BACKGROUND: Quinidine appeared to increase serum digoxin levels when given with quinidine. Therefore elevated serum digoxin concentrations and clinical toxicity have been reported in patient receiving quinidine. Currently, Bayesian method which estimates the most probable parameters of the drug for each patient from population parameters data is useful approach for adjusting digoxin dosage. To increase the accuracy of Bayesian method, it is desirable to use population parameters of Korean. Therefore we evaluated the effect of quinidine on digoxin clearance in Korea. METHOD: Patient's records from 19 adult cardiac disease without CHF having normal renal and liver function from Seoul National University of Hospital respectively wre evaluated. Digoxin pharmacokinetic parameters, CL and Vd, were obtained from serum concentration of digoxin of single and combined therapy at each steady-state by using bayesian method. RESULTS: This study show that quinidine reduced the total body clearance of digoxin from 2.39+/-0.17 to 1.51+/-0.08ml/min/kg(p<0.05) and reduced the digoxin volume of distribution from 8.57+/-0.29 to 4.98+/-0.19L/kg(p<0.05). This results show that digoxin dosage reduced to 40-50% in Korean, if quinidine therapy is initiated.
Adult ; Bayes Theorem ; Digoxin* ; Drug Interactions ; Heart Diseases ; Humans ; Korea ; Liver ; Pharmacokinetics ; Quinidine* ; Seoul

No abstract available.

No abstract available.
Fructosamine*

No abstract available.
Carotid-Cavernous Sinus Fistula ; Facial Bones

It is believed that catecholamine secretion is increased during cardiopulmonary bypass. However, the periods of maximum increase in catecholamine levels during cardiopulmonary bypass are different among several authors. 15 patients having valvular surgery were studied. Plasma epinephrine and norepine- phrine were determined by high performance liquid chromatography at 8 stages of the operation. During bypass plasma catecholamine levels continued to rise and maximally increased until aortic cross clamp off, and decreased gradually. Norepinephrine also showed the same results initially, but then increased gradually after the end of bypass. During bypass the maximum increases in epinephrine and norepinephrine were sixfold and twofold respectively in comparison with the levels prior to induction, which suggests that the predominant humoral response to cardiopulmonary bypass appears to be adrenomedullary release of epinephrine. The catecholamine levels at the period of aortic cross clamp off was higher than that of the lowest body temperature. There was no correlation between the increases in catecholamines and mean arterial pressure. Temperautures and eatecholamines also showed no correlations.
Arterial Pressure ; Body Temperature ; Cardiopulmonary Bypass* ; Catecholamines ; Chromatography, Liquid ; Epinephrine* ; Humans ; Norepinephrine* ; Plasma

Pulse oximetry is a noninvasive technique for measuring O2 saturation (SpO2) continuously. We applied pulse oximetry to 9 pediatric patients with tetralogy of Fallot during shunt surgery. Arterial oxygen tensions (PaO2) and saturations (SaO2) were also measured at the time of postinduction, just before the shunt, after the shunt and at the end of the operation. The SpO2 and SaO2 levels were identically changed in all 4 periods. The PaO2 was increased a little without statistical significance after the shunt procedure and at the end of the operation compared with the values before the shunt. However, SaO2 values increased with statistical significance after the shunt procedure and SpO2 values also showed similar increases with significance. In conclusion, continuous monitoring of SpO2 by pulse oximetry, instead of PaO2, is a very useful and reliable method to assess the improvement of perfusion after shunt, particularly in cyanotic cases.
Child, Preschool ; Human ; Infant ; Intraoperative Period ; *Oximetry ; Oxygen/blood ; Tetralogy of Fallot/blood/*surgery

No abstract available.
Female ; Fetal Blood* ; Humans ; Hypertension, Pregnancy-Induced* ; Infant, Newborn* ; Mothers* ; Pregnancy ; Pregnancy*

Posttraumatic volar instability of the thumb metacarpophalangeal joint with hyperextensile laxity makes pain and weakness during pinch or grip exercise. Several surgical procedures have been described to eliminate thumb metacarpophalangeal joint hyperextension. We treated a patient who had suffered from volar instability with pain for 17 years using volar plate repair and capsulodesis with suture anchor. The result was successful with satisfactory recovery of the hand function.
Hand ; Hand Strength ; Humans ; Metacarpophalangeal Joint ; Suture Anchors ; Thumb ; Palmar Plate

No abstract available.
Blood Donors* ; Chungcheongnam-do* ; Humans

In an attempt to define quantitatively the relation between left atrial size and atrial fibrillation, echocardiography was used to study 58 patients with mitral stenosis and sinus rhythm, 22 patients with mitral stenosis and newly appeared atrial fibrillation, 62 patients with mitral stenosis and atrial fibrillation, 14 patients with sinus rhythm who undergone mitral valve replacement, 18 patients with atrial fibrillation who undergone mitral valve replacement,17 patients with idiopathic atrial fibrillation and 22 control persons. In all groups of mitral stenosis, atrial fibrillation was rare when left atrial dimension was below 40mm but common when this dimension exceeded 40 mm. When left atrial dimension exceeded 50 mm, sinus rhythm was rare even in patients who undergone mitral replacement operation. These data suggest that left atrial size is an important factor in the development of atrial fibrillation. To reduce the risk of systemic embolism complicating atrial fibrillation and to reduce the need of long term anticoagulant therapy postoperatively, the left atrial dimension should be followed closely for the patients with mitral stenosis.
Atrial Fibrillation* ; Echocardiography* ; Embolism ; Heart Atria* ; Humans ; Mitral Valve ; Mitral Valve Stenosis