The excitatory influence on heart rate is generally considered by beta-adrenergic neuroreceptors of Ahlquist's classificantion. Blockade of the beta adrenergic system would therefore be expected to alter heart rate and consequently to have an effect of patients with a variety of cardiac arrhythmias. In 1964 a clinically useable agent was produced by the name of propranolol which would effectively block beta action of adrenergic system and safe from side effects. The purpose of this study is to determine and estimate the immediate therapeutic effects of propranolol on 29 cases with various cardiac arrhythmias, administered intravenously. The following results were obtained: 1. It is apparent that propranolol by the intravenous route offers a rapid means of inducing A-V block and hence a reduction of the ventricular response in atrial fibrillation and atrial flutter. 2. Propranolol may be of value in improving digitalis-resistant atrial tachyarrhythmias with the therapeutic supplement. 3. Propranolol diminishes the automaticity of ectopic pacemakers because this is evident in the slowing of atrial rate or conversion of paroxysmal atrial tachycardia to sinus rhythm and the abolition or diminution of ventricular extrasystoles. 4. Digitalis-induced ventricular arrhythmias respond to propranolol well, and propranolol may well be the drug of choice in treating digitalis-induced ventricular arrhythmias. 5. Ventricular arrhythmias not related to digitalis were not satisfactorily treated with propranolol in our series. 6. Side effects associated with propranolol treatment were not remarkable except for development of transient hypertension in 2 cases.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Digitalis ; Heart Rate ; Humans ; Hypertension ; Propranolol* ; Sensory Receptor Cells ; Tachycardia ; Ventricular Premature Complexes

Various renal functions were studied in 45 young Koreans, 41 males and 4 females. The glomerular filtration rate, the renal plasma and blood flows and the filtration fraction were comparable to those in the occidental. The renal diluting capacity, as judged by the value of positive free water clearance (CH2O), was also comparable to that in the occidental. However, the renal concentrating ability, as judged by values of both the maximum urine osmolality induced by pitressin injection or during dehydration and the maximum negative free water clearance (TcmH2O) during mannitol diuresis, was somewhat low in the Korean. The tubular reabsorptive capacity of glucose (TmG) Was significantly low in the Korean while the tubular secretory capacity of PAH (TmPAH) was not altered. The urea clearance and its ratio with the inulin clearance were generally low. Moreover, the normal osmolar composition of urine indicated that urea is responsible for only 20 to 30%, while salt accounts for nearly 2/3 of the total urine osmolality. In view of the fact that the Korean is chronically maintained on a low or poor protein diet, these results are discussed in the light of this peculiar dietary habit of the Korean. Although the reduction of both the renal concentrating ability and the urea clearance could be reasonably attributed to a low protein intake, the observed low value of Tmc could not be explained thus at present.
Female ; Male ; Humans

The purpose of the present study is to assess the effect of aging on left ventricular filling function and the relation between Doppler parameters of LV filling and radius/thickness ratio in an normal population and in hypertensive patients with left ventricular hypertrophy. We underwent M-mode echocardiography and pulsed Doppler measurement of the LV inflow in 123 normal controls and 78 hypertensive patinets with LVH. The results were as follows; 1) In hypertensive patients with LVH, the peak early velocity(60.9+/-13.5cm/sec)was significantly decreased, and the peak atrial velocity(78.9+/-19.6cm/sec)was significantly increased than that in normal controls(78.1+/-15.7cm/sec, 60.2+/-13.1cm/sec, P<0.005, respectively). 2) In the normal controls, peak early velocity correlated well with age(r=-0.388, -0.595, P<0.005, respectively), but not with radius/thickness ratio. 3) In the hypertensive patients with LVH, peak early velocity and the ratio of early to atrial velocity correlated with redius/thickness ratio (r=0.274 P<0.05, r=0.367 P<0.005, respectively), but not with age. In conclusion early LV diastolic filling is reduced and systolic is augmented, probably reflecting alteration in myocardial siffness with normal aging, whereas in chronic LVH, changes in radius/thickness ratio is more important determinants of ventricular compliance, overriding the effects of age.
Aging ; Compliance ; Echocardiography ; Humans ; Hypertrophy, Left Ventricular*

