Heart failure is a recognized, although uncommon, cause of massive liver cell necrosis, the clinical consequence of which are intermingled with those of cardiac insufficiency in most case. But, hepatic coma is rerely caused by hepatic congestion only. We report the three cases with heart failure resulted in massive liver cell necrosis and fulminant hepatic failure. The manifestations of fulminant hepatic failure were hepatic encephalopathy, jaundice, marked increase of prothrombin time and serum transaminase and there were no evidences of viral hepatitis and toxic hepatitis as a cause of liver failure.
Drug-Induced Liver Injury ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hepatic Encephalopathy ; Hepatitis ; Jaundice ; Liver ; Liver Failure ; Liver Failure, Acute* ; Necrosis ; Prothrombin Time

The authors reported here a 23 years-old female patient with acute renal failure and anaphylaxis induced by rifampicin, who was suffered from exudative pericarditis. The diagnosis was made by its reproducibility with rifampicin. The pathogenesis of acute renal failure and anaphylaxis in this case was thought to be immunologic mechanism, because of elevated IgE and depressed complements. Relevant literature was also reviewed.
Acute Kidney Injury* ; Anaphylaxis* ; Complement System Proteins ; Diagnosis ; Female ; Humans ; Immunoglobulin E ; Pericarditis ; Rifampin ; Young Adult

No abstract available.
Amlodipine* ; Humans ; Hypertension*

No abstract available.
Doxazosin* ; Hypertension*

No abstract available.
Humans ; Hypercholesterolemia* ; Lovastatin*

OBJECTIVES: There have been growing interests about alopecia occured during childhood and adolescence in clinical practice. The purpose of this paper is to explore the clinical characteristics of early onset alopecia in order to establish effective psychiatric intervention strategy. METHODS: The subjects were 31 early onset alopecia patients(14 males, 17 females) and 62 late onset control patients(26 males, 36 females). These patients had visited psychiatric outpatient clinic consulted from the department of dermatology, Yongsan hopital, Chung Ang University, Seoul, Korea, from January 1998 to june 1999. The sociodemographic data, clinical pattern of alopecia, psychiatic characteristics, comorbid physical illnesses and treatment variables were assesed. The data was statistically analyzed using chi-squre test and t-test through SPSSWIN 9.0V. RESULTS: 1) Early onset alopecia patients were more likely born in autum, had fewer siblings, and showed higher economical level of both patient and their parents than late onset patients. 2) Early onset alopecia patients were more likely to show diffuse hair loss, had more experienced past history of alopecia, more frequently had recurrence more than 3 times, were more severely damaged, had longer duration of hair loss had more loss of hairs on the vertex area at onset of alopecia, had more loss of hairs more than 2 areas, and had poorer prognosis such as no change or exacerbation in spite of treatment, spontaneous withdrawal of tratment and lack of efficacy to treatment than late onset patients. 3) Early onset alopecia patients were poorer in their adjustment in family life, or interpersonal relations, and more suffered from school stress such as changes of school life or test stress related with school entrance examination than late onset patients. 4) Early onset alopecia patients were more likely to show serious psychopathology such as increased rate of the anxiety disorders, of anxiety symptoms or depressive symptoms, and of personality disorders including the histrionic or the passive traits than late onset patients. 5) Early onset alopecia patients were more likely showed dermatitis including seborrheic dermatitis, and more significantly responding to the treatment with anti-anxiety drug, such as alprazolam, and dermatological therapies including polytar or tretinin than late onset patients. CONCLULSION: These findings suggest that dermatologists, as primary care physicians, are in unique position to recognize psychiatric comorbidity and to execute earlier intervention, in collaboration with psychiatrists, of early onset alopecia patients.
Adolescent* ; Alopecia* ; Alprazolam ; Ambulatory Care Facilities ; Anxiety ; Anxiety Disorders ; Comorbidity ; Cooperative Behavior ; Depression ; Dermatitis ; Dermatitis, Seborrheic ; Dermatology ; Equidae ; Hair ; Humans ; Interpersonal Relations ; Korea ; Male ; Parents ; Personality Disorders ; Physicians, Primary Care ; Prognosis ; Psychiatry ; Psychopathology ; Recurrence ; Seoul ; Siblings

