BACKGROUND : Heart rate variability informed us to diagnose impairment of autonomic nervous system in patient with diabetes, hypertension, ischemic heart disease, chronic renal disease, arrhythmia. Change of autonomic nervous system is related to circadian rhythm, stress, physical activity, age and so on. Especially, impairment of vagal nervous system with age help us to expect sudden cardiac death, myocardial infarction, arrhythmia. So we survey heart rate variability by using 24 hours Holter monitoring to expect impairment of autonomic nervous system in elderly hypertensive patients. METHODS : In order to assess 24 hours heart rate variability, we used Del Mar Avionics 563 Holter monitoring on 15 older hypertensive patient (>or=65 years), 15 older hypertensive patient(<64 years), 15 younger healthy subjects (<64 years), and 15 older healthy subjects (>or=65 years). The following frequency domain variables were considered: low frequency(LF), high frequency(HF) power spectral parameter, and LF/HF ratio. Results : 1) There was significant decrease in LF power spectral parameter in older groups compared with younger groups 394.0+/-237.8 vs 127.7+/-96.3, p<0.05, 171.8+/-173.5 vs 40.8+/-33.8, p<0.05). 2) In hypertensive patients, there was significant decrease in HF power spectral parameter compared with healthy subjects(989.2+/-553.8 vs 526.0+/-364.7, p<0.05, 804.2+/-404.5 vs 368.8+/-241.2, p<0.05). 3) Although there was no significant difference, L/H ratio decreased in older groups compared with younger gourps. 4) In circadian rhythm, control subjects had low HF power spectral parameter at morning. LF/HF ratio was high at morning in younger groups. CONCLUSION : L/H ratio was depressed in older groups. HF was blunted in hypertensive groups. Thus, impairment of autonomic nervous system was accelerated by age and hypertension.
Aged ; Arrhythmias, Cardiac ; Autonomic Nervous System ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Motor Activity ; Myocardial Infarction ; Myocardial Ischemia ; Nervous System ; Renal Insufficiency, Chronic

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

No abstract available.
Cryotherapy* ; Hot Temperature* ; Humans

Fractional time intervals during cardiac cycle were determined by means of the analyses of mechanocardiograms in 100 male patients with hypertension and 100 healthy males, which served as controls. The mechanocardiograms anyalyzed in this study were simultaneously recorded electrocardiograms, phoocardiograms, apexcardiograms and carotid pulse tracings. Of various time intervals during systolic in patients with hypertension, the mechanical systole(both C-D and C-A2 intervals), the isovolumic contraction time, the initial phase of ventricular contraction and the ventricular pressure elevation time were significantly prolonged, whereas the protodiastole was significantly shortened. The prolongation of the mechanical systole was caused primarily by the lengthening of the isovolumic contraction time, which resulted from the prolongation of the components of the latter, namely the initial phase of ventricular contraction and the ventricular pressure elevation time. During diastole, there were significant prolongation of the isovolumic relaxation time and the rapid ventricular filling period, and a significant shortening of the slow ventricular filling period. Among these time intervals, the mechanical systole(C-A2 inlerval), the isovolumic contraction time, the ventricular pressure elevation time and the isovolumic relaxation time showed significant positive correlation with blood pressure. On the other hand, the slow ventricular filling period was significantly negatively correlated with blood pressure. These facts suggested that the changes in these time intervals were related to increased afterload and/or resultant myocardial or hemodynamic alterations.
Blood Pressure ; Diastole ; Electrocardiography ; Hand ; Hemodynamics ; Humans ; Hypertension* ; Male ; Relaxation ; Systole ; Ventricular Pressure

