We evaluated the clinical effects of Nicorandil in 27 patients (17 male and 10 female) with ischemic heart disease (17 patients of stable effort angina, 3 patients of unstable effort angina, 6 patients of spontaneous angina, 1 patient of variant angina) in terms of the effect on the anginal pain, electrocardiographic changes and side effects. The results obtained were as follows; 1. The pulse rate was not changed by the drug administration and blood pressure were decreased slightly by Nicorandil in a daily dose of 15 mg divided into 3 dose, but these decrease were not significant in statistical meaning. 2. Improvement in EKG changes was observed in 9 patients (69%) among the 13 patients who showed abnormal EKG initially. 3. Anti-anginal effect of nicorandil were excellent in 14 patients, good in 8 patients, fair in 3 patients and so the rate of global improvement was 82%. 4. Nicorandil had side effects in 7 patients, headache (4 patients), palpitation, ocular pain, edema, but these were transitory and tolerable except of one case who could not be continued because of severe headache.
Angina Pectoris* ; Blood Pressure ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Nicorandil*

The antihypertensive effect and side reaction of pindolol were studied in 48 cases of essential hypertension 5mg to 15mg once regiment for average period of 6 weeks. 1) Average reduction of 25.11mmHg in systolic and 16.36mmHg in diastolic pressure were observed and their percentile reduction was 15.20% and 14.79%, respectively. The overall effect rate was 83.21%. The blood pressure was lowered significantly since 1 week of both in systolic and diastolic pressure with the daily of 10-15mg. 2) There was no significant change in heart rate before and after treatment. 3) No specific side reaction was observed except 1 cases in which discontinued the medication because of severe headache and fatigability on 2nd day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Pindolol

The antihypertensive effect and side reactions of perdipine was studied in 22 cases of essential hypertension using 20mg 3 times daily regimen for average period of 5 weeks. 1) Average reduction of 20mmHg in systolic and 17mmhg in diastolic pressure was observed and percentile reduction was 11.90% and 14.92%, respectively. The overall effect rate was 81.82%. The blood pressure lowered significantly after 2 weeks of treatment both in systolic and diastolic pressure. 2) There was no significant change in heart rates before and after treatment. 3) No specific side reaction was observed except 1 case in which discontinued the medication because of severe headache and fatigability on the 1st day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

No abstract available.

BACKGROUND: Despite progress in intubation techniques, dental trauma is one of the most common complications of general anesthesia. As the flange of the Macintosh blade appears responsible for most dental injuries, we modified the ordinary Macintosh blade by partially removing its flange and evaluated the effectiveness of the modified blade in terms of reducing potential of dental injuries. METHODS: Four hundred and eighty-three patients scheduled for elective surgery requiring general anesthesia with endotracheal tube placement were included in this prospective study. Laryngoscopy was performed twice, once using an ordinary Macintosh No. 3 blade and once using the modified Macintosh blade. The modification consisted of reducing the height of the flange by partial removal, as described by Callander et al. When optimum visibility of the glottis was obtained, the distance between the flange of the blade and the upper incisor was measured. We compared blade-tooth distances and laryngoscopic views for the two blades. RESULTS: The modified blade with low-height flange provided more distance than the ordinary type of blade (P<0.01). The incidence of direct contact between the blade and the upper tooth was 20.3% when the ordinary blade was used, and nearly 80% of these did not involve direct contact when using the modified blade. In addition, the modified blade provided a greater field of view than the ordinary blade (P<0.01). CONCLUSIONS: The modified Macintosh blade used in this study proved to be a useful device, which could reduce dental injuries and provide a better laryngoscopic view during laryngoscopy.
Anesthesia, General ; Glottis ; Humans ; Incidence ; Incisor ; Intubation ; Intubation, Intratracheal ; Laryngoscopes* ; Laryngoscopy ; Prospective Studies ; Tooth

