2.A Study for Diastolic Functions in Patients with Early Acute Myocardial Infarction.
Seung Jung KIM ; Gil Ja SHIN ; Si Hoon PARK
Korean Circulation Journal 1997;27(8):862-869
BACKGROUND: Doppler echocardiography is a non-invasive technique that has been used to evaluate LV diastolic dysfunction. Impaired left ventricular diastolic filling is known to occur in patients with coronary artery disease. Compared with those in normal subjects, Doppler-derived transmitral blood flow velocities have been reported to be reduced during early diastolic filling and to be compensatory elevated subsequent to atrial systole in patinets with coronary artery disease. But stiffness of myocardium normalize the E/A ratio, and normal E/A ratio may reveal increased ventricular filling pressure. We tried to investigate left ventricular filling parameters by Doppler echocardiography in patients with early myocardial infarction, and to compare left ventricular diastolic function regarding infarct location on EKG, one or multivessel disease on coronary angiography, and treatment modality. METHODS: From September 1993 to August 1995, Pulsed wave Doppler echocardiography was performed in patients with early acute myocardial infarction(N=95) and control group(N=20) within 5 days after admission, and parameters of diastolic function was evaluated. RESULTS: Echocardiographic data showed significant differences in mean ejection fraction, mean left ventricular mass, and mean left ventricular mass index between two groups. There was no significant difference in E/A ratio, deceleration time, and isovolumetric relaxation time between two groups. Neither, there was significant difference in each diastolic parameter for infarct related wall on EKG. And there was no significant difference in deceleration time for one or multi vessel disease on coronary angiography, treatment modality(conservative treatment, thrombolytic therapy, or primary PTCA). CONCLUSION: In patients with early acute myocardial infarction, left ventricular diastolic dysfunction was absent. And there was no significant correlation between the presence of diastolic dysfunction and the location of infarct related wall on EKG, or one or multi vessel disease, or treatment modality.
Blood Flow Velocity
;
Coronary Angiography
;
Coronary Artery Disease
;
Deceleration
;
Echocardiography
;
Echocardiography, Doppler
;
Electrocardiography
;
Humans
;
Myocardial Infarction*
;
Myocardium
;
Relaxation
;
Systole
;
Thrombolytic Therapy
3.The Effect of General Anesthesia on Oxygen Consumption .
Jung Gil JUNG ; Jin Woong PARK ; In Hyun KIM
Korean Journal of Anesthesiology 1972;5(1):29-32
Oxyen consumption of surgical patients was measured by McKesson Metabolar (Model 185) on the Recording Metabolar Chart (M-147) in four groups: group A, at resting state immediately before preanesthetic medication; group B, immediately following induction of anesthesia with thiopental (10 mg./kg.); group C. 30 minutes after surgical ether anesthesia; and group D, when conciousness returned during the stay in the recovery room. The results are as follows: (1) Thiopental reduced oxygen consumtion by 25 per cent. (2) Ether anesthesia reduced, oxygen consumption by 59 per cent. (3) During recovery from anesthesia, oxygen consumption was 28 per cent below the control. (4) Comparing with other data, ether anesthesia reduced oxygen consumption significantly more than fluothane or nitrous oxide did.
Anesthesia
;
Anesthesia, General*
;
Ether
;
Halothane
;
Humans
;
Nitrous Oxide
;
Oxygen Consumption*
;
Oxygen*
;
Preanesthetic Medication
;
Recovery Room
;
Thiopental
5.The Effects of Muscle Relaxants and Intravenous Anesthetics on Intraocular Pressure.
Korean Journal of Anesthesiology 1986;19(2):128-134
The effects of muscle relaxants and intravenous anesthetics on intraocular pressure(IOP) were studied in 40 patients ranging in age from 12~63 years and undergoning elective non-ophthalmic surgery. IOP was measured with the PErkins Applanation Tonometer before induction, 1 minute and 2 minutes after intravenous anesthesia, 1 minute after succinylcholine and 1 minute after intubation. The patients were divided into 4 groups: thiopental+succinylcholine+intubation (group A, control group) : pnacuronium pretreatment+thiopental+succinylcholine+intubation (group B): ketamine+succinylcholine+intubation (group C): and, pancuronium+ketamine+succinylcholine+intubation(group D). The results were as follows: 1) In group A, IOP changes following thiopental (5mg/kg) administration showed a highly significant decrease (p<0.01) after 1 minute and significant decrease(p<0.05) after 2 minutes compared with the control value. In group B, IOP changes following thiopental admistration decreased significantly(p<0.05) after 1 minute and 2 minutes compared with the control value. 2) The IOP changes following ketamine(2mg/kg) administration in group C and D showed mild increases or decreases and were not statiscally significant(p>0.05). 3)IOP changes after 1 minute following succinylcholine(1mg/kg) administration showed significant increases(p<0.05) in group A, C and highly significant increases(p<0.01) in group D. IOP changes after 1 minute of endotracheal intubation showed highly significant increases (p<0.01) compared with the control value in group A, C and D. 4) Pretreatment with a mondepolarizing muscle reaxant could not prevent the increase in IOP following succinylcholine administration.
