BACKGROUND: The angiotensin-converting enzyme inhibitors have been found to be safe and efficacious in the treatment of essential hypertension. Fosinopril is the first angiotensin-converting enzyme inhibitor from a new class of agents containing phosphorus. This drug is known to be metabolized to almost and equal extent by the hepatic and renal pathways. METHODS: This study was performed to investigate the efficacy and safety of oral fosinopril, a new class of phosporus-containing angiotensin converting enzyme inhibitor, on essential hypertension. A single daily dose of 10mg to 20mg fosinopril was administered in 21 hypertensive patients with diastolic blood pressure in the range of 95mmHg-115mmHg while off all other anti-hypertensive agents for 10 weeks. Blood pressure and heart rate were measured every 4 weeks. The complete blood count, blood chemistry by SMA-12, serum electrolytes and urinalysis were performed at 12th week of therapy. RESULTS: 1) Baseline systolic and diastolic blood pressures after 2 weeks of placebo at sitting position were 158.8+/-15.7 and 99.4+/-6.3mmHg respectively. There was a statistcally significant reduction of blood pressure after 4 week treatment of fosinopril which was maintained up to 12 weeks of follow-up(158.8+/-15.7-99.4+/-6.3mmHg vs 139.3+/-18.2/86.6+/-10.3mmHg, p<0.05). 2) The proportion of responders defined by diastolic blood pressures less than 90mmHg or decline more than 10mmHg at 4, 8 and 12 weeks after treatment with fosinopril were 90.5, 95.2, and 95.2% respectively. 3) THere were no significant changes in blood chemistry, serum electrolytes, hematologic findings and heart rate over the treatment period. 4) Three patients experienced severe non-productive cough that required to discontinue the medication. CONCLUSION: In patients with mild to moderate hypertension, once-daily fosinopril(10mg and 20mg) provided significant anti-hypertensive effects without serious side effects. The 10mg dose was effective in majority of patients and may be considered as a starting dose.
Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Electrolytes ; Fosinopril* ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Urinalysis

BACKGROUND: Hypertension is a major and growing public health problem and it calls for life-long management. The antihypertensive agents are still playing major roles in the management of hypertension. We studied the effect of the long-term therapy with a new calcium channel blocker, felodipine in patients with essential hypertension. METHODS: We recruited 31 patients with mild to moderate essential hypertention and gave them 5mg (1 tablet) of felodipine(Munobal(R)) once daily for 12 months. We measured the blood pressure and the heart rate every month and tried to detect any untoward symptoms and signs during the whole observation period. Baseline work-up for the hypertensive patients were done as usual before and after the study. RESULTS: The average systolic and diastolic blood pressures were 162.7+/-9.7/99.6+/-7.4mmHg respectively before the administration and they came down to the level of 139.7+/-15.0/87.3+/-8.6mmHg respectively at the end of the 1st month (p<0.05). This trend was maintained during the whole observation period, so they were 141.2+/-11.0/85.6+/-8.2mmHg respectively at the end of the study (p<0.05). Untoward drug reactions such as gastrointestinal troubles, facial edema, leg edema, chest pain and headache were present in 11 patients (35%) but they were not serious. There was no case in which the drug was withdrawn. There was one case in which the level of the serum triglyceride increased after the administration of the drug. CONCLUSION: Felodipine has good and persistent hypotensive effect and it is safe and easy to use.
Antihypertensive Agents ; Blood Pressure ; Calcium Channels ; Chest Pain ; Edema ; Felodipine ; Headache ; Heart Rate ; Humans ; Hypertension* ; Leg ; Public Health ; Triglycerides

