Acute pulmonary edema was experienced during the mass excision of a nasopharyngeal angiofibroma clue to massive transfusion (8,000ml of blood within 3 hours). High FIoz with manual PEEP, diuretics, steroid and digitalis were given immediately. Full recovery was observed after 18 hours of ICU care.
Angiofibroma* ; Digitalis ; Diuretics ; Edema* ; Pulmonary Edema

Giiiary muscle strongly resembles the heart muscle in its functional behaviour, although from the anatomic point of view, it can be considered part of the smooth or involuntary muscle system. Visual acuity, refractive state, near point of accommodation and accommodative-convergence/ accommodation were studied in 30 persons before and after instillation of 2 drops of 0.01% digitalis solution. The results showed that the chapge of near point of accommodation was significant. So the author concluded, "Digitalis favorably influences the accommodation".
Digitalis* ; Humans ; Muscle, Smooth ; Myocardium ; Visual Acuity

A case of chronic atrial tachycardia in a 12-year-old boy is reported. His complaints were frequent precordial palpitation and mild exertional dyspnea with 6 months duration, EKG showed the findings of chronic atrial tachycardia, repetitive type. Digitalis therapy was established and continued for about 6 months. The attack of tachycardia ceased from 2 weeks after beginning of the treatment and didn't reappeared until the end of treatment. After cessation of digitalis therapy, follow-up study was made for over 6 months but no attack of tachycardia was observed even during this period. A review of literatures was made briefly.
Child ; Digitalis ; Dyspnea ; Electrocardiography ; Follow-Up Studies ; Humans ; Male ; Tachycardia*

For the purpose of elucidating relation between red cell electrolyte concentrations and serum digoxin level, measurement of red cell electrolyte concentrations and seum digoxin level by radioimmunoassay were done in 46 normal controls and 63 patients of CHF including 8 patients with digitalis intoxication. The results obtained were as follows: 1. Red cell sodium concentration and ratio of red cell sodium to red cell potassium concentration in normal males were significantly higher than those of females, and red cell potassium concentration in normal males was significantly lower than that of normal females. 2. Red cell potassium concentration in patients of CHF was significantly higher than that of normal controls, but there was no difference in the red cell sodium concentration between the groups. 3. There was no relation between red cell electrolyte concentrations and serum digoxin level, and red cell electrolyte concentration did not exactly estimate serum digoxin level. 4. Red cell electrolyte concentrations in the patient of CHF were valuable in detecting digitalis toxicity.
Digitalis ; Digoxin* ; Female ; Humans ; Male ; Potassium ; Radioimmunoassay ; Sodium

From May, 1978 through Oct., 1979 the effect of Coenzyme Q10 was evaluated on 10 patients with chronic heart failure. The subjects selected for this study consisted of 7 patients with cardiomyopathy and 3 patients with valvular heart disease admitted to Severance Hospital, Yonsei University College of Medicine, All these patients had symptoms and signs of congestive heart failure which was stable for at least one month before starting Coenzyme Q10. Coenzyme Q10 was administered 30mg daily for eight weeks, one hour before meal and in combination with digitalis and/or diuretics. The drug effects were determined by measuring the cardio-thoracic ratio by chest X-ray, the sum of 'S' wave in V1 and 'R' wave in V5 in electrocardiogram, and PEP/LVET (pre-ejection period/left ventricular ejection time) by simultaneous tracings of carotid pulse and phonocardiogram every two weeks during medication. The cardio-thoracic ratio was improved in 4 of 10 cases, the sum of RV+SV5 was decreased in all 5 cases who showed voltages above 40mm before medication, and PEP/LVET ratio was decresed in 4 of 10 cases. The difference of average values before and after medication were not statistically significant(p<0.05) in all 3 parameters when examined by t-test. During treatment, there was improvement, if any, from two weeks after medication and no significant side effects were noted throughout the study period.
Cardiomyopathies ; Digitalis ; Diuretics ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Valve Diseases ; Humans ; Meals ; Thorax

