The influence of normal late pregnancy on insulin action and insulin secretion was studied in the Sprague-Dawley female rats. On 20th day after mating, intravenous glucose tolerance test(IVGTI) was performed in non pregnant control and pregnant rats. As results of IVGTT, glucose disappearance rate was not significantly different in both groups, but secretory response of insulin was significantly(p<0.05) increased in pregnant rat. And the ratio of insulin/ .glucose was significantly higher in pregnant rats, which means existence of insulin resistance. These insulin resistance was overcomed by increased secretory response of pancreatic insulin. Insulinogenic index( A insulin/glucose - 5 min) was highly significantly (r=0.62, p<0.01) correlated with progesterone concentration. Glycogen level and amounts of "C-glucose incorporated into glycogen after IVGTT were significantly(p<0. 05) decreased in the liver, but were not changed significantly in soleus. Glycogen synthase activity of soleus and liver was not differ significantly in the both groups. Insulin binding at varying concentrations of insulin to crude membrane of pregnant liver was not significantly different from control. In conclusions, although these pregnant rats were normal glucose tolerance due to increased secretory response of insulin, that was correlated with progesterone concentration, pregnant rat had insulin resistance. The mechanisms of insulin resistance were not related to defect of insulin binding phase and glycogen synthase, but suggest pre-receptor and/or postreceptor phase.
Animals ; Female ; Glucose ; Glucose Tolerance Test ; Glycogen ; Glycogen Synthase ; Humans ; Insulin Resistance* ; Insulin* ; Liver ; Membranes ; Pregnancy ; Progesterone ; Rats* ; Rats, Sprague-Dawley ; Receptor, Insulin

The effect of exercise on plasma insulin, free fatty acid, and glucose uptake and glycogen concentration in soleus, and intravenous glucose tolerance of streptozotocin treated, diabetic Sprague-Dawley rats were studied. Diabetic-trained animals were subjected to a regular program of treadmill running for 4 weeks. Seventy-two hours after the last training session, basal and insulin-stimulated glucose uptake was studied in incubated strips (about 20 mg) of soleus muscle in vitro. Glucose tolerance was measured with intravenous infusion of 0.5 g glucose/kg body weight. In diabetic rats, training was associated with increase glucose uptake in basal and maximal insulin concentrations, decreased fasting glucose concentrations, and increased muscle glycogen levels, but there were no changes in glucose tolerance curve and plasma insulin concentrations. These results suggest that regular running program for 4 weeks improve responsiveness of insulin on soleus muscle, but fails to cause improvement of impaired intravenous glucose tolerance in mild degree streptozotocin induced diabetic rats.
Animals ; Body Weight ; Exercise* ; Fasting ; Glucose Tolerance Test* ; Glucose* ; Glycogen ; In Vitro Techniques ; Infusions, Intravenous ; Insulin ; Muscle, Skeletal ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Running ; Streptozocin*

No abstract available.
Byssinosis*

Pacemaker Runaway is a rare, but potentially lethal complication after pacemaker implantation. Pacemaker runaway was one of the common manifestations of malfunctioning pacemaker at the time of fixed rate pacemaker, but has been less common after the demand type pacemaker had replaced the fixed rate model. The early recognition of runaway pacemaker is very important because runaway pacemaker can cause bradyarrhythmia, ventricular tachycardia-fibrillation and asystole resulting in syncope or death. We report a clinical experience of runaway pacemaker in 68 year-old woman, who received permanent pacemaker implantation(fixed rate 72/min, VVI, Micropulse 22U, Edwards system) due to sick sinus syndrome eight years ago. She complained of sudden chest tightness and dyspnea 10 days prior to admission. On physical examination, increased jugular venous pressure, rapid heart beats, basal rales on both lung fields and three finger-breath tender hepatomegaly. Electrocardiogram showed a rapid pacemaker rhythm of 140 beats per minute. So, the malfunctioning pacemaker was removed and replaced with a new programmable demand type pacemaker(VVI, OPTIMA-MP, Telectronics) in the same pocket under the diagnosis of pacemaker runaway. Her subject symptoms were relieved and electrocardiogram showed a regular pacemaker rhythm of 71 BPM. She was discharged ten days after pacemaker replacement.
Aged ; Bradycardia ; Child ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Heart ; Heart Arrest ; Hepatomegaly ; Homeless Youth* ; Humans ; Lung ; Physical Examination ; Respiratory Sounds ; Sick Sinus Syndrome ; Syncope ; Thorax ; Venous Pressure