BACKGROUND: Newly developed alpha-, beta-receptor blocker, Amosulalol HCI(YM-09538) was evaluated for its hypotensive efficacy, safety and usefulness in patients with mild to moderate essential hypertension. METHODS: Thirty patients of essential hypertension(male 8, female 22), mean age 55 years were included for the study. Amosulalol HCI was administered 20-60mg daily for 10 weeks and initial starting dose was 10mg twice daily and dose was increased 40mg and 60mg daily in cases of insatisfactory hypotensive effect ever 2 weeks interval. Patients were evaluated every two weeks on blood pressure, pulse rate, improvement of subjective symptoms and side effects. Laboratory examinations were carried out routinely in principle two times before trial and after completion of study. RESULTS: Blood pressure began to fall significantly after tow weeks of administration and changed from initial 172.4mmHg of systolic pressure to final 149.3mmHg and from 104.7mmHg of diastolic pressure to final 92.5mmHg. The response rates were marked fall in 30%, satisfactory fall in 40%, thus overall hypotensive effect was observed in 70%. Pulse rate decreased slightiy but significantly from 4 weeks of administration. Improvement of subjective symptoms were observed in 7 cases out of 12 cases and no significant side effects were observedd except of two mild transitory cases of polyuria and indigestion. Laboratory examination also did not show any significant changes before and after medication. CONCLUSION: The daily administration fo 20-60mg of Amosulalol HCI to moderate essectial hypertension seems to be effective and safe with clinical usefulness.
Blood Pressure ; Dyspepsia ; Female ; Heart Rate ; Humans ; Hypertension* ; Nifedipine ; Perindopril ; Polyuria

BACKGROUND: To assess the efficacy and safety of perindopril, a new angiotensin-converting enzyme(ACE) inhibitor, perindopril was compaired to nifedipine LP. METHODS: Perindopril(4mg q.d.) was compaired to nifedipine LP(20mg b.i.d.) in the double blind, parallel-group study involving total of 41 hypertensive patients with diatolic blood pressure(DBP) of 95-125mmHg. A 4-week single-blind placebo period preceeded 12 weeks of active tratment. Dose titration was at weeks 4 and 8 if the DBP was >90mmHg. The dose was doubled and, if necessary, a diuretic(hydrochlorthiazide 25mg) was added. The analysis of efficacy was performed on the 36 patients who completed the trial after 12 weeks; active treatment. The analysis of tolerance involved all 41 patients who entered the study. RESULTS: 1) The two groups were homogeneous prior to treatment. 2) The fall in blood pressure(BP) with perindopril was 22/11mmHg(from 160+/-14/101+/-6mmHg to 139+/-15/90+/-6mmHg) and 32/19mmHg(from 164+/-18/104+/-7 to 132+/-17/85+/-10mmHg) for nifedipine. 3) 65% of the perindopril group and 84% of the nifedipine group achived the target BP(diastolic BP< or =90mmHg). 4) The respone rate(DBP< or =90mmHg or the fall in DBP> or =10mmHg) was similar between two groups(88% cersus 89%). 5) Heart rate was not changed in the perindopril group. but increased in the nifedipine group. 6) Five patients withdrew from the study ; two were attributed to adverse events. one in the perindopril group and one in the nifedipine group. 7) The incidence of side effects in the perindopil group was less than that in the nifedipine group. Cough was reported by 10% of patients of the perindopril group. 8) Both groups did not induce changes in blood glucose and lipid profiles. 9) We could not find any significant relationship between the amount of blood pressure decline and 24 hour urine sodium excretion. 10) There were no clinically significant changes in laboratory parameters. CONCLUSION: Perindopril reduced blood pressure to slightly less extent than nifedipine, but had as similar efficacy as nifedipine. Perindopril had less side effects than nifedipine.
Blood Glucose ; Blood Pressure ; Cough ; Heart Rate ; Humans ; Incidence ; Nifedipine* ; Perindopril* ; Sodium

Toad toxin has digitalis-like cardioactive effects that include bradycardia, varying degrees of atrioventricular block, ventricular tachycardia, ventricular fibrillation and sudden cardiac death. We report here on a 54-year-old man who had varying degrees of atrioventricular block and nonsustained ventricular tachycardia two hours after he ate a bowl of toad soup.
Amphibian Venoms* ; Atrioventricular Block ; Bradycardia ; Death, Sudden, Cardiac ; Digitalis* ; Humans ; Hyperkalemia* ; Middle Aged ; Poisoning* ; Tachycardia, Ventricular ; Ventricular Fibrillation