Anesthesia, Intravenous
;
Anesthetics, Intravenous*
;
Humans
;
Intraocular Pressure*
;
Intubation
;
Intubation, Intratracheal
;
Succinylcholine
;
Thiopental
6.Angiofollicular Lymph Node Hyperplasia(Castleman's disease): 3 cases report.
Jeong Hee PARK ; Gil Ro HAN ; Hee Jin CHANG ; Jin Hee SOHN ; Jung Il SUH
Korean Journal of Pathology 1992;26(3):298-305
Angiofollicular lymph node hyperplasia(AFLNH) was first described in 1956 by Castleman et al. It was initially reported as a solitary mediastinal mass but multicentric and extranodal disease is now well known. Histologically two distinct variants, e.g. the hyaline vascular type and the plasma cell type, of AFLNH are recognized. And the plasma cell type is typically associated with clinical syndrome consisting of fever, anemia, elevated erythrocyte sedimentation rate and polyclonal hypergammaglobulinemia. Recently, we experineced three cases of AFLNH. Histologically, two cases were hyaline vascular type, that were presented as a right supraclavicular mass of 49-year-old female, and as an anterior mediastinal mass of 53-year-old female. The remaining one case was plasma cell type that was presented as a left axillary mass of 63-year-old male. The former two cases showed typical features of hyaline vascular type but in case 1, exuberant proliferation of hyalinized vessels of capillary size was characteristic feature. The latter case of plasma cell type characteristically showed clinical syndrome consisting of fever, hypoalbuminemia, polyclonal hypergammaglobulinemia. All cases were presented as a single mass and they were well after surgical excision.
Female
;
Humans
7.A Comparison Study of the Ketamine and the Thiopental Sodium as an Induction Agent in the Cesarian Section.
Jung Choul PARK ; Kyung Cheun LEE ; Yung Lae CHO
Korean Journal of Anesthesiology 1992;25(5):884-889
This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Apgar Score
;
Blood Gas Analysis
;
Blood Pressure
;
Cesarean Section
;
Female
;
Heart Rate
;
Humans
;
Intraoperative Awareness
;
Ketamine*
;
Memory
;
Pregnancy
;
Skin
;
Thiopental*
8.The Role of Insulin Resistance as a Risk Factor of Coronary Artery Disease.
Sung Ae JUNG ; Si Hoon PARK ; Gil Ja SHIN ; Woo Hyung LEE
Korean Circulation Journal 1996;26(1):35-43
BACKGROUND: Established risk factors for coronary artery disease include smoking, hypertension, diabetes mellitus and hypercholesterolemia. However, these account for less than 50% of the actual incidence of coronary artery disease and the importance of other risk factors is being increasingly realized. It has been known that insulin resistance associated with hyperinsulinemia is a pivotal link to several risk factors of coronary artery disease, including hypertension, glucose intolerance, dyslipidemia and obesity. Recently both experimental and clinical studies have produced evidence suggesting that high plasma insulin level may promote the development of atherosclerotic vascular diseasa. Several prospective studies showed independently that high plasma insulin is associated with an increased risk of major coronary artery disease. In our study, plasma glucose, insulin and C-peptide level were determined with oral glucose tolerance test to assess the insulin resistance or hyperinsulinemia as a risk factory of coronary artery disease. METHOD: From September 1993 to April 1995, after excluding patients with hypertension, diabetes mellitus, hypercholesterolemia and obesity, 17 patients with significant coronary artery stenosis and 10 control subjects with normal coronary finding were selected among the 226 patients who undertook coronary angiography. In the 17 cases(M:F=15:2) of coronary artery disease group, the mean age was 54+/-10 years, and in the 10 cases(M:F=8:2) of control group, 51+/-9 years. All were matched for age, gender and body mass index. Blood pressure, lipid and lipoprotein were measured and smoking history was assessed. Glucose, insulin and C-peptide responses to oral glucose tolerance test were also determined. RESULT: 1) There was no significant difference in systolic and diastolic and diastolic blood pressure, total-cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, ApoA and smoking history except ApoB between the subjects with coronary artery disease and normal control subjects. 2) In oral glucose tolerance test, the plasma glucose levels were not significantly different in the two groups. plasma insulin and C-peptide levels at 60 and 120 minutes were higher in the patient group than control, but the results lack statistical significance. The area under the insulin curve and C-peptide curve were larger in patient group than control, but the result lack statistical significance also. CONCLUSION: Although our study dose not prove the hypothesis that insulin resistance or hyperinsulinemia is statistically an independent risk factor for coronary artery disease, this study showed the tendency of insulinresistance to be correlated with development of coronary artery disease. As this study has limitations due to small sample size, further study is required to confirm the role of hyperinsulinemia using a larger sample size.
