A clinical trial was done to evaluate the antihypertensive efficacy and side effects of manidipine, a new calcium antagonist, in 30 patients with mild to moderate essential hypertension. 1) The study patients consisted of 19 men and 11 women, and the mean age was 51.8 years. 2) Blood pressure dropped significantly in 2 weeks and in 4 weeks, and well maintained throughout the study period. The mean-pressure drop was 26.2/14.9mmHg after 10 weeks. 3) Heart rate did not change significantly with manidipine therpy. 4) Optimal dose for effective pressure-drop was between 10 and 20 mg in 86% of patients. Overall good antihypertensive effect was achieved in 83% of patients. 5) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change, but serum calcium increased from 9.2% mg/dl (p=0.001) in 10 weeks. 6) Side effects were mild in nature(palpitation in 3, dry mouth in 1, weakness in 1 and impotence in 1 patient). In conclusion, manidipine monotherapy with 10 to 20 mg once a day regimen is effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Erectile Dysfunction ; Female ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth

Recent studies suggest that coronary endothelial dysfunction in atherosclerosis may contribute to the predisposition both for coronary spasm as well as for thrombus formation. The integrity of at least one aspect of endothelial function can be assessed by the intracoronary administration of acetylcholine. Eleven(13.4%, mean age 48+13, male 11) out of 82 consecutive patients with acute myocardial infarction showed angiographically normal or near normal coronary arteries at 7~10 in-hospital days. Ten(91%) had history of heavy smoking and 7 patients(64%) had no history of previous angina. Anterior myocardial infarction was in 8 and inferior in 3 patients. After intracoronary administration of acetylcholine(incremental dose of 20, 50ug for the right and 20, 50, 100ug for the left), 9(82) of 11 infarct related arteries showed total or subtotal occlusion, but only in 3(17%) out of 18 non-infarct related arteries of 10 patients. Multivessel spasm was noticed in 3. Ergonovine test(graded doses of 0.05, 0.1 and 0.2 mg intravenously) was performed 30 minutes after completion of acetylcholine test in 5 patients. In 1 patients, acetylcholine test was positive and but ergonovine test was negative. Conclusion : 1) Eleven(13.4%) out of 82 patients with acute myocardial infarction had angiographically normal coronary arteries. 2) Ach positive responses of infarct-related arteries are more frequent(82%) than that of non-infarct related arteries(17%), suggesting that the infarction might be related to coronary artery spasm. 3) Positive Ach responses of non-infarct related arteries occurred in 30% of Patients. 4) Ach and Erg induced vasospasm developed at the same site in 5, which suggests that local hyperreactivity might be related to spasm.
Acetylcholine* ; Arteries ; Atherosclerosis ; Coronary Vessels* ; Ergonovine ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Smoke ; Smoking ; Spasm* ; Thrombosis

Percutenous transluminal coronary angioplasty(PTCA) for total coronary occlusion was performed in 20 patients(mean age 51+11years, male 16, female 4) including 12 patients with recent myocardial infaction. Primary success rate of procedure was 71%(15 out of 21 lesions). The success rate with occlusion<3 months duration was 11 out of 13(85%) lesions vs 4 out of 8(50%) with occlusion>3 months duration(P=NS). There was no difference in success rate according to vessel dilated(left anterior descending and intermediate branch 70%, right coronary artery 83%, left circumflex 67%). All patients had well developled(>grade 2 in 15 patients) collateral flow to the occluded vessel. The leng of occluded lesion more than 1.5cm was in 4 out of 21, and 3 of them had procedural failure because of inability to cross with a guide wire. Six procedsural failures included inability to cross the lesion with a guide wire in 5 and one in inability to dilate the lesion due to recoiling. Complications included intimal dissection in 3(1.5%), prolonged chest pain in 1 1 and one death due to cardiogenic shock. Although the primary success rate is relatively lower than that associated with conventional stenotic lesions, coronary angioplasty could be performed safely and successfully in the majority of patients with coronary occlusion.
Angioplasty* ; Chest Pain ; Coronary Occlusion ; Coronary Vessels* ; Female ; Humans ; Male ; Shock, Cardiogenic

To assess the likelihood of procedural success in patients with multivessel coronary artery disease, 46 consecutive patients (male 34, female 12, mean age 60+/-9 years) umderwent single or multiple site angioplasty. The clinical diagnosis of unstable angina was in 20(44%), stable angina in 10 and acute or old myocardial infarction in 16. Coronary angiographic findings of 2 vessel disease was in 38(83%), triple vessel disease in 8. Left ventricular function was generally well preserved (mean ejection fraction 65+/-12%, range 30-82%) and mean 2.0 stenosis per patient angic, lasty had attempted. Single vessel angioplasty (SVA) was performed in 13 and multivessel angioplasty (MVA) in 33. Procedural success was achieved in 79(86%) out of total 92 stenoses. Sixty-six(88%) out of 75 stenoses in MVA and 13(76%) out of 17 stenoses in SVA had procedural success respectively. According to angiographic morphology of lesions, procedural success of type A stenoses was 17/17(100%), type B stenoses 57/66(86%) and type C stenoses was 5/9(33%). In 13 failures included inability to pass the guide wire cross the lesion in 7, inability to guide the griding catheter in 2 and inability to dilate lesions in 4. Before and after angioplasty, treadmill test (modified Bruce protocol)could be performed in 29 patients. Total duration of exercise and maximal double product improved significantly from 8.5+/-2.3 minute 5188+/-2403 to 12.2+1.3 min., 23,062+/-4111 respectively (p<0.001). 17 out of 24 patients who had positive treadmill test before angioplasty showed negative conversion after procedure. Complications included dissection in 29, prolongd chest pain in 5, acute closure in 3, cardiac tamponade in 1 and ventricular fibrillation due to side branch oclusion in 1. Thus, coronary angioplasty in selected paients with multivessel coronary artery disease might be useful and have relatively good immediate results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Cardiac Tamponade ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Exercise Test ; Female ; Humans ; Myocardial Infarction ; Ventricular Fibrillation ; Ventricular Function, Left

