The antihypertensive effect of trimazosin was studied in 24 cases of essential hypertension, which include 9 cases with pretreatment diastolic pressure of 114mmHg or more, for a period of 4 weeks. The average pretreatment systolic and diastolic blood pressures were approximately 175mmHg and 114mmHg, respectively. The treatment was started with 100mg of trimazosin daily in 2 divided doses and and the drug was titrated upward at weekly interval by 100mg up to 400mg/day depending on the response of the blood pressures. Routine blood counts, urinalyses, liver and kidney function tests, electrolyte balance, total serum cholesterol and triglyceride were determined before and at the end of treatment. The diastolic blood pressure fell 10mmHg or more in 20 out of 24 cases(83.3%), and in 12 cases out of 20 favorable responders it fell to 90mmHg or below. The pretreatment diastolic blood pressure in 4 nonresponders was all 115mmHg or more. The antihypertensive effect appeared during the first week of therapy and progressively increased until the end of treatment week without causing postural hypotension. Unpleasant symptoms appeared in 12 cases during treatment, which include dizziness, headache, numbness in the extremities and tinnitus in the decreasing order of frequency. However, these symptoms were mild and transient in all cases disappearing spontaneously despite continued medication. No significant biochemical changes in the blood were recorded after treatment. We conclude that trimzosin seems to be a safe and effective antihypertensive drug particularly useful for the treatment of mild to moderate hypertension.
Blood Pressure ; Cholesterol ; Dizziness ; Extremities ; Headache ; Hypertension* ; Hypesthesia ; Hypotension, Orthostatic ; Kidney Function Tests ; Liver ; Tinnitus ; Triglycerides ; Urinalysis ; Water-Electrolyte Balance

Twenty-one cases of mitral valve prolapse (MVP) diagnosed by M-mode echocardiograms were studied in regard to the underlying or associated conditions, types of MVP, and dimensions of the cardiac structures and parameters reflecting cardiac performance determined by echocardiograms. In 9 cases, MVP was thought to be idiopathic origin. Associated conditions in the remainder were 5 cases of congenital heart disease, 2 cases of rheumatic myocarditis, 1 case each of aortic valve disease, ischemic heart disease and hyperthyroidism, and 2 cases of undiagnosed cardiac conditions. There were 2 cases of buckling type of MVP and in the remainder hammock type. In these 2 patients with hammock type of MVP, mitral valve echoes were seen in the left atrium during systole in 1 case, and diastolic anterior displacement of posterior mitral leaflet in the other. In 9 cases of idiopathic MVP, cardiac dimensions and parameters reflecting cardiac performance as determined from echocardiograms showed no significant differences from those of 27 normal controls.
Aortic Valve ; Echocardiography* ; Heart Atria ; Heart Defects, Congenital ; Humans ; Hyperthyroidism ; Mitral Valve Prolapse* ; Mitral Valve* ; Myocardial Ischemia ; Myocarditis ; Systole

Collagenous gastroduodenitis is a rare gastrointestinal disease diagnosed histologically by subepithelial collagen deposition in the lamina propria. Its clinical presentation is diverse. The authors encountered a 17-year-old female patient who complained of epigastric pain. Endoscopy revealed several deep ulcers in the gastric body. The gastric mucosa around the ulcer showed diffuse fine nodularity in the shape of cobblestones with open-type atrophy. The duodenal mucosa showed nodular lesions similar to those of the gastric mucosa. The gastric ulcer healed completely with proton pump inhibitor treatment. The patient was followed up, showing no remarkable mucosal change of stomach or duodenum for several years. Collagenous gastroduodenitis was diagnosed by repeated histologic examinations. This paper reports a rare case of chronic collagen gastritis with deep gastric ulcer and its long-term clinical progress.