OBJECTIVES: The present study was performed to reveal correlations between the severity of the alopecia and their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment and to use them as basic materials for proper manaement and early prevention of the alopecia prone cases. METHODS: In order to analyze correlation between the severity of psychopathogy and the severity of hair losses, the subjects were divided into two subgroups as the 60 case of alopecia areata and the 33 cases of alopecia totalis with more severely affected loss of hairs, who had visited to the department of psychiatry after they were consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and T-test through SPSS-PC+ 8.0V. RESULTS: 1) Those with the more severely affected alopecia were more likely to visit to the department of dermatology in winter, and to show lower socioeconomical level in comparison to the alopecia areata. 2) Those with the more severely affected alopecia were more likely to show past history of alopecia, to recur frequently more than 3 times, to be damaged more severely, to have an younger mean age at onset of alopecia, to have longer total duration of hair loss than 2 years, to have longer recent duration of hair loss than 9 months, to have more loss of hairs on the vertex area at onset of alopecia, to have more loss of hairs in eyebrows, to have more loss of hairs more than 2 areas, to have more family history of alopecia in their parent, and to have poorer prognosis in comparison to those of the alopecia areata. 3) Psychosocial stress were positively correlated with the severity of loss of hairs. In the more severely affected alopecia group, their degree of stress were perceived higher. The more severely affected patients with alopecia , were poorer in their adjustment in family life,interpersonal relations or heterosexual relations, and suffered more from intrafamilial life changes in comparison to those of the alopecia areata group. 4) Those with the more severly affected alopecia were more likely to show serious psychopathology such as an increased rate of the depression, to complain more frequently with anxiety symptoms or depressive symptoms, to have personality disorders including the histrionic or the passive aggressive traits in comparison to the alopecia areata. 5) Those with the more severly affected alopecia were more likely to show neurotic MMPI code profiles such as histrionic or hypochondriacal trends. 6) Antianxiety drug such as alprazolam and drug therapies including tretinin,polytar or oral sorarens plus ultra-violet light A photochemotherapy were significantly more effective in the treatment of those with the more severly affected alopecia group. CONCLUSION: The most important factors in developing a psychopathologic reaction to the hair loss due to alopecia seems to be the presence of mental disorders including depression, the presence of stressful life events such as intrafamilial life changes, the presence of a significantly higher percentages of personality disorders such as the hysterical or the passive aggressive, and the presence of the psychosocial sequele and maladjustment in various life situations. From the above facts, the authors suggested that dermatologists acting as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for patients with alopecia with psychiatrists.
Alopecia Areata* ; Alopecia* ; Alprazolam ; Anxiety ; Climacteric ; Comorbidity ; Depression ; Dermatology ; Drug Therapy ; Equidae ; Eyebrows ; Hair ; Heterosexuality ; Humans ; Korea ; Mental Disorders ; MMPI ; Parents ; Personality Disorders ; Photochemotherapy ; Physicians, Primary Care ; Prognosis ; Psychiatry ; Psychopathology ; Seoul ; Statistics as Topic

BACKGROUND: In order to investigate the efficacy and safety of cilazapril, a recently developed angiotensin converting enzyme inhibitor, a clinical study was performed in the patients with mild to moderate essential hypertension. METHODS: The study subject consisted of 31 patients with diastolic blood pressure of 95mmHg~115mmHg (mean age : 56.0+/-8.1 years, 16 males and 15 females). Cilazapril was administered orally in a daily dose of 2.5mg~5.0mg Q.D. for 8 weeks. During cilazapril medication, anti-hypertensive efficacy, side effects and laboratory changes were monitored. RESULTS: Cilazapril decreased blood pressure from baseline value of 162.2+/-4.7/98.4+/-2.8mmHg to 144.6+/-10.0/89.7+/-5.7mmHg after 4weeks of medication (p<0.05) and 138.2+/-4.5/87.8+/-4.0mmHg after 8 weeks of medication (p<0.05). Heart rate change was not significant (72.3+/-4.7/min vs 71.7+/-3.6/min). Body weight change was not significant (66.6+/-9.8 Kg vs 66.8+/-9.9 Kg). There were no significant change in blood chemistry and hematologic examination except mild elevation of alanine transaminase and serum creatinine values but these date were within normal ranges. The side effects were dry cough (4 case, 12.9%), headache (2 case, 6.4%), indigestion (1 case, 3.2%) and dry mouth (1 case, 3.2%). One patient dropped out due to severe dry cough but others were mostly mild in nature. CONCLUSIONS: Cliazapril 2.5mg~5.0mg once daily regimen was effective and well tolerated in patients with mild to moderate essential hypertension.
Alanine Transaminase ; Blood Pressure ; Body Weight Changes ; Chemistry ; Cilazapril* ; Cough ; Creatinine ; Dyspepsia ; Headache ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth ; Peptidyl-Dipeptidase A ; Reference Values

The effect of ketanserin, serotonin antagonist, among 19 korean patients over 55 years with essential hypertension was assessed in an open clinical trial for three months. patients were given Ketanserin 20mg bid with monthly follow-up visits. Mean values of systolic/diastolic blood pressures fell from 169+/-17/104+/-10mmHg to 155+/-14/94+/-9mmHg at 2 weeks(p<0.01) and to 147+/-10/87+/-6mmHg at end of treatment 12 weeks after(p<0.001). There was no significant change in heart rate. Transient mild side effects were observed in 5 patients. We conclude that Ketanserin is an effective and safe drug for the treatment of elderly hypertensives.
Aged ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension* ; Ketanserin* ; Middle Aged* ; Serotonin

In single atrial and ventricular cells isolated from the guinea-pig and the rabbit heart, action potentials and membrane currents were recorded by using the whole cell voltage clamp technique. In rabbit atrial cells the repolarization showed two distinctive phases, referred as the early and late phases(early and late plateau phase), but in guinea-pig atrial cells there was a maintained plateau and less distinctive two phases of repolartization. Increasing intracellular sodium or reducing external sodium by replacement with lithium suppressed the late phase of the action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricle and guinea-pig atrial cells. Reducing external sodium decreased Ca-current and late inward current in voltage clamp. Ouabain in the concentration of 10(-5)M shortened the duration of action potential and shifted the holding current level to outward direction, decreased Ca-current and moved late inward current to outward direction. Ryanodine 10(-6)M which is known to be an inhibitor of Ca-release in the intracellular store, suppressed the late phase of action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricular cells. Ryanodine also decreased Ca-current and shifted late inward current to outward direction. It is concluded that an inward current activated by intracellular calcium contributes to the late Phase of the action potential in rabbit atrial cells and to the late plateau in rabbit ventricular cells and in guinea-pig atrial cells. It may be carried by the Na-Ca exchange precess and/or by calcium-activated non-specific channels but preferably Na-Ca exchange machanism.
Action Potentials* ; Calcium ; Heart* ; Lithium ; Membranes* ; Myocytes, Cardiac ; Ouabain ; Ryanodine ; Sodium