OBJECTIVE: Amniocentesis is the most commonly used invasive method for prenatal diagnosis of genetic disorders. We performed this study to analyze the indications, distributions of maternal age and cytogenetic results of midtrimester amniocentesis. METHODS: We retrospectively analyzed 785 cases of midtrimester prenatal genetic amniocentesis which were performed in the cytogenetics laboratory using in situ coverslip culture at Dong-A University Hospital from January 1995 to March 2003. RESULTS: Amniocentesis was practiced mostly from 15 weeks to 20 weeks of gestational ages. Requested indications of amniocentesis were abnormal maternal serum screening (421, 53.7%), advanced maternal age (233, 29.7%) and abnormal ultrasonographic finding (61, 7.8%) in the order of decrease. The overall incidence of chromosome abnormalities was 5.1% (40 cases), and it contains 27 cases (3.4%) of numerical abnormalities and 13 cases (1.7%) of structural abnormalities. Among autosomal abnormalities Down syndrome was most common (13 cases) and followed by Edward syndrome (2 cases). Of the sex chromosomal abnormalities, three cases of Turner syndrome and three cases of Kleinefelter syndrome were found. Chromosomal abnormalities were most frequently noted in the maternal age of 30 to 34 years old (14 cases, 35.0%), 25 to 29 years old (12 cases, 30.0%), followed by 35 to 39 years old (7 cases, 17.5%). The frequency of pseudomosaicism were 5 cases (0.6%). CONCLUSION: Maternal serum screening, advanced maternal age and antenatal ultrasonographic finding must be important screening methods for amniocentesis which is considered to the most effective diagnostic procecdure for prenatal cytogenetic studies. I conclude that the karyotyping analysis of midtrimester amniocentesis is efficacious method for detection of chromosomal aberration and genetic counselling for parents.
Adult ; Amniocentesis* ; Chromosome Aberrations ; Cytogenetic Analysis* ; Cytogenetics* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Incidence ; Karyotyping ; Mass Screening ; Maternal Age ; Parents ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Retrospective Studies ; Turner Syndrome

PURPOSE: The purpose of this study is to determine if there are prognostic factors leading to permanent parenchymal damages to kidney in children after acute pyelonephritis. METHODS: This study was conducted in 160 pediatric patients with acute pyelonephritis admitted to Ajou University Hospital from 2000 to 2005, whose renal cortical defects were confirmed by 99mTc-dimercaptosuccinic acid scintigraphy (DMSA scan). Along with the follow-up DMSA scan after 6 months, they were classified into two groups; recovered group (106) and scarred group (54). The clinical characteristics of each group were compared. RESULTS: Among the total of 160 patients, 106 (66.3%) showed recovery of the initial defect (the recovered group), while 54 (33.8%) showed permanent defects on the follow-up DMSA scan (scarred group). Recovery rate was poor for patients of 1 year and older, or patients with the duration of fever and pyuria longer than 7 days. The recovery rate was poor in the patients with history of frequent febrile episodes and abnormal results of imaging studies, such as voiding cystourethrography (VCUG), ultrasonography. CONCLUSION: The recovery rate of children with renal defects on DMSA scan with acute pyelonephritis was lower when the patient is older than 1 year, when the duration of fever and pyuria exceeded 7 days, and when the patients had the histories of frequent febrile episodes and had urinary tract abnormalities on imaging studies. These findings suggest that there may be under- or mis-diagnosis of acute pyelonephritis by pediatrician.
Child ; Cicatrix ; Fever ; Follow-Up Studies ; Humans ; Kidney ; Pyelonephritis ; Pyuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract ; Urinary Tract Infections

OBJECTIVE: During pregnancy, the impaired placental perfusion causes complications such as preeclampsia, intrauterine growth restriction and fetal death in utero. In order to investigate the maternal and fetal response to the impaired placental perfusion, the author induced the impaired placental perfusion by the ligation of the rat uterine artery and investigated its effect on the expression of VEGF (vascular endothelial growth factor) in the placenta and serum VEGF level. METHODS: The rats on day 15 of gestation were used for the experiment. They were divided into two groups. The control group consists of the 20 rats that underwent laparotomy without uterine artery ligation. The experimental group consists of the 20 rats that underwent laparotomy and the uterine artery ligation by silk on day 15 of gestation. On day 16, 17, 18 and 19 of gestation, the placental tissues were obtained. The mRNA expressions of the VEGF in the placenta were measured by the relative RT-PCR in the control and experimental group. The localization and intensity of immunohistochemical staining of VEGF in placenta were determined in both groups and the maternal serum levels of VEGF were also measured in both groups. RESULTS: The mRNA expressions of VEGF120 and VEGF164 were significantly increased 48 hours after the ligation (day 17 of gestation) but the mRNA expression of VEGF188 was not changed after the ligation. There was no difference in the location and intensity of immunohistochemical staining of VEGF in the placenta between control and experimental groups. The serum VEGF levels of control group were 9 times as high as those of non-pregnant rats. The significant increases of the serum VEGF levels were noted 48 and 72 hours after the ligation (day 17 and 18 of gestation) but the significant increase was not noted 96 hours after the ligation (day 19 of gestation) as compared to control group. CONCLUSION: This study demonstrated firstly that the experimentally induced reduction of placental perfusion increased expressions of VEGF in the placenta and maternal serum. The results support that the measurement of maternal serum VEGF levels in pregnancy may help the diagnosis of placental insufficiency.
Animals ; Diagnosis ; Fetal Death ; Laparotomy ; Ligation* ; Perfusion ; Placenta ; Placental Insufficiency ; Pre-Eclampsia ; Pregnancy ; Rats* ; RNA, Messenger ; Silk ; Uterine Artery* ; Vascular Endothelial Growth Factor A*

