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.

Diabetic nephropathy is characterized by an expansion of the glomerular mesangium, caused by mesangial cell proliferation and an excessive accumulation of extracellar matrix (ECM) proteins, which eventually leading to glomerulosclerosis. TGF-beta1 was found to play an important role in the accumulation of ECM in the kidney. In this study, TGF-beta1 RNA interference was used as an effective therapeutic strategy. The inhibitory effect of TGF-beta1 small interfering RNAs (siRNAs) on the high glucose-induced overexpression of TGF-beta1 in rat mesangial ceys (RMCs). A high levels of glucose induces TGF-beta1 mRNA and protein, and TGF-beta1 siRNAs reduce the ability of high glucose to stimulate their expression. We also examined the inhibitory effect of TGF-beta1 siRNAs on the expression of plasminogen activator inhibitor (PAI)-1 and Collagen Type I which are down-regulators of TGF-beta1. The expression of TGF-beta1, PAI-1 and Collagen Type I was increased in RMCs that were stimulated by 30 mM glucose. TGF-beta1 siRNAs reduces high glucose-induced TGF-beta1, PAI-1, and Collagen Type I mRNA and protein expression in a dose-dependent manner. In conclusion, the present study demonstrates that TGF-beta1 siRNAs effectively inhibits TGF-beta1 mRNA and protein expression in RMCs. These suggest that TGF-beta1 siRNAs through RNAi may be a useful tool for developing new therapeutic applications for the treatment of diabetic nephropathy.
Transforming Growth Factor beta1/*metabolism ; Rats, Sprague-Dawley ; Rats ; RNA, Small Interfering/*metabolism ; Microscopy, Fluorescence ; Mesangial Cells/*metabolism ; Male ; Glucose/*metabolism ; Glomerular Mesangium/*metabolism ; Gene Expression Regulation ; Diabetic Nephropathies/pathology ; Collagen Type I/metabolism ; Cells, Cultured ; Cell Proliferation ; Animals

PURPOSE: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. MATERIALS AND METHODS: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercies was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. RESULTS: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. CONCLUSION: These RESULTS suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.
Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Diagnosis ; Electrocardiography ; Exercise Test ; Female ; Heart Rate ; Humans ; Male ; Myocardial Ischemia ; Myocardium ; Perfusion ; Prevalence ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVES: The study was carried out to evaluate the work-relatedness and the occupational distribution in 147 carpal tunnel syndrome(CTS) cases diagnosed at a university hospital from May 1996 to May 1998. METHODS: We obtained the information on disease appearance, occupational history including job content and other life style by medical records and telephone interviews. RESULTS: Of the 147 patients with carpal tunnel syndrome, 51 patients(34.7 %) were shown to be work-related. Work-related CTS were most frequent in elementary workers (21 case, 41.2%). The other eases were 15(29.4%) workers in service and shop and market sales, 9(17.6%) workers in craft and related traders, 4(7.8%) workers in skilled agriculture and fishery. Only two workers had claimed to the Industrial Accident Compensation Insurance, but no one has been admitted as an occupational CTS yet. CONCLUSIONS: It is suggested that arrangements of surveillance system for adequate control of occupational CTD is neccessity.
Accidents, Occupational ; Agriculture ; Carpal Tunnel Syndrome* ; Commerce ; Compensation and Redress ; Fisheries ; Humans ; Insurance ; Interviews as Topic ; Life Style ; Medical Records