To evaluate the incidence and clinical course of AV conduction disturbances associated with acute myocardial infarction(MI) and coronary angiographic characteristics in acute inferior MI with AV blocks. We reviewed the medical records and serial ECG's in 89 patients with acute MI treated in CCU of Chonnam National University Hospital from january, 1987 through August, 1990. The subjects were 44 anterior MI's, 43 inferior MI's, and 2 anterior and inferior MI's. AV conduction disturbances were observed in 25.8% of all the patients with acute MI's, 48.8% of 43 inferior MI's and 4.5% of 44 anterior MI's. High degree AV block was observed in 20.0% of all the subjects, 39.3% of inferior MI patients, and none of anterior MI patients. The most severe AV blocks observed in each patients were 7(30.4%) first-degree, 5(21.7%) second-degree, and 11(47.8%) third-degree AV block. The initial AV conduction disturbances developed within 6 hours after onset of symptoms in 9(47.4%) and after 24-hours in 9(47.4%). Seven(30.4%) of 23 patients with AV block showed a transient progression in the degree of AV block, 5(29.4%) of 17 patients with first-or second-degree AV block progressed to third-degree AV block thereby constituting 45.5% of 11 third-degree AV blocks. Nine patients with early AV block less tended to progress in the degree of AV block than the patients with late AV block (1/9 vs 4.9). In early AV block the duration of high-degree AV block was shorter than late AV block(2.5 days vs 6.1 days). The duration of third-degree AV block was less than 2-hurs in 36.4~24 hours in 27.3%, and more than 24 hours in 36.4%. All third-degree AV blocks(90.9%) but one with the longest duration of 13 days returned to 1 : 1 AV conduction within 7 days. There was no significant difference in coronary angiographic findings including the incidence of stenotic lesion in proximal LAD and first septal perforator, number of involved vessel(s), and severity of RCA lesion between the patients with AV block and the patients without AV block in inferior MI.
Atrioventricular Block ; Humans ; Incidence ; Jeollanam-do ; Medical Records ; Myocardial Infarction*

PURPOSE: To compare the various imaging techniques including application of magnetization transfer(MT), administration of IV contrast materials, and imaging time after injection of contrast materials in 3D time-of-flight(TOF) cerebral magnetic resonance angiography(MRA) in normal volunteers. MATERIALS AND METHODS: Each of 11 healthy volunteers was prospectively studied with 3D TOF cerebral MRA using various imaging parameters. Various parameters of 3D TOF MRA were 1) pre-enhanced magnetization transfer(MT), 2) postenhanced MT, immediate phase, 3) postenhanced MT, 10-minutes delayed phase, 4) postenhanced MT, 20-minutes delayed phase, 5) pre-enhanced non-MT, 6) postenhanced non-MT, immediate phase, 7) postenhanced non-MT, 10-minutes delayed phase, 8) postenhanced non-MT, 20-minutes delayed phase. Image qualities of various parameters were compared with regard to depiction of cerebral arteries and veins by visual assessment For statistical analysis paired t-test was used. RESULTS: In pre-enhanced MRA, images with MT mode were better in arterial visualization than those with :n0n-MT mode(p<0.01). Postenhanced MT and non-MT images were better in arterial and venous visualization !than pre-enhanced MT and non-MT images(p<0.01), respectively. Images obtained immediately after injection of contrast material were better in both arterial and venous visualization than delayed images(p<0.01). CONCLUSION: Postenhanced cerebral 3D TOF MRA with MT obtained immediately after injection of contrast materal is the best to increase visualization of both cerebral arteries and veins, and may be indicated in some cranial vascular diseases.
Angiography* ; Brain* ; Cerebral Arteries ; Contrast Media ; Healthy Volunteers* ; Prospective Studies ; Vascular Diseases ; Veins

PURPOSE: To evaluate the efficacy, safety, predictability and subjective symptoms of the implantable contact lens to treat moderate to high myopia. METHODS: A Staar Collamer posterior chamber phakic IOL was implanted in 83 eyes of 44 patients with spherical equivalent -10.10D (-3.87~-19.37D). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, adverse events, subjective quality of vision and satisfaction were evaluated. Mean follow-up was 4.9 months (3~9 months). RESULTS: All patients had a UCVA of 0.7 or better, and 61.4% had UCVA of 1.0 or better. Gains of 2 or more lines of BCVA occurred in 15 eyes (18.1%). Mean spherical equivalent refraction at postoperative 3 months was -0.37D (+0.25~-1.75D) and remained stable. There was no change in cylinder diopters. 81.9% of eyes were within +/-0.5D, and 97.6% were within +/-1.0D of predicted refraction. Glare and halo was observed in 5 eyes (6%) after laser iridotomy, lens flipping in 1 eye (1.2%), corneal edema in 2eyes (2.4%), drug induced ocular hypertension in 4eyes (4.8%). There was no case of cataract, glaucoma, retinal detachment, and lens dislocation. There was significant decrease of pupil diameter at postoperative 1 month and decreased pupil diameter was maintained until the last examination. Generally patient satisfaction was very good. But, some patients reported poor in the category of glare and halo. CONCLUSIONS: ICL implantation had good visual, refractive results, and stability. Long term follow-up is required to confirm the significant complications that do not occur in most patients over time.
Cataract ; Corneal Edema ; Follow-Up Studies ; Glare ; Glaucoma ; Humans ; Lens Subluxation ; Lenses, Intraocular* ; Myopia* ; Ocular Hypertension ; Patient Satisfaction ; Pupil ; Retinal Detachment ; Visual Acuity