The present study was undertaken in an attempt to establish the range of normal blood pressure levels in Koreans. A representative group of the working population, consisting of 39,859 persons (23,834 men and 16,025 women) who were able to work regularly on daily duty and who lived in various parts of the country, was studied, using casual blood pressure readings. The arithmetic mean, the standard deviation and the frequency distribution of the blood pressure readings were determined for each sex and for each age group from five to seventy nine years of age. The normal range was assumed to include the 80% of all the readings which were within 40% of either side of the mean. Any blood pressure which the mean was considered to be abnormal. The readings falling between these two limits were regarded as borderline. The limits of normal blood pressure, as determined by this method, were found definitely to vary with age and sex. The effect of body weight on the blood pressure was investigated. It was found that the systolic and diastolic blood pressure were progressively increased with the increase in body weight regardless of sex and age. The incidence of systolic hypertension was 6.0% in adult males and 6.2% in females, diastolic hypertension occurred 6.8% in males and 5.8% in females. The incidence of hypotension, below 90 mmHg. systolic, was 0.6% in males and 1.7% in females, and below 60 mmHg. diastolic was 6.6% in males and 9.1% in females. A Comparison of the mean blood pressure was made between the rural and the urban population of Koreans. The mean blood pressure readings in the urban population are higher than those in the rural population, both in systolic and diastolic blood pressures and in all age groups. A comparison of the mean blood pressure also was made between Koreans and Americans, Chinese, Japanese, Filippinos and Indians. The systolic and diastolic blood pressure in Americans (U.S.A.) is higher than that in Koreans. Those in the Japanese and Chinese are similar until the age of fifty, from the age of fifty, the pressures are higher than those in Koreans. The blood pressure of Filippinos is similar to the blood pressure of Koreans all through the age groups. In Indians, pressures are lower than in Koreans.
Adult ; Male ; Female ; Humans ; Incidence

During cardiac catheterizations in 20 cases with congenital heart disease, intracardiac shunts were measured by two methods, dye dilution method and the Fick method, and the results were compared. Arterial dilution curves were used for the estimation of both the right-to-left and left-to-right shunts-Venous dilution curves were used for measurement of left-to-right shunts. In cases with a left-to-right shunt, the amount of the shunt was expressed as per cent of total pulmonary blood flow and, in cases with a right-to-left shunt, as per cent of total systemic blood flow. The following results were obtained. 1. In 8 cases with a right-to-left shunt, the amount of the shunt was 35.6 +/-18.1% by the Fick method and 34.0 +/-19.2% by arterial dilution curves. The difference was not statistically significant(p> 0.l). In 15 cases with a left-to-right shunt, the amount of shunt was 41.3 +/-26.6% by the arterial dilution curve and 36.6 +/-14.O% by the Fick method. The difference was not statistically significant(p> 0.1). Also venous dilution curve was performed in 8 cases of left-to-right shunt and the amount of the shunt was 33.0 +/-21.0%, as compared to 35.5 +/-17.3% by the Fick methods. The difference was not statistically significant (p> 0.1). 2. Arterial dilution curves could be used to localize right-to-left shunts and venous dilution curves left-to-right shunts, whereas tile Fick method was helpful only for the localization of left-to-right shunts. 3. It was possible to detect small left-to-right (less than 10%) and right-to-left (less than 5%) shunts by dye dilution curves, which was not possible with the Fick method. 4. In detection of small intracardiac shunts as well as in shunt localization, the dye dilution method was more accurate than the Fick method. The difference of the amount of the shunt estimated by the two methods was not statistically significant.
Adolescent ; Adult ; Cardiac Output ; Child ; Child, Preschool ; Dye Dilution Technique ; Female ; Heart Defects, Congenital/*physiopathology ; *Heart Function Tests ; Human ; Male

No abstract available.
Sciatic Nerve*

BACKGROUND AND PURPOSE: Progression of motor deficits in the acute period is frequently observed in patients with subcortical striatocapsular infarctions. Therefore, we sought to determine the factors associated with early motor progression in patients with infarcts confined to the striatocapsular region. METHODS: We studied 80 consecutive patients with striatocapsular-region infarction, as defined by clinical and MRI criteria, within 24 hours after stroke onset. Motor progression was defined as an increase of >2 points in the motor items of the National Institutes of Health Stroke Scale (NIHSS) within 7 days of stroke onset. The study population was divided into patients with and without motor progression, and risk factors, clinical features, and brain MRI/magnetic resonance angiograpy (MRA) findings were compared between these groups. RESULTS: Motor progression was observed in 40% of the 80 patients. The independent variables associated with motor progression were a history of hypertension (OR=7.8, 95% CI=1.5-39.8, p=0.013) and an initial infarct extent of > or =15 mm (OR=9.2, 95% CI=1.8-45.7, p=0.006). However, there were no differences in the initial NIHSS score, other stroke risk factors, vascular stenosis pattern, or cardioembolic source. CONCLUSIONS: Early motor progression in patients with striatocapsular-region infarction is associated with the initial extent of the lesion. However, the stroke mechanism and vascular stenosis did not differ between the motor progression and stable groups.
Brain ; Constriction, Pathologic ; Humans ; Hypertension ; Infarction ; Magnetic Resonance Imaging ; National Institutes of Health (U.S.) ; Risk Factors ; Stroke

