BACKGROUND: To evaluate the safety and the efficacy of amlodipine, a dihydropyridine calcium antagonist, monotherapy in the treatment of moderate essential hypertension. METHOD: Amlodipine 5mg once a day was administered as a starting dose in 30 patients with essential hypertension in the morning and a one step upward titration was performed (amlodipine 10 mg once a day) was done at the end of 4weeks treatment. Final evaluation was done at 12weeks with laboratory test and echocardiogram. RESULT: Within 4weeks treatment with dose of 5mg amlodipine once a day, the systolic blood pressure (SBP) was decreased(184.5+/-23.3/150.5+/-16.0mmHg,p<0.000), and the diastolic blood pressure(DBP) was also decreased significantly (109.9+/-04.6/92.3+/-11.5mmHg, P<0.001). After 12 weeks of treatment with a mean dosage of 6.6mg once a day, SBP and DBP was maintained comparing with basal level (147.0+/-15.8/88.1+/-0.9mmHg, respectively). The efficacy of amlodipine treatment was noted an excellent in 16 patients(53.3%), good in 4 patient(13.3%), fair in 4 patients(13.3%), and failed in 2 patients(6.7%). There was no significant change in heart rate before and after amlodipine treatment. (80.0+/-2.3/80.9+/-10.4 beats/minute n.s). Amlodipine had not significant effects on laboratory findings such as serum creatinine, BUN, ALT/AST, hemoglobin, leukocyte count,platelet and lipid profiles. There was facial flushing 2 patients, but no need to discontinue administration of amlodipine and all patients completed for 12weeks therapy. CONCLUSION: It is concluded that amlodipine is an effective antihypertensive agent, as monotherapy once a day in patients with moderate essential hypertension.
Amlodipine ; Blood Pressure ; Calcium ; Creatinine ; Flushing ; Heart Rate ; Humans ; Hypertension* ; Leukocytes

Despite current practice there is no evidence to demonstrate the efficacy of intraurethral 2% lidocaine gel as an anesthetic for rigid cystoscopy. To evaluate the usefulness of lidocaine on decreasing pain associated with cystoscopy, we performed a randomized controlled study comparing 2% lidocaine gel with a plain water based lubricant. Pain was recorded on a visual analogue scale by the patient and by the physician. Physician perception of pain experienced by the patient was compared with the actual pain experienced. We found decrease in pain perception in men following lidocaine gel instillation with a 5 or 10 minute dwell time compared to instillation of the plain lubricant.
Anesthetics ; Cystoscopy* ; Humans ; Lidocaine* ; Male ; Pain Perception ; Water

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

Purpose: Improving survival and health-related quality of life (HRQOL), along with symptom relief, is important for the treatment of metastatic breast cancer (MBC). This study measured HRQOL and analyzed its influence on sociodemographic and clinical factors in patients with MBC. Methods: We interviewed 298 patients with MBC to investigate their sociodemographic characteristics and HRQOL by using EuroQol-5D-5L (EQ-5D) between September and October 2014. We also reviewed medical records to examine the clinical condition of the patients, including disease progression, adverse events, treatments, chronic disease, and metastatic areas. The distribution of the EQ-5D index was compared between different clinical conditions by using the Kruskal-Wallis test. We also conducted multiple regression analyses to identify the factors affecting HRQOL in patients with MBC. Results: The mean EQ-5D index was 0.79 for all patients surveyed. The mean EQ-5D index score was significantly lower in patients in the progressed state than in those in the progression-free survival state (0.73 vs. 0.80, p = 0.0002). The HRQOL of patients treated with chemotherapy alone was significantly lower than that of patients treated with hormonal or targeted therapy (0.76 vs. 0.82 or 0.85; p = 0.0020). Regression analysis revealed that the clinical factors associated with lower HRQOL were progressed state, chemotherapy, and adverse events, such as hair loss or stomatitis. Finally, young age, high income, and employment were the sociodemographic factors that were positively associated with better HRQOL. Conclusion This study provides new information on the health utility of MBC patients on the basis of various patient characteristics and offers insights that can assist medical professionals in treating patients with MBC and help policymakers implement cancer strategies. Further research is needed to reflect the changing environment of cancer treatment and enrich available evidence.

