terolemia and 29% in mixed hyperlipidemia after treatment for 12 weeks. 4. The serum triglyceride decreased significantly at the rate of 58% in mixed hyperlipidemia and 42% in pure hypertriglyceridemia after treatment for 12 weeks. 5. The serum HDL-cholesterol increased at the rate of 10% in pure hypercholesterolemia, 14% in mixed hyperlipidemia and 26% in pure hypertriglyceridemia after treatment for 12 weeks, but the increase rate was statistically significant only in pure hypertriglyceridemia. 6. Transient epigastric discomfort was complained by 2 patients, but subsided spontaneously with continuous treatment. 7. In view of these results, procetofene appears to be an effective and well tolerated agent for the treatment of all the types of hyperlipidemia.
Cholesterol ; Fenofibrate ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Hypertriglyceridemia ; Triglycerides

Parameters of the left ventricular performance were evaluated by echocardiographic examination in 66 normal subjects. Effects of pulse rate, systemic arterial pressure, peripheral resistance and left ventricular end-diastolic dimension on the parameters were also observed. Normal value(mean+/-SD) of fractional shortening was 34.0+/-5.2%, ejection fraction 0.71+/-0.07, mean rate of circumferential fiber shortening 1.15+/-0.19 circ/sec, mean posterior wall velocity 4.05+/-0.70cm/sec, maximal posterior wall velocity 6.31+/-1.26cm/sec, mean normalized posterior wall velocity 0.82+/-0.14/sec, and maximal normalized posterior wall velocity 1.28+/-0.24/sec. There were negative correlations of peripheral resistance to fractional shortening, ejection fraction and mean rate of circumferential fiber shortening. Pulse rate and left ventricular end-diastolic dimension did not have significant effects on these parameters. Mean and maximal posterior wall velocity had negative correlations to peripheral resistance and positive correlations to left ventricular end-diastolic dimension. But mean and maximal normalized posterior wall velocity had no correlations to any of them.
Arterial Pressure ; Echocardiography* ; Heart Rate ; Vascular Resistance

Recently, the proportion of cardiovascular disease as a cause of death in diabetics is in ever increasing tendency. Present study is designed to evaluate the change of myocardial performance by the effect of microangiopathy of diabetics. The measurements of systolic time intervals were obtained from simultaneous high speed recordings(100mm/sec) of electrocardiography, phonocardiography, and carotid pulse tracing in diabetics(male 26, female 31). 1. As the diabetic retinopathy got severe, shortening of LVET and prologation of PEP were noted, but QS2 showed no significant change. 2. PEP/LVET ratio fo diabetics without diabetic retinopathy was significantly higher than that of normal control(p<0.01). 3. PEP/LVET ratio of diabetics with diastolic blood pressure under 95mmHg was significantly higher than that of normal control group(p<0.01), and PEP/LVET ratio of diabetics with diastolic blood pressure over 96mmHg was significantly higher than that of normal control and that of diabetics with diastolic blood pressure under 95mmHg(p<0.01). 4. PEP/LVET ratio of diabetics with proliperative retinopathy was significantly higher than that of normal control and that of diabetics with mild diabetic retinopathy(p<0.01), but this result was not conclusive because of the small case number.
Blood Pressure ; Cardiovascular Diseases ; Cause of Death ; Diabetic Retinopathy ; Electrocardiography ; Female ; Humans ; Phonocardiography ; Systole*

The systolic time intervals and hemodynamics were measured in 10 cases of acute anemia and 28 cases of chronic anemia. The measurment was done by non invasive technique, i.e., simultaneous recording of ECG, PCG and carotid and femoral pulse tracing with paper speed 100mm/sec. Compared with healthy persons chronic anemia showed significant reduction of the systolic time intervals except QS1, but the systolic time intervals were unaltered when they were corrected by pulse rate, diastolic pressure and stroke volume. Acute anemia showed decreased of the systolic time intervals except QS1 also the decrease of isovolumic contraction time(ICT) and QS2 when corrected as above. The preejection period(PEP)/left ventricular ejection time(LVET) ratio were not altered. ICT, PEP and PEP/LVET ratio decreased in proportion to the levels of hemoglobin. The heart rate, stroke volume and cardiac output showed significant increase in chronic anemia but mild incease in acute one. The decrease of diastolic pressures and peripheral resistances were more pronounced in chronic anemia than in acute one.
Anemia* ; Blood Pressure ; Cardiac Output ; Electrocardiography ; Heart Rate ; Hemodynamics* ; Humans ; Stroke Volume ; Systole*

BACKGROUND: Carotid artery stenosis is not infrequently associated with coronary artery disease. However, the technique performing selective carotid angiography is not established during right transradial coronary angiography. We investigated the reliability and safety of selective carotid angiography from the right transradial approach. MATERIALS AND METHODS: Following right transradial coronary angiography, selective carotid angio-graphy was performed using a 5 Fr Simmons-2 catheter in 103 patients (59+/-8 years [range, 18-80], 78 males). Ninety five (92%) patients had significant coronary artery disease. Subclavian and innominate arteries were moderately tortuous in 25 (24%) patients and aortic arch was elongated, more vertically oriented in 20 (19%). After forming a loop in ascending (n=65, 63%) or descending (n=38, 37%) aorta, the catheter was withdrawn and rotated counterclockwise to engage its tip in left carotid artery and innominate artery subsequently. After the catheter tip was adjusted at each ostia of carotid arteries, contrast material was delivered. In 63 (61%) patients, the procedures were performed on outpatient basis. RESULTS: Bilateral selective carotid angiography was successfully performed in 101 (98%) patients. In two patients with severely tortuous subclavian artery, the catheter was not engaged selectively in left carotid artery. The image quality of the angiograms performed by manual injection was determined satisfactory. Significant carotid stenosis was found in 17 (17%) patients. There were no complications, including thromboembolism and arterial dissection. CONCLUSION: Selective carotid angiography can be performed reliably and safely using a 5 Fr Simmons catheter from the right transradial approach. This technique is useful for evaluation of isolated or associated carotid artery stenosis from the right transradial approach.
Angiography* ; Aorta ; Aorta, Thoracic ; Brachiocephalic Trunk ; Carotid Arteries ; Carotid Stenosis ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Outpatients ; Radial Artery ; Subclavian Artery ; Thromboembolism

