No abstract available.

In order to define the relation between echocardiographically determined left atrial size and atrial fibrillation(AF) in rheumatic mitral valvular heart disease, 44 patients with mitral valvular heart disease with AF, 29 patients with mitral valvular heart disease without AF, 24 patients with idiopathic AF and 24 normal controls were studied. In mitral valvular heart disease with AF group, AF was more common when the absolute left atrial internal diameter(LAID) was above 50 mm(86.4%) than in mitral valvular heart disease without AF group(41.4%). In addition, although the values of LAID, LA(left atrium)/Aortic Root ratio and LA/BSA(body surface area) are higher in mitral valvular heart disease with AF group than in mitral valvular heart disease without AF group(p<0.05), there was no correlation between LAID and BSA(r=0.06). These findings suggest that an absolute value of LAID is a more important factor in the development of AF in mitral valvular heart disease than LAID considered in conjunction with BSA and that an absolute LAID of 50 mm may be used as a reliable guide to therapeutic and prophylactic intervention in AF associated with mitral valular heart disease.
Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans

BACKGROUND: To describe the fast experience of case-leased advanced cardiac life support(ACLC) course in Korea. METHODS: We have given case-based ACLC course to 13 nurses(6 emergency nurses, 4 coronary care unit muses, 3 professors) and 17 physicians(4 emergency physicians, 12 emergency residents, 1 intem). We performed the case-based ACLS course according to 1992 American Heart Association guidelines and recommendations for advanced cardiac life support by american ACLS instructors(1 pulmonologist, 4 critical care nurses). We performed final theoretical written test and 2 times written survey (immediate and 100th day after the course) about the course. RESULTS: On final written test, all practitioners answered at leasts 70% of the questions correctly. There was no significant difference between nurses and physicians(86.2+/-3.6 of physicians and 82.5+/-6.8 of nurses, p=0.06). 90%of participants considered that case-based advanced cardiac life support was acceptable. 100th day after the course, 93%of participants answered that ACLS course have been helpful on his/her job and also want retraining of ACLS course. 70%of participants considered that ideal ACLS training committee in Korea is the Korean Society of Emergency Medicine. CONCLUSION: Case-based ACLS course is a useful educational method far physicians and nurses in Korea. In the future, we should organize Korean resuscitation committee and then make guidelines for ACLS, and then continuously educate physicians and nurses.
Adult* ; Advanced Cardiac Life Support ; Alprostadil ; American Heart Association ; Coronary Care Units ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Korea* ; Resuscitation

Tibric acid is a new oral hypolipidemic agent with the chemical name of 2-chloro-5(3,5-dimethyl piperidinosulfonyl) benzoic acid. The results of tibric acid administration in 22 patients with primary hyperlipidemia were as follows. 1) Serum triglyceride level was significantly decreased in 84.6% of 22 cases with an average 43.9% decrease in serum triglyceride. 2) Serum cholesterol level was decreased in 59.1% of 22 cases with an average 15.8% decrease in serum cholesterol. The decrease in serum cholesterol level was not significant. 3) It seemed that there were significant falls in the serum triglyceride of the hyperlipoproteinemia type IV and IIb patietns and in the serum cholesterol of type IIa patients 4) The side effects of tibric acid were indigestion, loose stool and anorexia. There was no side effects in 63.6% of cases.
Anorexia ; Benzoic Acid ; Cholesterol ; Dyspepsia ; Humans ; Hyperlipidemias* ; Hyperlipoproteinemia Type IV ; Triglycerides

The results of alpha-acetyldigoxin(Dioxanin(R)) administration in 21 patients with congestive heart failure were as follows. Alpha-acetyldigoxin is a new oral preparation of cardiac glycoside derived from lanatosid C. 1. For rapid digitalization in 2-3 days, the initial dose was 1.2 to 2.6mg (average 1.96mg). For medium-fast digitalization in 4 days, the loading dose was 2.0 to 3.2mg (average 2.7mg). For slow digitalization 0.1 to 0.4mg was required for 5 to 6 days without loading dose. The maintenance dose was 0.1 to 0.4mg (average 0.33mg) daily. 2. The therapeutic effect of acetyldigoxin was excellent in 15 cases (71%), good in 4 cases (20%) and stationary in 2 cases (9%). 3. Side effects were observed in 2 cases with usual dosage regimen. One accidental case who took single dose of 4mg(20 tablests) developed supraventricular tachycardia with varying degree of atrioventricular block, ventricular bigeminy and premature beat but recovered completely after 6 days.
Acetyldigoxins* ; Atrioventricular Block ; Cardiac Complexes, Premature ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Tachycardia, Supraventricular

