No abstract availble.
Glomerulonephritis* ; Prognosis*

In general, each increase of 20/10 mmHg (systolic to diastolic) blood pressure (BP) above 115 mmHg and 75 mmHg results in a two-fold increased risk for cardiovascular complications. In addition, cerebrovascular events in association with hypertension are more frequent than myocardial infarctions in Asian populations. To prove the correlation between cardiovascular events and hypertension observed in the observational studies, BP-lowering studies should be performed to demonstrate the preventive effect on cardiovascular events. However, no randomized clinical studies to date have been able to prove the preventative effects of BP lowering in the blood pressure around 140/90 mmHg or mild hypertension. Despite the fact that many guidelines, including Joint National Committee-7 guidelines, recommend BP lowering for those ranges of blood pressure. In recent years, there have been many contradictory hypotheses about the asymmetry between the results from observational studies and clinical trials, which have led to the establishment of representative studies to set new target BPs. Such studies have proven the benefits of BP lowering closer to optimal blood pressure. Therefore, a discussion about applying these findings to patient care is needed.
Antihypertensive Agents ; Asian Continental Ancestry Group ; Blood Pressure* ; Humans ; Hypertension ; Joints ; Myocardial Infarction ; Patient Care ; Risk Assessment

No abstract available.
Circadian Rhythm ; Myocardial Infarction ; Prognosis

No abstract available.
Beauty ; Dihydropyridines ; Nitrophenols ; Organophosphorus Compounds

BACKGROUND: Unexpected and uncontrolled bleeding remains the principal fear of the surgeon performing transurethral resection of prostate (TURP). Many surgeons and anesthesiologists believe the spinal anesthesia reduces blood loss during TURP. This study evaluate the effects of spinal versus general anesthetic technique on the development of postoperative coagulopathies. METHODS: 20 patients undergoing TURP were randomly allocated into 2 groups. Group I (n=10) received general anesthesia and group II (n=10), spinal anesthesia. PT (prothrombin time), PTT (partial thromboplstin time), Hb (hemoglobin), FDP (fibrin degradation product), platelet and fibrinogen were measured before induction and 24 hours postoperatively. RESULTS: There was no significant difference in measured coagulation variables between the two groups, but there was significant decrease in postoperative Hb compared to preoperative values in both groups and the effect was more pronounced in the general anesthesia than in the spinal anethesia group. CONCLUSION: It is concluded that coagulopathies after TURP is not affected by the anesthetic technique.
Anesthesia, General* ; Anesthesia, Spinal ; Blood Platelets ; Fibrinogen ; Hemorrhage ; Humans ; Transurethral Resection of Prostate*

Sleep apnea syndrome (SAS) has known to be associated with obesity, hypoxemia, sympathetic activation, and hypertension. In addition, SAS is associated with various mechanisms involved in cardiovascular diseases, such as oxidative stress, dyslipidemia, smoking, and psychological stress. In recent prospective observation studies, SAS is known to be a risk factor for cardiovascular diseases, i.e., heart failure, stroke, and coronary artery diseases. The association with heart failure was most evident. In some participants in the longitudinal study applied with continuous positive airway pressure (CPAP) treatment, SAS was not associated with prognosis. With the viewpoints in the current standard of cardiovascular medicine, there seems to be few evidence showing that CPAP treatment could prevent or improve cardiovascular outcome. Detailed review of the limitations of the prospective observational studies suggests that more sophisticated measurement of the clinical outcomes and adjustment of confounding factors will be required in the future studies. And for the clinical application, more evidence of CPAP treatment on the cardiovascular outcomes are mandatory.
Anoxia ; Cardiovascular Diseases* ; Continuous Positive Airway Pressure ; Coronary Artery Disease ; Dyslipidemias ; Heart Failure ; Hypertension ; Longitudinal Studies ; Myocardial Infarction ; Obesity ; Oxidative Stress ; Prognosis ; Risk Factors ; Sleep Apnea Syndromes* ; Smoke ; Smoking ; Stress, Psychological ; Stroke

