BACKGROUND: The characterization of normal coronary blood flow dynamics should provide crucial guidelines for the accurate functional assessment of diseased coronary artery. However, the regional characteristics of coronary blood flow dynamics in normal human coronary artery have not been fully evaluated. METHODS: We performed proximal and distal segment velocity measurement of angiographically normal left anterior descending(LAD) and right coronary artery(RCA) in 25 patients(14 males, 12 females, age 50+/-10 yesre) with atypical chest pain. Spectral flow velocity parameters including average peak velocity(APV), average diastolic peak velocity(ADPV), average systolic peak velocity(ASPV), and diastolic-to-systolic velocity ratio(DSVR) were measured using 0.014 inch 15MHz Doppler wire at baseline and intracoronary adenosine-induced maximal hyperemic state. Coronary flow reserve(CFR) was calculated from the ratio of hyperemia to baseline APV. RESULTS: Comparison between LAD with RCA. LAD showed significantly higher APV than RCA at baseline(proximal ; 18+/-6cm/s vs 14+/-4cm/s, p<.005, and distal ; 17+/-6 cm/s vs 12+/-4cm/s, p<.005. LAD showed significantly higher ADPV and lower ASPV than RCA, therefore significantly higher DSVR than RCA> CFR was significantly lower in LAD than in RCA(proximal ; 301+/-0.9 vs 3.8+/-1.0 , p<3001, and distal ; 3.1+/-0.7 vs 3.6+/-0.8, p<.05). Comparison between proximal with distal segment. There was significant reduction in APV and ASPV from proximal to distal segment in RCA, but not in LAD. There was significant increase in DSVR from proximal to distal segment in RCA, but not in LAD. There was no difference in CFR between proximal and distal segment in both coronary arteries. CONCLUSION: We measured coronary blood flow velocities in angiographically normal coronary artery to characterized normal coronary blood flow dynamics and provide the reference values for the assessment of coronary artery disease. Significant regional differences of coronary blood flow velocities should be considered when we assess the diseased coronary artery.
Blood Flow Velocity ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels* ; Female ; Humans ; Hyperemia ; Male ; Reference Values

The purpose of the study was to explore the effect of 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hour on the frequency of "red man syndrome", phlebitis and length of peripheral catheter placement of infected patients, in order to provide safe infusion method for reducing vancomycin-induced RMS and phlebitis. The subjects of the study consisted of 16 hospitalized patients; 3 oncology and gastro-intestinal patients, 1 neurological patient, 6 thoracic surgical patients and 6 orthopedic patients, who had received vancomycin from July to October in 1999 at S-hospital. The dependent variables were the incidence of RMS, phlebitis and the length of peripheral catheter placement. The incidence of RMS was checked by an inspector at the first night whenever the infusion method of vancomycin was changed. RMS was observed every 15 minutes during an hour for symptoms of RMS such as itching, erythema, chest pain and systolic blood pressure. Incidence of phlebitis was assessed by inspector twice a day from the insertion of peripheral catheter to the removal of the catheter. The data were analyzed by percentage, mean, X2-test, t-test, repeated ANOVA, and logistic regression analysis using the SPSSWIN program. The results are summarized as follows; 1. No significant difference was identified in frequency of RMS between the experimental group and control group. 2. There was no significant difference in the change of systolic blood pressure as the time goes on between the experimental group and control group. 3. The incidence of phlebitis was significantly lower in the experimental group than in the control group. 4. The length of peripheral catheter placement was significantly longer in the experimental group than in the control group. 5. Other drugs administrated with vancomycin didn't influence the occurrence of phlebitis. However, the infusion method of vancomycin influenced the occurrence of phlebitis. The results suggest that 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hours may decrease the incidence of phlebitis and increase the length of peripheral catheter placement compared to 1 hour infusion of vancomycin(1g) in 100ml of isotonic saline every 12 hours. However, it does not reduce the incidence of RMS.
Blood Pressure ; Catheters* ; Chest Pain ; Erythema ; Humans ; Incidence* ; Logistic Models ; Orthopedics ; Phlebitis ; Pruritus ; Vancomycin*

Thirty-seven cases of cardiac neurosis were treated with propranolol (Inderal(R)) and following results were obtained. 1) Symptoms, such as palpitation, dyspnea, chest tightness and chest pain were disappeared or improved in all cases. 2) Heart rate reduced significantly after treatment from 99.8 per minutes to 74.8 per minutes. 3) Systolic blood pressure reduced significantly after treatment from 147.6 mmHg to 131.4 mmHg. but diastolic blood pressure were not reduced significantly. These results indicated that propranolol is recommendable medicine for improving cardiac symptoms and tachycardia in cardiac neurosis.
Blood Pressure ; Chest Pain ; Dyspnea ; Heart Rate ; Neurocirculatory Asthenia* ; Propranolol* ; Tachycardia ; Thorax

