No abstract available.
Cardiology* ; Cardiovascular Diseases* ; Epidemiology*

No abstract available.
Cardiovascular System* ; Molecular Biology*

No abstract available.

The hypotensive action of calcium antagonist has been recognized, however, clinical study on the hypotensive effect is not yet extensively carried out. Auther studied the effect of Dilitiazem(Herben(R)) on 23 hypertensive patients. The age of patient was average 58.5(30-75) years. There were 8 male and 15 female patients. Among 23 cases, 20 cases of essential hypertension had no previous medication for hypertension and they were given 90mg of Diltiazem daily in 3 divied doses for 8 weeks. The blood pressure and pulse were measured at one week interval. In 3 cases of hypertension who were refractory to other hypotensive drugs for 2 weeks. The results were as follows; 1) In 20 cases of untreated essential hypertension, the control average blood pressure was 179.8/106.3mmHg and pulse 77.1/min. After the Diltiazem medication average blood pressure in one week was 153.3/97.3mmHg and pulse 76.6/min, in 3 week 153.0/94.0mmHg, and pulse 76.6/min, in 5 week 143.0/92.0mmHg and pulse 75.4/min, and in 8 week 142.3/90.0mmHg and pulse 73.0/min. These data showed that after one week of medication, blood pressure fell significantly in systole and diastole but there was no significant pulse change. 2) The rate of hypotensive effect by grade were as follows; overall effectiveness in systolic pressure which fell more than 5 mmHg was 85% and more than 20mmHg fall was 70%. In diastolic pressure the overall effectiveness which fell more than 5mmHg was 60% and more than 15 mmhg fall was 40%. 3) In 3 cases which were refractory to other hypotensive drugs, the hypertension became normal blood pressure in one day by 90mg Diltiazem and the fall of blood pressure persisted for 2 weeks by continuous medication.
Blood Pressure ; Calcium ; Diastole ; Diltiazem* ; Female ; Humans ; Hypertension* ; Male ; Systole

Since the Plasma-Renin Activity (PRA) value varies by many factors such as amount of sodium in-take, diuretics and posture, the basal PRA with double stimulated PRA measurement is most widely used. However the method of the study is different according to investigators and especially the PRA study in out-patient is not easy. Author attempted to establish an easy and reliable method of PRA study in out-patient and their data were compaired with those of in-patient by the study of 38 normal cases in 207 hypertensive patients. Twenty four hours urine and overnight urine sodium measurement showed that the overnight urine sodium was about 45% of that of twenty four hour urine. More than 70mEq of overnight urine sodium is considered to be borderline to neglect sodium intake for study. The PRA of normal adult was measured at 30 minutes and one hour rest in supine or sitting position after arrival to hospital. There were minor increase of PRA after 30 minutes and one hour rest than basal PRA which will not confuse the evaluation of PRA. After Lasix 40mg and 20mg intravenous injection with walking respectively, the PRA changes were measured in 30 minutes, 1, 2, and 3 hours in normal adult. The results appeared that Lasix 20mg intravenous injection and 1 hour walking double stimulation is suitable method of PRA stimulation test in out-patient clinic. The Lasix 40mg I.V. and 2 hour walking stimulation test is considered to be suitable method of PRA stimulation test in ward patient. With above study, the following method of PRA study in out-patient clinic is recommended; 1) Overnight fasting and overnight urine collection for urinary sodium measurement 2) Patient should visit hospital in fasting state and take rest for 30 minutes in supine or sitting position and thereafter take blood sample about 5-10ml as out-patient basal PRA. Inject Lasix 20mg intravenously and walk for 1 hour and take blood sample again as double stimulation test. As double stimulation test of PRA for in-patient, Lasix 40mg l.V. and 2 hours walking is recommended. By using above method, the basal PRA in clinic in 16 young normal adults was 2.30+/-1.02(0.70-3.47)ng/ml/h sitting rest and 1.76+/-1.21(0.1-4.03)ng/ml/h in supine rest. In 47 non-hypertensive ward patients who will not have any abnormality in PRA, the 24 hour urinary sodium was average 221mEq and the basal PRA was and the basal PRA was 1.46+/-0.89(0.30-3.75)ng/ml/h. In outpatients with essential hypertension without complication, the average basal PRA was not different from that of normal adult. However male ward-patients with essential hypertension without complication had slightly higher average PRA than normal adult. The distribution of low(<0.56ng/ml/h) average(0.57-2.35ng/ml/h) and high(>2.36ng/ml/h) renin groups in essental hypertension showed higher incidence of high renin group in male ward-patients. But in out-patients with hypertension, the low renin group of patient was high. Relatively low normal value of PRA in this study may be due to high sodium in-take. The higher incidence of high PRA group in essential hypertension of in-patients may be due to the difference of hypertensive status between out-patient and in-patient.
Adult ; Diuretics ; Fasting ; Furosemide ; Humans ; Hypertension* ; Incidence ; Injections, Intravenous ; Inpatients* ; Male ; Outpatients* ; Plasma* ; Posture ; Reference Values ; Renin* ; Research Personnel ; Sodium ; Urine Specimen Collection ; Walking