Two cases of acute digitalis poisoning were presented. The first patient was 20-year-old male with asymptomatic ventricular septal defect (maladie de Roger) who attempted suicide by ingestion of degitalis leaf about 6.0 g (60 tablets). He developed severe epigastric pain and vomiting one hour after ingestion. Syncopal attack was developed once for a few minutes and recovered. Electrocardiogram revealed 2:1 A-V block. By conservative management he was recovered. The second patient was 2-year-old, healthy baby who ingested digoxin about 2.5 mg(10 tablets) by accident. He developed severe vomiting and electrocardiogram revealed 1degrees, 2degreesand 3degrees A-V block in series. He was recovered by conservative management without sequele.
Child, Preschool ; Digitalis* ; Digoxin ; Eating ; Electrocardiography ; Heart Septal Defects, Ventricular ; Humans ; Male ; Poisoning* ; Suicide, Attempted ; Vomiting ; Young Adult

The history of muscle relaxants is fascinating, and their use for clinical applications has been accepted. Depolarizing drugs can produce a non-depolarizing type of neuromuscular block. Decamethonium produces a nondepolarizing block in the isolated rabbit lumbrical muscle. Electromyographic studies of the hand muscles in man have demonstrated that a dual block will be produced with doses of succinylcholine varying from 500 to 1,500 mg (initially a delpolarizing block and subsequently a non-depolarizing block exists). The common peroneal nerve in the rabbit knee was stimulated by a "train of four" method (Ali et al) repeated intermittently. The muscle response with the "train of four" method to intravenous succinylcholine chloride (1 mg/kg) in the rabbit was recorded and analysed after a single injection and repeated intravenous injections of succinylcholine chloride 1 mg/kg. Result were as follows: 1) Time after the "train of four" to depression of muscle twiteh of 25, 50, 75 & 100% was 128. 2, 135. 3, 142. 8 and 159 seconds respectively. 2) Recovery index of a single intravenous injection of succinylcholine chloride 1 mg/kg was observed as 3 minutes and 14 seconds. 3) A depolarizing form of "train of four" response to the first succinylcholine chloride injection 1 mg/kg was observed and, a non-depolarizing form of "train of four" response to the second dose of succinylcholine chloride 1 mg/kg was observed definitely.
Depression ; Hand ; Injections, Intravenous ; Knee ; Methods ; Muscles ; Neuromuscular Blockade ; Peroneal Nerve ; Rabbits* ; Succinylcholine

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

OBJECTIVES: Panic disorder is a chronic condition that may carry significant negative impact on the quality of life in patients. However, the association between quality of life in panic patients and their clinical characteristics has not been investigated. Aim of this study is to compare quality of life in panic patients and healthy controls by using WHO Quality of Life(QOL) Scale that evaluates the domains of physical health, psychological health, social relationship and environment. Additionally, relationship between clinical factors in patients with panic disorders and their quality of life were explored. METHOD: 64 patients with panic disorder and 27 healthy controls were recruited in this study and WHO QOL Scales were completed. Total scores and scores of domains of WHO QOL Scale in two groups were compared. Correlation analysis and multiple regression analysis were performed to examine the relationship between quality of life and the clinical characteristics in patients with panic disorder. RESULTS: Total scores and scores of all domains except environmental domain of WHO QOL scale in patients with panic disorder were decreased compared to those in healthy controls. Clinical characteristics including the severity of agoraphobia and depression, number of symptoms during panic attacks and the frequency of panic attacks showed significant correlation with quality of life in general and most of subscales of QOL. Multiple regression revealed that the severity of depression, the number of symptoms during panic attacks and the severity of agoraphobia in the presence of accompanied persons were factors directly affecting the quality of life in the patients with panic disorder. CONCLUSION: Quality of life in patients with panic disorder was poorer than that of healthy controls. The severity of depression, the number of symptoms during panic attacks and the severity of agoraphobia in the presence of accompany were related to the quality of life in the patients with panic disorder.
Agoraphobia ; Depression ; Humans ; Panic Disorder* ; Panic* ; Quality of Life* ; Weights and Measures

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*