The pharmacological therapy of cardiac arrhythmias is still challenging. As is well known, antiarrhythmic drugs have a narrow therapeutic-toxic window and can induce lethal proarrhythmia (antiarrhythmic drug-induced arrhythmia). The harmful effect of antiarrhythmic drug was proven by CAST and so many clinical trials. Thus we need strict indications for prescription and objective parameters for monitoring of the drug action and side effects. The cardiac arrhythmias are classified as ectopic beats, bradyarrhythmia, and tachyarrhythmia. The main target of antiarrhythmic drugs is tachyarrhythmia. The clinical role of antiarrhythmic drugs is the acute conversion of arrhythmia to sinus rhythm and the chronic suppression/prevention of tachycardia. The cardiac arrhythmia (arrhythmogenesis) occurs in harmony of 3 components, namely, substrate, precipitating (modulating) factors, and trigger. The acute modification of arrhythmogenic environment by drug may be efficient, but the chronic suppression of arrhythmia only by the drug may not be complete. Recently, the clinical role of chronic drug therapy is replaced by RFCA (in patients with SVT except atrial fibrillation) and ICD (VT/SCD). The antiarrhythmic drugs are usually classified into Class I (sodium channel blocker), Class II (beta-blocker), Class III (potassium channel blocker), Class IV (calcium channel blocker), and others (digoxin and adenosine), according to Vaughn-Williams suggestion. Nowadays, the clinical electrophysiologist reclassified the agents into calcium channel-dependent drug (Class II, IV, digoxin, and adenosine) and sodium/potassium channel-dependent drug (Class I and III). The drug is effective only when the concentration in blood or tissue is sufficient to modify the arrhythmogenic substrate. We need to know the pharmacokinetic and pharmacodynamic properties of antiarrhythmic drugs exactly. We can expect the blood concentration of a drug if we know the elimination half-life and the dosing schedule of the drug because most drugs (including antiarrhythmic agents) have the first-order (elimination) kinetic. For a new steady-state of drug concentration, we should wait for 3 to 4 times of the half-life after changing the dosage (prescription). Finally, the consideration and management of the underlying heart disease and precipitating/modulating factors are needed for the effective antiarrhythmic drug therapy.
Anti-Arrhythmia Agents ; Appointments and Schedules ; Arrhythmias, Cardiac ; Bradycardia ; Calcium ; Digoxin ; Drug Therapy ; Half-Life ; Heart Diseases ; Humans ; Prescriptions ; Tachycardia

No abstract available.
Democratic People's Republic of Korea* ; Health Services*

No abstract available.
Denture, Partial, Fixed*

BACKGROUND AND OBJECTIVES: Primary intervention by stent implantation during acute myocardial infarction is a novel strategy to provide better myocardial perfusion compared to thrombolysis or baloon angioplasty. We aimed to assess the reperfusion achieved by primary stenting, employing TIMI frame count for more objective and quantitative measurement. MATERIALS AND METHOD: Measurements for number of frames required to opacify standardized angiographic landmark branch(TIMI frame count) were determined for the coronary arteries of 77 normal controls and 65 patients with acute myocardial infarction who underwent primary stenting within 12 hours of symptom onset. RESULTS: In normal subjects, TIMI frame count for left anterior descending artery(LAD) was 1.3 times of mean count of right coronary artery(RCA) and left circumflex artery(LCx), and significant less than that of TIMI study(22.3+/-4.9 vs 36.2+/-2.6, p<0.05). TIMI frame count for RCA and LCx was similar to results of TIMI study. In infarct related arteries(IRA), corrected TIMI frame count(CTFC) after primary stenting was similar to those of normal control. Frame counts of RCA was larger compared to that of normal control, but statistically insignificant(23.0+/-7.5 vs 17.6+/-3.5, p>0.05). There was no difference of CTFC of non-infarct related arteries between patients and normal controls. CONCLUSION: The TIMI frame count of LAD artery in normal Korean subjects was significantly less than that of American counterpart. In patients with acute myocardial infarction, primary stenting appeared to provide improved coronary flow similar to that observed in normal subjects, as measured by TIMI frame counting.
Angioplasty ; Arteries ; Coronary Vessels ; Humans ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Stents*

