No abstract available.
Child* ; Epilepsy* ; Humans

From June, 1988 to Feb, 1989 a total of 47 cases of percutaneous mitral valve balloon valvuloplasty(PMV) and 4 cases of aortic valve balloon valvuloplasty(PAV) were done at the Guro Hospital of the Korea University. Among these patients first 18 patients of PMV are the subjects of this study. 1) Among a total of 28 patients,10 patients were male and 18 patients were female patients. The age of the patients were between 21 and 59 years with the mean age of 40.9+/-12.2 Aortic Valve ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Blood Pressure ; Cardiac Output ; Cardiac Tamponade ; Catheters ; Drainage ; Electrocardiography ; Embolism ; Female ; Humans ; Korea ; Male ; Middle Cerebral Artery ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Mitral Valve* ; Sepsis ; Thrombosis ; Vascular Resistance

PURPOSE: In order to elucidate the actual mechanism and the optimal concentration of Lamotrigine(LTG) that suppresses epileptiform discharges, we observed epileptiform discharges from hippocampal slices of immature rat in 4-aminopyridine(4-AP) added Mg2+ - free medium of artificial cerebrospinal fluid(aCSF) with various LTG concentrations. METHODS: We divided 19-23 day-old Sprague-Dawley rats into 4 groups; control group(n=12) and 3 LTG groups depending on the concentrations of LTG such as 400 (n=9), 800(n=7), and 1,000(n=8) microM. The rats were anesthetized and their brains were taken, soaked in aCSF(NaCl 125 mM, KCl 2.5 mM, NaH2PO4 2 mM, MgSO4 1.25 mM NaHCO3 25 mM, CaCl2 2 mM, Glucose 10 mM, pH 7.3-7.4). And then the brains were cut into 400 microm hippocampal slices by a vibratome. The slices of control group were soaked in 200 microM 4-AP added Mg2+ -free medium of aCSF for 1 hour, and then extracellular recordings were performed in hippocampal CA1 pyramidal region. The slices of LTG groups were soaked in the solution containing 400, 800, and 1,000 microM LTG, then extracellular recordings were performed. RESULTS: Interictal discharges were observed in all the control and the LTG groups. The latency to the first interictal discharges after 4-AP addition was 52.7+/-26.9 sec in control group, but was 225.0+/-28.2 sec in 800 microM and 322.1+/-116.4 sec in 1,000 microM group of LTG(P<0.05). The duration of interictal discharges was 64.6+/-35.6 sec in control group, but was the shortest in 800 microM group of LTG at 39.3+/-12.6 sec. Ictal discharges were observed in all of control and 400 microM group, but the frequency was decreased as the concentration of LTG increases, 57.1% in 800 microM, 12.5% in 1,000 microM group. The latency to ictal discharge after 4-AP addition was 142.1+/-52.6 sec in control group, but increased as the concentration of LTG increases, 304.4+/-84.5 sec in 400 microM group and 689.8+/-213.1 sec in 800 microM group(P<0.05). The duration of ictal discharges was 1,534.7/-339.3 sec in control group, but decreased as the concentration of LTG increases, it was 126.5+/-76.1 sec in 800 microM group(P <0.05) and 42 sec in 1,000 microM group. CONCLUSION: The antiepileptic effects of LTG were most significant when the concentration, inhibiting epileptiform discharges induced by 4-AP and Mg2+ -free medium in hippocampal slices of immature rats, was 800 microM or higher. Although the basic pharmacologic mechanism of LTG is the inhibition of sodium channel, it may also work on potassium channel at higher concentrations.
4-Aminopyridine* ; Animals ; Brain ; Glucose ; Hydrogen-Ion Concentration ; Potassium Channels ; Rats* ; Rats, Sprague-Dawley ; Sodium Channels

