The antihypertensive efficacy and safety for once daily dosing of amlodipine, a new calcium channel blocker, was studied in a series of 36 patients with essential hypertension. The starting dose of amlodipine were 5mg/day, which were doubled after 4 weeks, if normalization of diastolic blood pressure was not reached. Amlodipine induced a clinically significant reduction in blood pressure(17.7mmHg in systolic blood pressure and 11.9mmHg in diastolic blood pressure) with similar heart rates after 12 weeks therapy. The efficacy of amlodipine therapy was noted an excellent in 18 patients(51.4%), good in 8 patients(22.9%), fair in 5 patients(14.3%), and failed in 4 patients(11.4%). There were few side reactions such as fatigue, headache, constipation and indigestion, but all studied patients completed for 12 weeks therapy except one patients who did not return. And also there was no abnormal results of laboratory tests before and after the amlodipine therapy. This results indicated that amlodipine is an effective and safe new long-acting calcium channel blocker in the treatment of hypertension.
Amlodipine* ; Blood Pressure ; Calcium Channels ; Constipation ; Dyspepsia ; Fatigue ; Headache ; Heart Rate ; Humans ; Hypertension*

We studied the results in forty-three knees in thirty patients-three male and twenty seven femalewho had rheumatoid arthritis, osteoarthritis, traumatic arthritis and osteonecrosis in the knee and were treated by total knee joint replacement. The average age of the patients was 56.7 years. The results were anaysed after follow-ups ranging from one year to three years and seven months, average being 23.6 months. The assessment was made upon the knee rating system of the Hospital for Special Surgery; the results were excellent in 29 knees, good in 12, fair in one and poor in one. The improvement of the flexion contractures was significant (postoperative average 1.7 degrees compared with preoperative average 20.1 degrees). The postoperative active flexion ranged from 70 degrees to 140 degrees (mean 110.2 degrees). One knee had a deep wound infection. The radiological loosening demonstrated in three cases, two of them had incomplete, nonprogressive radiolucent line, being less than one millimeter in width in the tibial component, one who had a deep infection showed three millimeters radiolucent line.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Male ; Osteoarthritis ; Osteonecrosis ; Wound Infection

No abstract available.
Atrioventricular Block*

Patients with cerebrovascular accidents often have abnormal electrocardiograms in the absence of known organic heart disease. In 1901 harvey Cushing has discovered sinus bradycardia in CVA patients. Burch, Myers and Abildskov were the first to report electrocardiographic abnormalities in CVA. Since then many reports have appeared in the literature. This study was done utilizing brain C-T scan to varify and localize the site of CVA, for purposes of correlation of the CVA with abnormalities of electrocardiogram. We obtained the following results. 1. Among 250 cases of CVA, 107 cases were excluded due to pre-existing cardiac disease, abnormal serum electrolyte and early death. 2. Among 143 cases, intracranial hemorrhage were 62.9% and brain infarction were 37.1%. 3. In intracranial hemorrhage, normal electrocardiographic finding were only 4.5%. Q-Tc prolongation revealed 64.5%. 4. In brain infarction, normal electrocardiographic finding was only 5.7%. Q-Tc prologation revealed 64%.
Bradycardia ; Brain ; Brain Infarction ; Electrocardiography* ; Heart Diseases ; Humans ; Intracranial Hemorrhages ; Stroke

Fournier described five patients with gangrene of male external genitalia in 1883 and emphasized three characteristics: (1) abrupt onset in young healthy male, (2) rapid progression to gangrene,(3) absence of discernible cause. But more recent reports described genital gangrene as occurring in any age group and 4 patients in our cases, the mean age was 46 years with an age range of 31 to 59 years. Predisposing causes were as follows: case 1. prostatic calculi, Buerger's disease, case 2, perianal abscess, case 3, diabetes mellitus, case 4, tuberculous spondylitis accompanied by paraplegia and bed sores, liver cirrhosis. The duration of symptoms prior to the development of gangrene varied between 4 to 10 days. The cultured organisms were as follows : case 1. Alpha-hemolytic streptococcus, case 2. E. coli, Alpha-hemolytic streptococcus case 3. Alpha-hemolytic streptococcus, case 4, Mycobacterium tuberculosis, proteus species. Reconstructive surgery of defected scrotum was performed postoperative 8 to 41 days (mean 28.7) and total admission period was 25 to 83 days (mean 46 days).
Abscess ; Calculi ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Genitalia ; Humans ; Liver Cirrhosis ; Male ; Mycobacterium tuberculosis ; Paraplegia ; Pressure Ulcer ; Proteus ; Scrotum ; Spondylitis ; Streptococcus ; Thromboangiitis Obliterans

