Although a variety of agents have been introduced for the treatment of hypertension, the ideal drug has not yet been discovered. However, among the agents available, prazosin hydrochloride (Minipress(R)) appears to be accepted by the majority of physicians as it lowers blood pressure effectively with relatively low incidence of side effects. It has been considered that the hypotensive effect of prazosin is a result of peripheral vasodilation due to direct relaxation of vascular smooth muscle and blockade of alpha-adrenergic receptors in the arteriolar smooth muscle. Following the development of prazosin. many trials have been designed to potentiate its hypotensive effect by the combination with other agent, especially thiazide or beta blocker. Minizide(R), a preparation that thiazide is added to prazosin, is an example. The antihypertensive effect of Minizide(R) was evaluated in 30 hypertensive subjecs. The results were as follows; 1. The systolic and diastolic blood pressure were effectively lowered in both supine and standing position with the overall response rate of 86.7% as judged to be responsive in one that lost systolic pressure more than 15 mmHg and distolic pressure 10 mmhg. Among 30 cases 18 cases could be maintained with their diastolic pressure below 90 mmHg and 24 cases with their diastolic pressure below 100 mmHg by the end of 8th week of treatment with the daily dose of minizide(R) from a half tablet to two tablets. 2. During the period of 8 weeks, troublesome postural hypotension was not observed in any case. The pulse rate was not accelerated significantly by Minizide(R) treatment. 3. Minimal side effects were recorded in 5 cases; two of mild nausea, one of slight dizziness, one of minimal gastrointestinal irritation symptom and one of mild glucosuria. neither of them hindered the authors from finding the study.
Blood Pressure ; Dizziness ; Heart Rate ; Hypertension ; Hypotension, Orthostatic ; Incidence ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Nausea ; Prazosin ; Receptors, Adrenergic, alpha ; Relaxation ; Tablets ; Vasodilation

Although a variety of agents have been introduced for the treatment of hypertension, the ideal drug has not yet been discovered. However, among the agents available, prazosin hydrochloride (Minipress(R)) appears to be accepted by the majority of physicians as it lowers blood pressure effectively with relatively low incidence of side effects. It has been considered that the hypotensive effect of prazosin is a result of peripheral vasodilation due to direct relaxation of vascular smooth muscle and blockade of alpha-adrenergic receptors in the arteriolar smooth muscle. Following the development of prazosin. many trials have been designed to potentiate its hypotensive effect by the combination with other agent, especially thiazide or beta blocker. Minizide(R), a preparation that thiazide is added to prazosin, is an example. The antihypertensive effect of Minizide(R) was evaluated in 30 hypertensive subjecs. The results were as follows; 1. The systolic and diastolic blood pressure were effectively lowered in both supine and standing position with the overall response rate of 86.7% as judged to be responsive in one that lost systolic pressure more than 15 mmHg and distolic pressure 10 mmhg. Among 30 cases 18 cases could be maintained with their diastolic pressure below 90 mmHg and 24 cases with their diastolic pressure below 100 mmHg by the end of 8th week of treatment with the daily dose of minizide(R) from a half tablet to two tablets. 2. During the period of 8 weeks, troublesome postural hypotension was not observed in any case. The pulse rate was not accelerated significantly by Minizide(R) treatment. 3. Minimal side effects were recorded in 5 cases; two of mild nausea, one of slight dizziness, one of minimal gastrointestinal irritation symptom and one of mild glucosuria. neither of them hindered the authors from finding the study.
Blood Pressure ; Dizziness ; Heart Rate ; Hypertension ; Hypotension, Orthostatic ; Incidence ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Nausea ; Prazosin ; Receptors, Adrenergic, alpha ; Relaxation ; Tablets ; Vasodilation

The investigation of systolic time intervals and hemodynamics was performed in 42 patients with liver cirrhosis by noninvascive methods. The patients were divided into four groups according to the presence or absence of anemia and/or ascites: i.e. group I; cirrhosis without anemia and ascites, group II; cirrhosis with ascites only, group III; cirrhosis with anemia only, and group IV; cirrhosis with ascites and anemia. In the resting state of the patients, the systolic time intervals and hemodynamic data were measured by the high speed simultaneous recordings of electrocardiogram, phonocardiogram, carotid and femoral arterial pulse tracings, and compared with those obtained from 155 normal adult subjects. 1. The pulse were increased considerably in group IV, and diastolic blood pressure was elevated in group II with significance. 2. The stroke volume and cardiac output were increased significantly in group III. 3. The peripheral resistance was reduced particularly in group III, and the volume elasticit coefficient was decreased in group IV. 4. The QS1 interval was prolonged significantly in group II and IV, but QS1 interval corrected by multiple regression equation proposed by our laboratory (illustrated in the text) did not show significant difference compared with that of normal subjects. 5. The left ventricular ejection time(LVET) and total electromechanical systole(QS 2) appeared to be shortened in group II and IV, but the corrected LVET and QS 2 were not different significantly from those of the normal subjects
Adult ; Anemia ; Ascites ; Blood Pressure ; Cardiac Output ; Electrocardiography ; Fibrosis ; Hemodynamics* ; Humans ; Liver Cirrhosis* ; Liver* ; Stroke Volume ; Systole ; Vascular Resistance

