BACKGROUND: Although hypoxic pulmonary vasoconstriction (HPC) and hypoxic coronary vasodilatation (HCD) have been recognized by many researchers, the precise mechanism remains unknown. As isolated arteries will constrict or relax in vitro in response to hypoxia, the oxygen sensor/transduction mechanism must reside in the arterial smooth muscle, the endothelium, or both. Unfortunately, much of the current evidence is conflicting, especially concerning to the dependency of HPC and HCD on the endothelium and the role of the K+ channel. Therefore, this experiment was attempted to clarify the dependency of HPC and HCD on the endothelium and the role of the K+ channel on HPC and HCD. METHODS: HPC was investigated in isolated main pulmonary arteries precontracted with norepinephrine (NE). HCD was investigated in isolated left circumflex coronary artery precontracted with prostaglandin F2 alpha. Vascular rings were suspended for isometric tension recording in an organ chamber filled with Krebs-Henseleit solution. Hypoxia was induced by gassing the chamber with 95% N2 +5% CO2, which was maintained for 15 - 25 min. RESULTS: 1)Hypoxia elicited a vasoconstriction in NE-precontracted pulmonary arteries with endothelium, but a vasodilatation in PGF 2 alpha-precontracted coronary arteries with and without endothelium. There was no difference between the amplitude of the HPC and HCD induced by two consecutive hypoxic challenges and the effect of normoxic and hyperoxic control Krebs-Henseleit solution on subsequent response to hypoxia. 2)Inhibition of NO synthesis by the treatment with Nw-nitro-L-arginine reduced HPC in pulmonary arteries, but inhibition of the cyclooxygenase pathway by treatment with indomethacin had no effect on HPC and HCD, respectively. 3)Blockades of the TEA-sensitive K+ channel abolished HPC and HCD. 4)Apamin, a small conductance Ca2+/-activated K+ (KCa) channel blocker, and iberiotoxin, a large conductance KCa channel blocker, had no effect on the HCD. 5)Glibenclamide, an ATP-sensitive K+ (KATP) channel blocker, reduced HCD. 6)Cromakalim, an K(ATP) channel opener, relaxed the coronary artery precontracted with prostaglandin F2 alpha. The degree of relaxation by cromakalim was similar to that by hypoxia and glibenclamide reduced both hypoxia- and cromakalim-induced vasodilations. 7)Verapamil, a Ca2+ entry blocker, caffeine, a Ca2+ emptying drug; and ryanodine, an inhibitor of Ca2+ release from SR, reduced HPC, respectively. CONCLUSION: HPC is dependent on the endothelium and is considered to be induced by inhibition of the mechanisms of NO-dependent vasodilation while HCD is independent of the endothelium and is considered to be induced by activation of the K(ATP) channel.
Anoxia ; Arteries ; Caffeine ; Coronary Vessels ; Cromakalim ; Dinoprost ; Endothelium ; Glyburide ; Indomethacin ; Muscle, Smooth ; Norepinephrine ; Oxygen ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins F ; Pulmonary Artery ; Relaxation ; Ryanodine ; Vasoconstriction* ; Vasodilation*

