From mechanocardiography and echocardiography, the systolic time intervals and the ejection phase indices were measured with determination of serum digoxin concentration(SDC) to elucidate the value of oral maintenance digoxin therapy on patients with heart failure in sinus rhythm. The drug interactions of digoxin with quinidine in heart failure, with verapamil in atrial fibrillation, and with aluminium hydroxide gel in healthy volunteers were observed with concomitant changes of SDCs. The results obtained are as follows. 1. After 10 days of treatment with digoxin 0.25 mg/day in 21 patients with heart failure there was a significant decrease in electromechanical systole(QS2), pre-ejection period(PEP) and PEP/left ventricular ejection time(LVET) ratio. There was also and equivocal decrease in LVET and an equivocal increase in mean velociy of circumferential fiber shortening(Vcf). However there was no significant change in ejection fraction(EF) and heart rate. The steadystate SDC was 1.20+/-0.12(S.E.M.)ng/ml. 2. Excellent correlation of the systolic time interval sand ejection phase indices measured from mechanocardiography and those determined from echocardiography was demonstrated. 3. SDCs were measured before and following quinidine therapy in 20 patients receiving maintenance digoxin for heart failure and who require quinidine for suppression of ventricular premature beats. Steady-state SDC following quinidine(Y) could be estimated form steady-state SDC before quinidine(X) as expressed by regression equation, Y=-0.394+2.309 X with correlation coeffcient, r=0.927(p<0.01). 4. In 12 patients with atrial fibrillation receving maintenance digoxin 0.25 mg/day, SDC before and following coadministration fo first 160 mg/day and later 240 mg/day of verapamil for 7days on each occasion was 0.85+/-0.07(S.E.M.) ng/ml, 1.00+/-0.09(S.E.M.)ng/ml and 1.33+/-0.13(S.E.M.)ng/ml, respectively. The difference of SDC between at control and under 240mg/day of verapamil was significant statistically(p<0.05). 5. Digoxin 0.75mg single-dose studies of bioavailability in 11 healthy volunteers showed a statistically significant difference(p<0.05) of the area under the 8-hour SDC curve between the digoxin only group and the digoxin plus aluminium hydroxide gel group. The area under the curve was 680+/-25(S.E.M.) min*ng/ml and 509+/-29(S.E.M.) min*ng/ml, respectively.
Atrial Fibrillation ; Biological Availability ; Cardiac Complexes, Premature ; Digoxin* ; Drug Interactions ; Echocardiography ; Healthy Volunteers ; Heart Failure ; Heart Rate ; Humans ; Quinidine ; Silicon Dioxide ; Systole ; Verapamil

A statistical study was done on arrhythmia of the aged who were older than 60 during the period 1963~1972 at Seoul national University Hospital. This study included 6,511 patients among 40,000 total patients. The results were as follows. 1) Arrhythmias were observed among 3,058 patients(46.97%). Sinus irregularitis were the most frequent arrhythmia. 2) Except sinus irregularities premature beat (38.3%), atrial fibrillation (16.1%), bundle branch block (10.5%), atriovenricular block (10.5%), atrioventricular escape beat (5.1%), atrioventricular junctional rhythm (4.9%), wandering pacemaker(4.0%) and paroxysmal tachycardia(2.5%) were frequent arrhythmias. 3) Cardiovascular disease was major underlying disease. In cardiovascular disease group, the incidence of arrhythmia was 51.15% which was three times as high as non-cardiovascular and normal group. 4) Most arrhythmias were more frequently observed among the aged except bundle branch block and ventricular paroxysmal tachycardia. 5) The incidence of arrhythmia was similar among the aged except pre-excitation syndrome which was predisposed to woman. 6) Arrhythmia was most frequently observed in coronary heart disease. 7) Among sinus irregularities, simus bradycardia was more frequent in the aged. 8) There were no significant differences in frequency of arrhythmia between non-cardiovascular disease group patients and normal group.
Arrhythmias, Cardiac* ; Atrial Fibrillation ; Bradycardia ; Bundle-Branch Block ; Cardiac Complexes, Premature ; Cardiovascular Diseases ; Coronary Disease ; Female ; Humans ; Incidence ; Pre-Excitation Syndromes ; Seoul ; Statistics as Topic* ; Tachycardia, Paroxysmal ; United Nations

