OBJECTIVE: This study was performed to investigate the effect and safety of cardiac rehabilitation program in heart failure. METHOD: 36 patients who suffered from heart failure with decreased left ventricular ejection fraction less than 50% by echocardiogram were recruited for study subject. They took graded exercise test before and after cardiac rehabilitation program. Cardiac rehabilitation program was consisted of 6~8 weeks monitoring exercise according to the result of exercise test. We reviewed the all courses of the program to see the safety and compared the several results to know the effect of the program. RESULTS: During totally 696 exercise-hours with ECG monitoring, 12 abnormal hemodynamic responses were happened, but those were minor in severity. All of them were managed successfully and could complete their exercise program as their schedules. Even in heart failure patients, cardiac rehabilitation program could improve exercise capacity in terms of increased maximal oxygen consumption, maximal exercise time, and maximal myocardial oxygen demand. Submaximal myocardial oxygen demand and rate of perceived exertion were significantly decreased after cardiac rehabilitation program. CONCLUSION: In case of prudent monitoring and proper management, cardiac rehabilitation program is safe and effective to improve exercise capacity in heart failure patient.
Appointments and Schedules ; Electrocardiography ; Exercise Test ; Heart Failure* ; Heart* ; Hemodynamics ; Humans ; Oxygen ; Oxygen Consumption ; Rehabilitation* ; Stroke Volume

OBJECTIVE: To investigate the effect of epilepsy and neonatal seizure on development in children with cerebral palsy (CP) or delayed development (DD). METHOD: The subjects were 135 patients with CP or DD. Development was evaluated by Bayley Scale of Infant Development II (BSID II). Epilepsy was diagnosed on the base of clinical features, past history and electroencephalography. RESULTS: The incidence of epilepsy was 18.4% in CP, and 37.8% in DD. Spastic quadriplegia of CP has the highest incidence of epilepsy (38.4%). First seizure attack was occurred before 6 months old of age in 66.7% of CP with epilepsy and in 64.3% of DD with epilepsy. The prevailing type of epilepsy was generalized seizure in DD (57.1%), partial seizure in CP (50.0%). The group with epilepsy had lower psychomotor and mental development quotient on BSID II than the group without epilesy (p<0.05). Polytherapy was more used to control epilepsy than monotherapy. Valproate (50.0%), phenobarbital (37.5%), carbamazepine (31.3%) were commonly used drugs for controlling epilepsy. CONCLUSION: The epilpesy has a negative effect on psychomotor and mental development in the children with CP or DD.
Carbamazepine ; Cerebral Palsy* ; Child ; Child Development ; Developmental Disabilities* ; Electroencephalography ; Epilepsy* ; Humans ; Incidence ; Infant ; Phenobarbital ; Quadriplegia ; Seizures* ; Valproic Acid

No abstract available.

This study evaluated the effects of saddle height on the muscle activity and oxygen uptake during bicycling. The subjects were 20 young adult volunteers. Muscle activity and oxygen uptake were measured with the two saddle heights (maximum knee extension of 180degrees and 120degrees) and at two power outputs (70 and 100 watts, respectively.) The pedaling rate was 40 rpm. The exercise time was 1 minute and the resting time between each condition was 3 minutes. The raw electromyogram activity was measured for 1 minute and was converted to a root mean square value. Oxygen uptake was measured during exercise using the mixing chamber mode. The activities of two flexors (the medial hamstring and medial head of gastrocnemius) increased at the high saddle height and the activities of four extensors (rectus femoris, vastus medialis, vastus lateralis, and tibialis anterior) increased at the low saddle height. The oxygen uptake at the low saddle height was significantly higher than that at the high saddle height. The oxygen uptake positively correlated with the muscle activities of the knee extensors. The muscle activity and oxygen uptake were significantly affected by the postures (saddle heights) in cycle ergometer. The postures should be considered in the exercise test and prescription.
Bicycling ; Exercise Test ; Head ; Humans ; Knee ; Muscles ; Oxygen ; Posture ; Prescriptions ; Quadriceps Muscle ; Young Adult