The investigation of systolic time intervals and hemodynamics was performed in 42 patients with liver cirrhosis by noninvascive methods. The patients were divided into four groups according to the presence or absence of anemia and/or ascites: i.e. group I; cirrhosis without anemia and ascites, group II; cirrhosis with ascites only, group III; cirrhosis with anemia only, and group IV; cirrhosis with ascites and anemia. In the resting state of the patients, the systolic time intervals and hemodynamic data were measured by the high speed simultaneous recordings of electrocardiogram, phonocardiogram, carotid and femoral arterial pulse tracings, and compared with those obtained from 155 normal adult subjects. 1. The pulse were increased considerably in group IV, and diastolic blood pressure was elevated in group II with significance. 2. The stroke volume and cardiac output were increased significantly in group III. 3. The peripheral resistance was reduced particularly in group III, and the volume elasticit coefficient was decreased in group IV. 4. The QS1 interval was prolonged significantly in group II and IV, but QS1 interval corrected by multiple regression equation proposed by our laboratory (illustrated in the text) did not show significant difference compared with that of normal subjects. 5. The left ventricular ejection time(LVET) and total electromechanical systole(QS 2) appeared to be shortened in group II and IV, but the corrected LVET and QS 2 were not different significantly from those of the normal subjects
Adult ; Anemia ; Ascites ; Blood Pressure ; Cardiac Output ; Electrocardiography ; Fibrosis ; Hemodynamics* ; Humans ; Liver Cirrhosis* ; Liver* ; Stroke Volume ; Systole ; Vascular Resistance

OBJECTIVES: This study was conducted to assess the development of posttraumatic stress disorder (PTSD) after occupational physical injuries and the risk factors in occupational accident patients for PTSD. METHODS: Forty-seven occupational accident patients with physical injuries were administered BDI, STAI I and II, SCL-90-R, IES and questionnaires for risk factors and Clinician-Administered PTSD Scale(CAPS). RESULTS: 1) 12 patients(25%) were diagnosed as PTSD. 2) The BDI, STAI I and II and IES scores are significantly high(<0.05) in PTSD group than non-PTSD group. 3) The subscales of SCL-90-R, with an exception of PAR subscale, showed higher scores(<0.05) in PTSD group. 4) The loss of consciousness(LOC) was only significant risk factor in the occupational accident-related factors(<0.05). CONCLUSION: The results of this study show the development of PTSD among occupational accident patients. The loss of consciousness(LOC) was the only signiticant risk factor for PTSD in occupational accident patients.
Accidents, Occupational* ; Humans ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic*

In obsterics and gynecology laparoscopic surgery is increasing in numbers and gaining wide popularity replacing classical laparotomy and is becoming new trend in surgical fields. Laparoscopic surgery is favoured over the classical laparotomy because of numerous advantages but it can cause complications by insuffulatory CO2 to induce artificial pneumoperitoneum. Therefore, wide knowledges and thorough understandings of anesthesiologist on the prevention of complications and their treatments are essential. Authors present one case that the patient developed subcutaneous emphysema and ateleciasis on right upper lobe, pulmonary edema in left side lung resulting from inadvertent one lung ventilation during laparoscopic hysterectomy under general anesthesia and on trendelenberg position.
Anesthesia, General* ; Gynecology ; Humans ; Hysterectomy* ; Laparoscopy ; Laparotomy ; Lung ; One-Lung Ventilation* ; Pneumoperitoneum, Artificial ; Pulmonary Edema ; Subcutaneous Emphysema*

Purpose: Although the number of elderly patients with breast cancer is increasing as the population ages, their treatment is controversial. We evaluated the prognostic factors associated with survival in elderly breast cancer patients and assessed the impact of comorbidity on prognosis. Methods: This study included 362 patients (aged ≥65 years) who underwent surgery for breast cancer in our institution between 2003 and 2014. The patients were divided into early-aged (65–74 years) and late-aged (≥75 years) groups. Comorbidity was parametrized using the Charlson comorbidity index (CCI). Kaplan–Meier analysis was used to analyze overall survival (OS) and distant metastasis-free survival (DMFS). Prognostic factors were evaluated by Cox proportional hazards regression. Results: The surgical method, subtypes, stage, and oncological features were similar between early- and late-aged groups; however, smaller proportions of patients in the late-aged group received chemotherapy (12.9% vs. 45.5%) and endocrine therapy (55.3% vs. 73.3%). In multivariable analysis, the poor prognostic factors associated with DMFS and OS were high CCI, high histologic grade, and advanced stage. Chemotherapy, endocrine therapy, and radiotherapy were not significantly related to DMFS and OS. Conclusion In this study, adjuvant treatments did not affect the prognosis of elderly patients with breast cancer. To clarify the effects of adjuvant therapies in these patients, a large-scale retrospective study that considers not only tumor characteristics but also life expectancy is necessary.