Acute stroke has been associated with a variety of cardiac abnormalities. Data derived from EGC monitoring have suggested that cardiac arrhythmia may be more common in stroke patient. Acute stroke such as cerebral infarction has been reported to increase serum cardiac enzyme and histologic changes, focal myocardial myocytolysis. Also, plasma norepinephrine was significantly elevated in a group of stroke patients compared with non-stroke control. These observations led to the hypothesis that acute stroke may increase sympathetic activity with resultant electrocardiographic abnormalities and myocardial cell necrosis. In order to test this hypothesis, we evaluated 24 acute stroke patients for several cardiac parameter including arrythmias defected by 24 hour Holter monitoring, serum cardiac enzymes such as CK, LDH, SGOT and plasma catecholamine values. Similar studies were also performed in 15 control subjects matched with stroke patients for age. The result were as follows; 1) Arrhythmias such as VPB, SVPB in the acute stroke group were more common than in the non-stroke group. VPB(209+/-61/24hr, P<0.005) SVPB(232+/-54/24hr, P<0.005). 2) Plasma norepinephrine, epinephrine and CK was significantly elevated in a group of stroke patients compared with non-stroke controls. norepinephrine(715.3+/-93.8 pg/ml, P<0.005) epinephrine(346.1+/-63.1 pg/ml, P<0.005). 3) Stroke patients with abnormal serum CK values(above 80 IU/L) had a higher(P<0.05) mean norepinephrine concentration(776.6+/-142.0 pg/ml) than remaining stroke patients(406.3+/-101.7 pg/ml). 4) Stroke patients with high plasma norepinephrine did not exhibit an increase in cardiac arrhythmias.
Arrhythmias, Cardiac* ; Aspartate Aminotransferases ; Cerebral Infarction ; Electrocardiography ; Electrocardiography, Ambulatory ; Epinephrine ; Humans ; Necrosis ; Norepinephrine ; Plasma* ; Stroke*

Thirty patients who coincided with CVA and MI, from january 1980 to August 1984, at Department of Internal Medicine, Kyung Hee University Hospital, were studied. And the following results were obtained; 1) The ratio of male to female was 2:1. The average age was 61.6 years. The in-hospital mortality rate was higher than cerebrovascular accident or myocardial infarction alone. 2) The most common risk factor was hypertension(83%), smoking(64%), hyperlipidemia(57%) and diabetes mellitus(33%) in order of frequency. 3) Fifteen cases of 30 patients had acute episode of MI and CVA during hospitalization and showed highest in -hospital mortality rate(66.7%). 4) There was no difference in mortality rate between cereral infarction and cerebral hemorrhage.
Cerebral Hemorrhage ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Infarction ; Internal Medicine ; Male ; Mortality ; Myocardial Infarction* ; Risk Factors ; Stroke*

Clinical electrophysilogical study(EPS) was done in 5 patients with chronic bifascicular block of completa RBBB and left anterior fascicular block. The results were as follows. 1) In 2 patients who needed permenent pacemaker therapy, EPS disclosed prolonged HV interval(>70msec) and block distal to his bundle by atrial with cycle length of longer than 545msec. 2) In 3 patients who didn't need permenent pacemaker therapy, AV conduction and to choose the therapeutic measures in the patients with chronic bifascicular block and unexplained dizziness and/or syncope.
Bundle of His ; Bundle-Branch Block ; Dizziness ; Humans ; Syncope

Pheochromocytoma is a hazardous and dramatic cause of hypertension. This potentially lethal neoplasm originates in most cases in the adrenal medulla and less frequently in the cells of the extraadrenal paraganglion system which are disseminated along the paravertebral axis from the pelvis to the base of the skull. The organ of Zuckerkandl is paraganglia lying the abdominal aorta with highest incidence in the region of the inferior mesenteric artery and usually degenerate shortly after birth. In the literature, and additional one case of pheochromocytoma arising from the organ of Zuckerkandl associated with intracerebral hemorrhage which was treated recently in the Kyung Hee University Hospital is presented in this report.
Adrenal Medulla ; Aorta, Abdominal ; Axis, Cervical Vertebra ; Cerebral Hemorrhage* ; Deception ; Hypertension ; Incidence ; Mesenteric Artery, Inferior ; Para-Aortic Bodies* ; Parturition ; Pelvis ; Pheochromocytoma* ; Skull