BACKGROUND: Fosinopril is a new phosphorous containing angiotensin converting enzyme inhibitor. To assess the antihypertensive efficacy and safety of fosinopril, the clinical trial was done in patients with mild to moderate hypertension. METHODS: In 30 patients with mild to moderate essential hypertension, we administered fosinopril 10-20mg once daily for 10 weeks and checked their blood pressure every 2 weeks. RESULTS: The blood pressure decreased from 158+/-12.3/103.4+/-4.2mmHg to 139+/-7.5/88.4+/-5.9mmHg at the end of treatment(p<0.05). Heart rate did not change significantly during therapeutic period. Of 30 patients, the efficacy of fosinopril therapy disclosed 25 patients(83.7%) with normal diastolic pressure of more than 10mmHg decline of diastolic blood pressure. But two patients had no effects and three patients were not followed up. The adverse reactions due to fosinopril were reported in 3 patients(10%) with dry cough, 2 patients with palpitation(6.7%) and 1 patient with weakness(3.3%), but there were no patients who discontinued fosinopril due to adverse effect. CONCLUSION: Fosinopril has an excellent antihypertensive effect at low dosage as a first line antihypertensive agent or as a substituting agent for other antihypertensives in patients with mild to moderate essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A

Seven hemiplegic stroke patients suffering elbow flexor spasticity were selected for musculocutaneous nerve (MN) blocks. The MN was identified at the proximal 1/3 area on anteromedial surface of upper arm at supine position. An injectable monopolar EMG needle electrode was inserted into MN under real time ultrasonography. The 7% phenol solution was injected 0.2 ml at a time into MN until biceps brachii and brachialis muscle contractions were completely blocked at a maximum of 5 mA electrical stimulation. The total dose of injected phenol solution was 1.2~2.2 ml. We examined modified Ashworth scale (MAS) of elbow flexor and elbow angle at the standing position. In all the subjects, MAS was decreased and elbow angle was increased after nerve block. Ultrasonography guidance makes it exact to identify MN and to inject neurolytic solution to target. It can lead minimal complications by using the least dosage of neurolytic drug.
Arm ; Elbow* ; Electric Stimulation ; Electrodes ; Humans ; Muscle Contraction ; Muscle Spasticity* ; Musculocutaneous Nerve* ; Needles ; Nerve Block ; Phenol* ; Stroke ; Supine Position ; Ultrasonography

OBJECTIVE: To compare the exercise capacity after cardiac rehabilitation (CR) in patients with percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery. METHOD: 27 patients who underwent PCI and 18 patients who underwent CABG surgery were included. All the subjects performed supervised exercise training for 6~8 weeks at hospital and self-exercise at community for additional 16~18 weeks. Exercise capacity was measured by symptom limited graded exercise tests at study entry and 6 months later. RESULTS: After 6 months of CR, maximal oxygen consumption (VO2max) was significantly increased, resting heart rate (HR) and submaximal rate pressure product (RPP) were significantly decreased in both groups (p<0.05). There were no significant change of maximal HR in both groups (p<0.05). Maximal RPP in CABG increased significantly (p<0.05) but did not change significantly in PCI group. Resting HR was significantly higher, VO2max was significantly lower in CABG group than PCI group at study entry (p<0.05). Resting HR was not significantly different in both groups but, VO2max was still lower in CABG group than PCI group even after 6 months of CR (p<0.05). CONCLUSION: The cardiac rehabilitation program was effective in both PCI and CABG group. Although VO2max in PCI group was higher than CABG group after 6 month CR, the range of improvement was greater in CABG group than PCI group.
Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Exercise Test ; Heart Rate ; Humans ; Oxygen Consumption ; Percutaneous Coronary Intervention ; Transplants