PURPOSE: With the westernization of dietary life, domestic prostate cancer prevalence has remarkably increased recently. Therefore, to examine the effects of obesity on prostate cancer, we analyzed the effects of leptin and adiponectin, which are the cytokines secreted from adipocytes, on prostate cancer in vitro and confirmed the results by in vivo experiment. MATERIALS AND METHODS: In vitro, the human androgen-independent prostate cancer cell line DU-145 was exposed to various concentrations of adiponectin and leptin, and their effects were measured with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. In vivo, the effects of tumor growth were observed in xenografted nude mice with prostate cancer. RESULTS: Adiponectin significantly repressed DU-145 cell growth in a dose-dependent manner. Leptin promoted DU-145 cell growth in dose-dependent manner, but it was not significant statistically. In vivo, adiponectin-treated mice demonstrated a reduced tumor volume, although it was not significant statistically. By contrast, leptin-treated mice showed a significantly increased tumor volume (p<0.01). CONCLUSIONS: The in vitro and in vivo finding suggested that adiponectin suppresses the proliferation of prostate cancer cells and that leptin plays an important role in the proliferation of prostate cancer cells. We suggest that adiponectin and leptin have a relation to the progression of prostate cancer in the obese population.
Adipocytes ; Adiponectin ; Animals ; Cell Line ; Cytokines ; Humans ; Leptin ; Mice ; Mice, Nude ; Obesity ; Prevalence ; Prostate ; Prostatic Neoplasms ; Tetrazolium Salts ; Thiazoles ; Transplantation, Heterologous ; Tumor Burden

PURPOSE: The objective of this study is to report our initial experience about the feasibility, effectiveness, and safety of transobturator tension-free vaginal mesh (Prolift(TM)) and concomitant tension-free vaginal tape (TVT) as a treatment of female anterior vaginal wall prolapse associated with stress urinary incontinence (SUI). MATERIALS AND METHODS: We reviewed the charts of patients who underwent Prolift(TM) and TVT between April 2009 and March 2010. All patients had a physical examination and staging of cystocele. According to the International Continence Society system 2, 5 and 3 women had stage grade II, III and IV respectively. All the patients underwent pelvic examination 1, 3, 6 month and 1 year after operation and anatomical and functional outcomes were recorded. An anatomic cure after intervention was defined as stage 0 and an improvement was defined as stage I. Anatomic failures were defined as stage II or higher on the last physical examination. RESULTS: The mean follow-up was 7.1 (1-11) months. Overall success rate of cystocele repair was 90%. The anatomical cure rate of cystocele was 50%. The cystocele repair improved 4 patients, but failed in 1. SUI was cured in all patients. No significant complications including bladder or vessel injury and mesh related erosion occurred. The postoperative complication was transient voiding difficulty (2 cases). CONCLUSIONS: These preliminary results suggest that Prolift(TM) and TVT offer a safe and effective treatment for female anterior vaginal wall prolapse and SUI. However, a long-term follow up is necessary in order to support the good result maintenance.
Cystocele ; Female ; Follow-Up Studies ; Glycosaminoglycans ; Gynecological Examination ; Humans ; Physical Examination ; Postoperative Complications ; Prolapse ; Suburethral Slings ; Urinary Bladder ; Urinary Incontinence

A 44-year-old man, who had a history of myocardial infarction (MI) due to thrombotic occlusion of right coronary artery (RCA) aneurysm, visited emergency department presenting with ST-segment elevation myocardial infarction (STEMI). The patient had been on oral anticoagulant therapy (warfarin) from the first thrombotic event, but the medication had been recently changed to aspirin 4 months before the second event. Emergent coronary angiography revealed thrombotic total occlusion of RCA with heavy thrombotic burden from middle RCA to the ostium of the posterior descending branch. Combination pharmacotherapy was performed with anticoagulants (heparin), fibrinolytics (urokinase), and Glycoprotein IIb/IIIa antagonists (abciximab), in addition to mechanical thrombosuction. However, on hospital day 2, the patient complained recurrent chest pain and again underwent coronary angiography, which revealed distal embolization of large thrombus to the posterior lateral branch. Coronary flow was recovered after repeated mechanical thrombosuction was performed. This case has shown the importance of aggressive combination drug therapy, accompanied by mechanical thrombosuction in patient with myocardial infarction due to thrombotic occlusion of coronary artery aneurysm and the importance of unceasing life-long anticoagulant therapy in those particular patients.
Adult ; Aneurysm* ; Anticoagulants ; Aspirin ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Occlusion* ; Coronary Vessels* ; Drug Therapy ; Drug Therapy, Combination ; Emergency Service, Hospital ; Glycoproteins ; Humans ; Myocardial Infarction* ; Thrombectomy ; Thrombosis ; Warfarin*