Although the conclusion is controversial, there has long been an appealing notion that catecholamines may be involved in some way in the pathogenesis of primary hypertension and almost invariably most of hypotensive drugs involve at various sites of the neuron and produce their effect by depletion of norepinephrine in the sympathetic nerve ending. The authors undertook the comparative study on catecholamine depleting action of 3 most effective drugs available for the treatment of hypertension, reserpine, guanethidine and alpha-methyldopa, measuring the plasma catecholamine levels and urinary exceretion of caecholamine by the modified fluorometric method of Weil-Malherbe and Bone during the treatment of hypertension. The results are as follows: 1) Before the administration of hypotensive drugs, mean blood pressure was 180/110mmH, mean psalma epinephrine level was 0.36+/-0.23gamma%, mean plasma norepinephrine level was 0.48+/-0.35gamma%, 24 hours urinary excretion of epinephrine was 3.6+/-0.12gamma/day and 24 hours urinary excretion of norepinephrine was 68.9+/-0.34gamma/day. 2) In group 1 (reserpin administered group), the mean blood pressure was 190/110mmHg before the treatment and which was declined to 155/89mmHg on the last day of 4th week, in group 2 (guanethidine administered group), the mean blood pressure measured before the treatment was 185/110mmHg and which was declined to 150/85mmHg on the last day of 4th week, and in group 3 (alpha-methylodpa administered group), the mean blood measured pressure measured before the treatment was 182/110mmHg and which was declined to 153/88mmHg on the last day of 4th week. 3) After the treatment for 4 weeks with reserpin guanethidine and alpha-methyldopa, the mean plasma epinephrine levels were declined from 0.37+/-0.12gamma% to 0.11+/-0.08gamma% in group 1, from 0.38+/-0.16gamma% to 0.14+/-0.10gamma% in group 2 and from 0.33+/-0.23gamma% to 0.10+/-0.09gamma% in group 3. 4) The mean plasma norepinephrine levels were declined from 0.05+/-0.21gamma% to 0.22+/-0.12gamma% in group 1, from 0.51+/-0.25gamma% to 0.20+/-0.10gamma% in group 2 and from 0.51+/-0.21gamma% to 0.20+/-0.11gamma% in group 3 after the treatment of 4 weeks respectively. 5) Urinary exceretion of epinephine was declined from 32.3+/-0.16gamma/day to 10.4+/-0.10gamma/day in group 1, from 34.5+/-0.34gamma/day to 17.2+/-0.16gamma/day in group 2, and from 28.2+/-0.14gamma/day to 10.3+/-0.11gamma/day in group in group 3 after the treatment of 4weeks duration. 6) The mean value of 24 hours urinary excretion of norepinephrine was declined to from 72.2+/-0.35gamma/day to 28.5+/-0.14gamma/day in group1, from 69.2+/-0.34gamma/day to 22.6+/-0.21gamma/day in group 2 and from 68.6+/-0.34gamma/day to 18.2+/-0.10gamma/day in group 3 after the treatment of 4 weeks duration. 7) From the above result we can summarized as follows: Antihypertensive effect of each drugs was; guanethidine>alpha-methylodopa>reserpin in order but depressing action plasma norepinephrine levels was; alpha-methyldopa>guanethidine>reserpin and depressing effect of urinary norepinephrine excretion was; alpha-methyldopa>guanethidine>reserpin, in order.
Antihypertensive Agents* ; Blood Pressure ; Catecholamines ; Epinephrine ; Guanethidine ; Humans ; Hypertension ; Methyldopa ; Nerve Endings ; Neurons ; Norepinephrine ; Plasma* ; Reserpine

Experimental, epidemiological and clinical studies indicate and important relationship between abnormalities in serum lipoproteins and atherosclerosis. With the introduction in 1965 by Fredrickson and Lees of a system for phenotyping hyperlipoproteinemias, quantitation of pre-and beta-lipoproteins gained much significance, and hence, the development of simple method for studying serum lipids and lipoproteins is needed. In the past, several methods have been proposed for the estimation of serum lipoproteins by electrophoresis. Authors observed serum total lipoprotein, beta-lipoprotein, pre-beta-lipoprotein and alpha-lipoprotein fractions in 80 (male:40, female;40)normal individuals with electrophoesis using cellulose acetate membrane instead of filter paper and concluded as follow: 1) Total lipoprotein and beta-lipoprotein levels had increasing tendency according to aging on both sexes. 2) Serum pre-beta-lipoprotein level also had increasing tendency according to age on both sexes and these features are more conspicious after fifth decade. 3) Electrophoresis using cellulose acetate membrance seem to be convinient method for analysis of serum lipoproteins especially pre-beta-lipoprotein fraction. 4) This method can be likely applied as routine screening test of hyperlipemia.
Aging ; Atherosclerosis ; Cellulose* ; Electrophoresis* ; Hyperlipidemias ; Hyperlipoproteinemias ; Lipoproteins ; Lipoproteins, LDL ; Mass Screening ; Membranes*

No abstract available.
Humans ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Tract Infections* ; Urinary Tract*

The treatment of pain in the back and extremities remains empirical. The application of surface electrodes to the dorsal columns of the spinal cord has been used by Shealy. The rationale. for dorsal column stimulation has been the “gate control theory” of pain proposed by Melzack and Wall. Transcutaneous electrical nerve stimulation is well recognized for its effectiveness in pain relief. The authors studied 48 cases of group A (physiotherapy, medication) and compared them with 43 cases of group B(physiotherapy, medication 'and diadynamic current), in the Department of Orthopedic Surgery, Yonsei University Hospital, from April, 1983, to June, 1984. The results were as follows: 1. Significant relief of pain was noted in group B in long term follow up of acute pain in the back and extremities. 2. In long term follow-up of group B, there was more improvement than in group A, especially when there was radiating pain in the extermities with or without back pain. 3. In long term follow-up according to the causes of the pain, there was more improvement in group B than in group A in cases of herniated nucleus pulposus and low back syndrome. From a consideration of these studies, it was concluded that satisfactory results were obtained from diadynamic current treatment for the patient with pain in the back and extremities.
Acute Pain ; Back Pain ; Electrodes ; Extremities ; Follow-Up Studies ; Humans ; Orthopedics ; Spinal Cord ; Transcutaneous Electric Nerve Stimulation