During 1 year and 9 month period, from September, 1980 to June, 1983, retrospective study was performed on 35 patients with Mitral Valve Prolapse at Kyung Hee University Medical Center. And the following results were obtained; 1) The mitral valve prolapse syndrome presents with various cardiovascular symptoms including dyspnea(63%), palpitation(49%), chest pain(34%), syncope and dizziness(11%). 2) Of 35 patients with MVP, 17 cases were isolated MVP, 13 cases were associated with cardiovascular disorders and 5 cases were associated with non-cardiovascular disorders. 3) Electrocardiographic abnormalities were found in 20 patients with MVP. The most common abnormality was ST-T change and atrial fibrillation, VPB, RBBB, first degree A-V block and W-P-W syndrome were also noted. 4) QTc interval prolongation was more common in serverely symptomatic patients with MVP. 5) 18 cases in 35 patients showed systolic click or murmur on phonocardiography. 6) Of 35 patients with MVP, 19 patients demonstrated prolapse of the anterior leaflet, 11 patients demonstrated prolapse of posterior leaflet and 5 patients demonstrated prolapse of the both leaflets. 7) There were severe derangement on echocardiography in severely symptomatic patients were MVP.
Academic Medical Centers ; Atrial Fibrillation ; Echocardiography ; Electrocardiography ; Humans ; Mitral Valve Prolapse* ; Mitral Valve* ; Phonocardiography ; Prolapse ; Retrospective Studies ; Syncope ; Thorax

No abstract available.
Cell Line, Tumor* ; Doxorubicin* ; Epirubicin* ; Humans*

Congenitally corrected transposition of the great arteries is a rate congenital heart disease. In this discase, there is discordance between both the atria and ventricles and the ventricles and great vessels. The anatomic left ventricle lies on the rightside and is connected to the pulmonic trunk, whereas the anatomic right ventricles lies on the left side and functions as the systemic ventricle. Most patients have associated another cardiac anomalies and conduction disturbance.Less commonly, ventricular extrasystoles, paroxismal supraventricular tachycardia, WPW preexitaion and atrial fibrillation may be obserced. We report an adult case of congenitally corrected transposition of great arteries associated with paroxysmal atrial fibrillation and heart failure.
Adult* ; Arteries* ; Atrial Fibrillation* ; Chymopapain ; Heart Defects, Congenital ; Heart Failure* ; Heart Ventricles ; Heart* ; Humans ; Tachycardia, Supraventricular ; Transposition of Great Vessels ; Ventricular Premature Complexes

BACKGROUND: Calcium antagonists are highly effective agents for lowering high blood pressure and play a very important role in the treatment of Patient with ischemic heart disease and various other cardiovascular disorder. Manidipine, a dihydropyridine-type ccalcium channel blocker, is a potent relaxant of the arteriolar smooth muscle. We studied ths new calcium channel blocker to evaluated the efficacy and safety in patients with essectial hypertension. METHODS: Twenty patients(ten women and ten men;range of age, 30-66 years old)with mild-to-moderate essential hypertension were enrolled in this study. After a placebo run-in phase of two weeks duration, 5mg-20mg manidipine once daily orally was administered for eight weeks. RESULTS: 1) At the end of 8 weeks of manidipine therapy, systolic and diastolic blood pressure were significantly reduced from 160.1+/-11.8/105.5+/-5.1mmHG in sitting, 160.1+/-12.1/104.5+/-5.4mmHG in supine, 157.1+/-17.0/104.1+/-5.3mmHg in standing to 128.4+/-10.1/85.2+/-5.7mmHg in sitting, 129.1+/-10.2/84.2+/-5.9mmHg in supine, 128.1+/-12.8/86.7+/-5.9mmHg in standing(p<0.01). 2) The pulse rate did dnot change significantly. 3) The reduction of mean systolic and diastolic blood pressur at the end of 8 weeks were 31.5+/-14.5/20.3+/-7.4mmHg in sitting. 4) There was no serious side effect except mild symptom, mild headache(6 casem 30%) and facial flushing(1 case, 5%). CONCLUSION: These results indicate that manidipine is an effective and safe antihypertensive agent in the treatment of mild and moderate essential hypertension.
Blood Pressure ; Calcium ; Calcium Channels ; Female ; Heart Rate ; Humans ; Hypertension* ; Muscle, Smooth ; Myocardial Ischemia