Cardiovascular syphilis is one of the most important complications of tertiary syphilis, although its incidence is decreasing in recent years. Aortitis is the primary manifestation of cardiovascular syphilis, resulting most commonly in aortic aneurysm, aortic regurgitation and coronary artery ostial obstruction. The authors experienced 46-year-ole male with a history of chancre 20 years ago, and several bouts of right chest pain since last year. Serologic tests revealed reactive in VDRL (1:64) and in TPHA test. Chest x-ray, chest CT, echocardiogram and aortogram showed aneurysm of ascending aorta with no evidence of aortic regrugitation of coronary obstruction. Histologic findings of involved aorta revealed "tree bark" appearance in gross, and microscopically adventitial thickening with endarteritis of the vasa vasorum and destruction of elastic tissue of media, showing moth-eaten appearance. The patient was underwent excision of the aneurysm and dacron aortic prosthetic graft was replaced with success.
Aneurysm* ; Aorta* ; Aortic Aneurysm ; Aortic Valve Insufficiency ; Aortitis ; Chancre ; Chest Pain ; Coronary Vessels ; Elastic Tissue ; Endarteritis ; Humans ; Incidence ; Male ; Polyethylene Terephthalates ; Serologic Tests ; Syphilis ; Syphilis, Cardiovascular ; Thorax ; Tomography, X-Ray Computed ; Transplants ; Vasa Vasorum

It has been well known that dilated cardiomyopathy (D-CMP) has characterized by systolic dysfunction of left ventricle (LV). But there are few studies about LV diastolic and right ventricular (RV) dysfunction in D-CMP. The purpose of this study is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The purpose of this tudy is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The gated blood pool scan (GBPS) was undertaken in 14 patients with D-CMP and 14 normal controls. The results are as follows : 1) Compared to normal controls, the global and regional ejection fraction of LV were significantly reduced (P<0.001) in D-CMP. But, there was no significant difference in LV ejection time between the two groups. 2) Peak filling rate and peak filling time were significantly reduced (P<0.001, P<0.05) in D-CMP 3) Global ejection fraction of RV was also significantly reduced in D-CMP compared to normal controls (P<0.001) But there was no significant difference in ejection rate of right ventricle between the two groups. 4) There was close correlation (R=0.802) between ejection fraction and filling rate of LV : filling rate was also reduced as ejection fraction decreased. And LV filling rate was also reduced with reduction of ejection rate. It is concluded that D-CMP shows diastolic impairment as well as systolic pumping failure and this systolic dysfunction is accounted for the diastolic impairment in D-CMP. And D-CMP shows also right ventricular dysfunction in almost all cases, as well as left ventricular dysfunction.
Cardiomyopathy, Dilated* ; Heart Ventricles ; Humans ; Ventricular Dysfunction, Left ; Ventricular Dysfunction, Right

Ventricular performance was evaluated in 21 patients with uncomplicated acute transmural myocardial infarction (10 anterior and 11 inferior). Left ventricular global and regional ejection fraction, ejection rate and right ventricular ejection fraction were assessed using radionuclide ventriculography. The results were as follows : 1) In anterior infarction, left ventricular global ejection fraction was more significantly depressed than in inferior infarction(mean+/-SD : 33. 0+/-15.4% versus 48.6+/-7.0%, P<0.01). 2) In inferior infarction, right ventricular global ejection fraction was more depressed than in anterior infarction(33.3+/-9.8% versus 45.0+/-13.2%, P<0.05). 3) Regional ejection fraction of septal, apico-inferior and posterolateral wall were found to be depressed in anterior infarction than in inferior infarction, but no significant differences were present. It is concluded that the magnitude of right and left vnetricular dysfunction was affected by the location of acute transmural infarction.
Humans ; Infarction ; Myocardial Infarction* ; Radionuclide Ventriculography ; Stroke Volume

