The antihypertensive effect of nicardipine was studied in 31 cases of essential hypertension and following results were obtained. 1) Daily dose was 30-60mg for 10 weeks. 2) Mean systolic and diastolic pressure were decreased by 39.5mmHg 921%) and 17.2mmHg(15%) respectively(P<0.005) and in 84% of cases, good or fair control of blood pressure was proved. 3) There was no significant change in heart rates before and after treatment. 4) There were no significant side effects except two cases of mild headache and facial flushing which subsided spontaneously.
Blood Pressure ; Flushing ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

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

OBJECTIVES: A retrospective study was performed to clarify the change of lumbar bone mineral density(BMD) according to the duration of hormone replacement therapy(HRT) and the other factors such as age, years since menopause(YSM) and initial BMD in postmenopausal women. METHODS: From January, 1995 to December, 1998 we measured lumbar bone mineral density in 100 postmenopausal women in the department of obstetrics and gynecology, Inha University Hospital. These women had been followed for 2 years after taking HRT. We investigated whether there were any relation between the duration of HRT, age, YSM, initial BMD and change of BMD. RESULTS: Lumbar BMD was increased 2.06% after one year of HRT(p=0.0001) but there was no change of BMD at the 2nd year of HRT(p=0.847). The response to HRT was greatest in those who were oldest(r=0.209 ; p=0.039) and furthest YSM(r=0.209; p=0.039), and consequently among those who had the lowest BMD(r=0.590 ; p=0.0001). CONCLUSION: The bone mass was increased upto 2.06% at the 1st year of HRT but no more progressive increase was occurred. It suggest that intensive HRT is needed at 1st year of therapy. The risk of fracture is not decreased to that of the healthy population inspite of HRT, so the earlier therapy is necessary to prevent osteoporotic fracture despite of intervention.
Bone Density* ; Female ; Gynecology ; Hormone Replacement Therapy* ; Humans ; Obstetrics ; Osteoporotic Fractures ; Retrospective Studies

OBJECTIVES: Apathy Evaluation Scale (AES) is one of the most frequently used scales to evaluate apathy. The purpose of this study was to evaluate the reliability and validity of the Korean version of the AES (K-AES) and to apply the K-AES in examining the characteristics of apathy in the Korean patients with schizophrenia. METHODS: 129 healthy people and 29 patients with schizophrenia have been evaluated using the K-AES, Physical Anhedonia Scale (PAS), Social Anhedonia Scale (SAS), and the Beck's Depression Inventory (BDI). Split-half reliability and internal consistency were evaluated and factor analysis and correlation analysis was conducted. Between-group comparison was conducted using independent sample t-tests. RESULTS: K-AES showed good reliability and validity. Factor analysis confirmed 3 factors, which represented interest and drive, initiative, self-awareness and self-assessment. Patients with schizophrenia showed significantly higher K-AES and BDI scores than the healthy group. K-AES scores in patients with schizophrenia were significantly correlated with the PAS score, but did not correlate with SAS and BDI scores. CONCLUSION: This study demonstrates the reliability and validity of the K-AES. Our findings also suggest that the K-AES may be a reliable instrument in assessing apathy as a negative symptom in patients with schizophrenia.
Anhedonia ; Apathy* ; Depression ; Factor Analysis, Statistical ; Humans ; Reproducibility of Results* ; Schizophrenia* ; Self-Assessment ; Weights and Measures

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

Assessment of Myocardial contractility is critically important task in the evaluation of patients with heart disease. In recent years many indices have been studied to evaluate myocardial inotropic state, applying the skeletal muscle mechanics to intact heart. Among such indices, Vmax(maximum velocity of shortening of the unloaded contractile elements) and Vpm(physiologic maximum observed velocity of myocardial shortening) provide a measure of myocardial contractility independent of preload or afterload. To obtain normal values in Korean adults, the left ventricular pressure data of 16 patients with normal physical activities were analyzed, using the digital computer. Seven patients had ventricular septal defect with Qp/Qs less than 2.0, one patient had mitral stenosis, another one patient had mitral stenosis and aortic regurgitation (grade I/IV and the remainder seven patients had no intrinsic cardiac disorder. But, the cardiac performances of all patients were apparently normal. The results were as follows: 1) Cardiac index was greater than 3.0 l/min/m2 in all patinets: 4.9+/-1.32(+/-S.D.)l.min/m2. 2) Ejection fraction was greater than 55% in all patients: 71.2+/-8.04(+/-S.D.)%. 3) Left ventricular end diastolic pressure(LVEDP) ranged from 3 mmHg to 12 mmHg. 4) Vmax: 48.1+/-9.41(+/-S.D.) sec(-1). 5) Vpm: 39.3+/-8.13(+/-S.D.) sec(-1).
Adult* ; Aortic Valve Insufficiency ; Computers ; Heart ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Mechanics ; Mitral Valve Stenosis ; Motor Activity* ; Muscle, Skeletal ; Reference Values ; Ventricular Pressure

