Holter ECG monitoring is a continuous tape recording of a patient's electrocardiogram during ordinary activities and picks up hidden abnormalities in rate, rhythm or conduction. The authors delineated the types and incidence rates of arrhythmia in 32 normal Koreans by utilizing medical personnels and patients without evident heart diseases or symptoms, or significant systemic illness. Tracings and analysis were performed using 24 hour Holter monitoring processor(SCM 240, Fukuda, japan), auto-analyser (SCM-25), casette recorder(SM 24) and chrome tape. Results are as follows: 1) Portable 24 houre Holter ECG monitoring was performed in 32 persons(age range of 21 to 35) without cardiovascular disease, as defined by normal clinical and noninvasive cardiovascular examination. 2) During exercise, maximal heart rates ranged from 125.0+/-12.1/min and minimal rates from 96.7+/-5.8/min. During normal activity period, maximal and minimal heart rates were, respectively, 95.4+/-16.2/min and 62.6+/-6.3/min. Maximal sleep rates were 90.3+/-26.6/min and minimal sleep rates 57.4+/-12.4/min. 3) P-R interval decreased as heart rate increased. Transient first degree AV block was noted in 3 subjects(9.4%) and Wenckebach type second degree AV block in 2 subjects(6.3%). 4) Sinus tachycardia and bradycardia were observed in all subjects and sinus arrhythmia was more frequently noted during waking periods. Three subjects had episodes of sinus pause with maximum duration of 3.24 seconds. 5) In 13 persons(40.6%) having supraventricular premature beats, the frequency was 50.01+/-49.36/hr and in 14 persons having(44%) ventricular premature beats the frequency 26.33+/-18.83/hr. Transient ventricular tachycardia of 3 seconds' duration was observed in one subject under the extreme stressful environment. 6) ST segment elevation over 1mm was noted in 5 subjects(15.6%), of whom one had a nocturnal chest pain and ST segment depression over 1mm in 2 subjects. T wave inversion was also found during exercise(3.1%) and during sleep(9.4%).
Arrhythmia, Sinus ; Arrhythmias, Cardiac ; Atrioventricular Block ; Bradycardia ; Cardiac Complexes, Premature ; Cardiovascular Diseases ; Chest Pain ; Depression ; Electrocardiography* ; Electrocardiography, Ambulatory ; Heart Diseases ; Heart Rate ; Humans ; Incidence ; Tachycardia, Sinus ; Tachycardia, Ventricular ; Tape Recording

The incidence of atherosclerosis in Korea seems to be much increased due to diet change after national development. The pathogenesis of atherosclerosis is not clarified and there are many hypothesis but the most recent and reliable hypothesis is the ratio of HDL-cholesterol per total cholesterol. Under the basis of this hypothesis there have been much trials to administer the agents which has effect on lipid metabolism, so we tried pantethine on 30 patients who visited Han-Yang University Hospital Internal medicine Department, and the result as follows; 1) The mean age of study population was 50.1 years of age, mean body weight was 62kg, and mean height was 160.8cm. male was 17, and female 10. 2) The associated disease of study population was <19 with> cardiovascular disease, in 19, gastrointestinal disease 3, obesity in 1 and others in 4. 3) The undesirable effect of the drug was found on 3 patients; that is, constipation on 1 patient, dizziness on 1 patient, and skin eruption on 1 patient. 4) The mean serum lipids before and after pantethine administration(levels) are as following table. In conclusion, it seems that the effect of the drug which decreases the serum lipids is mild at initial but more increasing as the time goes by and constant, and we experience little side reaction except mild dizziness, constipation and skin eruption.
Atherosclerosis ; Body Weight ; Cardiovascular Diseases ; Cholesterol* ; Constipation ; Diet ; Dizziness ; Female ; Gastrointestinal Diseases ; Humans ; Incidence ; Internal Medicine ; Korea ; Lipid Metabolism ; Male ; Obesity ; Skin ; Triglycerides*

Left ventricular hypertrophy is a compensatory response to hemodynamic overload secondary to an increased systemic resistance. This increase, however, is not the only cause of hypertrophy, and there are other factors which can have a significant effect on its incidence. To determine whether chronic antihypertensive therapy by enalapril modifies the cellular and subcellular changes of left ventricular hypertrophy observed in spontaneously hypertensive rats(SHR), 20-weeks-old SHR were treated for 22 weeks with enalapril(2mg/kg) and compared with normotensive Wister-Kyoto rats and not-treated SHR. Systolic blood pressure in enalapril-treated SHR was significantly lowered after 22 weeks compared with that of untreated control SHR group. Myocytes were reduced in size and fibrination seen in cardiac muscle fibers of control SHR was decreased in treated SHR group. Myofibrils appeared to be irregular in shape and myofilaments are decreased in control SHR but in enalapril-treated SHR the diameter and length of the myofilament became turned to regular forms. These results suggest that, enalapril, angiotensin converting enzyme inhibitor, may regress hypertrophy and some subcellular changes may be modified by enalapril.
Animals ; Blood Pressure ; Enalapril* ; Fibrin ; Hemodynamics ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Incidence ; Muscle Cells ; Myocardium ; Myofibrils ; Peptidyl-Dipeptidase A ; Rats ; Rats, Inbred SHR*