OBJECTIVE: The purpose of this study was to identify the predictors of one-year clozapine treatment in refractory schizophrenic patients. METHODS: We defined treatment response as the reduction of total PANSS scores by 20% or more and as the total PANSS scores below 60, or as the CGI severity score below 3, after one-year of clozapine treatment. We compared age, duration of illness, number of hospitalization, plasma monoamine metabolites, ventricle-brain ratio, and short-term treatment response between treatment response group and treatment non-response group. RESULTS: Among the total patients of 26, 12(46%) were categorized as treatment response group. In comparing between treatment response group(N=12) and treatment non-response group (N=14), there were no differences in age, onset age, duration of illness, but the number of hospitalization was significantly more frequent in treatment non-response group. There was no significant difference in total PANSS scores between the two groups before clozapine treatment. After 4 weeks of clozapine treatment, the changes of PANSS positive score was more higher in treatment response group. The baseline plasma HVA levels and HVA/5-HIAA ratio were significantly higher in treatment response group than in non-response group, but there was no significant difference in baseline plasma 5-HIAA levels between the two groups. No difference existed in ventricle-brain ratio between the two groups. CONCLUSION: This study suggests that number of hospitalization and short-term treatment response rate may be useful as the clinical predictors, and that plasma HVA levels also as a biological predictor of long term clozapine treatment.
Age of Onset ; Clozapine* ; Hospitalization ; Humans ; Hydroxyindoleacetic Acid ; Plasma ; Schizophrenia*

PURPOSE: To evaluate magnetic resonance (MR) imaging features of non-surgically treated tuberculous spondylitis and to evaluate the relationships between these features and clinical outcomes. MATERIALS AND METHODS: Data from ten patients (male:female=6:4, mean age=45 years) with clinically proven tuberculous spondylitis who were treated nonsurgically over three months were analyzed retrospectively from 2000 to 2007. MRI was performed at least three times for each patient, at baseline, every three or six months, and at the end of treatment. All images were analyzed by two radiologists. RESULTS: The mean follow-up period for the MR examination was 10.1 months (range, 4-17 months). Six patients had clinically complete resolution of tuberculous spondylitis with medication treatment only. Four patients were treated with surgical management alongside medication. All ten patients were divided into two groups by clinical outcome; six patients with complete treatment and four patients with incomplete treatment. In the complete treatment group, follow-up MR findings showed a loss of subligamentous spread of abscesses, decreased size of abscesses, no interval changes in vertebral body heights, and fatty changes in spinal lesions. MR findings in the incomplete treatment group showed bone marrow edema extension to adjacent vertebra, extension of the abscesses, and decreased height of the vertebral bodies. CONCLUSION: During the nonsurgical management of tuberculous spondylitis, MR imaging may play a role in predicting patient response to antituberculous drug treatment.
Abscess ; Anti-Bacterial Agents ; Body Height ; Bone Marrow ; Edema ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Retrospective Studies ; Spine ; Spondylitis ; Tuberculosis

Brunner's gland adenoma is a rare benign small bowel neoplasm and it represents 10% of small bowel benign tumor. Most of adenoma manifest as polypoidal, multiple and size does not exceed 1 cm and mostly asymptomatic, but the lesion larger than 1cm is solitary and can cause bleeding, obstruction, intussusception and there are some reports of showing malignant transformation. Until the present, there are two cases of over cm huge Brunner's gland adenoma in Korea and each of their chief complaint was abdominal discomfort and melena, but there is no case report of over 8cm Brunner's gland adenoma accompanied with acute bleeding as seen in this case. We diagnosed an 8cm sized, huge duodenal Brunner's gland adenoma which accompanied with acute bleeding and treated it by endoscopic resection using an IT-knife, successfully.
Adenoma* ; Endoscopy ; Hemorrhage* ; Intussusception ; Korea ; Melena