BACKGROUND: Form the 1970's calcium channel blockers have been used as one of the most effective drugs for antihypertensive therapy. Nilvadipine(Nivadil(R)) is a new vessel-selective calcium channel blocker with a markedly high oral bioaviliability and a long elimination half-life time. To evaluate the efficacy and side effects of nilvadipine, daily monotherapy was done in 22 patients with essential hypertension. METHOD: After more than 2 weeks of previous drug wash-out periods, Nilvadipine 8-12mg was administered daily in 2 or 3 divided dosage for 8 weeks in patients with mild to severe essential hypertension. The sitting blood pressure(BP) and heart rate were measured before and 2, 4, 8 weeks after medication. RESULT: Systolic and diastolic BP were significantly reduced at 2 weeks after medication and no further significant BP reduction were noted throughout the remainer of the trial(4 to 8 weeks). Normotension(diastolic BP < or =90mmHg) was achieved in 14 cases(67%) after 8 weeks therapy and in 7 cases(33%) BP reduced effectively. The side effect noted were headache and facial flushing in 2 cases and in one of them the medication were discontinued. And fatigue, dizziness were complaint in 1 case respectively. There were no significant laboratory changes before and after nilvadipine therapy. CONCLUSION: It can be concluded that nilvadipine(Nivadil(R)) monotherapy is effective in many patients with essential hypertension and a clinical study of combined therapy with other antihypertensive agents in larger numbers of patients will be needed.
Antihypertensive Agents ; Calcium Channel Blockers ; Calcium Channels ; Dizziness ; Fatigue ; Flushing ; Half-Life ; Headache ; Heart Rate ; Humans ; Hypertension*

PURPOSE: Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS: In vitro, the human platelets were activated with application of shear stress, 20 microgram/ml collagen, 2 mM CaCl2 and 10U thrombin/1 x 109 platelets. Level of vascular endothelial growth factor (VEGF) and platelet microparticle (PMP) in the activated platelets were checked. In the animal study, human angiogenic factors-enriched PRP was tested in 28 athymic rat's cranial critical bone defects with beta-TCP. Angiogenesis and osteogenesis were evaluated by laser Doppler perfusion imaging, histology, dual energy X-ray densinometry, and micro-computed tomography. RESULTS: In vitro, this human angiogenic factors-enriched PRP resulted in better cellular proliferation and osteogenic differentiation. In vivo, increasing angiogenic potential of the PRP showed significantly higher blood perfusion around the defect and enhanced new bone formation around acellular bone graft material. CONCLUSION: Angiogenic factor-enriched PRP leads to faster and more extensive new bone formation in the critical size bone defect. The results implicate that rapid angiogenesis in the initial healing period by PRP could be supposed as a way to overcome short term effect of the rapid angiogenesis.
Angiogenesis Inducing Agents ; Animals ; Blood Platelets ; Bone Regeneration ; Calcium Phosphates ; Cell Proliferation ; Collagen ; Durapatite ; Humans ; Intercellular Signaling Peptides and Proteins ; Osteogenesis ; Perfusion ; Perfusion Imaging ; Platelet-Rich Plasma ; Rats, Nude ; Transplants ; Vascular Endothelial Growth Factor A

PURPOSE: To evaluate clinical and radiological results and to analyse the parapatellar complications after endoscopic anterior cruciate ligament reconstruction using central one-third bone-patellar tendon-bone autografts. MATERIALS AND METHODS: 66 cases among 158 consecutive cases from Feb 1990 to May 1996 were reviewed and evaluated with regard to patellofemoral pain, crepitus, quadriceps atrophy, graft donor site complication, Lysholm knee scoring system and radiological assessment. The average period of follow up was 23 months (range, 12-57 months) and the average age at operation was 31 years old (range, 18-58 years). RESULTS: The average Lysholmn knee score improved from 57.5 points preoperatively to 91.3 points at follow up. The instrumented anterior laxity test showed that excellent anterior stability was regained in most patients. There were many cases of parapatellar complications, 7 cases (10.6%) of anterior knee pain, 21 cases (32.8%) of crepitus, 43 cases (65.1%) of quadriceps weakness, 29 cases (45.3%) of graft donor site paresthesia and 15 cases (23.4%) of pain on kneeling. CONCLUSIONS: Although endoscopic ACL reconstruction using central one-third bone-patellar tendon-bone autografts had good clinical results, many parapatellar complications were noted. In order to prevent these complications, different reconstruction techniques and graft materials should be considered
Adult ; Anterior Cruciate Ligament Reconstruction ; Atrophy ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Paresthesia ; Tissue Donors ; Transplants

