Essential hypertension is an important public health problem in Korea-being common, asymptomatic, easily treatable, and often leading to lethal complication in left untreated. The number of patients with hypertension has been significantly increased, and this factor may be an importnat one responsible for the increase in cardivascular mortality during past 20 years in Korea. As the drug therapy for hypertension needs longer period, it is very important to evaluate the efficacy and the adverse effects. Thirty patients(17 men and 13 womon) with essential hypertension were evaluated in this study. All patients had received oral Isradipine 1.25~2.5mg b.i.d. for 8 weeks. 1) The systolic and diastolic pressure were decreased significantly(166.8+/-9.0mmHg vs 147.3+/-12.0mmHg, p<0.001 and 100.3+/-4.0mmHg vs 90.3+/-6.1mmHg, p<0.001, respectively) 2) Heart rate, body weight, laboratory tests, chest X-ray, ECG studies were not changed significantly. 3) The systolic pressure was lowered by 20mmHg or more in 17 cases(56.7% of total), and the diastolic pressure was lowered by 10mmHg or more in 20 cases(66.7% of total) at 8 weeks after Isradipine administration. 4) The adverse effects of Isradipine were edema in 3(10%), constipation in 2(6.7%), headache in 2(6.7%), and insomnia, dizziness and dry mouth in 1 patient respectively, and none of them discontinued Isradipine administration due to adverse effects. In many patients with essential hypertension there is an effective response to Isradipine, even though there may be some mild adverse effects.
Blood Pressure ; Body Weight ; Constipation ; Dizziness ; Drug Therapy ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension ; Isradipine ; Korea ; Male ; Mortality ; Mouth ; Public Health ; Sleep Initiation and Maintenance Disorders ; Thorax

Little has been reported concerning post-operative hypoglycemia in previously asymptomatic individuals. Post-operative hypoglycemic coma is one of the most perplexing problems and must be differentiated from other conditions accompaning coma. We experienced a case of hypoglycemia following emergency cesarean section in primigravida with cephalopelvic disproportion on the fourth post operative day. The comatous state appeared abruptly and developed repeatedly. The causes of post-hypoglycemic coma are discussed and the prolonged starvation before and after operation was suspected to be the cause of coma.
Cephalopelvic Disproportion ; Cesarean Section* ; Coma ; Emergencies ; Female ; Hypoglycemia* ; Pregnancy ; Starvation

Maternal and fetal effects of anesthesis for 781 cases ceasarean sections, performed during the past 10 years (1965~1974) in Hanil Hospital have been evaluated clinically. It is emphasized that the selection of anesthetic agents and methods, should depend upon the physical status of the patients and the ability of both obstetricians and anesthesiologists. Optimal results require effective teamwork amongst obstetricians, anesthesiologists and nursing personnel. The anesthesiologist should be fully infermed of obstetric aspects. A variety of anesthetic techniques can be used for elective and emergency Caesarean sections. Each technique has its own advantages, disadvantages and limitations which must be thoroughly understood for proper application. The choice of anesthesia should be determined primarily by the experience of the operator, the degree of ugency, condition of the monther and the fetus, the physiopathology, the skill of the obstetrician and the desires and the emotional state of the monther.
Anesthesia ; Anesthetics ; Cesarean Section* ; Emergencies ; Female ; Fetus ; Humans ; Nursing ; Pregnancy

BACKGROUND: To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital. METHODS: This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined. RESULTS: There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital. CONCLUSION: The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.
Humans ; Lung Diseases ; Nontuberculous Mycobacteria

PURPOSE: This study was designed to pursue the basic relationship between MMP-2 and ligament injury via ex vivo stretching of the anterior cruciate ligament (ACL) and its changes by signal transduction pathway. MATERIALS AND METHODS: After femur-ACL-tibia complex was harvested from rats, release of MMP-2 in stretch group and non-stretch group was checked using gelatin zymography. Firstly, authors investigated whether MMP-2 was released from the ligament or not and if so, how long it was released. In addition, the complexes were divided into two groups. In group I, 5 and 12N weights were used to stretch the complex for 10, 30, and 60-minute. In group II, after the ligament complexes were stretched by 15N for 30 minutes, various signal pathway inhibitors such as pertusis toxin, SP600125, PD98059, KT5720, curcumin, and Bay11-7082 were added to their supernatants. MMP-2 activity was evaluated. RESULTS: MMP-2 was immediately released after ligament injury and its activity was increased in proportion to stretching duration and magnitude. As for the signal pathways, inhibition of JNK, ERK, AP-1, and NF-k beta pathways caused MMP-2 expression to be decreased. CONCLUSION: It is considered that the release of MMP-2 plays an important role in remodeling process after ACL injury.
Animals ; Anterior Cruciate Ligament ; Anthracenes ; Carbazoles ; Curcumin ; Flavonoids ; Gelatin ; Knee ; Ligaments ; Matrix Metalloproteinase 2 ; Nitriles ; Pyrroles ; Rats ; Signal Transduction ; Sulfones ; Transcription Factor AP-1 ; Weights and Measures