Apolipoproteins A
;
Apolipoproteins B
;
Blood Glucose
;
Blood Pressure
;
Body Mass Index
;
C-Peptide
;
Coronary Angiography
;
Coronary Artery Disease*
;
Coronary Stenosis
;
Coronary Vessels*
;
Diabetes Mellitus
;
Dyslipidemias
;
Glucose
;
Glucose Intolerance
;
Glucose Tolerance Test
;
Humans
;
Hypercholesterolemia
;
Hyperinsulinism
;
Hypertension
;
Incidence
;
Insulin Resistance*
;
Insulin*
;
Lipoproteins
;
Obesity
;
Plasma
;
Prospective Studies
;
Risk Factors*
;
Sample Size
;
Smoke
;
Smoking
;
Triglycerides
9.Circadian Variation of Ventricular Premature Complex in Hypertension and Ischemic Heart Disease Patients.
Seung Jung KIM ; Si Hoon PARK ; Gil Ja SHIN ; Woo Hyung LEE
Korean Circulation Journal 1995;25(3):581-588
BACKGROUND: Circadian rhythms have been described for acute myocardial infarction, sudden cardiac death, cerebrovascular disease, ischemic heart disease, and ventricular arrhythmia. Most of studies reported that the frequency of ventricular permature contractions(VPC's) shows a peak in day time. We tried to see that the circadian rhythm of VPC's in hypertension and ischemic heart disease(IHD) patients. And we will also studied the relationship between heart rate and frequencey of VPC's. METHOD: Twenty four hour holter monitoring was performed in hypertensive patients (N=23), ischemic heart disease patients(N=25), and normal control group(N=30). We tested the circadian pattern of VPC's and heart rates and the relationships of the frequency of VPC's and heart rates. RESULT: In hypertension group, a peak incidence of heart rate is between 5 and 8 P.M., in ischemic heart disease group, between 3 and 6 P.M.. In control group, the heart rate shows a peak beteen 1 and 3 P.M.. The frequency of VPC's in hypertension group shows the first peak between 4 and 10 P.M., and the second peak beteen 7 and 10 A.M.. In ischemic heart disease group, they show a peak between 2 and 8 P.M..In control group, there was no circadian variation for the frequency of VPC;s. Both in hypertension and IHD patients group, there was significant correlation between the frequency of VPC's and the heart rates. CONCLUSION: It seemed that VPC' were more frequently occurred in relation to the increase of heart rate in the afternoon, in hypertensive and ischemic heart disease patients.
Arrhythmias, Cardiac
;
Circadian Rhythm
;
Death, Sudden, Cardiac
;
Electrocardiography, Ambulatory
;
Heart
;
Heart Rate
;
Humans
;
Hypertension*
;
Incidence
;
Myocardial Infarction
;
Myocardial Ischemia*
;
Ventricular Premature Complexes*
10.A Study on the R-R Wave Intervals of Consecutive EKG for the Diabetic Patients with Urologic Complications.
Ho Geun KWAK ; Gil He LEE ; Re Jung PARK
Korean Journal of Urology 1994;35(8):883-886
Diabetic complications such as cystopathy and retrograde ejaculation are slowly progressive disease without any specific signs and symptoms so it is difficult to diagnose its complication and prevent it. Diabetic autonomic neuropathy is known as a neurologic lesion with combined involvement in cardiovascular and genitourinary systems. The purpose of this study is to assess correlation between diabetic cystopathy and heart rate variation on consecutive EKG waves and to detect early cystopathy in patients with decreased heart rate variation. We have studied 12 cases of diabetic cystopathy and 9 cases of retrograde ejaculation who were managed in Seoul Eulji Hospital from Mar. 1992 to Aug. 1993 and concluded as follows. Diabetic patients with autonomic neuropathy shows decreased heart rate variability(HRV) (CV%: 2.16+/-0.97) than diabetic patients without autonomic neuropathy (CV%: 3.29+/-0.58, P <0.0001 ), it means that decreased HRV on consecutive EKG waves well correlates to diabetic autonomic neuropathy such as cystopathy and retrograde ejaculation so we think that the measurement of HRV provides a simple test to be concerned urologic complications such as cystopathy or retrograde ejaculation.
Diabetes Complications
;
Diabetes Mellitus
;
Diabetic Neuropathies
;
Ejaculation
;
Electrocardiography*
;
Heart Rate
;
Humans
;
Male
;
Seoul
;
Urogenital System