This study was designed to assess the antihypertensive efficacy and overall tolerance of doxazosin in patients with mild-to-moderate essential hypertension. Doxazosin was administered in once-daily dose from 1 to 3mg to 97 patients both in a general hospital and a local clinic in rural area. These patients are composed of three groups. One group has 49 Patients treated with doxazosin monotherapy, another group with 31 patients treated with doxazosin as well as other antihypertensive drugs combined and a third group is composed of 17 patients with renal insufficiency n addition to hypertension. The patients in the third group with renal insufficiency had 2.5mg/dl-5.0mg/dl in serum creatinine. Results are as follows : 1) The study sample is composed of 37 males (38.1%) and 60 females (61.9%) with mean age 51.4 years. Among three subasmples no statistically significant difference is observed in age, sex, mean body weight and heigh at 0.05 error level. 2) A total of 47 patients (48.5%) of the 97 patients have completed twelve-week doxazosin antihypertensive treatment. At a mean dose of 4.4+/-0.4mg at twelfth week, 37 patients (78.7%) responded to doxazosin therapy. Twenty-nine(61.7% patients achieved "excellent" blood pressure control(mean sitting DBP of < or =90mmHg), and 8 patients (17.0%) showed "good respone" (10mmHg or more DBP reduction from baseline). Whereas remaining 10 patients (21.3%) showed only "fair response" (5-9mmHg DBP reduction) or "failed"(0-4mmHg DBP reduction). In doxazosin monotherapy group thirteen(68.4%) of nineteen patients showed "excellent" or "good response" at a mean dose of 4.8mg/day. Combination therapy group with eighteen patients showed 100% therapeutic success. This group had fourteen(77.8%) "excellent" and four(22.2%) "good respinse" at a mean daily dose of doxazosin 3.9mg. Renal insufficiency group with ten patients showed six(60.0%) "excellent" and four (40.0%) "failure"cases at a mean daily dose of 4.6mg. 3) The mean baseline sitting blood pressures of doxazosin monotherapy group were 175/109 whose blood pressure at twelfth week were 150/94 at a mean daily dose of 4.8mg. The baseline blood pressure of combined therapy group 180/111 were reduced to 145/91 at twelfth week at a mean daily dose of 3.9mg. Those of renal insufficiency group were 177/112 and 156/98 respectively at a mean doxazosin daily dose of 4.6mg. 4) Of the 97 study cases, adverse effect were reported in 19.6%. The most prevalent adverse effects were dizziness(11.3%), blurred vision(9.3%), headache(5.2%), most of which were mild or moderate and disappeared with or were tolerated on continued therapy. But three cases(3.1%) had to refrain from doxazosin administration due to blurred vision, dizzines, and headache. 5) The change of lipid analysis between before and after treatment in the monotherapy group with doxazosin showed 3.8% decrease of total cholesterol and 4.6% increase of HDL cholesterol and 11% increase of triglycerides, which were not statistically significant. In the combination therapy group 0.4% decrease of total cholesterol, 24.1% decrease of HDL cholesterol and 44.3% increase of triglycerides were observed. In the renal insufficiency group 4.9% decrease of total cholesterol, 22.1% decrease of HDL cholesterol, 0.1% decrease of triglycerides were observed. But all these findings have limitation in generalization due to small number of sample and a short period of observation. 6) Laboratory chemistry test results revealed no apparent treatment-related abnormalities.
Antihypertensive Agents ; Blood Pressure* ; Body Weight ; Chemistry ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Doxazosin* ; Female ; Generalization (Psychology) ; Headache ; Hospitals, General ; Humans ; Hypertension ; Male ; Renal Insufficiency ; Triglycerides

Takayasu's arteritis is briefly as an inflammatory process of unknown etiology occuring dominantly in young female most commonly involving the great vessels arising from the aortic arch. The disease process results in stenosis and obliteration of involved vessels. Syncope in Takayasu's arteritis is known to result from decreased blood flow to brain because of stenosing blood vessels. We herein describe a case of paroxysmal atrioventricular block in a 40-year old man with Takayasu's arteritis. The patient presented with spontaneous recurrent syncope associated with paroxysmal AV block. Carotid sinus pressure repeatedly induced paroxysmal AV block and syncope. Carotid sinus pressure after pretreatment of atropine failed to induce AV block or syncope. Coronary angiogram was normal. We concluded that syncope in this patients was attributed to carotid hypersensitivity rather than decreased blood flow to the brain due to vessel stenosis.
Adult ; Aorta, Thoracic ; Atrioventricular Block* ; Atropine ; Blood Vessels ; Brain ; Carotid Sinus ; Constriction, Pathologic ; Female ; Humans ; Hypersensitivity ; Syncope ; Takayasu Arteritis*