PURPOSE: Use of a composite graft combining a polytetrafluoroethylene graft with an autogenous vein is an option for limb salvage in the absence of an adequate single segment vein graft. We aimed to investigate the results of infrainguinal bypass with a composite graft. MATERIALS AND METHODS: We retrospectively reviewed 11 infrainguinal arterial bypasses on 11 limbs which underwent surgery from March 2012 to November 2016. RESULTS: Critical limb ischemia was common (63.6%) indication of bypass surgery and most (90.9%) of the patients had history of failed previous treatment including endovascular treatment (36.4%) and bypass surgery (72.7%). At the 2 years after graft implantations, primary patency and amputation-free survival of below-knee bypasses using composite graft were 73% and 76%, respectively. CONCLUSION: Infrainguinal arterial bypasses with composite graft had an acceptable patency. In patients without other alternative conduits for revascularization, bypass with a composite graft can be an option.
Extremities ; Humans ; Ischemia ; Limb Salvage ; Polytetrafluoroethylene* ; Retrospective Studies ; Saphenous Vein* ; Transplants* ; Veins*

Symptomatic primary heart tumors are rare in newborn. Cardiac rhabdomyoma is the most common lesion of the primary heart tumors and over half of them are related to kthe tuberous s clerosis. We described a case of cardiac rhabdomyoma, in a 2 day-old female newborn who presented with dyspnea and cyanosis. A 2D Echocardiogram demonstrated two masses; one is in the rt. ventricle and another is in the interventricular septum. Additional cardiac masses and cerebral tubers and subependymal giant cell astrocytoma were found at autopsy.
Astrocytoma ; Autopsy ; Cyanosis ; Dyspnea ; Female ; Heart Neoplasms* ; Humans ; Infant, Newborn* ; Rhabdomyoma ; Tuberous Sclerosis*

Electrocardiographic findings in 18 cases of hypertrophic obstructive cardiomyopathy(HOCM) were compared with those in 20 hypertensives with disproportinate septal hypertrophy(DSH) and in 20 normal controls. In conventional 12 leads electrocardiograms, abmormal Q waves were seen only in 6 cases of HOCM and none in the remadinder. The R waves were tallest in leads V4 in 6 cases(33%) of HOCM, 3(15%) hypertensives with DSH, and 4(20%) of the controls. The correlations of the QRS voltages with echocardiographically measured left ventricular dimension, interventricular septal thickness and left ventricular mass were significant in the hypertensives with DST and normal controls, but insignificant in patients with HOCM. We conclude that these electrocardiographic differences in patients with HOCM from the others would be caused by uneven distribution of hypertrophied muscle mass in the left ventricule and/or by the altered depolarization in hypertrophied cardiac muscles.
Cardiomyopathy, Hypertrophic* ; Electrocardiography* ; Humans ; Hypertension* ; Myocardium

Sinogenic intracranial complications are rare but serious conditions. Sometimes, the diagnosis is delayed because the initial symptoms of sphenoid sinuses intracranial complications are not remarkable especially when they are of sphenoid sinus origin. Deep location of the sphenoid sinuses places them adjacent to the dura mater, major intracranial vessels, and some cranial nerves. Therefore, delayed diagnosis of the sphenoid sinusitis and its complications can make disastrous results. We experienced a 55 year old female patient who developed fulminant meningitis, vasculitis, and a stroke due to vasculitis as a complication of sphenoid sinusitis. We review the case and related articles.
Cranial Nerves ; Delayed Diagnosis ; Diagnosis ; Dura Mater ; Female ; Humans ; Meningitis ; Middle Aged ; Sphenoid Sinus* ; Sphenoid Sinusitis* ; Stroke* ; Vasculitis*