OBJECTIVE: The purpose of this study was to evaluate the clinical effectiveness of intravesical oxybutynin chloride instillation in the management of neurogenic bladder dysfunction in spinal cord injured patients. METHOD: Fifty-two spinal cord injured patients with hyperreflexic or hypertonic neurogenic bladder were treated with intravesical oxybutynin instillation therapy. The purified oxybutynin chloride was dissolved in sterile water and mixed with normal saline. This oxybutynin solution was instilled twice a day for 7 days. The urodynamic studies were compared before and after the instillation. Total volume of daily incontinence was also monitored. RESULTS: After the intravesical oxybutynin instillations, mean maximal bladder capacity increased from 212.13 to 323.81 ml (p<0.01), mean bladder compliance increased from 11.73 to 18.56 ml/cmH2O (p<0.01), mean maximal detrusor pressure decreased from 67.19 to 50.90 cmH2O (p<0.01) and mean daily amount of incontinence decreased from 735.58 to 201.73 ml (p<0.01). No significant differences were found between the groups according to the level of injury, completeness of injury, duration since onset of injury and the presence of asymptomatic bacteriuria. CONCLUSION: This study proved that intravesical instillation of oxybutynin solution is an effective method in spinal cord injured patients with hyperreflexic or hypertonic neurogenic bladder dysfunction regardless the level and completeness of injury, as well as duration since the onset of injury or the presence of asymptomatic bacteriuria.
Administration, Intravesical ; Bacteriuria ; Compliance ; Humans ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics ; Water

OBJECTIVE: To observe the termination point of graded exercise test (GXT) in cardiac patients and the reasons for the premature termination. METHOD: Cardiac patients taking GXT within 4 weeks after medical intervention or surgery were reviewed. If the GXT was stopped below the respiratory exchange ratio of 1.0, the subjects were chosen as the final study subjects and reviewed for the reason of premature termination. RESULTS: 115 out of a total of 715 subjects terminated GXT prematurely. There were 36 cardiovascular, and 79 non- cardiovascular reasons. The cardiovascular reasons were abnormal blood pressure response (19.1%), dysrhythmia (6.1%), ST abnormality (3.5%), vascular claudication (2.6%). The non-cardio-vascular reasons were subjective dyspnea (45.2%), lower limb fatigue (7.8%), hemiplegic gait (5.2%), arthralgia (3.5%), anxiety (3.5%), neurogenic claudication (2.6%), and abdominal pain (0.9%). The causes of dyspnea were low physical fitness (71.1%), concurrent chronic obstructive pulmonary disease (15.4%), poor motivation (5.8%), and secondary gain (7.7%). CONCLUSION: 16.1% of GXT were terminated prematurely and 68.7% of those for non-cardiovascular reasons. The main causes of the non-cardiovascular premature GXT were subjective dyspnea due to low physical fitness.
Abdominal Pain ; Anxiety ; Arthralgia ; Blood Pressure ; Dyspnea ; Exercise Test* ; Fatigue ; Gait Disorders, Neurologic ; Humans ; Lower Extremity ; Motivation ; Physical Fitness ; Pulmonary Disease, Chronic Obstructive ; Rehabilitation*

Sturge-Weber syndrome is a congenital neurocutaneous disorder of the vessels of the face, the leptomeninges and the brain. Clinically SWS consists of symptoms and signs including a facial nevus (port-wine stain), seizure, hemiparesis, mental retardation. But only a few reports related to atypical Sturge-Weber syndrome without facial nevus have been published. We report a patient with atypical Sturge-Weber syndrome without any clinical feature except hemiparesis. In neuroimaging studies using brain CT scan and MRI, leptomeningeal angiomatosis was demonstated that is the characteristic feature of Sturge- Weber syndrome. In atypical Sturge-Weber syndrome, there may be late- developed complications such as hemiparesis. In conclusion, neuroimaging study is recommended to confirm diagnosis in suspicious atypical SWS patient.
Angiomatosis ; Brain ; Brain Stem Infarctions ; Diagnosis ; Humans ; Intellectual Disability ; Magnetic Resonance Imaging ; Neurocutaneous Syndromes ; Neuroimaging ; Nevus ; Paresis ; Seizures ; Sturge-Weber Syndrome* ; Tomography, X-Ray Computed