Spontaneous hemorrhage in the patients undergoing hemodialysis is the ralatively common problem, but spontaneous mediastinal hemorrhage in such patients reported only few cases. We experienced a case of spontaneous mediastinal hemorrhage in chronic hemodialysis patient who complained of continuous pleuritic chest pain and mild dyspnea. The diagnosis was made dy chest computed tomography,magnetic resonance imaging and percutaneous fine needle aspiration of liquified dark reddish old blood material guided by ultrasonography. Treatment is usually conservative, with blood volume replacement and intensive hemodialysis using regional heparinization. We report on a patient undergoing hemodialysis due to endstage renal disease who developed spontaneous mediastinal hemorrhage.
Biopsy, Fine-Needle ; Blood Volume ; Chest Pain ; Diagnosis ; Dyspnea ; Hemorrhage* ; Heparin ; Humans ; Renal Dialysis* ; Thorax ; Ultrasonography

The effects of oral nicorandil were evaluated in 32 patients with angina pectoris who were diagnosed by typical chest pain and postitive treadmill exercise test from December 1986 throught May 1987. The effects were measured by clinical improvement rating at 4 and 8 weeks after administration of nicorandil, and by repeated treadmill exercise test in 16 patients. The results were as follow's: 1) Clinical improvement was observed in 23(71.5%) and 25(78%) of 32 patients at 4 and 8 weeks after oral nicorandil. 2) Repeated treadmill exercise test of 16 patients showed significant prolongation of exercise duration (464+/-148 seconds vs. 526+/-174, p<0.05). 3) Hemodynamic data like blood pressure or heart rate were independent of nicorandil administration. 4) Three patients complained of headache, and one of them discontinued nicorandil. Mild indigestion was also found in another one patient.
Angina Pectoris* ; Blood Pressure ; Chest Pain ; Dyspepsia ; Exercise Test ; Headache ; Heart Rate ; Hemodynamics ; Humans ; Nicorandil*

Intramural hematoma of the esophagus is a rare cause of chest pain. Varying degrees of submucosal dissection and rupture of the esophagus can induce intramural hematoma of the esophagus. It is viewed as a complication of endoscopic sclerotherapy of esophageal varices, and is likely caused by an elevation in intraesophageal pressure due to factors such as blood coagulation abnormality, drugs, trauma or vomiting. We describe one case of pill-induced spontaneous intramural hematoma that was successfully managed by conservative treatment and discuss the case with a review of the literature.
Blood Coagulation ; Chest Pain ; Esophageal and Gastric Varices ; Esophagus ; Hematoma ; Rupture ; Sclerotherapy ; Vomiting

BACKGROUND: To evaluate the safety and effectiveness of rosiglitazone/metformin in patients with type 2 (non-insulin-dependent) diabetes. METHODS: A total of 982 patients were enrolled by 19 physicians from November 2003 to November 2010. Patients treated with rosiglitazone/metformin at least once, were included in safety assessment. The incidences of adverse events (AEs) and serious adverse events (SAEs) were estimated. The effectiveness of rosiglitazone/metformin was evaluated through change in fasting blood glucose (FBG), 2-hour postprandial glucose (2hr PPG), Hemoglobin A1c (HbA1c). RESULTS: Of the 982 patients, 713 patients with the mean age of 56.4 +/- 11.5 years were included in the safety assessment. A total of 130 AEs were reported from 110 patients (15.4 %). The most frequent AEs were upper respiratory infection (2.4 %), oedema (2.2 %), gastritis (1.3 %), and weight increase (1.1 %). The incidence of unexpected AEs was 5.9 % (42/713, 47 AEs). Three SAEs such as bacterial pneumonia, hyperglycaemia, chest pain were reported in 2 patients. As it is about effectiveness, patients showed statistically significant reductions after treatment of rosiglitazone/metformin in FBG, 2hr PPG, and HbA1c (P<0.001 by paired t-test, for all). CONCLUSION: Our data suggest that rosiglitazone/metformin is well tolerated and effective in Korean patients with type 2 (non-insulin-dependent) diabetes.
Blood Glucose ; Chest Pain ; Fasting ; Gastritis ; Glucose ; Hemoglobins ; Humans ; Incidence ; Metformin ; Pneumonia, Bacterial ; Thiazolidinediones