Leaving behind substantial reflections or skepticisms on the shortage of evidences about blood pressure (BP) thresholds for antihypertensive drug therapy and target BPs, major hypertensive guidelines including Korean hypertension guidelines were recently updated for earlier and more intensive control of BP. Because hypertension is one of the major risk factors for death, stroke, cardiovascular (CV) disease, heart failure, and cognitive impairment, substantial improvement of hypertension management is necessary to reduce disease and socioeconomic burdens and to promote CV health. Theoretically, earlier intervention in terms of age and BP level and thorough control of BP into within normal range would prevent or delay major adverse CV events. Revised hypertension guidelines were developed by the American College of Cardiology/American Heart Association, Korean Society of Hypertension, European Society of Cardiology/European Society of Hypertension, and Japanese Society of Hypertension in order. In this article, recent updates and clinical significances of the Korean hypertension guidelines will be discussed with comparison of foreign hypertension guidelines and considerable changes in the management of hypertension will be introduced for cardiologists and general practitioners.

A role of angiotensin-converting enzyme 2 (ACE2) in the coronavirus disease 2019 pandemic has been suggested, because it is the molecular receptor for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2). ACE2 is known to provide a protective effect for cardiac and vascular tissues, because it generally counteracts angiotensin II (Ang II) activity. ACE2 downregulation has been implicated in the pathogenesis of cardiovascular disease. ACE inhibitors and angiotensin receptor blockers may enhance ACE2 mRNA expression and enzyme activity. However, this has not been demonstrated in lung tissue. In the lungs, Ang II induces vasoconstriction to prevent ventilation perfusion mismatch, while also increasing vascular permeability (which can precipitate pulmonary edema). ACE2 is expressed in 0.67% of human lung cells, 80% of which are type 2 alveolar cells. Men (of all ethnicities) and Asian individuals have been shown to express higher levels of ACE2 than women and non-Asian individuals, respectively. However, there are no data from human studies indicating that high ACE2 expression increases the likelihood of SARS-CoV2 infection. In animal studies, an increase in Ang II caused by SARS-CoV2 or spike protein interactions, in turn due to ACE2 downregulation, has been identified as the key mechanism underlying lung injury. In human studies of SARS-CoV2 infection, ACE2 overexpression was shown to cause inflammatory apoptosis and a cytokine storm. The actions of ACE2 and Ang II in SARS-CoV2-infected vascular and lung tissues differ between animals and humans. ACE2 expression levels pre- and post-SARS-CoV2 infection should be differentiated.

Purpose: We investigated the changes in ocular deviation after the monocular occlusion test in adults with intermittent exotropia and evaluated its association with the level of control. Methods: We retrospectively enrolled adults (aged ≥18 years) with intermittent exotropia who visited our clinic between September 2015 and May 2019. Patients with basic intermittent exotropia with a distant deviation within 10 prism diopters (PD) of the near deviation were included. The largest ocular deviations obtained before and after 1 hour of monocular occlusion were compared. The level of control was measured using the LACTOSE (Look and Cover, then Ten seconds of Observation Scale for Exotropia) control scoring system. Results: Forty-six consecutive adult patients (28 males, 18 females; mean age, 34.3 years) were enrolled. The mean ocular deviation was 36.3 PD (range, 18 to 5 PD) at distant fixation and 38.5 PD (range, 18 to 80 PD) at near fixation, which increased significantly to 38.5 PD (p = 0.043) and 41.1 PD (p = 0.011), respectively, after monocular occlusion. The mean ocular deviation increased ≥5 PD in 14 (30.4%) and 15 (32.6%) patients at distant and near fixation, respectively. The level of control was measured in 30 patients. A higher degree of near control was significantly associated with an increase of ≥5 PD in near fixation after the test (p = 0.009 for a near control score ≤2). Conclusions The monocular occlusion test may help to determine the largest ocular deviation in adults with intermittent exotropia. Approximately one-third of patients exhibited an increase in ocular deviation ≥5 PD. Patients exhibiting good control were more likely to manifest an increase in the ocular deviation.