BACKGROUND: The effective ventricular function during ejection and filling is likely to depend on the coordinated action of the longitudinally and circumferentially orientated myocardial fibers and the function of these longitudinal fibers has not been extensively studied. METHODS: The role of longitudinally and circumferentially orientated fibers in left ventricular wall motion was evaluated by M-mode echocardiograms of the mitral ring(whose motion reflect long axis change) and the standard minor axis(left ventricular posterior wall), simultaneous recordings of phonocardiograms and electrocardiograms on the paper (speed 100mm/sec), in 24 healty individuals, 17 patients with mitral stenosis, 11 patients with open mitral commissurotomy and 17 mitral valve replaced patients. RESULTS: In the controls long axis shortening significantly preceded minor axis shortening (phase difference between two axes : 20+/-3 msec, mean+/-SEM) during early systole, indicating left ventricle become more spherical. This phase difference was also observed in the patients with mitral stenosis and in those with open mitral commissurotomy. In patients with mitral valve replacement(MVR) whose papillary muscles had been sectioned, the onset of long axis shortening was more delayed during early systole than that of short axis(-33+/-6msec) and the end of shortening was also prolonged to early diastole more than that of normal controls (54+/-3 msec vs 90+/-8 msec, mean+/-SEM, p<0.01 by t-test). CONCLUSION: We observed the time relations between long and short axis motion in normal controls. It can be concluded that the reversed time relation in patients with MVR is one of the important factors which may effect negatively on ventricular function and long-term prognosis, thus the surgical procedures to preserve papillary annular continuity should be considered in patients with mitral valvular disease. And the controlled, prospective, clinical trials with homogenous groups of patients are needed to evaluate the potential benefits of papillary annular continuity in preserving atrio-ventricular interaction in patients undergoing mitral valvular surgery.
Axis, Cervical Vertebra* ; Diastole ; Echocardiography ; Electrocardiography ; Heart Valve Diseases* ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Papillary Muscles ; Prognosis ; Systole ; Ventricular Function

BACKGROUND: In previous study, hypertensive patients with left ventricular diastolic dysfunction showed delayed relaxation time intervals and increased relaxation nonuniformity of regional wall motion. In this point of view, the effects of amlodipine on the regional wall motion and mitral flow patterns were evaluated. METHODS: Before and 32weeks after the antihypertensive medication of amlodipine, M-mode & Doppler echocardiogram were performed in 14 patients with moderate hypertension. We measured A2 to the peak thinning rate point of left ventricular(LV)posterior wall [A2-(-)dpw/dt] and the peak lengthening rate point of mitral annulus [A2-dL/dt] on M-mode echocardiogram and we defined nonuniformity as the time interval, (-)dpw/dt-dL/dt. RESULTS: 1) Mitral flow velocity E/A ratio was increased (0.95+/-0.4 vs 1.42+/-0.6, p<0.05) after amlodipine medication. 2) Heart rate and LV posterior wall thickness was decreased (79+/-9.3 vs 72+/-10.8 beats/min, 10.7+/-1.5 vs 9.4+/-2.0mm, p<0.05 respectively). 3) Long axis relaxation was improved (A2-dL/dt ; 165+/-44 vs 140+/-23msec, p<0.05) and nonuniformity index was decreased ((-)dpw/dt-dL/dt ; 63+/-49 vs 41+/-30msec p=0.07). CONCLUSION: Amlodipine improved E/A ratio of mitral flow (E/A ratio) in hypertensive patients with diastolic dysfunction, which could be attributed to the decreased heart rate, the decrease in wall thickness and the improvement in relaxation movement of LV long axis.
Amlodipine* ; Axis, Cervical Vertebra ; Heart Rate ; Humans ; Hypertension* ; Relaxation