BACKGROUND: To evaluate the safety and effectiveness of rosiglitazone/metformin in patients with type 2 (non-insulin-dependent) diabetes. METHODS: A total of 982 patients were enrolled by 19 physicians from November 2003 to November 2010. Patients treated with rosiglitazone/metformin at least once, were included in safety assessment. The incidences of adverse events (AEs) and serious adverse events (SAEs) were estimated. The effectiveness of rosiglitazone/metformin was evaluated through change in fasting blood glucose (FBG), 2-hour postprandial glucose (2hr PPG), Hemoglobin A1c (HbA1c). RESULTS: Of the 982 patients, 713 patients with the mean age of 56.4 +/- 11.5 years were included in the safety assessment. A total of 130 AEs were reported from 110 patients (15.4 %). The most frequent AEs were upper respiratory infection (2.4 %), oedema (2.2 %), gastritis (1.3 %), and weight increase (1.1 %). The incidence of unexpected AEs was 5.9 % (42/713, 47 AEs). Three SAEs such as bacterial pneumonia, hyperglycaemia, chest pain were reported in 2 patients. As it is about effectiveness, patients showed statistically significant reductions after treatment of rosiglitazone/metformin in FBG, 2hr PPG, and HbA1c (P<0.001 by paired t-test, for all). CONCLUSION: Our data suggest that rosiglitazone/metformin is well tolerated and effective in Korean patients with type 2 (non-insulin-dependent) diabetes.
Blood Glucose ; Chest Pain ; Fasting ; Gastritis ; Glucose ; Hemoglobins ; Humans ; Incidence ; Metformin ; Pneumonia, Bacterial ; Thiazolidinediones

BACKGROUND AND PURPOSE: Left ventricular hypertrophy (LVH) is a well known cardiovascular risk factor, independent of hypertension, even in the absence of epicardial coronary artery disease. Possible mechanisms have been proposed, including increased LV mass, reduced coronary flow reserve (CFR) and diastolic filling abnormalities. However, the relations among LV hypertrophy, diastolic function, hypertension and coronary flow reserve (CFR) in patients with chest pain and normal coronary angiograms have not been well defined. SUBJECTS AND METHOD: Twenty-six patients with chest pain and normal coronary angiograms were included. LV mass, isovolumic relaxation time (IVRT), deceleration time (DT) and E/A ratio were assessed by 2-D echo-cardiography. Coronary blood flow velocity before and after intracoronary adenosine were measured using intracoronary Doppler wire (FIoWire). CFR was defined as ratio of peak flow velocity after adenosine to baseline flow velocity. Subjects were devided into 4 groups according to presence of LVH and hypertension and the parameters were compared among groups. RESULTS: FR was lower (p<0.01) in the groups with either hypertension or LVH or both than in the groups without them. The decrement in CFR was not linearly related to the degree of LVH (r=0.31, p=0.135). Although there were modest increment in IVRT and DT and decrement in E/A ratio in the groups with hypertension or LVH or both, there was no statistical significance. CONCLUSION: These findings suggest that the underlying mechanism of impaired CFR in patients with LVH or hypertension may be the consequence of primary coronary microvascular lesion rather than the process of left ventricular hypertrophy.
Adenosine ; Blood Flow Velocity ; Chest Pain* ; Coronary Artery Disease ; Deceleration ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Risk Factors ; Thorax*

A study carried out to evaluate the bleeding control and prophylactic effect of rebleeding using emergency endoseopic sclerotherapy in patients with hleeding gastric varices. 42 patients with gastric variceal bleeding were admitted to the Yeungnam University Hospital from May, 1983 to August, 1992. Patients were randomly classified into control group, 20 patients treated with conservative management, and sclerotherapy group, 22 patients treated with emergency endoscopic sclerotherapy. The two group were analysed with age, sex, etiology of liver cirrhosis, nature of bleeding episode, hematocrit on admitting day, amount of sclercsants used, rebleeding episodes, complications, and mortality. There were no significant differences in the severity of underlying liver disease and hematocrit on admission between two groups. Blood transfusion were performed in 19 cases of control group and 21 cases in sclerotherapy group(p>0.05). The amounts of transfusion were 7. 7units in control group and 6.1 units in sclerotherapy group(p<0,05). Rebleeding were developed in 65% and 18% of the patiehts with control and sclerotherapy group, respectively(p<0.05). Chest pain and mild fever were observed after endoscopic sclerotherapy. These results suggest that the endoscopic sclerotherapy is effective method in hemostasis of bleeding gastric varices and short-term prevention of rebleeding, but mortality rate was not decreased compared to control group. Development of more effective methods to treat gastric variceal bleeding is required.
Blood Transfusion ; Chest Pain ; Emergencies ; Esophageal and Gastric Varices* ; Fever ; Hematocrit ; Hemorrhage* ; Hemostasis ; Humans ; Liver Cirrhosis ; Liver Diseases ; Mortality ; Sclerotherapy*