No abstract available.
Epinephrine* ; Facial Nerve* ; Paralysis* ; Rabbits*

Echocardiographic right ventricular systolic time invervals were measured in 69 cases of congenital and acquired valvular heart disease, who have neither arrhythmia nor conduction disturbances. The results were as follows: 1) Right ventricular preejection periord(RVPEP) relates with main pulmonary arterial systolic pressure (MPA(s)), main pulmonary arterial diastolic pressure (MPA(d)), main pulmonary arterial mean pressure (MPA(m)), pulmonary vascular resistance (Rp), and the ratio of pulmonary systemic vascular resistance (Rp/Rs) (r=0.746, 0.738, 0.755, 0.721, 0.687). 2) Rifht ventricular ejection time relates with MPA (s), MPA (d), MPA (m), Rp, and Rp/Rs (r=-0.580, -0.541, -0.544, -0.577, -0.420). 3) The ratio of right ventricular preejection period-right ventricular ejection time (RVPEP/RVET) relates with MPA (s), MPA (d), MPA (m), Rp and Rp/Rs (r=0.789, 0.784, 0.781, 0.778, 0.695). 4) Pulmonary hypertension and increased pulmonary vascular resistance can be predicted, when RVPEP/RVET is over 0.3. 5) By serial preoperative and postoperative measurements, pulmonary hypertension and increased pulmonary vascular resistance were relieved in the cases of mitral stenosis. But in the cases of congenital heart diseas there were no significant change in RVPEP/RVET ratio.
Adult* ; Arrhythmias, Cardiac ; Blood Pressure ; Echocardiography* ; Heart ; Heart Valve Diseases ; Humans ; Hypertension, Pulmonary ; Mitral Valve Stenosis ; Systole* ; Vascular Resistance

Clinical EPS was performed in 16 normal adults without evidence of conduction disease on the surface standard 12 lead electrocardiogram in order to provide normal electrophysiological values of the sinus node function and AV conduction. EPS was also performed in 15 patients with sick sinus syndrome and 10 patients with AV conduction disturbance to evaluate the clinical usefulness of EPS in detecting sinus node dysfunction and AV conduction disturbance. The results were as follows. 1) The results of sinus node function test in the normal group were m-SNRT 853+/-198msec(range 800-1,560msec), c-SNRT 230+/-66msec(range 120-370msec), and %m -SNRT/SCL 127+/-11%(range 114-149%). 2) In 15 patients with SSS, the M-SNRT were ranged from 1,270 to 12,330msec and 10 patients(66%) had significantly increased m-SNRT exceeding 1,560msec. The c-SNRT were ranged from 230 to 10,730msec and 13 patients(83%) had significantly increased c-SNRT exceeding 370msec. The % m-SNRT/SCL were ranged from 136 to 770% and 12 patients(80%) had significantly increased % m-SNRT/SCL exceeding 150%. 3) The SACT in normal group were 84+/-14msec(range 70-105msec) measured by continuous atrial pacing method and 80+/-19 msec(range 60-115msec) measured by atrial extrastimulation method. 4) In SSS, the SACT measured by continuous atrial pacing method was ranged from 80 to 1,050msec and 11/12 patients(92%) had significantly increased SACT exceeding 112 msec. The SACT measured by atrial extrastimulation method was ranged from 90 to 310msec and 7/8 patients(88%) had significantly increased SACT exceeding 118 msec. 5) C-SNRT, % m-SNRT/SCL, and SACT were more useful in detecting sinus node dysfunction than m-SNRT. 6) The AV conduction intervals in normal group were PA interval 17+/-6(range 5-25msec), AH interval 96+/-18 msec(range 70-135msec), and HV interval 46+/-7msec(range 35-55msec). 7) Rapid atrial pacing induced Wenckebach type second degree AV block proximal to H at pacing rate of 90 to 190/min in 14/16 normal adults. 2 patients maintained intact AV conduction upto maximum pacing rate of 200/min. 8) His bundle electrogram showed the site of AV block in 9 of 10 patients with AV conduction disturbances. The sites of AV block were AV nodal area 1 case, intraHis bundle 4 cases, and infraHis bundle 4 cases. 9) EPS provided a good supportive information that was useful in selecting pacemaker therapy in a patient with chronic bifascicular block who revealed prolonged HV interval and infraHis bundle block at a pacing rate of 70min. 10) The refractory periods of AV conduction system in normal group were AERP 274+/-54msec (range 170-410msec), AVN-FRp 467+/-74msec(range 285-600msec), AVN-ERP 341+76msec(range 190-460), and V-ERP 280+/-25msec(range 240-320msec).
Adult ; Atrioventricular Block ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Humans ; Sick Sinus Syndrome ; Sinoatrial Node*