BACKGROUND: Viral myocarditis is considered as a cause of dilated cardiomyopathy. At present, two pathogenic mechanisms may be involved in the pathogenesis of viral myocarditis and subsequent cardiomyopathy. First, the virus infection of myocyte may directly lead to either cell death or persistent metabolic dysfunction. Second, virus-induced immune or autoimmune mechanism may play a role. METHODS: To test the therapeutic efficacy of immunosuppression with cyclophophamide(CYP) on coxsackievirus B3(CB3) myocarditis, 10-14 week-old Balb/c mice were inoculated with 4000 plaque-forming units of CB3. In experiment 1, CYP (100mg/kg/day subcutaneous injection, s.c) was administrated daily on days 1-7(group 2, n=16). In experiment 2, CYP 30mg/kg/day s.c(group 3, n=32) or CYP 100mg/kg/day s.c(group 4, n=32) were administrated on days 8-14. The animals of infected controls(group 1, n=26) and group 2, 3, 4 were dissected at days 4, 7, 15, 22 and spleen, heart, thymus and body weights were measured. RESULTS: In experiment 1. survival rate in group 2 on day 7, 15 were low compared with group 1(85%, 0% vs 100%, p<0.05). and myocardial virus titers in group 2 on day 4 was 50 times, and on day 7, 1000 times higher compared with group 1, Histologically, on day 7, focal cellular infiltrations were prominent findings in group 1, but diffuse myocardial necrosis without cellular infiltration were observed in group 2. In experiment 2, survival rate, cardiac histopathology myocardial virus titer and serum neutralizing antibody titers did not differ among groups 1, 3 and 4. In experiment 1 and 2, the spleen-to-body-weight and thymus-to-body-weight ratios were significantly lower in CYP treated groups than those in controls and marked cellular depletions in spleens and thymus were observed in CYP treated groups. CONCLUSIONS: As the results of above, it can be concluded that the immunosuppression during viremic phase of murine viral myocarditis aggravated the myocardial necrosis, and during aviremic phase, the administration of CYP didnot affect the process of viral myocarditis. Thus, direct viral mechanisms in the production of cardiomyocyte injury in CB3-infected mice appear to bo more important than cell mediated immune mechanism. To understand relevant pathogenic mechanisms of clinical myocarditis and dilated cardiomyopathy resulting from viral infection, the experimental study expanding into nonmurine animals and into various models using other infectious agents may be required.
Animals ; Antibodies, Neutralizing ; Body Weight ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cell Death ; Cyclophosphamide* ; Heart ; Immunosuppression ; Injections, Subcutaneous ; Mice ; Muscle Cells ; Myocarditis* ; Myocytes, Cardiac ; Necrosis ; Spleen ; Survival Rate ; Thymus Gland ; Viral Load

BACKGROUND: This study was designed to evaluate the safety and the efficacy of fosinopril(Monopril(R)) in the treatment of mild to moderate essential hypertension. METHOD: Fosinopril(10mg) once a day was administrated as a starting dose in 20 patients with essential hypertension in the morning and a one step upward titration was performed(fosinopril 20mg once a day, after 4 weeks treatment). RESULT: After 2 weeks treatment with dose of 10mg, the systolic blood pressure(SBP) was decreased(183.8+/-28.5 vs, 161.5+/-25.9mmHg, p<0.05) and the diastolic blood pressure(DBP) was also decreased significantly(108.3+/-9.3 vs, 96.6+/-10.3mmHg, p<0.05). The effect of fosinopril were maintained. The SBP an DBP were decreased in 14 out of 20 patients till 8 weeks. There was no significant change in heart rate before and after fosinopril treatment(74.3+/-10 vs, 76.4+/-7.9beats/min). Fosinopril had no significant effects on laboratory findings such as serum creatinin, BUN, AST/ALT, WBC, Platelet and lipid profiles. Mild dry coughing was noticed only in 5 patients and it did not disturb continuing medication. CONCLUSION: Fosinopril is an effective antihypertensive agent, as monotherapy once a day in patients with mild to moderate hypertension.
Blood Platelets ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension*

No abstract available.
Echocardiography* ; Electrocardiography*