Bronchial Asthma could be developed by occupational origin. 4-16% of bronchial asthmas are known to be related to occupational exposure. However, occupational asthma has not been reported from the periodic occupational health examination, but reported through case report from clinicians. The authors analysed hospital records to find out work-related bronchial asthma and their occupational characteristics at a university hospital in Jnchon. All records which were confirmed as bronchial asthma in adult by an allergist from June, 1996 to May, 1998 were selected. Through record reviewing, any suspected work related asthma was selected and the interview was done by phone or at the out-patient clinic. The possible cases were confirmed by additional tests including specific bronchial provocation test. Sixteen(3. 9%) out of 411 bronchial asthma were confirmed as work-related asthma. Eight cases out of 16 worked at furniture industry, three worked at dye manufacturing and two worked at musical instrument manufacturing industry. Others worked at farm and machinary industry. The confirmed asthmogen were toluene diisocyante(8), reactive dye(3), and grain dust(1). None of the cases was detected as work-related asthma in the periodic health examination. Twelve out of sixteen occupational asthma patients discontinued their work. The results suggested that many patients with occupational asthma were not reported and the periodic health examination was not an effective system for detecting the workrelated asthma. Thus, setting up the surveillance system involving allergist or pulmonologist would be important to detect and prevent occupational asthma.
Adult ; Asthma* ; Asthma, Occupational ; Bronchial Provocation Tests ; Cereals ; Hospital Records ; Humans ; Incheon* ; Interior Design and Furnishings ; Music ; Occupational Exposure ; Occupational Health ; Outpatients ; Toluene

BACKGROUND: Electroconvulsive(ECT) or electroshock therapy(EST) remains controversial and its indications are still the subject of discussion. Despite both medical and legal opposition, it is still widely practiced. The aim of ECT is to produce a grand mal seizure rather than the electrical stimulus which is responsible for the therapeutic effect. This causes widespread physiological changes, particularly affecting the cardiovascular and nervous system. The anesthetic agents for ECT should provide a smoooth rapid induction, a rapid recovery and attenuation of the physiologic effect of ECT. METHODS: Propofol(1 mg/kg) and thiopental sodium(2 mg/kg) were compared as anesthetic agents for ECT in 20 patients on four occasions in a repeated measure crossover study. In each patients receiving propofol or thiopental sodium on different occasions, arterial pressure, heart rate, seizure duration and recovery time were recorded. RESULTS: The incidence of discomfort on injection was significantly higher with propofol (47.5%) compared to thiopental sodium (2.5%). The duration of seizure with propofol was 37+/-11.3 sec and thiopental sodium was 41.2+/-11.6 sec but it was not significant(P=0.11). The increase in systolic and diastolic arterial pressure and heart rate were higher with thiopental sodium. Recovery time was significantly shorter with thiopental sodium (476.5+/-47.7 sec) compares to propofol (506.6+/-62.2 sec) (P<0.05). CONCLUSIONS: Propofol is more effective than thiopental sodium at obtunding the hypertensive to ECT without causing significant hypotention.
Anesthetics ; Arterial Pressure ; Cross-Over Studies ; Electroconvulsive Therapy* ; Electroshock ; Heart Rate ; Humans ; Incidence ; Nervous System ; Propofol* ; Seizures ; Thiopental*

PURPOSE: South Korean adolescents have been identified as a chronic partial sleep-deprived population in several previous studies. This study was to identify the current nocturnal sleep duration by age in South Korean adolescents and to analyze the association of emotional status factors such as subjective happiness, depression and suicidal attempts, and health-risk behaviors with the nocturnal sleep duration. METHODS: The findings in this study are based on the data obtained from the 7th Korea Youth Risk Behavior Web-Based Survey (KYRBWS-VII), a cross-sectional, annual survey of the health-risk behaviors in a representative sample of South Korean middle- and high-school students aged 13-18 years, which was conducted in 2011. Out of 75,643 students from 800 schools across the nation, 75,205 students were selected by using the complex sampling design of the survey. We analyzed the relationships between the duration of nocturnal sleep and emotional status (subjective happiness, stress level, depression, and suicidal thoughts), health-risk behaviors (smoking, drinking), and sleep satisfaction. RESULTS: There was a significant relationship between the duration of sleep and the emotional status. In general, happy students had the longest nocturnal sleep duration, regardless of their grades. Self-rated stress levels and depression in adolescents were inversely proportional to nocturnal sleep duration. Health-risk behaviors such as smoking and alcohol consumptions were more common in sleep-deprived students (P<0.001). CONCLUSION: Appropriate nocturnal sleep duration is critical for emotional health as well as prevention of suicide in the adolescent population.
Adolescent* ; Depression ; Happiness ; Humans ; Korea ; Risk-Taking ; Sleep Deprivation ; Smoke ; Smoking ; Suicidal Ideation ; Suicide