The antihypertensive effect of verapamil, a calcium channel blocker, was studied in 12 cases of essential hypertension (mean age 49, range 24-64). After 6 weeks administration (80-160mg t.i.d.), the following results were obtained : 1) Before medication, average systolic and diastolic blood pressure was 176.3/108.6mmHg. After completion of therapy, blood presure fell significantly down to 154.8/94.2mmHg (p<0.01). 2) Heart rate decreased slightly from average 74.3 per minute prior to medication to 69.3 per minute at the end of study (p<0.01). 3) Side effects, among which constipation was most common, were mild and did not compel any patient to diacontinue therapy. In conclusion, verapamil seems to be a safe and effective first-line drug for hypertension along with diuretics or beta blockers.
Blood Pressure ; Calcium Channels ; Constipation ; Diuretics ; Heart Rate ; Humans ; Hypertension ; Verapamil*

Thirty-nine healthy pigs (28-32 days old) were purchased from a commercial swine farm and housed at swine pens of the College. The animals were vaccinated intramuscularly (1 ml) with an attenuated live hog cholera virus (HCV, LOM strain) and then boostered at 5 weeks after the first vaccination. The animals were divided into 4 experimental groups: 0.05% (w/w) PowerFeel-supplemented diet (T-1, n = 10); 3% (w/w) SuperFeed-supplemented diet (T-2, n = 10); diluted PowerFeel solution (1 : 500, v/v) as drinking water (T-3, n=9); control (n=10). PowerFeel is an original form of ionized alkali mineral complex (IAMC) and SuperFeed is a commercial product of IAMC. The subpopulation of lymphocyte in blood was assayed by a flow cytometry and HCV-specific antibody was determined by an indirect immunofluorescence assay. In IMAC-treated groups, the proportions of subpopulation expressing MHC-class II, CD2+, CD4+, CD8+, and surface IgM+ B lymphocytes were significantly decreased at 5-weeks after the first vaccination. Significant decreases were also observed in the proportions of MHC-class II, CD2+ and CD8+ lymphocyte at 3-weeks after the booster injection. The humoral immune responses in T-1 and T-2 groups were greater than those in T-3 or control group. These results suggest that IAMC-supplemented diets may have an HCV-specific immunostimulatory effect in pigs.
Animal Feed ; Animals ; Antibodies, Monoclonal/*blood/isolation & purification ; Antigens, CD2/blood ; B-Lymphocytes/immunology ; CD4-Positive T-Lymphocytes/immunology ; CD8-Positive T-Lymphocytes/immunology ; Classical Swine Fever/*immunology ; Classical swine fever virus/*immunology ; Dietary Supplements ; Ions ; Lymphocyte Subsets/*immunology ; *Minerals ; Swine ; Vaccines, Attenuated/*administration & dosage ; Viral Vaccines/*administration & dosage

PURPOSE: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. MATERIALS AND METHODS: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. RESULTS: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). CONCLUSION: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.
Basal Ganglia* ; Cerebellum* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Perfusion ; Seizures ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Thorax* ; Ventilators, Mechanical*

PURPOSE: To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. MATERIALS AND METHODS: lnterictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Bath positive images showing ictal hypoperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hypoperfusion, hypoperfusion-plus, combined hypoperfusion-hypoperfusion, and focal hypoperfusion only. RESULTS: The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hypoperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hypoperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hypoperfusion alone was seen only in mesial TLE while lateral temporal hypoperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hypoperfusion in the neighboring brain regions where ictal discharges propagated. CONCLUSION: Hypoperfusion as well as hypoperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanisrn of ictal hypopertusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.
Baths ; Brain ; Epilepsies, Partial* ; Epilepsy ; Epilepsy, Temporal Lobe ; Humans ; Incidence ; Pathology ; Perfusion* ; Sclerosis ; Seizures ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To analyse the causes of coagulopathy and determine the effect of embolotherapy on acute gastrointestinal(GI) bleeding coexisting with coagulopathy. MATERIALS AND METHODS: Between June 1991 and December 1998, 29 patients with acute GI bleeding (M:F =21:8, mean age, 57.8 years) underwent percutaneous embolotherapy and immediate cessation of bleeding was confirmed. The patients were divided into two groups: control (n =16) and those with coagulopathy (n =13), group membership being determined according to the criteria of >+/-2SD of normal prothrombin time (PT) and activated partial thromboplastin time (aPTT) ( PT >23 seconds, aPTT >40 seconds) at the time at which embolization was requested. Embolotherapy was, defined as clinically successful, if the patient was stable for at least three days, without bleeding, after technically successful embolization. The clinical success rate of embolization and the mortality rate were compared between the two groups, and the causes of coagulopathy statistically analysed. RESULTS: The clinical success rate of embolization was 75% (n =12) in the control group, compared with 38.5% (n =5) in the coagulopathic group (p < 0.05), while the mortality rate for the two groups was 6.3% (n =1) and 53.8% (n =7), respectively (p < 0.005). Statistically, massive transfusion and sustained shock before embolization were the causes of coagulopathy (p < 0.05). CONCLUSION: In coagulopathic patients with acute GI bleeding, embolotherapy induces transient bleeding control, but is unlikely to save lives.
Embolization, Therapeutic* ; Hemorrhage* ; Humans ; Mortality ; Partial Thromboplastin Time ; Prothrombin Time ; Shock

