No abstract available.
Central Venous Catheters* ; Prospective Studies* ; Thrombophlebitis*

The antihypertensive effects of diltiazem was observed in 30 cases of essential hypertension, and following results were obtained. 1) Mean decrease in systolic and diastolic blood pressure by oral diltiazem was 42.0+/-2.5mmHg and 17.8+/-1.7mmHg. The results of antihypertensive therapy revealed good control in 50% fair control in 30% poor in 17% and failure in 3% of the cases. In 80% of the cases, good or fair control of Hypertension which means drop of diastolic pressure to the level of less than 100mmhg was observed. 2) Mean drop in heart rate was 21+/-2 beats/min. 3) Daily dose was 90-180mg. 4) The side effect of oral Diltiazem was mild headache and dizziness, respectively one case.
Blood Pressure ; Diltiazem* ; Dizziness ; Headache ; Heart Rate ; Hypertension

No abstract available.
Humans ; Neurodegenerative Diseases/*drug therapy/*etiology

Imipramine(Tofranil(R)) is one of the tricyclic antidepressants commonly used in depressive symptoms or enuresis. An accidental or nonaccidental poisoning of imipramine is common today. A 16 years old girl was admitted to Seoul National university Hospital because of unocnsciousness and frequent attacks of seizure after the impulsive ingestion of 1.4gm of imipramine. She showed variable arrhythmias such as complete RBBB, secod degree AV block and ventricular tachycardia and recovered from poisoning without residual myocardial damage. We present a case of imipramine poisoning with cardiac arrhythmias with review of literatures.
Adolescent ; Antidepressive Agents, Tricyclic ; Arrhythmias, Cardiac* ; Atrioventricular Block ; Depression ; Eating ; Enuresis ; Female ; Humans ; Imipramine ; Poisoning* ; Seizures ; Seoul ; Tachycardia, Ventricular

Massive pulmonary embolism is a major cause of morbidity and death in hospital. Most episodes of acute pulmonary embolism occurred from multiple emboli. When pulmonary embolism is suspected, the definitive diagnosis is pulmonary arteriography, but high degree of certainty can also be achieved with ventilation-perfusion scanning. The therapeutic modalities available for patients with acute pulmonary embolism are prophylatic and definitive therapy. Prophylatic therapy including anticoagulant with heparin is used to prevent further emboli episodes that might be fatal. Definitive therapy for pulmonary embolism including thrombolytic agents and pulmonary embolectomy attempts to dissolve and remove the resolution of the pathophysiologic sequelae of pulmonary embolism. We experienced a case of acute massive pulmonary embolism which occupied the pulmonary arteries bilaterally. Patient with orthopedic surgery one month before developedd dyspnea and chest tightness. Eventhough continuing enough amount of anticoagulant therapy, rapid hemodynamic deterioration and severe hypoxia occurred progressively. Urgent pulmonary embolectomy was succeeded and he has been followed up at out patient department.
Angiography ; Anoxia ; Diagnosis ; Dyspnea ; Embolectomy ; Fibrinolytic Agents ; Hemodynamics ; Heparin ; Humans ; Orthopedics ; Pulmonary Artery* ; Pulmonary Embolism* ; Thorax

Patients can be tested for the H. pylori infection via invasive or non-invasive methods. At present, no single test is absolutely relied upon to detect colonization of H. pylori, and a combination of two tests is recommended if feasible. A growing interest in non-invasive tests for the detection of Helicobacter pylori has been observed recently. Although serology for IgG often is chosen in the outpatient setting because of its convenience, it is less accurate than either the urea breath test (UBT) or stool antigen test. In addition, the UBT and stool antigen test can be used to confirm eradication, whereas serology remains positive for months after eradication. The test should be used in the basis of the clinical circumstances, the likelihood ratio of positive and negative tests, the cost-effectiveness of the testing strategy, and the availability of the tests.
Breath Tests ; Colon ; Diagnosis* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Outpatients ; Urea

Desmoplastic fibroma, which develops predominantly in long bones and the mandible, is a rare and benign but locally aggressive tumor. Desmoplastic fibroma of the cranium is extremely rare. We report a case of desmoplastic fibroma of the frontal bone in a young man. Because of its locally aggressive behavior, complete surgical excision with a safety margin is essential.
Fibroma, Desmoplastic ; Frontal Bone ; Mandible ; Skull

A 25-year-old 7 month pregnant woman with mitral stenosis was hospitalized because of life threatening hemoptysis dispite intensive medical treatment. Emergency mitral commissurotomy resulted in prompt cessation of hemorrhage and at nine months follows-up, the hemoptysis has not recurred. Mitral valve surgery appears to be consitently associated with rapid and sustained cessation of hemoptysis. Therefore, surgery should be considered in hemoptysis due to mitral stenosis, particulary when the danger of asphyxiation exists.
Adult ; Emergencies* ; Female ; Hemoptysis* ; Hemorrhage ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Pregnant Women