Although measurement of cerebral blood flow by radioactive - isotope method became popular, there is still no report of study on the cerebral blood flow in Korea. Auther studied the regional cerebral blood flow in 28 normal Korean adults and and 76 patients including 14 cases of essential hypertension, 11 cases of heart diseases (coronary artery disease, valvular diseases and A-V block), 14 cases of brain diseases(cerebral thrombosis and cerebral insufficiency), 22 cases of head trauma and 15 cases of miscellaneous medical diseases. The regional cerebral blood flow was measured by intravenous in jection of (99m)Tc-DTPA 15-20Ci and by taking serial cerebral angiograms with CGR Gamma Tome 7000 and was analized by computer Imac 7310. The results were as follows: 1) The average regional cerebral blood flow of normal Korean adult was 50.0+/-5.89mg/100g /min. with range of 41-60ml/100g/min. 2) In most cases of essential hypertension the regional cerebral blood flow was within normal limit except rare case which was considered to have impaired autoregulation of cerebral blood flow. 3) In patients with myocardial infarction, valvular heart diseases with congestive heart failure and complete A-V block, there was markedly reduced cerebral blood flow. The reduced cerebral blood flow increased after the improvement of congestive heart failure and after the implantation of pacemaker. 4) In patients with cerebral thrombosis with infarction and cerebral insufficiency with symptoms of dizziness, headache or blurred vision, the cerebral blood flow was considerably reduced. However in acute encephalits the cerebral blood flow was increased. The measurement of cerebral blood flow by radioactiveisotope method is considered to be accurate, easy and useful clinical test to evaluate brain diseases and function.
Adult* ; Arteries ; Brain ; Brain Diseases ; Craniocerebral Trauma ; Dizziness ; Headache ; Heart Diseases ; Heart Failure ; Heart Valve Diseases ; Homeostasis ; Humans ; Hypertension ; Infarction ; Intracranial Thrombosis ; Korea ; Myocardial Infarction ; Thrombosis

Onychomycosis can be diagnosed by mycological examination, but it is not easy to detect its causative organisms because the positive rate of culture is lower and its scores are variable due to the contamination inherently introduced in the current method used in sampling the ovychomycosis organisms. It was suggested that the scores depended upon the handicraft of operates and the gainning method of nail material, so we modeled the watch mending drivers into the punching instruments, and holed deeply & widly through the nail plate, from the surface to the bottom. Afterward, the KOH mount & culture were performed to compare this new punch method used with that of standard scrapping method. Through the KOH examination more numerous hypaes were found in the punch methods sample than the scrapping methods sample. Also, the punch methods positive culture rate was found to be 2. 5 times higher than that of the scrapping methods culture rate, with a 5 to 5. 5 times lower amount of contamination. In conclusion, the punch method was found to be a more precise and effective method of obtaining onychomycosis organisms. Although this method required a slight greater time to perform than the standard scrapping method, I believe it will be a valuable aid in the detection of causative organisms of onychamycosis.
Onychomycosis*

Since the development of cardiac monitoring, Holter ECG monitoring, His Bundle electrogram and cardiac pacemaker, the cardiac conduction defect has been diagosed more precisely. Also SA block and sick sinus syndrome were well investigated recently. Author reviewed 10,084 cases of electrocardiograms for recent 3 years which were examined at korea University Hospital and analyzed the incidence of conduction defect, type of SA block, conduction defect in myocardial infarction and the relation of SA and AV conduction defect and Q-T(c). There were 5,390 cases of male and 4,694 cases of female with age range of 10 months to more than 80 years. In 60 cases, 24 hour Holter ECG monitoring were also carried out. The data were as follows; 1. There were 568 cases of cardiac conduction defect out of 10,084 cases and the incidence was 5.64% as a whole. Among the conduction defects, there was SA block in 0.36%, AV block in 2.12%(1st degree in 1.86%, Mobitz type I in 0.11%, Mobitz type II in 0.08%, complete block in 0.07%), bundle branck block in 2.52%(RBBB in 2.13%, LBBB in 0.39%), intraventricular conduction defect in 0.20%, left bundle hemiblock in 0.07%, bifascicular block in 0.05%, 1st degree AV block with BBB in 0.18%, W-P-W syndrome in 0.1% and L-G-L syndrome in 0.04%. 2. There were 36 cases of SA block among 10,084 cases(0.36%). In 26 cases, there were one case of Mobitz type I 2nd degree SA block, Mobitz type II in 20 cases, no P wave with nodal escape in 13 cases and 2 cases of transient sinus arrest associated with syncopal attack which were diagnosed by 24 hour Holter ECG monitoring. 3. There were 45 cases of conduction defect in 122 cases of acute or subacute myocardial infarction(36.9%). Among the 45 cases, there were 2 cases of SA block, 15 cases of 1st degree AV block, 2 cases of 2nd degree AV block, 2 cases of complete AV block, 10 cases of RBBB, 3 cases of LBBB, 4 cases of intraventricular conduction defect and 7 cases of left bundle hemiblock. These data showed lower incidence of critical conduction defect such as Mobitz type II and complete AV block in Korea than in United States. 4. The Q-T(c)interval were measured in 207 cases of SA block and AV block without BBB or IVCD. The values of Q-T(c)in cases of conduction defect were within normal limits. In cases of myocardial infarction, there were mild prolongation of Q-T(c)interval, however there was no difference of Q-T(c)interval between infarction with conduction defect and those without conduction defect. There was no correlation between P-R interval prolongation and Q-T(c)interval. These data suggested that the cardiac conduction defect is a specific involvement of conduction system by various causes rather than diffuse myocardial changes.
Atrioventricular Block ; Electrocardiography* ; Electrocardiography, Ambulatory ; Electrophysiologic Techniques, Cardiac ; Female ; Heart* ; Humans ; Incidence ; Infarction ; Korea ; Male ; Myocardial Infarction ; Sick Sinus Syndrome ; United Nations ; United States