The purpose of this study was to investigate the causes of food impaction and to explore solutions as well. For this study, 39 patients with food impaction wee selected. 77 contact areas in these patients were investigated mobility, tightness of contact area, gingival index, plaque index, attachment loss, alveolar bone loss, proximal caries, marginal ridge distance and occlusal relationships. The results were as follows ; 1. Teeth without distal support were found to be the most frequent site of food impaction (41.6%). Food impaction was found to be more frequent in the upper teeth (66.2%) than the lower teeth (33.8%). 2. Food impaction was found in tight contact cases (71.4%). Alveolar bone loss was not found in the early stage of food impaction (83.1%) 3. The distance between the marginal ridges of food impaction sites (mean=0.48mm) was shorter than that of the control group. (mean=0.77mm) (p<0.001) 4. In 18.2% of t he cases, proximal carries were found at the food impaction site. 5. Food impaction affected patient's occlusion with the following frequencies ; cusp to marginal ridge relationship (72.7%), cusp to fossa relationship (3.9%) and stepped relationship (23.4%).
Alveolar Bone Loss ; Humans ; Periodontal Index ; Tooth

The authors performed a study of 32 patients who had undergone anterior lumbar interbody fusion using allograft with posterior pedicular instrumentation. The clinical outcomes were evaluated and the radiographs were analyzed with respect to graft subsidence, interspace collapse, graft collapse, sagittal angle and fusion status. In 71% of the levels there was a loss of disc space height during the follow-up, with 18% of the levels being narrower than their preoperative height at late follow-up. Significant(more than 3mm) subsidence and collapse were noted in three and four levels respectively. Approximately 84% of the 32 patients had satisfactory results and a radiological fusion was obtained in 88.2% of the 34 levels. We consider the pedicle screw fixation improves the retention of interspace distraction and the fusion rate of allograft in anterior lumbar interbody fusion.
Allografts* ; Follow-Up Studies ; Humans ; Spine ; Transplants

Author take off the pelvic bone from the cadaver and made the accruate reconstructed the pelvic bone as well as normal bone. Then author setted the pelvic bone into the specialized acrylic globe as the normal person erect position. For the acetabular posterior wall, projected the radiologic beam from the 0°to 45°cephalad direction and then pelvic bone rotated internally 0°~45°, each section is 5°. For acetabular anterior wall, projected the radiologic beam from 0° to 45° caudal direction and pelvic bone rotated externally 0°~45°, each section is 5° too. From the pelvic bone experiments, author get on the good radiologic angle for acetabular anterior and posterior wall. Ane then make the radiologic projection for normal person as the pelvic experiment. In pelvic bone model experiment, For acetabular anterior wall and anterior colum, external rotation 20°~30° caudal tilting 30°~45° angle projection has good visualization. For acetabular posterior wall and posterior column (including anterior column partially), internal rotation 15°~20° cephalad tilting 15°~30°angle projection has the good visualization. In normal person experiment, For acetabular anterior wall and anterior column, external rotation 20°caudal tilting 30°angle projection shows the good visualization. For acetabular posterior wall and column (including anterior column partially) internal rotation 20°cephalad tilting 30°angle projection shows good visualization. From the pelvic bone model and normal person experiments, the following conclusion are obtained. 1. For posterior wall and posterior column(including anterior column partially), internal rotation 20°, cephalad tilting 30°view is good. 2. For anterior wall and anterior column, external rotation 20°, caudal tilting 30°view is good.
Acetabulum ; Cadaver ; Humans ; Pelvic Bones

BACKGROUND: Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1 year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3 4 months. Some data showed that changes of bone markers after 3 months could predict the changes of the BMD after 1 year. METHODS: 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups, HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made. RESULTS: Our results showed those findings 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8% 4.7%). CONCLUSION: These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1 year treatment. But, HRT with antiresorptive agents may be effective in treating postmenopausal osteoporotic Korean women.
Alendronate ; Bone Density Conservation Agents ; Calcitonin ; Female ; Humans ; Metabolism ; Osteoporosis* ; Postmenopause ; Spine

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Breast Neoplasms* ; Breast*