The infected endocarditis related permanent pacemaker occurs rare and most of them occur at generator pocket but endocarditis related permanant pacemaker lead itself occurs very rarely. The rate of infection after pacemaker implantation is reported as 0.13-7% or 0.13-19.9% and mortality rate is up to 24-33%. Focal inflammation of generator pocket is easily detected but it is difficult to diagnose endocarditis related pacemaker lead and it has poor prognosis. Especially, early diagnosis is most important because endocarditis related pacemaker is fatal. Thirteen years ago, a womon was inserted the permanent pacemaker and then only generator was removed after one month. We report a case that we had removed the pacemaker lead by open thoracostomy and cardiopulmonary circulation to treat endocarditis related pacemaker lead.
Early Diagnosis ; Endocarditis* ; Inflammation ; Mortality ; Prognosis ; Thoracostomy

BACKGROUND AND OBJECTIVES: Angiotensin converting enzyme inhibitor and aniotensin II receptor blocker have been used in the treatment of heart failure. However, the effects of both agents are not known exactly in patients with ischemic heart failure. The clinical effects of Imidapril, Losartan and its combination on ischemic heart failure were observed after percutaneous coronary interventions (PCI). METHODS: Thirty six patients (58+/-8.8 year-old, 30 male) with myocardial infarction who underwent PCI with ejection fraction less than 45% by echocardiogram were included. The patients were divided into four groups; low (5 mg) and high (10 mg) doses of Imidapril (Group I: 58+/-6.1 years, M:F=:2 and II: 61+/-6 years, M:F=:1), combination of low dose Imidapril and 50 mg Losartan (Group III: 56+/-13 years, M:F=:0), and Losartan alone (Group IV: 57+/-9.3 years, M:F=:3). Clinical symptoms of angina and dyspnea, laboratory changes, exercise tolerance by treadmill test, and left ventricular function with dimension, and wall motion score by echocardiogram were observed at 4-week interval for 12 weeks. RESULTS: There were no significant differences among 4 groups in baseline clinical characteristics. In Group I, dyspnea and ejection fraction improved 12 weeks after therapy. Dyspnea and exercise tolerance improved in Group II. However, dyspnea and left ventricular function were unchanged in Group III, and 4 of them developed hypotension. In Group IV, left ventricular ejection fraction improved after therapy. Dry cough observed in 3 of Imidapril-treated patients, but withdrawal of drug was performed only in one of Group II. CONCLUSIONS: Monotherapy of Imidapril or Losartan is effective in the management of ischemic heart failure, but its combination shows no additional benefit.
Cough ; Dyspnea ; Exercise Test ; Exercise Tolerance ; Heart Failure* ; Heart* ; Humans ; Hypotension ; Losartan* ; Myocardial Infarction ; Peptidyl-Dipeptidase A ; Percutaneous Coronary Intervention ; Stroke Volume ; Ventricular Function, Left

BACKGROUND AND OBJECTIVES: Angiotensin converting enzyme inhibitor and aniotensin II receptor blocker have been used in the treatment of heart failure. However, the effects of both agents are not known exactly in patients with ischemic heart failure. The clinical effects of Imidapril, Losartan and its combination on ischemic heart failure were observed after percutaneous coronary interventions (PCI). METHODS: Thirty six patients (58+/-8.8 year-old, 30 male) with myocardial infarction who underwent PCI with ejection fraction less than 45% by echocardiogram were included. The patients were divided into four groups; low (5 mg) and high (10 mg) doses of Imidapril (Group I: 58+/-6.1 years, M:F=:2 and II: 61+/-6 years, M:F=:1), combination of low dose Imidapril and 50 mg Losartan (Group III: 56+/-13 years, M:F=:0), and Losartan alone (Group IV: 57+/-9.3 years, M:F=:3). Clinical symptoms of angina and dyspnea, laboratory changes, exercise tolerance by treadmill test, and left ventricular function with dimension, and wall motion score by echocardiogram were observed at 4-week interval for 12 weeks. RESULTS: There were no significant differences among 4 groups in baseline clinical characteristics. In Group I, dyspnea and ejection fraction improved 12 weeks after therapy. Dyspnea and exercise tolerance improved in Group II. However, dyspnea and left ventricular function were unchanged in Group III, and 4 of them developed hypotension. In Group IV, left ventricular ejection fraction improved after therapy. Dry cough observed in 3 of Imidapril-treated patients, but withdrawal of drug was performed only in one of Group II. CONCLUSIONS: Monotherapy of Imidapril or Losartan is effective in the management of ischemic heart failure, but its combination shows no additional benefit.
Cough ; Dyspnea ; Exercise Test ; Exercise Tolerance ; Heart Failure* ; Heart* ; Humans ; Hypotension ; Losartan* ; Myocardial Infarction ; Peptidyl-Dipeptidase A ; Percutaneous Coronary Intervention ; Stroke Volume ; Ventricular Function, Left