To assess the efficacy of amiodarone on chronic atral fibrillation(AF) and to evaluate the relation between the ability to convert AF to sinus rhythm (SR) with amiodarone therapy and left atrial(LA) size and atrial fibrillatory wave forms, 22 patients with AF, aged 40 to 60 years(mean 47.5 years), were studied. Nine patients(40.9%) had mitral valvaular heart disease, 6(27.3%) hypertension, 5(18.2%) lone AF and 2 (9.1%) cadiomyopathy. Amiodarone therapy with either 600mg for 1 week, 200mg for 4 weeks in 5 consecutive patients, or 800mg for 1 week, 400mg for 4 weeks and 200mg for 6 weeks in 17 patients, converted AF to SR in 9(40.9%) patients 3 to 6 weeks after amiodarone was started on. In either group, patients who achieved conversion had smaller LA size(mean 43.7mm) than those who failed conversion(mean50.2mm)(P<0.05). Those who had LA size less than 45mm achieved conversion of AF to SR in 70%, comparing to 16.7% in patients with LA size more than 46mm(P<0.05). Among patients who achieved conversion, LA size was less than 46mm in 77.8% comparing to 23.1% in patients who failed conversion on Amiodarone. Those with coarse AF(46.2mm), althogh the difference was not significant statistically. There was no converstion in patients with LA size greater then 58mm and in patients with coarse AF who concomittantly had MVD. These findings suggest that the efficacy of amiodarone was related to LA size, and to the atrial fibrillation wave form in patients with mitral valvular heart disease.
Amiodarone* ; Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans ; Hypertension

This study was carried out to investigate the light and electron microscopic findings of the livers of rats after an intraperitoneal injection of cadmium chloride. The Sprague-Dawley rats were intraperitoneally injected with cadmium chloride dissolved in water, once a day for three days. These animals were sacrificed at 1, 3, 8, and 24 hr after the last injection. Control groups of the rats were also sacrificed in the same manner. The liver was extirpated and examined by both light and electron microscopy. The results obtained are as follows: The parenchyma of the liver shows focal neutrophilic infiltration and spotty necrosis. The hepatocytes show fatty change, ballooning degeneration, swelling of the endoplasmic reticulum and mitochondria, increase numbers of secondary lysosomes and residual bodies. Focal patic venules and sinusoids of the liver are congested. The Kupffer cells are increase in number. Therefore, it can be concluded that the cadmium is directly acted to hepatocytes resulting in cellular injuries and deposits in the fat droplets of the cytoplasm of the hepatocytes, not Ito cells as previously suggeted.
Rats ; Animals

No abstract available.
Herpes Zoster*

In an attempt to investigate which of the ST-segment parameters, e.g., ST-segment level, ST-segment slope, ST-segment index and ST-segment intergral obtained by mannual drawing can most sensitively indicate quantitatively the extent of exertional myocardial ischemia in patients with angina pectoris, 26 patients with angina pectoris underwent exrecise stress testing, using a bicycle ergometer and thallium-201 myocardial perfusion scintigraphy(Thallium-201 MPS). The exrecise was terminated either when symptoms or signs indicative of myocardial ischemia developed or when the heart rate reached the predicted maximal heart rate during exrecise. The myocardial ischemia region was quantitated by Thallium-201 MPS. The number of myocardial ischemia segments was similar in patients who had positive exrecise test(4.9+/-1.9) and in those who had negative result(3.7+/-2.2). However, it was greater in patients who showed pseudonormalization of the T wave in exercise ECG(6.3+/-2.6) than in those with negative exercise test(3.7+/-2.2)(P<0.05). The extent of myocardial ischemia region expressed by the number of myocardial ischemia segments correlates best with the ST-segment index(r=-0.83) among ST-segment slop(r=-0.60), ST-segment intergral(r=-0.59) and ST-segment(r=0.50). These data suggest that the ST-segment index is the most reliable indicator to reveal the extent of exertional myocardial ischemia among the ST-segment parameters and that pseudonormalization of T wave in exercise ECG is a finding indicative of exertional myocaridial ischemia in patients with angina pectoris.
Angina Pectoris ; Electrocardiography* ; Exercise Test ; Heart Rate ; Humans ; Ischemia ; Myocardial Ischemia* ; Perfusion