No abstract available.
Head* ; Neck* ; Neurilemmoma*

BACKGROUND: Eleven percent of severe hemophilia A patients and 5% of severe hemophilia B patients may develop inhibitors. We have conducted aPCC-based maintenance therapy for hemophilia patients with high levels of responding inhibitors and we analyzed the efficacy, safety, the factor consumption and the expense of this treatment, as compared to on-demand therapy. METHODS: Eleven hemophilia patients with high levels of responding inhibitors were eligible for the study. We tried to evaluate the longitudinal bleeding episodes, the inhibitor titers, the X-ray findings, the adverse events and the factor consumption between on-demand therapy and maintenance therapy. The bypassing agent in this study was aPCC having a longer half-life. The dosage was 30~50 U/kg, 3 times a week. RESULTS: The mean follow-up period was 6.8 months for on-demand therapy and 10.6 months for maintenance therapy. The mean dosage of aPCC was 45.2 U/kg. The episodes of hemarthrosis decreased by 61.4% (P=0.003) and other significant bleedings decreased by 45.2% (P=0.109). The inhibitor titers decreased in 7 patients and these increased in 4 patients, but anamnesis took place in only 1 patient. Radiologically, 2 patients improved, 1 patient got worse and 7 patients were stable. Neither adverse signs nor symptoms were noticed. The mean factor consumption changed from 55.8x10(3) U for aPCC and 48.6 mg for rFVIIa on-demand therapy to 216x10(3) U for aPCC and 4.8 mg rFVIIa for maintenance therapy. Maintenance therapy cost 67% more than on-demand therapy monthly (P=0.041). CONCLUSION: aPCC-based maintenance therapy for hemophilia patients with high responding inhibitors cost 67% more than on-demand therapy, but it reduced by 61.4% the episodes of hemarthrosis and 45.2% of the other significant bleedings. aPCC-based maintenance therapy can very effectively reduce the bleeding episodes of hemophilia patients with high levels of responding inhibitors.
Factor VIIa ; Follow-Up Studies ; Half-Life ; Hemarthrosis ; Hemophilia A ; Hemophilia B ; Hemorrhage ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Prothrombin ; Recombinant Proteins

No abstract available.
Chylothorax*

The antihypertensive effects of tripamide was studied in 19 cases of essential hypertension. After 4 weeks treatment with daily dosage of Tripamide (Normonal(R)) 15mg, the dosage was adjusted to 30mg in 10 cases. Before and after treatment laboratory tests were performed in 11 cases. The obtained results were as follows: 1) After 4 weeks treatment with daily dosage of Tripamide 15mg, mean systolic and diastolic blood pressure was decreased by 25 mmHg (12.7%) and 9.7 mmHg (8.5%) respectively(p<0.01), and in 58% of the cases, good or fair control of blood pressure was resulted. 2) After final treatment, mean systolic and diastolic blood pressure was decreased by 29.7 mmHg(15.1%) and 15.0 mmHg(120.5%) respectively(p<0.005) and in 79% of the cases, good or fair control of blood pressure was resulted. 3) There was no significant changes in the values of sodium, potassium, BUN, creatinine, uric acid, cholesterol, SGOT, SGPT and calcium after treatment. 4) There was no significant side effect except one case of mild fatigue and tingling sense of extrmities which were subsided spontaneousely.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Calcium ; Cholesterol ; Creatinine ; Fatigue ; Hypertension ; Potassium ; Sodium ; Uric Acid

The antihypertensive effect of acebutolol was observed in 26 cases of essential hypertension, and following results were obtained. 1) Mean decrease in systolic and diastolic blood pressure by oral acebutolol was 21mmHg and 11mmHg. The results of antihypertensive therapy revealed good control in 30.8%, fair control in 34.6%, poor in 11.5% and failure in 23.1% of the cases. In 65.4% of the cases, good or fair control of hypertension which means drop of diastolic pressure to the level of less than 100mmHg was observed. 2) Mean drop in heart rate was 7/min. 3) Average daily dose was 508+/-171.9mg. 4) The side effect of oral acebutolol was mild gastrointestinal discomfort in two cases.
Acebutolol* ; Blood Pressure ; Heart Rate ; Hypertension

The antihypertensive effect of acebutolol was observed in 26 cases of essential hypertension, and following results were obtained. 1) Mean decrease in systolic and diastolic blood pressure by oral acebutolol was 21mmHg and 11mmHg. The results of antihypertensive therapy revealed good control in 30.8%, fair control in 34.6%, poor in 11.5% and failure in 23.1% of the cases. In 65.4% of the cases, good or fair control of hypertension which means drop of diastolic pressure to the level of less than 100mmHg was observed. 2) Mean drop in heart rate was 7/min. 3) Average daily dose was 508+/-171.9mg. 4) The side effect of oral acebutolol was mild gastrointestinal discomfort in two cases.
Acebutolol* ; Blood Pressure ; Heart Rate ; Hypertension

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