BACKGROUND: We evaluated the antihypertensive effect, safety and effect on serum lipids of terazosin, second generation alpha1-blocker. METHODS: Terazosin 1-4mg was adminstered once daily in 20 patients for 12 weeks with dose titration every 2 weeks. RESULTS: 1) The systolic and diastolic blood pressure were decreased from 170.0+/-13.0/104.0+/-6.0mmHg to 144.0+/-13.3/88.0+/-5.6mmHg(p<0.01), but the heart rate and body weight were independant of terazosin administration. 2) Total cholesterol was decreased significantly from 209.9+/-33.5mg/dL to 194.6+/-30.1mg/dL after 12 weeks treatment(p<0.05), triglyceride was decreased significantly from 185.4+/-37.0mg/dL to 168.9+/-35.0mg/dL(p<0.05). and LDL-cholesterol was decreased significantly from 134.5+/-31.9mg/dL to 122.7+/-29.9mg/dL(p<0.05), but HDL-cholesterol was increased significantly from 37.8+/-5.6mg/dL to 40.6+/-5.5mg/dL(p<0.05). 3) The adverse effects of terazosin were dizziness in 2, headache in 2, asthenia in 1, peripheral edema in 1 and skin rash in 1 patient, but were not troublesome enough to stop medication. CONCLUSIONS: Terazosin 1-4mg once daily regimen was effective and safe as an antihypertensive agent, and moreover terazosin has favorable effects on serum lipids.
Asthenia ; Blood Pressure* ; Body Weight ; Cholesterol ; Dizziness ; Edema ; Exanthema ; Headache ; Heart Rate ; Humans ; Hypertension* ; Triglycerides

BACKGROUND: The hypotensive effect of the lisinopril, a long acting angiotensin converting enzyme inhibitor, was studied. METHOD: 10mg of lisinopril was administered in 30 hypertensive Korean adults during twelve week after a weeks observation for washout with stepwise increments of the dose according to the patients blood pressure in every two weeks. RESULTS: The supine blood pressures were decreased from 173.3+/-27.9/105.7+/-19.4mmHg to 131.8+/-23.1mmHg/81.4+/-18.7mmHg at the end of twelve weeks durg therapy(P<0.05). The standing blood pressures were also decreased conferrably and to the some lower levels. Hematologic examination and blood chemistry revealed no discernible abnormal findings before and after the treatment. During the period of the study a few probably drug-related symptom such as dry cough and dry mouth developed but not troublesome enough to stop administering. CONCLUSION: Lisinopril 10mg once daily regimen is well tolerated and effective in the treatment of hypertensive patients.
Adult ; Blood Pressure ; Chemistry ; Cough ; Humans ; Hypertension ; Lisinopril* ; Mouth ; Peptidyl-Dipeptidase A

BACKGROUND: Celiprolol is a beta-adrenergic blocker characterized by selective blokade of beta1 receptors and partial agonist activity at beta2 receptors. This study was designed to evaluate the antihypertensive efficacy, metabolic effects and safety of celiprolol in patients with essential hypertension. METHODS: Celiprolol 200mg was administered once daily in 20 hypertensive Korean adults(9 males and 11 females) for ten weeks with dose titration every 2 weeks. RESULTS: The supine blood pressure was decreased from 168.8+/-20.6/106.5/12.0mmHg(mean/S.D) to 131.2+/-12.8/88.2+/-7.9mmHg at the end treatment(P<0.05). Heart rate was not changed significantly throughout the period. Total cholesterol(TC) was decreased from 211.3+/-12.6mg/dl to 186.7+/-10.4mg/dl(P<0.05) and triglyceride(TG) from 223.7+/-24.5mg/dl to 198.4+/-12.9mg/dl after 10 weeks treatment(P<0.05). LDL(low-density lipoprotein)-cholesterol was decreased from 126.4+/-13.4mg/dl to 118.5+/-12.3mg/dl after 10 weeks treatment(P<0.05). During the period of the study, headache and fatigue developed in a few patient but were not troublesome enough to stop medication. CONCLUSIONS: Celiprolol 200mg once daily regimen was well tolerated and effective in the treatment of essential hypertensiove patients with favorable effects on blood lipids.
Blood Pressure ; Celiprolol* ; Fatigue ; Headache ; Heart Rate ; Humans ; Hypertension ; Male