BACKGROUND: It is known that left ventricular(LV) wall motion is not uniform even in normal heart, and the restoring forces make phase differences between LV wall motion and mitral flow velocity during rapid filling period. METHOD: To investigate the regional nonuniformity and restoring forces in 46 patients with hypertension(HT)(group:normal wall thickiness.n=12,II:LVH with fractional shortening(FS)>25%. n=22. III:FS<25%.n=12). We measured the time intervals from A2 to peak thinning rate point of LV posterior wall(A2-(-)dpw/dt).to mitral flow starting point (IRT).and to peak mitral flow velocity(A2-E) by M-mode and Doppler echocardiography. RESULTS: The noniformity((-)dpW/dt-dL/dt)and phase differance((-)dpw/dt-E) were increased in HT(control:HT.22+/-7.8 vs. 49+/-5.2msec, 63+/-4.5 vs, 86+/-6.2msec, p<0.05 respectively).In group comparison, nonuniformity increased in group II and III(group I: group II, III, 35+/-5.1 vs. 50+/-7.1,70+/-14msec, p<0.05 respectively). but phase difference increased only in group II(groupII: group I, III, 93+/-6.0 vs. 75+/-5.2, 80+/-20msec, p<0.05, respectively). CONCLUSION: We interpreted these data that in HT with hypertrophy or not, the nonuniformity of LV wall motion working on the restoring forces which can be expressed as phase difference between LV wall motion and mitral flow. But in HT with hypertensive heart failure group, no significant changes of phase difference and it's suggest that other mechanism could be also working on early diastolic filling.
Echocardiography* ; Echocardiography, Doppler ; Heart ; Heart Failure ; Humans ; Hypertension* ; Hypertrophy

BACKGROUND: A regional wall motion nonuniformity and a phase difference between LV posterior wall motion and transmitral flow are present during normal rapid filling period and are thought to be an evidence for involvement of ventricular restoring forces. To assess the role of nonuniformity on diastolic funtional impairment of asymmetric septal hypertrophy(ASH), the time relations between left ventricular regional wall motions and filling velocity were studied. METHOD: We measured the time intervals from A2 to peak rate of LV posterior wall(short axis) thinning(A2-(-)dpw/dt), peak rate of medial mitral annulus (long axis dimension) lengthening(A2-dL/dt) and peak mitral flow(A2-E) by M-mode and Doppler echocardiography. Result: In ASH patients, A2-(-)dpw/dt(106+/-6msec, mean SE) and the regional wall motion nonuniformity((-)dpw/dt-dL/dt, 89+/-11msec, mean SE) were increased significantly when compared with normal control values(88+/-4, 28+/-5msec, mean SE, p<0.01,respectively).In normal controls, peak mitral flow velocity lagged peak rate of regional wall motion, so the phase differences were present((-)dpw/dt-E :71+/-8msec, dL/dt-E:44+/-6msec). In ASH patients, (-)dpw/dt-E was present(90+/-16msec) but dL/dt-E was not present or reversed(-21+/-18 msec). So these chacteristic phase differences were disturbed. CONCLUSION: These data suggested that the relaxation nonuniformity of regional wall motion in ASH may act as an energy dissipating factor of restoring forces during rapid filling period.
Axis, Cervical Vertebra ; Cardiomyopathy, Hypertrophic* ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Relaxation

No Abstract Available.
Health Behavior*

No abstract available.
Hand* ; Neutrophils* ; Skin Diseases* ; Sweet Syndrome

No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

PURPOSE: We examined the relationship between BIS, sedation score and plasma midazolam concentration to verify the usefulness of BIS to assess the patient's consciousness during sedation. PATIENTS AND METHODS: Twenty-five young, healthy adult volunteers participated in this clinical study. Midazolam was administered intravenously up to 0.08 mg/kg to induce unconsciousness and we monitored the patient's physiological and conscious status until complete recovery from sedation. BIS and sedation score were measured before sedation, 10, 20, 30 minutes after midazolam administration. Plasma midazolam concentration was measured 10 minutes after midazolam administration. BIS was measured using A-2000 BISTM monitor (Aspect Medical Systems, USA) and the degree of sedation was evaluated with the sedation score. RESULTS: The BIS score correlated with the sedation score (r = 0.676, P < 0.05). With the decreased plasma midazolam concentration, the correlation was better with sedation score(r = -0.656).Although BIS values did not correlate with calculated plasma concentration of midazolam (r = 0.467) at 10 minutes after midazolam administration, values after sedation were well distinguished from those before sedation. CONCLUSIONS: BIS is known for an effective predictor of patient's hypnotic state, and it is correlated with the sedation score. But, it doesn't always coincide with the clinical parameters of depth of sedation. So more attention is needed using BIS only during sedation, and it is advisable that the patient's consciousness is monitored with variable sedation score systems every several minutes.
Adult ; Consciousness ; Humans ; Midazolam* ; Plasma* ; Unconsciousness ; Volunteers

Aplasia cutis congenita is a rare disorder characterized by localized or generalized absence of skin at birth. Group 4 in Friden's classification, which is associated with embryologic malformations including myelomeningocele, encephalomeningocele, omphalocele, gastroschisis. The authors have experienced a case of aplasia cutis congenita of right frontal scalp associated with bony defect, forming encephalocele in a newborn. We reported this case with brief review of literatures.
Classification ; Ectodermal Dysplasia* ; Encephalocele ; Gastroschisis ; Hernia, Umbilical ; Humans ; Infant, Newborn ; Meningomyelocele ; Parturition ; Scalp ; Skin