From May, 1978 through Oct., 1979 the effect of Coenzyme Q10 was evaluated on 10 patients with chronic heart failure. The subjects selected for this study consisted of 7 patients with cardiomyopathy and 3 patients with valvular heart disease admitted to Severance Hospital, Yonsei University College of Medicine, All these patients had symptoms and signs of congestive heart failure which was stable for at least one month before starting Coenzyme Q10. Coenzyme Q10 was administered 30mg daily for eight weeks, one hour before meal and in combination with digitalis and/or diuretics. The drug effects were determined by measuring the cardio-thoracic ratio by chest X-ray, the sum of 'S' wave in V1 and 'R' wave in V5 in electrocardiogram, and PEP/LVET (pre-ejection period/left ventricular ejection time) by simultaneous tracings of carotid pulse and phonocardiogram every two weeks during medication. The cardio-thoracic ratio was improved in 4 of 10 cases, the sum of RV+SV5 was decreased in all 5 cases who showed voltages above 40mm before medication, and PEP/LVET ratio was decresed in 4 of 10 cases. The difference of average values before and after medication were not statistically significant(p<0.05) in all 3 parameters when examined by t-test. During treatment, there was improvement, if any, from two weeks after medication and no significant side effects were noted throughout the study period.
Cardiomyopathies ; Digitalis ; Diuretics ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Valve Diseases ; Humans ; Meals ; Thorax

Influences of intracerebroventricular(icv) ouabain on cardiovascular system and on pressor response to raised intracranial pressure(ICP) were investigated in urethane-anesthetized rabbits. Intravenous(iv) 40 microgram/kg ouabain did not affect blood pressure of rabbit. Icv ouabain(5, 10, 20 microgram/kg) and digoxin(6.25, 12.5 microgram/kg) produced dose-dependent pressor responses and marked decrease of heart rate. After bilateral vagotomy, the bradycardiac effect of ouabain disappeared, while the pressor effect was significantly potentiated. The ouabain-induced pressor effect was not affected by iv and icy phentolamine or propranolol, and significantly inhibited by icy infusion of lidocaine(0.1 mg/kg/min) and diazepam(0.025 mg/kg/min). The pressor response to raised ICP was not affected by iv 40 microgram/kg ouabain but disappeared by icy 10 microgram/kg ouabain and 6.25 microgram/kg digoxin. These data suggests that ouabain causes pressor effect through direct interaction with a site(s) in central nervous system and bradycardiac effect by direct activation of vagal center, and ouabain blocks central sympathetic stimulation by increase of ICP in rabbits.
Blood Pressure ; Cardiovascular System* ; Central Nervous System ; Digitalis* ; Digoxin ; Heart Rate ; Intracranial Pressure ; Ouabain ; Phentolamine ; Propranolol ; Rabbits* ; Vagotomy

Miller Fisher syndrome is characterized by ophthalmoplegia, ataxia and areflexia and usually develops after respiratory tract viral infection. Other various events that precede neurologic symptoms are GI tract infection, vaccination, digitalis intoxication, insect bite, and delivery. The clinical course is usually benign with complete recovery. Miller Fisher syndrome is rare and occurred after insect bite is even more rare. The authors experienced a case of Miller Fisher syndrome in 7-year-old female who had the sudden onset of ophthalmoplegia, ataxia and areflexia. These symptomes developed after insect bite.
Ataxia ; Child ; Digitalis ; Female ; Gastrointestinal Tract ; Humans ; Insect Bites and Stings* ; Insects* ; Miller Fisher Syndrome* ; Neurologic Manifestations ; Ophthalmoplegia ; Respiratory System ; Vaccination

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

It is a highly risky procedure to perform general anesthesia on a patient with toxemia in whom the function of the vital organs is seriously impaired. The risk is much increased when pulmonary edema is also a complication. Recently, many physicians are increasingly interested in PEEP(positive end-expiratory pressure) as a valuable therapeutic approach for pulmonary edema. There are reports that the PEEP has contributed a great deal of the treatment of the pulmonary edema. This is a case report of a patient with toxemia and pulmonary edema who underwent cesarean section. She was treated with oxygen, diuretics, digitalis, steroids, bronchodilators and PEEP(pr.=10cm.H2O, Vt=700ml., assist mode), The therapeutic result was excellent.
Anesthesia* ; Anesthesia, General ; Bronchodilator Agents ; Cesarean Section ; Digitalis ; Diuretics ; Female ; Humans ; Oxygen ; Pregnancy ; Pulmonary Edema* ; Steroids ; Toxemia*