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

No abstract available.

No abstract available.
Cardiovascular System* ; Molecular Biology*

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

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

Although platelet have been implicated in the pathogenesis of the thrombotic disease, the platelet aggregability was not well studied in Korea. Author measured platelet aggregability in 103 clinical cases including 30 healthy volunteers to evaluate the platelet function and the effect of Aspirin and Dipyridamole on aggregability in Korean. 24 patients with cerebral thrombosis, 24 patients with ischemic heart disease and 25 patients with hypercholesterolemia were included for this study. Aggregation tests were performed at three final concentrations of epinephrine(10microM/L) and ADP(4 microM/L, 10 microM/L) with platelet aggregometer which was made by Chrono-Log Corp. in all cases. Platelet aggregations were measured in patients who were treated with Aspirin, Dipyridamole and combined treatment of Aspirin and Dipyridamole respectively. The following results were obtained. 1) The mean maximal platelet aggregability in the normal subjects induced by 10 microM/L epinephrine was 59.3+/-24.26%, 66.6+/-14.00% in Bm and 62.5+/-19.30% in B5 in induction by 4 microM/L ADP, and 77.2+/-8.99% in Bm and 76.6+/-9.83% in B5 in induction by 10microM/L ADP. 2) The mean maximal platelet aggregability in patients with cerebral thrombosis induced by 10 microM/L epinephrine was 89.2+/-7.33%, 78.8+/-9.41% in Bm and 78.5+/-9.93% in B5 in induction by 4 microM/L ADP, and 86.4+/-7.69% in Bm and B5 in induction by 10 microM/L ADP. The results showed significantly elevated platelet aggergability than that of normal subjects(p<0.01). 3) The mean maximal platelet aggregability in patients with ischemic heart disease induced by 10 microM/L epinephrine was 88.1+/-11.99%, 78.2+/-12.50% in Bm and B5 in induction by 10 microM/L ADP. The results showed significantly elevated platelet aggregability than that of normal subjects(P<0.01). 4) The mean maximal platelet aggregability in patients with hypercholesterolemia induced by 10 microM/L epinephrine was 86.8+/-15.99%, 82.7+/-11.19% in Bm and 82.0+/-12.87% in B5 in induction by 4 microM/L ADP, and 88.5+/-11.47% in Bm and B5 in induction by 10 microM/L ADP. The results showed signifcantly elevated platelet aggregability than that of normal subjects(P<0.01). 5) The mean maximal platelet aggregability in patients with thrombotic disease was studied by Dipyridamole administration. The platelet aggregability induced by epinephrine before administration was 90.9+/- 8.52% and after administration it was 78.9+/-15.68%, and the results showed that Dipyidamole lowered aggregability significantly. The platelet aggregability induced by 4 microM/L ADP before administration was 84.0+/-11.90% in Bm and B5 and after administration it was 78.0+/-11.44% in Bm and B5, and the results showed that Dipyridamole lowered aggregability but not significant. The platelet aggregability induced by 10 microM/L ADP before administration was 89.2+/-10.39% in Bm and B5 and after administration it was 80.5+/-8.44% in Bm and B5, and the results showed that Dipyridamole lowered aggregability significantly. 6) The mean maximal platelet aggregability in patients with thrombotic disease was studied by Aspirin administration. The platelet aggregability induced by epinephrine before administration was 91.0+/-4.79% and after administration it was 47.6+/-17.72%. The platelet aggregability induced by 4 microM/L ADP before administration was 84.6+/-10.37% in Bm and B5 and after administration it was 72.6+/-11.85% in Bm and 65.3+/-15.97% in B5. The platelet aggregability induced by 10 microM/L ADP before administration was 84.9+/-6.30% in Bm and B5 and after adminstration it was 77.7+/-8.60% in Bm and 75.0+/-8.89%. The results showed that Aspirin lowered aggregability markedly. 7) The mean maximal platelet aggregability in patients with thrombotic disease was studied by combined administration of Aspirin and Dipyridamole. The platelet aggregability induced by epinephrine before administration was 86.7+/-13.77% and after administration it was 36.7+/-14.01%. The platelet aggregability induced by 4 microM/L ADP before administration was 81.5+/-12.93% in Bm and 80.6+/-14.15% in B5 amd after administration it was 54.7+/-17.27% in Bm and 44.6+/-21.17% in B5. The platelet aggregability induced by 10 microM/L ADP before administration was 87.8+/-10.11% in Bm and B5 and after administration it was 65.7+/-13.59% in Bm and 62.0+/-16.42% in B5. The results showed that combined administration of Aspirin and Dipyridamole lowered aggregability significantly and the results were lower than that of normal subjects. 8) The effects of combined treatment of Aspirin and Dipyridamole showed marked reduction of platelet aggregability than that of single treatment of Aspirin or Dipyridamole in thrombotic disease.
Adenosine Diphosphate ; Aspirin* ; Blood Platelets* ; Dipyridamole* ; Epinephrine ; Healthy Volunteers ; Humans ; Hypercholesterolemia* ; Intracranial Thrombosis ; Korea ; Myocardial Ischemia

Effects of Pravastatin(Mevalotin(R)), a new HMG-CoA reductase inhibitor on the blood lipids were studied for the period of 3 months in 40 subjects with hypercholesterolemia more than 250mg/dl. Age of the subject was 50 years in average with range of 34 to 72 years. There were 22 cases of male and 18 cases of female. The cause of hyperlipidemia was not specified, but there were no case of liver, thyroid and renal disease. The 10mg of Preavastatin was given in devided doses in the morning and at bed time for 3 months. Serum LDL-cholesterol, total cholesterol, HDL-cholesterol, triglyceride and atherogenic index were measured before and after the medication in every month and following results were obtained. 1) Serum cholesterol decreased maximally at 2months after the medication with average decrease of LDL-cholesterol 79.8mg/dl(43%), serum total cholesterol 99.8mg/dl(34%) and the atherogenic index 3.0(45%). The decrease of total serum cholesterol was dependent on the pretreatment level. 2) The serum triglyceride decreased in average 81mg/dl(26%) in one month after the medication however the change was not statistically significant because of wide variation. 3) The HDL-cholesterol decreased in average 1.6mg/dl(4%) in one month and statistically significant. 4) The serum total cholesterol started to change in 3 days and tended to decrease with unstable variation up to the end of 2 weeks after the medication. In one month after cutting drug, there were slight increase of cholesterol but did not return to control value. 5) The significant effect of blood lipid lowering drug in non-specific hyperlipidemia should be evaluated when the changes are more than intra-individual variation of blood lipids. 6) There were only 2 cases of side effect with epigastric pain and fullness which subsided soon and there was no change in liver functions, serum creatinine and fasting blood sugar after the medication. In conclusion, the pravastatin is an excellent new lipid lowering drug with safety.
Blood Glucose ; Cholesterol ; Creatinine ; Fasting ; Female ; Humans ; Hypercholesterolemia ; Hyperlipidemias* ; Liver ; Male ; Oxidoreductases ; Pravastatin ; Thyroid Gland ; Triglycerides

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