In order to review the epidemiological data of cardiovascular diseases, statistical observation was made on the 7,271 patients with cardiovascular diseases who were treated in the Department of Internal Medicine, Han-Yang University Hospital during the 10 year period from May 1972 to December 1981. A. General Findings (1) Cardiovascular disease was seen in 18.6% out of a total 39,004 medical inpatients treated during this 10 year time span. (2) Incidences of cardiovascular disease seemed to increase in frequency in consecutive years, especially incidence of coronary heart disease and arrhythmia. (3) Incidence of cardiovascular disease occurred most frequently to patients in their fifth decade, and next most frequently to those in their sixth and fourth decade, in that order. (4) The overall ratio of male to female incidence of cardiovascular disease was 1:1. B. Specific Epidemiology (1) Hypertension was the most common form of cardiovascular problem, accounting for 52.9% of patients with cardiovascular disease and 9.9% of the total medical in-patients population. Incidence of hypertension occured most frequently in the fifth decade of life. It occured next most in the sixth and fourth decades, in that order. The male to female ratio of incidence of hypertension was 1:1. Patients with malignant hypertension made up 5.9% all hypertension patients. (2) Patients with rheumatic heart disease made up 6% of those patients with cardiovascular diseases. Male to female ratio of incidence of rheumatic heart disease was 1:2.4. The most common form of this disease was mitral valvular disease, but isolated aortic valvular disease proved to be rather uncommon in this study in Korea. (3) Coronary heart disease made up 15.5 % of all incidence of cardiovascular diseases. It occured most frequently to patients in their fifth and sixth decades, and in a male to female ratio of 1.5 to 1. (4) Congenital heart disease made of 0.9% of the total incidence of cardiovascular diseases with ventricular septal defect as the most common form of this disease. (5) The remaining forms of cardiovascular diseases diagnosed during the time span of this study were arrhythmia 16.8%, cor pulmonale 1.4%, cardiomyopathy 1.3%, peripheral vascular disease 1.0%, pericarditis 1.0%, thyrotoxic heart disease 0.8%, endocarditis 0.5%, postpartum cardiomyopathy 0.3%, myxedematous heart disease 0.1%, and miscellaneous heart ailments 1.5%.
Arrhythmias, Cardiac ; Cardiomyopathies ; Cardiovascular Diseases* ; Coronary Disease ; Endocarditis ; Epidemiology ; Female ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Hypertension ; Hypertension, Malignant ; Incidence ; Inpatients ; Internal Medicine ; Korea* ; Male ; Pericarditis ; Peripheral Vascular Diseases ; Postpartum Period ; Pulmonary Heart Disease ; Rheumatic Heart Disease

Hypercalcemia is a common complication in CAPD patients treated with calcium-containing phosphate binders and using the standard dialysate (SCD) calcium concentration of 3.5mEq/L. We performed a retrospective study in 25 CAPD patients to determine whether a low calcium dialysate (LCD) containing 2.5mEq/L calcium would reduce the incidence of hypercalemia with adequate control of serum inorganic phosphate levels and diminish the need to use aluminum-containing phosphate binders. All patients had previously used SCD before converting to LCD. The incidence of hypercalcemia (more than 2 episodes of corrected serum calcium > or = 10.5mg/dL) tended to be lower after converting to LCDl 0.27 (0-2.76) vs. 0 (0-1.97) episodes/patient-yearl. Intact PTH level increased from 38.8 (0.1-1599.3)pg/mL to 70.6 (9.5-1540.0)pg/mL after conversion, but there was no statistical sifnificance. Serum calcium, inorganic phosphate, alkaline phosphatase and bicarbonate levels did not change after converting to LCD. We were able to reduce aluminum hydroxide dosagel 1.09 (0-10.88) vs. 0 (0-3.26)g/day/patientl and increase calcium carbonate dosage (1.95 0.92 vs. 2.98 2.14g/day/ patient) after conversion significantly (P<0.05). The frequency of peritonitis was similar in LCD and SCD period. In conclusion, low calcium dialysate is useful in diminishing aluminum-containing phosphate binder dosage and increasing calcium carbonate dosage to maintain a similar phosphate value. Its effects on renal osteodystrophy remain to be assessed.
Alkaline Phosphatase ; Aluminum Hydroxide ; Calcium Carbonate ; Calcium* ; Humans ; Hypercalcemia ; Incidence ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Osteodystrophy ; Retrospective Studies

