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

No abstract available.
Thorax* ; Ventilators, Mechanical*

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

BACKGROUND: The typical MRI features of hippocampal sclerosis (HS) are volume loss and increased T2 weighted signal intensity. Hippocampal volumetry and T2 relaxometry are useful quantitative methods for presurgical diagnosis of HS, especially in the cases of mild, bilateral or focal hippocampal atrophies. We investigated the value of a new quantitative method using FLAIR (Fluid Attenuated Inversion Recovery) MR images compared to those of visual inter-pretation and MR volumetry. METHODS: Forty-five patients with mesial temporal lobe epilepsy (TLE) and 21 under-went volumetric MRI (T1-weighted, SPGR, T2 weighted, and FLAIR images). All patients underwent anterior temporal lobectomy with amygdalohippocampectomy., where visual analysis and hippocampal volumetry were performed. The absolute and normalized values of hippocampal FLAIR signal intensity [hippocampal FLAIR intensity/superior frontal FLAIR intensity=Hippocampal-Frontal Signal Intensity Ratio (HFSR)] were obtained from both normal subjects and patients with TLE. RESULTS: The pathology of resected hippocampus showed HS in all patients. Visual interpretation of presurgical MRI failed to lateralize HS in 10 patients (22.2%). Among these 10 patients, the HS was lateralized by HFSR method in seven patients (70%) [Five (50%) by right-to-left difference of HFSR and the other two (20%) by analysis of a longitudinal regional curve of HFSR] while it was further lateralized by hippocampal volumetry in only three. CONCLUSIONS: In presurgical evaluation of patients with TLE, the hippocampal FLAIR signal analysis appeared to be complementary to visual interpretation and MR volumetry.
Anterior Temporal Lobectomy ; Atrophy ; Diagnosis ; Epilepsy, Temporal Lobe* ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Pathology ; Sclerosis ; Temporal Lobe*

PURPOSE: The detection of epileptogenic lesion plays an important role in the management of patients with partial epilepsy. Although the development of MRI improved the examination of cerebral hemispheres greatly, many patients with neocortical temporal lobe epilepsy (TLE) or extratemporal lobe epilepsy (extra-TLE) still show no lesion in conventional two-dimensional (2D) images. To increase the yield of MRI in those patients, we performed three-dimensional (3D) surface-projection rendering (SPR) of the cerebral hemispheres. METHODS: Conventional 2D MRI (T1, T2, FLAIR, thin slice SPGR) and 3D SPR were performed in 24 patients with neocortical TLE and extra-TLE, and 20 normal subjects. Sulcogyral patterns were evaluated blindly to clinical information. The locations of the epileptogenic zone, ictal onset zone (IOZ) and irritative zone (IRZ) were determined by intracranial EEG monitoring and epilepsy surgery. RESULTS: The 2D MRI identified epileptogenic lesions in five of the 10 neocortical TLE (50%) and five of the 14 extra-TLE (35.7%). 3D SPR revealed abnormal sulcogyral patterns in 9 of the 10 neocortical TLE (90%) and 9 of the 14 extra-TLE (64.3%). Cortical deformation zones with sulcogyral anomalies included the whole area of IOZ in 10 (55.5%) and IRZ in 6 (33.3%), overlapped with IOZ in 7 (38.9%) and IRZ in 11 (61.1%), were connected to IOZ in 1 (5.6%) and IRZ in 1 (5.6%). CONCLUSION: 3D SPR of volumetric MRI data can detect epileptogenic structural lesions of neocortical epilepsy that are not visible in the conventional 2D images.
Brain* ; Cerebrum ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Temporal Lobe ; Humans ; Magnetic Resonance Imaging*

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 Injury Severity Score (ISS), which is defined as the sum of the squares of the single highest Abbreviated Injury Scale (AIS) score in each of the three most severely injured body regions, does not take into account multiple injuries in the same body region. The New ISS (NISS), which is defined as the sum of the squares of the AIS scores of a patient's three most severe injuries regardless of body region, has been proposed to provide a more accurate measure of trauma severity. The purpose of this study was to evaluate the ISS and the NISS in patients with chest trauma. METHODS: A retrospective study of 263 cases of trauma victims with chest injuries, who visited the emergency center of Daegu Catholic University Hospital during a 42-month-period from January 1998 to June 2001, was performed. For each patient, we calculated the ISS and the NISS. The power of the two scoring systems to predict hospital length of stay, intensive care, operation, and mortality was gauged through comparison of receiver operating characteristic (ROC) curves. RESULTS: The mean ISS was 12, and the mean NISS was 14. The areas under the curves (AUC) of the hospital length of stay (0.764 vs 0.762), operation (0.772 vs 0.764), and mortality (0.873 vs 0.860) were greater for the ISS than the NISS. CONCLUSION: The significant difference in the predictive abilities of the ISS and the NISS reported in studies of severe blunt trauma patients was not seen in this review of moderate trauma patients with chest injuries.
Abbreviated Injury Scale ; Body Regions ; Daegu ; Emergencies ; Humans ; Injury Severity Score* ; Critical Care ; Length of Stay ; Mortality ; Multiple Trauma ; Retrospective Studies ; ROC Curve ; Thoracic Injuries* ; Thorax*

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