Fractional time intervals during cardiac cycle were determined by means of the analyses of mechanocardiograms in 100 male patients with hypertension and 100 healthy males, which served as controls. The mechanocardiograms anyalyzed in this study were simultaneously recorded electrocardiograms, phoocardiograms, apexcardiograms and carotid pulse tracings. Of various time intervals during systolic in patients with hypertension, the mechanical systole(both C-D and C-A2 intervals), the isovolumic contraction time, the initial phase of ventricular contraction and the ventricular pressure elevation time were significantly prolonged, whereas the protodiastole was significantly shortened. The prolongation of the mechanical systole was caused primarily by the lengthening of the isovolumic contraction time, which resulted from the prolongation of the components of the latter, namely the initial phase of ventricular contraction and the ventricular pressure elevation time. During diastole, there were significant prolongation of the isovolumic relaxation time and the rapid ventricular filling period, and a significant shortening of the slow ventricular filling period. Among these time intervals, the mechanical systole(C-A2 inlerval), the isovolumic contraction time, the ventricular pressure elevation time and the isovolumic relaxation time showed significant positive correlation with blood pressure. On the other hand, the slow ventricular filling period was significantly negatively correlated with blood pressure. These facts suggested that the changes in these time intervals were related to increased afterload and/or resultant myocardial or hemodynamic alterations.
Blood Pressure ; Diastole ; Electrocardiography ; Hand ; Hemodynamics ; Humans ; Hypertension* ; Male ; Relaxation ; Systole ; Ventricular Pressure

The introduction of the strong clover-leafed nail combined with the principle of reaming out the medullary canal and the development of image intensifiers has been extended the indications of the in tramedullary nailing. In this report, an attempt was made to introduce the method and to verify the indications and advantage of retrograde intramedullary nailing of humeral shaft fractures, as compared with the conventionally accepted methods.
Fracture Fixation, Intramedullary ; Humerus ; Methods

Pheochromocytoma stems from the chromaffin cell and mostly is located in the adrenal medulla. It is an important cause of secondary hypertension due to correction of hypertension by a resection of the tumor. Because it produces and secretes catecholamine, it bothers anesthesiologists with excessive hypertension, tachycardia and arrhythmia during the anesthetic period. Therefore, anesthetic management is directed to avoid these conditions. We report a case of bilateral pheochromocytoma successfully managed intraoperatively with an infusion of nicardipine and an intermittent esmolol injection.
Adrenal Medulla ; Arrhythmias, Cardiac ; Chromaffin Cells ; Hypertension ; Nicardipine* ; Pheochromocytoma* ; Tachycardia

BACKGROUND: Induction of anesthesia with a high dose of fentanyl and vecuronium decreases the heart rate and blood pressure. This study was designed to evaluate the effect of preinduction atropine on these hemodynamic changes in patients undergoing coronary artery bypass graft surgery (CABG). METHODS: Forty-one patients who underwent CABG were randomly divided into two groups. After insertion of a radial artery cannula and a Swan-Ganz catheter, normal saline 1 ml (control group, n = 20) or atropine 0.5 mg (atropine group, n = 21) was injected intravenously 1 min before the induction of anesthesia. Anesthesia was induced with a first dose of fentanyl (5-8 microgram/kg) and vecuronium (0.12 mg/kg) and a second dose of fentanyl (5-10 microgram/kg). The patient was then intubated. Hemodynamic variables were measured before the induction of anesthesia, 1 min after the administration of each drug during the induction of anesthesia and 5, 10, and 30 min after the intubation. RESULTS: There was no significant differences between the two groups in terms of demographic data except that the number of patients with diabetes mellitus was greater in the control group than in the atropine group. The number of patients treated for hypotension or bradycardia during the induction of anesthesia was greater in the control group than in the atropine group, but this was not statistically significant. Heart rates significantly decreased in the control group but were maintained in the atropine group without any significant tachycardia. Blood pressure significantly decreased in both groups. CONCLUSIONS: Intravenous injection of atropine before anesthetic induction in patients undergoing CABG attenuates the decrease in heart rate resulting from anesthetic induction with high dose fentanyl and vecuronium. However, it didn't prevent the decrease in blood pressure nor did it reduce the incidence of treatment for hypotension.
Anesthesia ; Atropine* ; Blood Pressure ; Bradycardia ; Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diabetes Mellitus ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Injections, Intravenous ; Intubation ; Radial Artery ; Tachycardia ; Transplants ; Vecuronium Bromide*

BACKGROUND: Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model. METHODS: Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF). RESULTS: Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF. CONCLUSIONS: Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Acute Lung Injury* ; Animals ; Arrhythmias, Cardiac ; Bronchoalveolar Lavage ; Flecainide* ; Infusions, Subcutaneous ; Injections, Intraperitoneal ; Interleukin-8 ; Leukocytes ; Lung ; Lung Injury ; Models, Animal ; Neutrophils ; Rats ; Sepsis*

No abstract available.
Copper* ; Female ; Humans ; Intrauterine Devices*