In patients with chronic aortic regurgitation, irreversible left ventricular dysfunction, which is associated poor longterm prognosis, often develops before onset of severe symtoms. To determine whether evidence of left ventricular dysfunction could be detected before it appeared at rest, 48 patients with chronic aortic regurgition were studied using exercise echocardiography, and 25 patients were followed-up for 16.1 months in average by serial echocardiographical and clinical examination to evaluate the prognostic value of exercise-echocardiographic data. Among 41 patients with normal resting ejection fraction, left ventricular ejection fraction increased more than 5% with exercise(big up tri, DeltaEF> or =5%) in 14 patients (Group I), while in 27 patients ejection fraction change with exercise was less than normal (big up tri, DeltaEF <5%) (Group II). In the remaining 7 patients with subnormal resting ejection fraction, the exercise response was also subnormal (big up tri, DeltaEF<5%)(Group III). 1) There was no significant difference in radius-thickness ratio, ejection fraction at rest, work capacity, exercise duration and NYHA functional class between group I, II and III. But left ventricular internal dimension and wall stress were greater in group II than in group I. Group III had the largest left ventricualr internal dimension and stress. 2) Among the 15 patients with left vnetricular end-systolic dimension(LVESD) greater than 55mm, only one patient belong to group I. The other 14 patients belonged to group II(7 patients) and group III(7 patients). In contrast, in 22 patients with LVESD less than 50mm, 13 patients were group I, 9 patients were group II. In 26 patients with LVESD greater than 50 mm, only one patient showed normal exercise response, but the remaining 25 patients showed subnormal response. 3) Serial echocardiographic and clinical follow-up study for average 16.1 months showed group I the best, group II better than group III, group III the poorest clinical course and prognosis. Left ventricular functional status of group II patients seemed to be intermediate stage between group I and group III. 4) Total work duration and work capacity were more reduced in NYHA functional class II and III than in class I. But, using NYHA functional classification there were no differences in left ventricular internal dimension, ejection fraction at rest, exercise change in ejection fraction(big up tri, DeltaEF), wall stress and radius-thickness ratio between class I, II and III. According to the above results the classification based on the resting ejection fraction and big up tri, DeltaE.F., seemed to be useful for identification of patients with different clinical course and prognosis, especially in asymptomatic cases. The consideration of indices obtained by exercise-echocardiography, such as, LVESD, resting ejection fraction, big up tri, DeltaE.F. and wall stress, as well as the clinical status of patient, would be a useful guideline for follow-up and determining the optimal time for surgical intervention in patients with chronic aortic regurgitation.
Aortic Valve Insufficiency* ; Classification ; Echocardiography* ; Follow-Up Studies* ; Humans ; Prognosis ; Stroke Volume ; Ventricular Dysfunction, Left

Prosthetic valve endocarditis(PVE) is not infrequent and one of the serious complications of cardiac valve replacement despite advances in antimicrobial therapy, diagnostic techniquens and surgical procedures. Although the incidence of PVE may be declining, the absolute number of cases of this infection is increasing. In patients with a prosthetic valve, fever, a regurgitant heart murmur, peripheral manifestations of infective endocarditis and postitive blood cultures, the diagnosis of PVE is evident. We have reviewed our experience with 13 patients with PVE from October 1976 through August 1983. During this period valve replacements were performed in 686 patients, with an infection rate of 1.9%. PVE currently accounts for approximately 14% of the total number of cases of infective endocarditis seen at Seoul national University Hospital. PVE occurred more often after multiple valve replacement than after replacement of single valve alone. Blood cultures were positive in 69% cases of PVE. Systemic emboli could be seen in 54% of patients with PVE and overall mortality was about 23%.
Diagnosis ; Endocarditis* ; Fever ; Heart Murmurs ; Heart Valves ; Humans ; Incidence ; Mortality ; Seoul

This study was performed to evaluate the method of quantification of exercise thallium-201(201Tl) myocardial perfusion imaginges(M.P.I.) for the detection of coronary artery disease. Exercise 201 Tl MPI were interpreted objectively, reproducibly, quantitatively and easily by a computer assisted technique-Circumferential profile method. Exercise 201Tl MPI and redistribution images were taken in 32 patients(9 cases of post infarction angina, 13 cases of angina pectoris, 8 cases of atypical chest pain, 1 case of arrhythmial and 1 case of caridac neurosis). The results obtained were as follows: 1) Exercise 201Tl MPI of 3 cases of angina pectoris demonstrated transient perfusion defect in 5 cases, persistent perfusion defect in 2 cases, transient and persistent perfusion defect in 1 cases and no perfusion defect in 5 cases. Exercise 201Tl MPI of 9 case of post-infarction angina revealed persistent perfusion defect in 7 cases and transient and persistent perfusion defect in 2 cases. 201Tl MPI of 8 cases of atypical chest pain showed transient perfusion defect in 1 case and no perfusion defect in 7 cases. There was no perfusion defect in 1 case of arrhythmia and another case of cardiac neurosis. 2) The location of persistent perfusion defects in several views of 201Tl MPI in 9 case of postinfarction angina were consistent with those of infarction area in the electrocardiogram. 3) While visual analysis interpreted three cases to have no perfusion defect and one case to have transient perfusion defect respectively, objective analysis revealed that one of them had transient perfusion defect, another of them had persistent perfusion defect and the other had transient and persistent perfusion defect. 201Tl MPI of three cases could be done easily by circumferential profile method, which were difficult to interprete by subjective visual analysis. The results indicate that Exercise 201Tl MPI interpreted by circumferential profile analysis would be an objective, quantitative and noninvasive method for the detection of ischemic change and location in coronary artery disease.
Angina Pectoris ; Arrhythmias, Cardiac ; Chest Pain ; Coronary Artery Disease ; Electrocardiography ; Infarction ; Myocardial Ischemia* ; Neurocirculatory Asthenia ; Perfusion

A patient, 59 years old male, with paroxysmal AV reentrant tachycardia utilizing a concealed left lateral accessory pathway with long VA conduction time is presented. During tachycardia P waves were negative in leads I, aVL, and V6 and positive in leads aVR and V1. The R-P/P-R ratio was 1.6. Radiofrequency catheter ablation was successful to interrupt the VA conduction through the accessory pathway.
Catheter Ablation ; Humans ; Male ; Middle Aged ; Tachycardia*