An exercise stress test using the bicycle ergometer was carried out in Korea University Hospital in 121 untrained apparently healthy male Koreans with the ages ranging from 20 to 69 years. The graded exercise test consisted of 12 minutes' work on the bicycle ergometer, 4 minutes with each work load, such as 50 W, 100W and 150W, and an additional time with the maximal load to the point of voluntary exhaustion or until other symptoms of exercise intolerance appeared. During the graded exercise a bipolar electrocardiogram from the forehead to the V 5 position(lead CH5) was monitored with an oscilloscope with the sweep speed of 50mm per second and recorded for the analysis. The results obtained were summarized as follows. 1. Heart rates were measured before and during the graded exercise at 50W, 100W, 150W and maximal work loads, and those of the 98 cases with no significant ST segment depression in the exercise ECG are presented. Mean heart rates per minute on 150W load by age group were: 171.0 in the 20-29 year-old group, 170.8 in the 30~39 year-old group, 168.0 in the 40-49year-old group, 162.9 in the 50-59 year-old group and 153.6 in the 60-69 year-old group. Mean heart rates per minute on maximal work load by age group were: 186.0 in the 20-29 year-old group, 178.8 in the 30-39 year-old group, 174.7 in the 40-49 year-old group, 166.0 in the 50-59 year-old group and 161.8 in the 60-69 year-old group. 2. The maximal working capacities by age group were: 266.3W in the 29-29 year-old group, 186.1W in the 30-39 year-old group, 182.2W in the 40-49 year-old group, 160.0W in the 50-59 year-old group and 161.8W in the 60-69 year-old group. 3. More than 1mm ST segment depression 0.08 second after the J point was seen in 10.7% and that 0.06 second after the J point in 19.1%. 4. Electrocardiographic QX/QT ratios ranging from 50 to 59% were seen in 21.5% and more than 60% in 0.8% of the cases. 5. Arrhythmias observed during the exercise test included premature ventricular contraction (2.5%), atrial premature contraction(1.7%) and nodal premature contraction(0.8%). 6. Distressing symtoms experienced during the graded exercise test were dizziness(6.6%) and leg pain(5.8%). Excessive sweating(3.3%), hypotension(1.7%) and nausea and vomiting (0.8%) were noticed immediately after the maximal exercise was finished.
Arrhythmias, Cardiac ; Depression ; Electrocardiography ; Exercise Test* ; Forehead ; Heart Rate ; Humans ; Korea ; Leg ; Male* ; Nausea ; Ventricular Premature Complexes ; Vomiting

No abstract available.
Hedgehogs ; Tinea ; Trichophyton

To evaluate the influencing factors on pulmonary venous flow(PVF) pattern, we studied the relationship between PVF and left ventricular ejection fracton(EF), mitral annulus motion(MAM) and transmitral flow using pulsed doppler echocardiography in patients with dilated cardiomyopathy(DCMP), acute myocardioal infarction(AMI), left ventricular hypertrophy(LVH) and atrial fibrillation(AE). Ther results were as follows : 1) In the normal controls(13 cases), two forward flow during ventricular systole(VS) and diastole(VD) and one retrograde flow during atrial systole(AS) were observed. The peak velocity of VS, VD and AS flow was 45.9cm/s, 42.8cm/s and -18.3cm/sec, respectively. The peak VS/VD ratio was 1.1. 2) In patients with DCMP(11 cases), (a) compared to the noraml subjects, the peak velocity of VS flow and VS/VD ratio were were significantly reduced(p<0.005 and p<0.001, respectively) and were positively correlated with ejection fraction(r=0.8 and r=0.7, respectively) (b) in 2 DCMP cases with severe mitral regurgitation, systolic retrograde flow was observed in the pulmonary vein instead of forward VS flow. 3) In 12 AMI cases and 7 LVH cases with normal or slightly diminished left ventricular systolic function but with abnormal diastolic function. (a) the peak velocity of VS flow and peak VS/VD ratio were significantly increased(r<0.005 and p<0.01, respectively). (b) the peak velocity of VD flow is positively correlated with transmitral E/A ratio(r=0.8) and the peak VS/VD ratio was positively correlated with transmitral pressure half time(r=0.8). (c) the peak velocity of retrograde AS flow was significantly increased(p<0.001). (d) there was no correlation between doppler parameters of PVF and left ventricular ejection fraction. 4) In patients with atrial fibrillation(10 cases), VS flow was markedly diminished or absent and only VD flow was observed. Also, retrograde AS flow was not observed. These findings suggest that the pattern of PVF is influnced by LVEF, MAM, transmitral inflow and atrial contraction. However, main contributary factors in determining the pattern of PVF in each disease are diverse according to its main pathophysiology.
Deoxycytidine Monophosphate ; Echocardiography, Doppler, Pulsed ; Heart Diseases* ; Heart* ; Humans ; Mitral Valve Insufficiency ; Pulmonary Veins ; Stroke Volume