BACKGROUND AND OBJECTIVE: Percutaneous transluminal coronary angioplasty of chronic total occlusion has been limited by a relatively low success rate and a high restenosis rate. This study investigated procedural outcome, factors predictive of procedural success and safety of coronary angioplasty for chronic total coronary occlusion. MATERIALS AND METHODS: The study population was composed of 45 lesions attempting PTCA with or without stent implantation for recanalization of chronic total coronary occlusion between January 1997 and July 1999. The clinical and angiographic data of the 45 lesions were reviewed. The results of successful PTCA in 28 lesions were compared with those in 17 lesions whose PTCA was failed. RESULTS: The overall success of balloon angioplasty and stenting was achieved in 28 lesions (62.2%) and did not differ significantly by clinical variables. The most common cause of failure of balloon angioplasty was inability to pass the guide wire across the occlusion( 14 of 23 lesions, 61%). Procedural success was more common in patients with occlusions with a tapered entry configuration(77.2% vs. 47.8%, p=.042), with lesions without side branches(82.3% vs. 50%, p=.03). Multiple logistic regression analysis identified the absence of side branch(p<0.01) and the presence of a tapered entry configuration(p<0.05) as independent predictors of procedural success. One case(2.2%) needed emergency coronary bypass surgery after failure to recanalize the occluded vessel. There was no Q wave acute myocardial infarction, death. CONCLUSIONS: The favorable cases(>60%) of chronic total coronary occlusions can be successfully dilated by balloon angioplasty with or without stent implantation, with a major complication rate of 2.2%. Therefore, with careful patient selection, we need to try the aggressive recanalization for chronic total coronary occlusion.
Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary* ; Coronary Occlusion ; Emergencies ; Humans ; Logistic Models ; Myocardial Infarction ; Patient Selection ; Stents

BACKGROUND AND OBJECTIVES: To evaluate the association between chronic infection with Chlamydia pneumoniae, as measured by Immunoglobulin G and A, and acute myocardial infarction (AMI) in Korea. MATERIALS AND METHODS: A total of 136 patients [normal control 65 cases (male:female 27:8, mean age 55.1+/-11.7 years), AMI 71 cases (male:female 54:17, mean age 58.9+/-12.7 years)] had immunoglobulin G, A, and M antibody titers measured against Chlamydia pneumoniae by microimmunoflorescence assay and had coronary angiography performed. We investigated the incidence of major adverse cardiac events (MACE) at 6 month follow-up. Controls were defined as patients with no significant stenosis on coronary angiography. RESULTS: 1) AMI patients were more likely to be male (76.1: 41.5%) and smokers (67.6: 16.9%) compared with the controls. >2) In AMI patients, there was a weak correlation with IgG and IgA antibody titers (r=0.39, p=0.001).> 3) After adjusting for gender and smoking status, IgG and IgA antibody titers were similar between two groups.> 4) Increased IgG and IgA titers did not affect the MACE during follow-up. CONCLUSION: Chronic Chlamydia pneumoniae infection detected by immunoglobulin assay is not significantly associated with AMI. Further studies, such as polymerase chain reaction, immunocytochemistry, or culture of the atheromatous plaques, are needed to better define the association.
Chlamydia* ; Chlamydophila pneumoniae* ; Constriction, Pathologic ; Coronary Angiography ; Follow-Up Studies ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulins ; Immunohistochemistry ; Incidence ; Korea* ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Polymerase Chain Reaction ; Risk Factors* ; Smoke ; Smoking

In this article, on page 139, the title has been spelled incorrectly: "It" should have appeared as "Is".

Therapeutic hypothermia (TH) has been used to protect neurological functions in cardiac arrest patient. Although Osborn wave is not pathognomonic of hypothermia, it is a well-known electrocardiogram finding of hypothermic patients. The cellular and ionic mechanisms of the Osborn wave have been suggested, and its relationship to tachyarrhythmias, such as ventricular tachycardia and ventricular fibrillation, is being explored. This case highlights the arrhythmogenic potential of Osborn wave and individual difference in response of TH.
Electrocardiography ; Heart Arrest ; Humans ; Hypothermia* ; Individuality ; Tachycardia ; Tachycardia, Ventricular ; Ventricular Fibrillation*

Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHTN) are complications of portal hypertension and cirrhosis. Their pathophysiological mechanisms clearly differ. HPS is characterized by a defect in arterial oxygenation induced by pulmonary vascular dilatation. In contrast, PPHTN is predominantly due to excessive pulmonary vasoconstriction and vascular remodeling, but is rarely associated with hypoxia. We report a case of a patient who had both HPS and PPHTN at the time of presentation. HPS was aggravated after sildenafil administration for the treatment of PPHTN. We demonstrated increased amount of intrapulmonay shunt after sildenafil challenge by using agitated saline contrast transthoracic echocardiography.
Anoxia ; Dihydroergotamine ; Dilatation ; Echocardiography ; Fibrosis ; Hepatopulmonary Syndrome* ; Humans ; Hypertension* ; Hypertension, Portal ; Oxygen ; Vasoconstriction ; Sildenafil Citrate