Lumbar spinal stenosis may be defined as any type of narrowing of the spinal canal, nerve root canals or intervertebral foramina. It may be local, segmental or generalized and may be caused by the encroachment of bone or soft tissue. The narrowing may involve the bony canal alone or the dural sac or both. Routine conventional radiographs or sagittal tomographs cannot accurately assess the midsagittal diameters of the lumbar canal or detect encroachment on the canal by osteoarthritis articular facets. However, myelography and computed tomography provide a means for distinguishing between herniation of a disc and bony encroachment on the spinal cord. The goals of surgical treatment in lumbar spinal stenosis are the relief of pain and the preservation or restoration of neurological functi ions. The surgical strategy is based on the patients symptoms and roentgenographic findings. Eighty-two operative cases of lumbar spinal stenosis were analyzed who were admitted in the Department of Orthopedic Surgery at Yonsei University College of Medicine from January, 1979, to July, 1984. The male female ratio was 1.3:1 and 66 cases (80.5%) included in their 50's and 60's. The results of the study are as follows: 1. Clinical symptoms included aggravation of pain during back extension (28.0%); back pain with radiating pain (22.0%); paresthesia of extremities (18.3%); back pain only (13.4%); and claudication (12.2%). 2. On physical examination, the straight leg raising test showed positive results in 25.6%, motor changes occurred in 24.4%, sensory changes in 20.7%, and DTR changes in 11.0%. 3. The most frequent level of spinal stenosis, L5-Sl invertebral space, was found in 68.3%(56cases) followed by L4-L5 intervertebral space found in 61.0% (50 cases). 4. Operative findings induded 31 lesions (46.3%) identified as herniated or ruptured discs,20 lesions (29.9%) identified as thickening of lamina and ligamentum flavum, and 5 lesions (7.5%) as compression of a nerve root by scar adhesion. 5. Of the 67 patients (81.7%) operated through the posterior surgical approach, 52 cases (77.6%) were effective; and of the 15 patients operated on by the anterior surgical approach, 9 cases (60.0%) were effective. 6. When the duration of symptoms was less than 1 year and the involved level of spinal stenosis was less than 2, operative results were satisfactory. 7. When there was a degenerative type of stenosis without a herniated or ruptured disc, operative results were excellent. 8. For post operative external support, 32 cases (39.0%) wore body jacket cast and 38 cases (46.3%) wore back braces.
Back Pain ; Braces ; Cicatrix ; Clinical Study ; Constriction, Pathologic ; Dental Pulp Cavity ; Extremities ; Female ; Humans ; Ions ; Leg ; Ligamentum Flavum ; Male ; Myelography ; Orthopedics ; Osteoarthritis ; Paresthesia ; Physical Examination ; Spinal Canal ; Spinal Cord ; Spinal Stenosis

Trimazosin Hydrochloride is a new orally active antihypertensive agent derived from the Quinazoline family, related chemically and pharamacologically to parazosin, but unlike its precedecessor, no first-dose syncope has been note, and no tolerance in the management of long term hypertensive patients. The antihypertensive effect of Trimazosin was observed from Oct. 1984 to Mar, 1985 at hospital of Chung-Ang Univesity as outpatient base involving a total 25 patients(Male;16, Female;9)with mild to moderate Hypertension(Diastolic B, P> or =90mmHG but< or =110mmHg). And the average age was 51.5 year(39-66yrs.) Our data demonstrate that 1) Trimazosin is an effective antihypertensive agent for controlling both systolic(166mmHg to 135.7mmHg)and diastolic(102.8mmHg to 85.3mmHg)pressure, and the mean arterial pressure was decreased from 123.8mmHg to 102.1mmHg(P%0.001). 2) We achieved significant sustained reduction in blood pressure with Trimazosin alone in 10 patients, Trimazosin plus Thoazide diuretics in 4 patients, Trimazosin plus-Beta-blocker in 5 patients, and with above triple regimensin 5 patients. 3) Side effects observed during Trimazosin theraphy(mean 3.8 months)appear to be minor and are reflection of its hemodynamic effects, (fatigability 2, dizziness 3, nausea 3 and headache 3) except one had to stop due to severe pounding headache.
Arterial Pressure ; Blood Pressure ; Diuretics ; Dizziness ; Headache ; Hemodynamics ; Humans ; Hypertension* ; Nausea ; Outpatients ; Syncope