BACKGROUND: The concept of myocardial injury after coronary occlusion is changing in recent years. Brief episode of ischemial induces reversible myocardial injury and repeated brief ischemic insults might cause myocardial necrosis due to cummulative damages. Recent observations showed that brief episodes of ischemia have protective effects on the myocardium increasing the myocardial tolerance to a subsequent sustained ischemic insult. This phenomenon is termed ischemic preconditioning and can be noticed after a variety of protocols in multiple species of experimental animals. This study was planned to 1) measure the changes of hemodynamic parameters and the ischemic damage of insulted myocardium during ischemic preconditioning, and 2) compare the infarct sizes with or without preconditioning. METHODS: Using canine model of a single 90 minutes' occlusion of left anterior descending coronary artery and 240 minutes' reperfusion, 14 mongrel dogs were randomized to with(n=7) or without(n=7) ischemic preconditioning such as four 5 minutes' occlusion and 5 minutes' reperfusion, Changes of hemodynamic parameters and extents of the ischemic myocardial damages during preconditioning were observed. And using in vitro myocardial staining with monastral blue and triphenyl tetrazolium chloride, we compared the infarct sizes and risk areas in two groups of occlusion and reperfusion canine model with and without preconditioning. RESULTS: 1) Heart rate was significantly decreased after first 5 minutes' occlusion compared with those of basal control(151+/-27 VS 163+/-25 BPM, p<0.05) without further changes in subsequent ischemic insults. Left ventricular systolic pressure was significantly decreased after first 5 minutes' occlusion(109.0+/-19.9 VS 130.6+/-23.3mmHg, p<0.005), and after first 5 minutes' reperfusion and second 5 minutes' occlusion compared with those of basal control(111.3+/-29.8, 109.9+/-17.2 VS 130.6+/-23.3mmHg respectively, p<0.05), without further changes during remaining ischemia. Left ventricular end diastolic pressure and maximum +dp/dt were not changed. Peak -dp/dt was decreased significantly after first and second 5 min occlusion(943.7+/-294.4, and 962.1+/-281.5) from basal control level(1168.2+/-358.8mmHg, p<0.05). Thereafter no change was noted during remaining preconditioning. The changes in rate-pressure product were same as those of left ventricular systolic pressure(first 5 minutes occlusion ; 17.3+/-3.7 VS 21.2+/-3.5, p<0.005, second 5 minutes' occlusion ; 17.9+/-5.3, 18.1+/-3.4 VS 21.2+/-3.5, p<0.05). 2)Transmyocardial lactate extraction ratio was significantly decreased in early phase of ischemic preconditioning(17.5+/-11.3 VS 25.2+/-9.9%, p<0.05). 3) Hemodynamic parameters such as heart rate, left ventricular systolic pressure, left ventricular end-diastolic pressure, maximum +dp/dt, peak -dp/dt and rate-pressure product were changed similarly in both control and precontioned groups. 4) There was no significant difference of mean myocardial blood flows in infarct zones, which represent collateral blood flow, after 5 minutes' brief occlusion and 60 minutes of sustained occlusion in preconditioned group. 5) The infarct area/risk area ratio was significantly reduced in preconditioned group(27.0+/-9.6 VS 5.6+/-3.1%, p<0.005), but the risk area/left ventricular area ratio showed no difference in the two groups. CONCLUSIONS: These findings suggest that, in the early phase of brief repeated occlusion and reperfusion, myocardial ischemic damage accompaning systolic and diastolic myocardial dysfuctions develops and myocardial protective effect of ischemic preconditioning was obtained at the same time. Ischemic preconditioning group demonstrated reduced infarct sizes compared to those of control group after 90 minutes' sustained ischemia and reperfusion in canine acute myocardial infarction model.
Animals ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Heart Rate ; Hemodynamics ; Ischemia ; Ischemic Preconditioning* ; Lactic Acid ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Necrosis ; Reperfusion

OBJECTIVE: To assess the relationship between vaginal cytology and bone mineral density in postmenopausal women. METHODS: In 93 postmenopausal women, vaginal cytology smears were taken for maturation index, serum estradiol level and bone mineral density were also taken. the percentage of each cell type found By vaginal cytology was multiplied to its specific value:superficial cells, 1.0; intermediate cell, 0.6; parabasal cell, 0.2 and modified to maturation value. Bone mineral density was measured at lumbar spine using DEXA. RESULTS: The mean bone mineral density was 0.88+/-0.14g/cm2. Mean maturation value was 50.53+/-20.74 and it was related with age and bone mineral density. CONCLUSION: Maturation value of vaginal epithelial cell represents the influence of estrogen on bone mineral density.
Bone Density* ; Epithelial Cells ; Epithelium* ; Estradiol ; Estrogens ; Female ; Humans ; Spine