The maximal stress exercise test was studied in 49 normal korean and 231 cases of various diseases. Bicycle ergometer was used in 122 cases and treadmill was used in 109 cases by modified Bruce protocol which was designed by author. The maximal heart rate, maximal work capacity, End point of maximal exercise and ST changes especially in coronary artery disease were investigated. Total 231 cases in cluded 8 cases of myocardial infarction, 46 cases of anginal pectoris, 91 cases of atypical anginal pain, 68 cases of hypertension and 18 and of diabetes mellitus. The results are as follows; 1. The maximal heart rate was markedly reduced in myocardial infarction(115/min. comparing 162/min. in normal) and slightly less reduction in angina pectoris. Also mild reductions were observed in atypical anginal pain, hypertension and diabetes mellitus. 2. The maximal work capacity was markedly reduced in myocardial infarction(93 wt comparing 180 wt in normal). It was only slightly reduced in anginal pectoris, atypical anginal pain, hypertension and diabetes mellitus which were not significantly reduced from that of normal, especially in anginal pectoris, the reduction on maximal work capacity was unremarkale comparing that of maximal heart rate. 3. The End point of maximal exercise test were exhaution in 34%, leg pain in 30%, maximal heart rate in 22%, ST depression more than 1 mm in 21%, dyspnea in 19%, anginal pain in 15% by bicycle ergometer, while by treadmill test, the End point were exhaution in 47%, dyspnea in 35%, Maximal heart rate in 22%, ST depression more than 1 mm in 19%, leg pain in 15% and anginal pain in 10%. 4. In coronary artery disease, the positive maximal exercise test(sensitivity) was 76% in treadmill test and 68% in bicycle ergometer test. 5. The ST changes among 231 patients druing the maximal exercise test occured in 47 cases(20%). In 43 cases the ST segment depressed more than 1 mm and the degree of depression ranged 1-3.5mm. The upward sloping type and horizontal depression type were equally common. There were 4 cases(1.7%) of ST elevation during exercise which returned to normal after exercise. There were 3 cases among 54 cases of coronary artery disease(5.5%) and 2 cases among 46 cases of anginal pectoris(4.3%). In one case of anginal pectoris with elevated ST segment, myocardial infarction occured in few days later. Therefore it appears that the variant angina in this study is very few.
Angina Pectoris ; Coronary Artery Disease ; Coronary Vessels ; Depression ; Diabetes Mellitus ; Dyspnea ; Exercise Test* ; Heart Rate ; Humans ; Hypertension ; Leg ; Myocardial Infarction

The evaluation of the regional wall motion abnormalities were done in 16 patients with myocardial infarction and 9 patients with anginal pectoris by the two dimensional echocardiography. The regional wall motion abnormalities detected by the two dimensional echocardiography were the highly sensitive indexes of the location of infarction(sensitivity: 84.6%) and were well correlated with the sites of infarction of the 12-lead EKG. In the patients with myocardial infarction, the apex and the distal septum of the left ventricle were the most frequently observed regions with wall motion abnormalities, which comprised 60.7% of the regions with the abnormal wall motion. The frequency of the regional wall motion abnormalities were much less frequently seen in the patients with anginal pectoris. The severity and the extent of the regional wall motion abnormalities as well as the global function of the left ventricle were well correlated with the clinical course and the prognosis in the patients with myocardial infarction during the short term observation.
Coronary Artery Disease* ; Coronary Vessels* ; Dyskinesias* ; Echocardiography ; Electrocardiography ; Heart Ventricles ; Humans ; Infarction ; Myocardial Infarction ; Prognosis