No abstract available.
Glioma*

No abstract available.
Diagnosis*

Ullrich's disease is a congenital muscular dystrophy clinically characterized by generalized muscle weakness, multiple contractures of the proximal joints, and hyperextensibility of the distal joints. All the patients develop rigidity of spine, often assoicated with scoliosis, failure to thrive, and early and severe respiratory involvement, irrespective of their levels of motor function. Intellectual development is normal. The biopsied muscles show dystrophies including remarkable variation in the fiber size, notably proliferated endomysial connective tissues, and a lot of degenerated and regenerated fibers. The expression of merosin and dytrophin is normal. Recent studies have demonstrated that collagen VI is deficient in the muscles of the patients with Ullrich's disease, and some result from recessive mutations of the collagen VIalpha 2 gene(COL6A2). And a marked reduction of fibronectin receptors in the extracellular matrix of skin and cultured fibroblasts of these patients is also reported. These results suggest that collagen VI deficiency may lead to the reduction of fibronectin receptors and that any abnormalities of cell adhesion may be involved in the pathogenesis of the disease. A case of Ullrich's disease has not been reported yet in Korea. So, we describe a male patient with Ullrich's disease with a brief review of the literature.
Cell Adhesion ; Collagen ; Connective Tissue ; Contracture ; Extracellular Matrix ; Failure to Thrive ; Fibroblasts ; Humans ; Integrin alpha5beta1 ; Joints ; Korea ; Laminin ; Male ; Muscle Weakness ; Muscles ; Muscular Dystrophies ; Receptors, Fibronectin ; Scoliosis ; Skin ; Spine

BACKGROUND: Kidney donation is a relatively safe procedure with minimal adverse effects. But some reports have described the development of proteinuria and hypertension in donors after nephrectomy. There have been a number of non-Korean studies which conclude that the procedure is relatively safe and a good quality of life is expected for living donors after kidney transplantation, but not enough of these studies have been published in Korea. We evaluated the physiologic and psychosocial impacts after kidney donation in this study. METHODS: Between April 1988 and April 2010, we performed 201 living donor nephrectomies and obtained information for 88 (43.7%) of the donors. We measured their estimated glomerular filtration rate (GFR), blood pressure, body mass index, hemoglobin and cholesterol level, and assessed the prevalence of hypertension and proteinuria in this group. These donors completed a questionnaire regarding their health status and psychosocial outcomes after donation. RESULTS: The average time of the donor assessment after nephrectomy was 95.05+/-85.45 months (range, 6~261). The left kidney was used in 76 patients (86%). There was a total complication rate of 8%, but no serious complications were observed. Proteinuria was found in 9 patients (10%) and hypertension in 11 patients (11%). GFR decreased from 103.65+/-25.02 mL/min to 76.12+/-19.90 mL/min (P<0.001) and hemoglobin decreased from 13.91+/-1.62 g/dL to 13.01+/-1.72 g/dL (P<0.001). Five patients (6%) developed a post-donation GFR between 40 and 60 mL/min, with 2 patients being observed to have a post-donation GFR below 20 mL/min. In the questionnaire responses, most donors did not report problems affecting routine life or any economic impact. Their donation satisfaction results were very high (92%). CONCLUSIONS: Living kidney donors were observed to result in reduced GFR after nephrectomy. Follow-up visits with living kidney donors is essential in order to monitor risk factors related to the deterioration of their residual kidney function.
Blood Pressure ; Body Mass Index ; Cholesterol ; Follow-Up Studies ; Glomerular Filtration Rate ; Hemoglobins ; Humans ; Hypertension ; Kidney ; Kidney Transplantation ; Korea ; Living Donors ; Nephrectomy ; Organothiophosphorus Compounds ; Prevalence ; Proteinuria ; Quality of Life ; Questionnaires ; Risk Factors ; Tissue Donors

The abnormalities of left ventricular ejection patterns have been studied using echocardiography, contrast angiography, radionuclide angiography, and apex cardiography in patients with various heart disease. Recently it has been recognized that diastolic impairment may occur in the absence of abnormal systolic performance in hypertension, valvular heart disease, ischemic heart diseases, and cardiomyopathies. In order to identify whether diastolic dysfunction can develop without systolic dysfunction, we evaluated patterns of left ventricular filling and ejection by echocardiography in 10 chronic mitral regurgitations without pulmonary congestion symptom, who were confirmed by cardiac catheterization. Indices of left ventricular systolic function, including ejection fraction, fractional shortening, ejection rate, mean velocity of circumferential fiber shortening, and preejection period/left ventricular ejection time revealed no significant difference in mitral regurgitation patients compared with normal control group. Diastolic parameters, including atrial emptying index,mean velocity of circumferential fiber lengthening, rapid filling period, and rapid filling velocity were changed significantly in mitral regurgitation. There were no significant alterations in blood pressure and heart rate between two groups. It is concluded that impaired diastolic performance may be frequently encountered in patients with chronic mitral regurgitation and intact systolic function.
Angiography ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathies ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart Diseases ; Heart Rate ; Heart Valve Diseases ; Humans ; Hypertension ; Kinetocardiography ; Mitral Valve Insufficiency* ; Myocardial Ischemia ; Radionuclide Angiography ; Ventricular Function, Left*