No abstract available.
Hematoma*

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

Eosinophilic gastroenteritis is a rare disease characterized by the eosinophilic infiltration of the gastro-intestinal tract without involvement of organs outside the gastrointestinal tract and may be misdiagnosed in clinical practice. The pathophysiology of eosinophilic gastroenteritis is not known well. We report a case of serosal eosinophilic enteritis presenting sterile eosinophilic ascites, peripheral eosinophilia and abdominal pain. Diagnosis was confirmed by laparoscopic biopsy of small bowel. The patient was improved dramatically with prednisolone therapy.
Abdominal Pain ; Ascites ; Biopsy* ; Diagnosis ; Enteritis* ; Eosinophilia ; Eosinophils* ; Gastroenteritis ; Gastrointestinal Tract ; Humans ; Prednisolone ; Rare Diseases

We present a rare case of abdominal compartment syndrome due to a bulimic attack in a 19-year-old female patient with bulimia nervosa. She was admitted to our emergency room with complaints of progressive abdominal pain following bulimia. Computed tomography showed dilated stomach with food and air pressed other visceral organs and major abdominal vessels. Decompression using nasogastric tube or gastric lavage tube failed. At laparotomy, we performed gastrotomy and decompression was performed. After decompression, she fell into hypovolemic shock due to bleeding in the intra-gastric and peritoneal cavity. Twelve hours after the operation, the patient died due to refractory hypovolemic shock from uncontrolled bleeding following decompression of abdominal compartment. It should keep in mind that binge-eating habits in patients with bulimic nervosa could cause abdominal compartment syndrome due to gastric distension and this may be a potentially fatal condition.
Abdominal Pain ; Bulimia ; Bulimia Nervosa ; Compartment Syndromes ; Decompression ; Emergencies ; Female ; Gastric Lavage ; Hemorrhage ; Humans ; Intra-Abdominal Hypertension ; Laparotomy ; Peritoneal Cavity ; Reperfusion Injury ; Shock ; Stomach ; Young Adult

OBJECTIVE: To demonstrate a conduction block of the median nerve at the flexor retinaculum (FR) in carpal tunnel syndrome (CTS), comparison of potentials obtained with stimulation of median nerve at the wrist and the palm may be required. METHOD: To determine the severity and incidence of conduction block in patients with CTS, seventy hands of neurologically healthy adults (mean age, 48 years) as control, and seventy hands of patients with CTS (mean age, 51 years) were tested. We performed median motor and middle finger recorded antidromic sensory conduction study with stimulation of the wrist and palm of a distance of 5 cm. The negative peak spike duration and baseline to peak amplitude of the compound muscle action potential (CMAP), and sensory nerve action potential (SNAP) with wrist and palm stimulations were measured. From these values, the wrist to palm duration ratio and amplitude ratio were obtained. RESULTS: The criteria of median motor nerve conduction block were a wrist to palm amplitude ratio of less than 0.7 and a wrist to palm duration ratio of less than 1.13. The criteria of median sensory conduction block were a wrist to palm amplitude ratio of less than 0.61 and a wrist to palm duration ratio of less than 1.33. In the patient group, 10 hands (14.3%) showed motor conduction block and 12 hands (17.1%) showed sensory conduction block and 3 hands (4.3%) showed both. The wrist to palm amplitude ratios of CMAP and SNAP in the patient showing conduction block were 0.6+/-0.1, and 0.4+/-0.2, respectively. There was no correlation between palm CMAP or SNAP amplitude and respective wrist to palm ratios. CONCLUSION: Comparison of the amplitude and duration of CMAP or SNAP obtained with stimulation of both wrist and palm may be able to differentiate between conduction block and axonal degeneration. These values may be useful in planning treatment and predicting outcome.
Action Potentials ; Adult ; Axons ; Carpal Tunnel Syndrome* ; Fingers ; Hand ; Humans ; Incidence ; Median Nerve ; Neural Conduction ; Wrist