BACKGROUND: In order to investigate the structural abnormalities in juvenile myoclonic epilepsy (JME), the volumes of the hippocampus and frontal lobe were measured. METHODS: Nineteen JME patients and 19 age- and sex-matched normal controls underwent a 1.6 mm thick brain SPGR MRI. The volumes of the frontal lobe and hippocampus were measured with a volume of interest method. The differences of volumes between JME and normal groups were compared. The volumes were also compared between the early and late onset groups, and between the short and long seizure duration groups. The correlations between the volumes of the frontal lobe, hippocampus, or mid-sagittal area of the corpus callosum, and the age of seizure onset or the duration of disease were tested. RESULTS: The cerebral volume was not found to be different between the JME and normal groups (p=0.521). The left hippocampus was significantly smaller in the JME group (p=0.032) while the left frontal lobe was significantly larger in the JME group (p=0.004). The area of the rostral body of corpus callosum showed a significant positive correlation with the age of onset (r=0.561, p=0.012). The right frontal lobe volume showed a significant negative correlation with the duration of disease (r=-0.511, p=0.025). CONCLUSIONS: These results imply that JME has volume changes in the frontal lobe and hippocampus. The volume reduction of the right frontal lobe in patients with a longer disease duration may suggest a progressive nature of JME. The smaller rostral body of the corpus callosum in patients with earlier seizure onset may suggest an ontogenic abnormality of JME.
Age of Onset ; Brain ; Corpus Callosum ; Frontal Lobe* ; Hippocampus* ; Humans ; Magnetic Resonance Imaging ; Myoclonic Epilepsy, Juvenile* ; Seizures

No abstract available.
Seizures*

Traumatic tricuspid insufficiency(TI) is a relatively uncommon disorder. We experienced a case in which traumatic TI was suspected by history and the diagnosis was confirmed nonivasively by 2-D echocardiography with Doppler technique. Tricuspid valve in this case showed flail anterior leaflet during systole and Doppler echocardiography demonstrated the presence of tricuspid insufficiency.
Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Systole ; Tricuspid Valve

PURPOSE: The Korea Veterans Health Service (KVHS) implemented the ‘designated hospital system’ so that veterans can receive prompt medical attention at hospitals near their residences when experience medical emergencies, including hip fractures. We analyzed the hospital-selection process of Korean veterans following a hip fracture. We then evaluated (the validity and considerations) for choosing designated hospitals. MATERIALS AND METHODS: The study population consisted of 183 veteran patients (84 treated at a single veterans hospital and the remaining 99 treated at 39 designated hospitals) who underwent hip fracture between January 2010 and February 2015 in the Honam region of South Korea. The subjects were divided into the ‘nearest group’ (those who chose the hospital closest to their residences) and the ‘non-nearest group’ (those who did not choose the hospital closest to their residences). We compared the age, ambulatory status, combined disease and fracture type, factors that we speculated may impact hospital choice. RESULTS: Although the patients had difficulty moving due to hip fractures, 116 (63.4%) patients choose hospitals that were not closest to their residences. Patients with three or more comorbidities (P=0.028) and older ages (P=0.046) were statistically more likely to fall into the non-nearest group. Ambulatory status and fracture type were shown not to significantly impact choice between nearest and non-nearest hospital. Patients in the non-nearest group tended to seek care at larger hospitals. CONCLUSION: Korean veterans with hip fractures tended to seek care at larger hospitals, regardless of distance. We must therefore consider the number of beds and departments when choosing designated hospitals.
Comorbidity ; Emergencies ; Hip Fractures* ; Hip* ; Hospitals, Veterans ; Humans ; Korea ; Veterans Health ; Veterans*