A oral inotropic agent, denopamine(TA-064, (-)-alpha-(3,4-dimethoxyphenethyl aminomethyl)-4-hydroxybenzylalcohol), was shown to have strong positive inotropic effect in experimental animals. To determine effects of denopamine on the left ventricular9LV) function and clinical features in patients with severe chronic heart failure who were treated with conventional regimens, denopamine(5mg 3 times per day for 4 weeks) was administered orally to 28 patients with chronic heart failure(22 dilated cariomyopathy, 6 ischemic heart disease) and systolic time interval, 2-D and Doppler echocardiognaphy were performed to evaluate LV function. Denopamine had no effect on LV dimension, volume and fractional shortening, and produced modest increase of ejection fraction and cardiac index, and modest decrease of PEP/LVET and cardiothoracic ratio in the cheat X-ray(PA view). The stroke volume was significantly increased (32.8+/-10.0 to 36.4+/-11.1 ml, p<0.05). Systolic BP was decreased (131.3+/-32.7 to 123.2+/-20.8 mmHg, p<0.05) with little change in diastolic BP and heart rate. Subjective symptoms and NYHA functional class were improved (71.4%, 67.9%, respectively). No adverse effect and ECG abnormality were noted. In conclusion, the addition of denopamine to conventional therapy improved clinical symptoms and caused modest increase of LV contractile function in patients with severe chronic heart failure without significant untoward effects. Therefore, the addinion of denopamine to conventional therapy may be an effective and safe method for the treatment of chronic congestive heart failure.
Animals ; Electrocardiography ; Heart Failure* ; Heart Rate ; Heart* ; Humans ; Stroke Volume ; Systole ; Ventricular Function, Left*

The effects and safety of using oral Nicardipine(NCP, Perdipine(R)) a calcium blocking agent of the dihydropyridine derivative, were assessed in 29 patients(14 males, 15 females, mean age 56.3 years) with essensed hypertension with complications of left ventricular hypertrophy and/or hypertensive retinopathy. The patients with a sitting blood pressure(BP) of more than 160/100mHg at 4th week while off all antihypertensive agents, were entered into the study and recieved NCP, 20mg tid for 2 weeks, BP being measured once every week. NCP significantly reduced. The systolic BP from 179.5+/-18.2mmHg to 143.4 +/-18.2mmHg, the diastolic BP from 112.9+/-16.2mmHg to 93.1+/-10.4mmHg and the mean BP from 135.2+/-11.7mmHg to 110.0+/-9.9mmHg(mean+/-S.D. of weekly BP for 4 weeks)(P<0.001). Fall in systolic, distolic and mean BP was 35.1+/-15.1mmHg, 20.0+/-8.3mmHg and 25.3+/-10.2mmHg, respectively. A fall in systolic BP of more than 20mmHg, in diastolic BP of more than 10mmHg and in mean BP of more than 13mmHg was obtained in 86.2%, 89.6% and 86.2% of the cases, respectively. The heart rate did not change with oral NCP. The side effects were headache, facial flushing, dizziness and palpitation, but they were tolerable. These finding suggest that NCP is an effective and safe drug for the treatment of sustained essential hypertension.
Antihypertensive Agents ; Calcium ; Dizziness ; Female ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Male ; Nicardipine*

BACKGROUND: The two most commonly used drugs as a stressor during wtress echocardiography are dipyridamole and dobutamine. The purpose of this study was to compare diagnostic accuracies of dipyridamole and dobutamine stress echocardiography for fixed coronary artery disease and evaluate complications related to the two agents in the same patients. METHODS: 30(M : 5=19 : 11, age=56+/-8.8yr) consecutive patients without history of previous myocardial infarction underwent coronary angiography, dipyridamole and dobutamine stress echocardiography in random order. Dipyridamole was infused up to 0.84mg/Kg for 10 minutes during clinical, ECG and echocardiographic montioring. Dobutamine was infused in dose increments from 5 to 40microg/Kg/min under the same condition. Positive criteria for myocardial ischemia by echocardiography was now regional wall mation abnormatity or worsening of regional wall motion after stress. Significant coronary disease was defined as more than 70% stenosis by coronary angiography. RESULTS: The sensitivity and specificity of both stress echocardiography were same, 82% and 92% respectively. In a single vessel disease the sensitivity of dipyridamole echocardiography was 75% and dobutamine echocardiography was 83% without statistical difference. The correlation of ischemic free time during both stress test was 0.375. During dipyridamole infusion no test was prematurely terminated because of side effects, but 3 patients(10%) developed severe hypertension and ventricular arrytricular arrythmia during dobutamine infusion and test was terminated. CONCLUSION: Thus, by this prospective direct comparison of both stress test, dipyridamole and dobutamine stress echocardiography have similar diagnostic accuracies for the detection of coronary artery disease. But during dobutamine infusion, careful monitoring for hemodynamic changes arrythmia is required for possible serious complications.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Sensitivity and Specificity