No abstract available.
Humans ; Infant* ; Infant, Newborn* ; Reference Values*

The Diltiazem hydrochloride is a new calcium antagonist of which effect on angina pectoris has been reported. Authors studied the clinical effect of Diltiazem in 18 cases of angina pectoris including stable and unstable angina. The 14 cases were male and 4 cases were female with ages ranging 46 to 72 years. All cases had typical anginal attack on 1-6 times in everyday with transient improvement by sublingual nitroglycerin. After coutine physical and laboratory work-up, Diltiazem 30mg tablet was given 3 times a day for 3 consecutive weeks and checked the response of angical pain for first 3 times visit with 3 days interval and thereafter with one week interval. In 13 cases of 15 cases, the Diltiazem alone was medicated. There was considerable improvement of anginal attack in 13 cases of 15 cases with Diltiazem alone, namely complete subsidence of anginal attack throughout 3 weeks in 2 cases, only minimal substernal discomfort on effort once a week in 4 cases and in 7 cases the frequency and severity of anginal pain reduced to about 50% of control state. In 2 of 15 cases there were no effect on anginal pain until one week, subsequently a beta-blocker was added and the anginal attack improved considerably in both cases. In 3 cases of 18 cases, the anginal attacks were so severe and frequent that the Diltiazem with beta-blocker were given from the beginning. In one case the anginal pain disappeared completely and in two cases there were good effect. The effect of Diltiazem usually started to occurs in 3 days to one week after medication. The overall effectiveness of Diltiazem in angina pectoris was 87% with excellent effect in 40%, good effect in 27% and fair effect in 20%. In 5 cases of good response to Diltiazem, the stress exercise test by bicycle ergometer was carried out before and after one week medication with programs of 30 wt, 50 wt, 75 wt, and 100 wt loading for 4 minutes in each stage. The exercise tolerance improved about 25-50 wt, the ST depression by exercise became less by 1-2mm and the maximal heart rate increased by 4-9/min. These data showed marked improvement of exercise tolerance in angina pectoris by Dltiazem objectively. There were macular skin rash, diarrhea and mild dizziness in one case respectively which were improved without treatment. These data showed that Diltiazem was highly effective in angina pectoris except few very severe cases. In severe cases, the combined therapy of Diltiazem and beta-blocker was more effective.
Angina Pectoris* ; Angina, Unstable ; Calcium ; Depression ; Diarrhea ; Diltiazem* ; Dizziness ; Exanthema ; Exercise Test ; Exercise Tolerance ; Female ; Heart Rate ; Humans ; Male ; Nitroglycerin

Purpose: The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a deformed femur. Materials and Methods: Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after primary total hip arthroplasty using an S-ROM proximal modular femoral stem, between January 2001 and March 2004. The average follow-up was 44 months (range, 24 to 60 months). The mean age of the patients was 48.5 years old and there was a predominance of female patients (65.5%). The preoperative diagnoses included 26 cases of developmental dysplasia of the hip, 13 cases of sequalae of LCP, 2 cases of epiphyseal dysplasia, 3 cases of sequalae of pyogenic arthritis, and 1 case of congenital coxa vara. Results: The average Harris hip score improved from 52.2 points to 85.5 points. All the femoral stems demosntrated stable fixation, which included 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stems were found at the latest follow-up. Postoperative complications included: 2 cases of hip dislocations, 1 case of periprosthetic fracture, 1 case of infected cup loosening, and 1 case of sciatic nerve palsy. Overall, forty-one hips (91.9%) exhibited excellent or good clinical results at the most recent follow-up. Conclusion: For advanced secondary coxarthrosis, total hip arthroplasty with use of a proximal modular femoral stem yielded good mid-term results based on clinical and radiological criteria.
Arthritis ; Arthroplasty, Replacement, Hip* ; Coxa Vara ; Diagnosis ; Female ; Femur* ; Follow-Up Studies ; Hip Dislocation ; Hip* ; Humans ; Osteoarthritis, Hip* ; Osteolysis ; Periprosthetic Fractures ; Postoperative Complications ; Sciatic Neuropathy