In carpal injury, a good functional end result seems to correlate with final anatomic alignment of carpus after treatment. Some cases are often misdiagnosed and result in inadequate treatment. Forty six cases of carpal injuries were analysed which were treated for 9 years from 1975 to 1984 at the Department of Orthopedic Surgery, Seoul National University Hospital. The observations can be summarized as follows. 1. The male to female ratio was 3.5: 1 and 82% of total cases were in the third and fourth decades. 2. The most frequent cause of injury was fall from height with outstretched hand. 3. Trans-scaphoid perilunar dislocation and its variant were the most common diagnosis in this analysis. 4. All of the scapho-lunate dissociation showed volar flexion intercalated segmental instability with scapho-lunate gap more than 2 mm in our series. 5. In 11 cases of trans-scaphoid perilunar dislocation and its variant, carpal collapse was found in 10 cases. In 5 cases dorsiflexion intercalated segmental instability pattern and in one case volar flexion intercalated segmental instability pattern were found to be present. 6, There was an increase in scapho-lunate angle in all cases of dorsiflexion intercalated segmental instability, but a decrease in scapho-lunate angle is not a consistent finding in volar flexion intercalated segmental instability. 7. In 24 cases more than 6 months follow-up, excellent and good results were obtained in 20 cases. 8. As a result of above findings, authors conclude that scapho-lunate gap more than 2mm has diagnostic value in scapho-lunate dissociation but that dorsiflexion intercalated segmental instability or volar flexion intercalated segmental instability only means the changes in the relationship between carpal bones and does not have definite or specific diagnostic value for a specific carpal injury.
Carpal Bones ; Diagnosis ; Dislocations ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Orthopedics ; Seoul ; Wrist

Two cases of exercise-induced atrial fibrillation were diagnosed in 68 years old female and 47 years old male. They complained palpitation during exercise, and emotional upset for the last 5 years. There was no evidence of organic heart disease except mild hypertension in female patient. The atrial fibrillation was induced repeatedly by treadmill exercise test and intravenous infusion of isoproterenol. The beta blocker(atenolol 50mg po dialy) prevented the induction of atrial fibrillation during treadmill exercise. We report two cases of exercise-induced atrial fibrillation which is very rare and might be related to catecholamine.
Aged ; Atrial Fibrillation* ; Exercise Test ; Female ; Heart Diseases ; Humans ; Hypertension ; Infusions, Intravenous ; Isoproterenol ; Male ; Middle Aged

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

A variety of disease states are marked by prolonged and profound eosinophilia associated with localized or widespread eosinophilic infiltrates. Cardiac involvement maybe a major cause of morbidity and mortality of this disease. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocardilic myocarditis by endomyocardial biopsy.
Biopsy ; Eosinophilia ; Eosinophils* ; Mortality ; Myocarditis*

Single coronary artery is a rare congenital anomaly occurring in approximately 0.04% of the population. This entity can be diagnosed during life only by coronary angiography. Typical angina does not occur with single coronary artery in the absence of coexisting coronary artery disease or aortic stenosis. Among 874 patients who underwent diagnostic coronary angiography at Asan Medical Center. we have experienced a case of single coronary artery with significant atherosclerotic coronary artery disease which has been managed succesfully coronary angioplasty. We report this case of single coronary artery with a review of literature.
Angioplasty ; Aortic Valve Stenosis ; Chungcheongnam-do ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Humans

Of several possible configurations of pin fixation of a displaced supracondylar fracture of the humerus in children, the medial and lateral crossed pinning technique has been known to provide the greatest resistance to gross rotational displacement. A new technique with ipsilateral two lateral crossed pins was devised so as to avoid the ulnar nerve injury with good stability for fracture site. During the period from 1992 to 1994, 18 children with displaced supracondylar fracture of the humerus were treated by closed reduction and ipsilateral two lateral crossed pinning. Eighty nine percents of the final results were satisfactory. There were no ulnar nerve injuries and fixation loss in all cases from the treatment. This is a safe, simple and reliable technique for providing the good stability of fracture site as well as avoiding the ulnar nerve injury.
Child ; Humans ; Humerus ; Ulnar Nerve ; Ulnar Neuropathies ; United Nations