BACKGROUND: Improvements in catheter equipments and increasing experience of the operators have brought about a broadening of the indications and applications of percutaneous transluminal coronary angioplasty(PTCA). In particular, coronary angioplasty has been employed in total occlusions.We evaluated the initial success rate and safety of PTCA total occulsive coronary artery disease. METHODS: To assess the success rate and safety of PTCA total coronary artery occlusion, the data of 24 patients(male 19, female 5, mean age 55+/-9 years), in whom PTCA for total occlusion were performed, were examined. RESULTS: Primary success rate of procedure was 66.7%(16 out of 24 lesions).The success rate according to the duration of total occlusions was 8 out of 11(72.7%) with occlusions<4 weeks duration and 3 out of 7(42.9%) with occlusions>4 weeks duration(p=0.07). There was no difference in success rate according to vassel dilate(left anterior descending 75.0%, right coronary 44.4%) and length of occluded lesion(0.93%+/-0.47%cm, p=0.35). Eight procedural failures included inability to cross the lesion with a guide wire in 6 and inability to dilate the lesion in 2, but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Even though the recanalization of occluded coronary arteries has a lower initial success rate than angioplasty for stenotic arteries, PTCA in total occlusion can be performed as a safe and effective therapeutic modality in selective patients.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Catheters ; Coronary Artery Disease ; Coronary Vessels* ; Death ; Emergencies ; Female ; Humans

BACKGROUND: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) have been broaden recent years. We evaluated the initial success rate and safety of PTCA in mulitiple lesions and vessels. METHODS: To assess the success rate and safety of PTCA In mulitiple lesions and vessels, the data of 60 lesions from 28 patients(male 23, female 5, mean age 56+/-12 years), in whom PTCA for multiple lesions and vessels were performed, were examined. Initial results and complications were compared in 37 lesions undergoing multivessel and 23 lesions undergoing multilesion PTCA. RESULTS: Overall primary success rate of procedure was 82%(49 out of 60 lesions). Angioplasty was attempted in mean 2.1 stenotic lesions per patient. Primary success rate per lesion was 84%(31 of 37) among those who underwent multivessel and 78%(18 of 23) among those who underwent multilesion PTCA(p>0.05). Success rate according to the combination of dilated vessels was 85.7%(12 of 14) in left anterior descending(LAD) and left circumflex(LCX), 83.3%(10 of 12) in LAD and right coronary artery(RCA), 100.0%(4 of 4) in LAD and diagonal branch, RCA and LCX in 75.0%(3 of 4), and 66.7%(2 of 3) in LAD, LCX and diagonal branch. Eleven failures(18.3%) included inability to pass the guide wire cross the lesion or inability to locate the balloon catheter in 5(8,3%), abrupt closure in 2(3,3%), coronary spasm in 1(1.7%) and major branch occlusion in 3(5.0%), but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Coronary angioplasty in selected patients with multivessel and multilesion coronary artery disease might be useful and have relatively good initial results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angioplasty* ; Catheters ; Coronary Artery Disease ; Death ; Emergencies ; Female ; Humans ; Spasm

No abstract available.

No abstract available.
Echocardiography, Stress*

A clinical study is done on 234 adult patients with congenital heart disease who visited Dong San Hospital, Keimyung University during the period of January 1982 to May 1987. Among those the number of men is 109 and the female is 125. There are female preponderance in atrial septal defect and patent ductus arteriosus while male in tetralogy of Fallot and pulmonary stenosis. Most of patients are found below 30 years of age and the incidence decrease with age; below 30 years of age, ninty percent of ventricular septal defect, eight-eight percent of tetralogy of Fallot, eighty-four percent of patent ductus arteriosus and seventy-seven percent of atrial septal defect are found. The incidence of congenital heart diseases in adult are as follow; ventricular septal defect 30.8%, atrial septal defect 30.3%, tetralogy of Fallot 17.1%, patent ductus arteriosus 12.8%, pulmonary stenosis 3.4% and miscellaneous congenital diseases 4%. Associated anomalies of major congenital heart diseases are as follows; the most commonly associated anomaly in ventricular septal defect is pulmonary stenosis, and Sinus Valsalva aneurysm with/without rupture or aortic regrugitation is frequently associated in ventricular septal defect. Mitral regurgitation or pulmonary stenosis are frequently as sociated with atrial septal defect. Patent foramen ovale or atrial septal defect and persistent left superior vena cave are associated with tetralogy of Fallot. The lesion of aortic valve is frequent in patient ductus arteriosus.
Adult ; Aneurysm ; Aortic Valve ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Female ; Foramen Ovale, Patent ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Incidence ; Male ; Mitral Valve Insufficiency ; Multiple Endocrine Neoplasia Type 1 ; Pulmonary Valve Stenosis ; Rupture ; Tetralogy of Fallot