CT findings of twenty-four patients with adrenal gland tumors were analyzed to evaluate their location, size,shape, density etc. The post-surgical confirmation was made in 17 cases. The findings were as follows: 1. 4-10cmsized tumor messes were most common (42%). 2. Round or oval shaped forme were most common (59%). 3. Functionaltomors were 71% (17/24) including Cushing's syndrome of 10 cases, pheochromocytomas of 6 cases and aldosteronismof 1 case. 4. Abnormal adrenal glands were delineated in 88%(21/24), most effectively by CT. We concluded that CTwas the valuable study in the evaluation of the adrenal gland tumors and in the determination of surgicaloperation.
Adrenal Glands ; Cushing Syndrome ; Humans ; Pheochromocytoma

No abstract available.

No abstract available.
Congenital Hypothyroidism* ; Diagnosis* ; Prognosis*

OBJECTIVE: To investigate the neuropathic changes induced by nucleus pulposus and possible role of nitric oxide (NO) in the pathogenesis of painful radiculopathy. METHOD: Autologous nucleus pulposus was harvested from the rat coccygeal intervertebral disc and grafted to the sciatic nerve. Pain behavior, neurophysiologic and pathologic changes were compared between autografted and sham operated group during 14-day-period. Western immunoblotting and immunohistochemistry with anti-nitrotyrosine mouse monoclonal antibody were used to compare the NO production and nerve damage in autografted and sham operated nerve tissues. RESULTS: Mechanical allodynia and thermal hyperalgesia were observed 2 days after autograft of nucleus pulposus and persisted during 14-day-period (p<0.05). Motor nerve conduction latency was delayed and compound muscle action potential amplitude was decreased 5 days after autograft (p<0.05). Histologically, nucleus pulposus induced severe inflammatory reaction with fibroblast proliferation and foamy macrophage infiltration, which were persisted during 14-day- period. More nitrated proteins were detected consistently in nerve tissues with autograft of nucleus pulposus and immunohistochemical staining of nitrotyrosine was prominent around foamy macrophages. CONCLUSION: These data suggest that nucleus pulposus induce mechanical allodynia, thermal hyperalgesia and nerve dysfunction through inflammatory reaction with macrophage infiltration. NO and NO related tissue injury may play an important role in the pathogenesis of painful radiculopathy.
Action Potentials ; Animals ; Autografts* ; Blotting, Western ; Fibroblasts ; Hyperalgesia ; Immunohistochemistry ; Intervertebral Disc ; Macrophages ; Mice ; Nerve Tissue ; Neural Conduction ; Neuralgia ; Nitric Oxide* ; Radiculopathy ; Rats* ; Sciatic Nerve* ; Transplants

Two hundreds and four consecutive patients who sustained proven spontaneous subarachnoid hemorrhage with conservative treatment were studied retrospectively. The reasons for conservative treatment were poor condition for surgery, difficulties in surgery and operation refusal. Comparative study was done in proven 47 cases of aneurysmal SAH, 27 cases of SAH with negative angiography and 130 cases of SAH without angiography about age, aneurysm site & size, neurologic grade mortality & morbidity, etc. Death had occurred in 2 weeks after attack predominantly. Rebleeding was most common cause of mortality(64%, 68/107). Survivals had good quality of life(73%, 19/26).
Aneurysm ; Angiography ; Disulfiram ; Follow-Up Studies* ; Humans ; Mortality ; Retrospective Studies ; Subarachnoid Hemorrhage