OBJECTIVE: During pregnancy, the impaired placental perfusion causes complications such as preeclampsia, intrauterine growth restriction and fetal death in utero. In order to investigate the maternal and fetal response to the impaired placental perfusion, the author induced the impaired placental perfusion by the ligation of the rat uterine artery and investigated its effect on the expression of VEGF (vascular endothelial growth factor) in the placenta and serum VEGF level. METHODS: The rats on day 15 of gestation were used for the experiment. They were divided into two groups. The control group consists of the 20 rats that underwent laparotomy without uterine artery ligation. The experimental group consists of the 20 rats that underwent laparotomy and the uterine artery ligation by silk on day 15 of gestation. On day 16, 17, 18 and 19 of gestation, the placental tissues were obtained. The mRNA expressions of the VEGF in the placenta were measured by the relative RT-PCR in the control and experimental group. The localization and intensity of immunohistochemical staining of VEGF in placenta were determined in both groups and the maternal serum levels of VEGF were also measured in both groups. RESULTS: The mRNA expressions of VEGF120 and VEGF164 were significantly increased 48 hours after the ligation (day 17 of gestation) but the mRNA expression of VEGF188 was not changed after the ligation. There was no difference in the location and intensity of immunohistochemical staining of VEGF in the placenta between control and experimental groups. The serum VEGF levels of control group were 9 times as high as those of non-pregnant rats. The significant increases of the serum VEGF levels were noted 48 and 72 hours after the ligation (day 17 and 18 of gestation) but the significant increase was not noted 96 hours after the ligation (day 19 of gestation) as compared to control group. CONCLUSION: This study demonstrated firstly that the experimentally induced reduction of placental perfusion increased expressions of VEGF in the placenta and maternal serum. The results support that the measurement of maternal serum VEGF levels in pregnancy may help the diagnosis of placental insufficiency.
Animals ; Diagnosis ; Fetal Death ; Laparotomy ; Ligation* ; Perfusion ; Placenta ; Placental Insufficiency ; Pre-Eclampsia ; Pregnancy ; Rats* ; RNA, Messenger ; Silk ; Uterine Artery* ; Vascular Endothelial Growth Factor A*

PURPOSE: Early intervention is needed to treat patent ductus arteriosus (PDA) as it is a major cause of increased mortality in preterm infants. However, it is uncertain which is better, medical versus surgical management. We reviewed medical records to compare the treatment course and outcome between medically and surgically treated preterm PDA infants. METHODS: Thirth-two Mechanically ventilated pretem infants (gestational age<34 wks, birth weight<2,000gm) who survived beyond 30 days were studied. Treatment course and outcome were compared between indomethacin-treated (INDO, n=15) and surgically treated who have not responded to indomethacin (Surg, n=17). RESULTS: Volume of administered fluid and urine output during the first five days of life were similar, however, initial weight loss were lower in the SURG group than INDO group (p=0.031). Size of PDA on the echocardiogram were larger in SURG group (mean 3.4 mm) than INDO group (mean 2.5 mm) (p=0.046). Duration of hospitalization was longer in the SURG group (mean 46 days) than INDO group (mean 72 days) (p=0.033), however, time to start feeding, ventilator duration and weaning time were similar in both groups. Incidence of intraventricular hemorrhage was lower in the SURG group (47%) than INDO group (6%) (p=0.009). CONCLUSION: Preterm infants with poor initial weight loss and large size of PDA were likely to become surgical candidates and required longer periods of hospitalization and showed increased incidence of IVH. Although surgical treatment of PDA in preterm infants is definitive, fluid restriction and medical management at early postnatal period is recommended.
Ductus Arteriosus, Patent* ; Early Intervention (Education) ; Hemorrhage ; Hospitalization ; Humans ; Incidence ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Medical Records ; Mortality ; Parturition ; Ventilators, Mechanical ; Weaning ; Weight Loss