Objectives:Primary pulmonary hypertension (PPH) that affects predominantly young and productive people is a progressive fatal disease of unknown cause. The objectives of this study were to characterize mortality in patients with PPH and to investigate the factors associated with their survival.Methods:Thirteen patients with PPH were enrolled between 1988 and 1996 and followed-up through July 1999. Measurements at diagnosis included hemodynamic and pulmonary function variables in addition to information on demographic data and medical history.Results:1) The mean age of the patients with PPH enrolled into the study was 36.1 ± 9.3 years with female predominance. 2) The estimated median survival was 3.4 ± 0.6 years. 3) Decreased cardiac index was the only significant predictor of mortality (Cox proportional hazards model).Conclusion:Patients with PPH have a poor survival expectancy. In this limited study with a small number of patients, mortality is largely associated with decreased cardiac index.

Background and Objectives: Drug-eluting stents (DES) have been used worldwide for conducting safe and effective percutaneous coronary intervention (PCI) for treating coronary artery disease. However, the DES might cause a higher frequency of an acute side branch occlusion or stent jails near the target lesion after PCI than that with using bare metal stents (BMS). This may be due to the eluted drug or the thick stent struts. We evaluated the clinical and angiographic outcomes of compromised side branches (stent jail) after PCI and the frequency of side branch occlusion or stent jails between sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES). Subjects and Methods: We analyzed the clinical results and angiographic findings of 47 patients who were treated with a SES and 45 patients who were treated with a PES. We only analyzed the left anterior descending artery (LAD) and its side branches that were more than one millimeter in diameter. Side branch occlusion was defined as the development of total occlusion or a reduction of the thrombolysis in myocardial infarction (TIMI) flow more than grade 1 after stenting. The peak cardiac enzyme levels were measured. We evaluated the clinical outcomes in the hospital and at the 6 month follow up. Results: There were no significant differences of the baseline clinical demographics between the SES and the PES groups. The total length and diameter of the implanted stents were 42.85±15.3 mm vs. 41.68±13.3 mm (p=0.93) and 3.09±0.3 mm vs. 3.1±0.2 mm (p=0.69) in the SES group and PES group, respectively. On average, the number of side branches of the LAD were 2.00±0.9 vs. 2.13±0.8 and on angiography after stenting, side branch occlusion and reduction of the TIMI developed in 8.51% vs. 13.33% (p=0.46) and 17% vs. 15% (p=0.88) of the SES group and PES group, respectively. The laboratory data showed that the peak creatine kinase-MB (CK-MB) and troponin-I levels were 13.5±31 U/L vs. 15.6±33 U/L (p=0.77) and 6.3±15 ng/mL vs. 5.42±9 ng/mL (p=0.77), respectively. There were no clinical in-hospital events for either group. There were no statistically significant differences in major adverse cardiac events (MACEs) at the 6-month follow up (4.3% vs. 8.9%, respectively). Conclusion: The clinical and angiographic outcomes of compromised side branches (stent jail) after PCI and the frequency of side branch occlusion or stent jails between SES and PES were similar. (Korean Circ J 2007;37: [630][631][632][633][634]

Background and Objectives：Since echocardiography became a routine diagnostic tool, pericardial effusion has become a common clinical finding. The major causes of hemorrhagic pericardial effusion are malignancy and tuberculosis. However, it was unknown to the use of biochemical analysis of pericardial fluid and serum, for differentiation of malignancy from tuberculosis. To evaluate this, we investigated the biochemical analysis of pericardial fluid and serum in relation to the causes of pericardial tamponade. Subjects and Methods：46 patients who were admitted to Pusan National University Hospital from January 1, 1995, to April 30, 2002, and underwent both a pericardiocentesis and a pericardiostomy for the relif of cardiac tamponade, were included in this study. the pericardial fluid was routinely analyzed for the following：gross appearance, cell count, glucose, total protein (TP), lactate dehydrogenase (LDH), cytology, gram stain, cultures for bacteria and mycobacterium, pericardial fluid to serum ratios of total protein and lactate dehydrogenase, (p/s TP, p/s LDH, respectively). Results：Of the 46 patients who underwent both pericardiocentesis and pericardiostomy, for the relief of cardiac tamponade, 33 patients (71.7%) had hemorrhagic pericardial effusion. The common causes of hemorrhagic pericardial effusion were malignancy (51.5%) and tuberculosis (33.3%) but, those of nonhemorrhagic pericardial effusion were idiopathic (38.5%). Cell counts were higher in hemorrhagic than nonhemorrhagic group (p=0.029). Serum LDH (sLDH) was higher in malignant than tuberculous group (p=0.001) but, serum total protein (sTP) was higher in tuberculous group (p=0.004). Compared malignant group with tuberculosis group in patients with hemorrhagic pericardial effusion, p/s ratio of LDH and sTP were higher in tuberculous group (p=0.029, p=0.017), but sLDH was higher in malignant group (p=0.002). Conclusion：It is difficult to differentiate tuberculosis from malignancy only on the basis of the biochemical analysis of pericardial fluid in hemorrhagic pericardial effusion. However, the analysis of both pericardial fluid and serum may make it possible to evaluate the cause of pericardial effusion. (Korean Circulation J 2003 ; 33 (3) : 227-232)

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Background Inappropriate sinus tachycardia IST manifests chronic nonparoxysmal sinus tachycardia in healthy individuals and is characterized by consistently elevated heart rate and exaggerated responses to minimal physical activity. Heart rate variability HRV using 24-hour Holter monitoring represents one of the methods of evaluating the harmony of autonomic nervous system activity. So, authors investigate the autonomic nervous system activity by the HRV in patients with IST. Methods We compared the pattern of cardiac sympathetic and parasympathetic activity through the time domain analysis of heart rate variability with 24-hour Holter monitoring between 23 patients with IST and 23 healthy control subjects. None of the patients had organic heart disease as determined by routine laboratory examination and echocardiography. And then, time domain measures mean NN, SDNN, SDANN, SD, rMSSD, pNN50 were analyzed. Results The mean age of patients and control were 38 10 and 37 9 years, respectively p NS . The mean clinical heart rate of patients and control was 104 5/min and 72 5/min, respectively p 0.05 . Among the time domain indices, mean of all normal RR intervals mean NN , standard deviation of all normal RR intervals SDNN , standard deviation of mean RR interval SDANN , mean of standard deviations of all normal RR intervals SD , root mean square successive differences between adjacent normal RR intervals rMSSD , and percent of difference between adjacent normal RR intervals pNN50 in the patient group were significantly shorter compared to control group p 0.01 . Conclusion In IST, cardiac vagal influence on the heart rate is blunted. Korean Circulation J 2000 ; 30 9 : 1133-1138