The usually stable body temperature of homeothermic animals can be affected by innumerable biolagical and physical agents. Neurotransmitters, neuromodulators, synthetic drugs will cause an elevation or depression in body temperature depending on the dose, species and route of administration. The effects of clonidine (0.15 mg/kg), hydralazine (1 mg/kg), nifedipine (1 mg/kg) and verapamil (5 mg/kg) on rectal temperature in Sprague-Dawley rats were assessed 15, 30 and 45 min. After intraperitoneal injection of drugs. The results were as follows; 1) Rectal temperature of rats was significantly increased in clonidine group compared with hydralazine group. However, there were no significant changes in other groups. 2) In hydralazine group, there was highly significant decrease in rectal temperature of rats compared with control, clonidine and nifedipine group. 3) Rectal temperature of rats was significantly increase in nifedipine group compared with hydralazine group. However, there were no significant differences in changes of rectal temperature between nifedipine and other groups. 4) Rectal temperature of rats no significantly changes in verapamil group compared with other groups.
Animals ; Antihypertensive Agents* ; Body Temperature* ; Clonidine ; Depression ; Hydralazine ; Injections, Intraperitoneal ; Neurotransmitter Agents ; Nifedipine ; Rats* ; Rats, Sprague-Dawley ; Verapamil

Recurrent disc herniation and postoperative fibrosis are the main disease entities causing failed back surgery syndrome (FBSS) and magnetic resonance (MR) imaging has become a major diagnostic modality in differentiating the two. To observe the variable entities of FBSS and their MR findings, we retrospectively analyzed 15 MR images in 12 patients. The causes of FBSS were as follows; normal (no organic cause), fibrosis, new or recurrent disc herniation, discitis, osteomyelitis, inflammation at operation site, epidural abscess, arachnoiditis, and hematoma. Except a case of hematoma, gadolinium enhancement scan was necessary and informative in the diagnosis of FBSS and MR imaging only was not enough in the diagnosis of arachnoiditis.
Arachnoid ; Arachnoiditis ; Diagnosis ; Discitis ; Epidural Abscess ; Failed Back Surgery Syndrome* ; Fibrosis ; Gadolinium ; Hematoma ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Osteomyelitis ; Retrospective Studies

Antihypertensive effect and side effect of Tripamide(Normonal(R)) was studied in 22 cases of essential hypertension using 15mg once daily regimen for average period of 9 weeks. 1) Antihypertensive effect Average reduction of 25mmHg in systolic and 19mmHg in systolic and 19 mmHg in diastolic pressure was observed and reduction rate was 15.7% and 17.6% respectively. The overall effect rate was 86%. The blood pressure lowered significantly in 1 week of treatment both in systolic and diastolic pressure and the extent of fall in systolic pressure approached near the level of maximum reduction in 2 weeks of administration and that of diastolic after 5 weeks of treatment. 2) Laboratory tests and side effect There was no significant changes in individual and mean value of Na, K, Cl, BUN, creatinine, uric acid, fasting blood sugar, cholesterol, GOT, GPT studied before and after treatment except one case showing elevation of uric acid. No significant side effect was observed during trial except of 2 cases of transient diuretic effect.
Blood Glucose ; Blood Pressure ; Cholesterol ; Creatinine ; Diuretics ; Fasting ; Hypertension ; Uric Acid

Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.
Adult ; Male ; Female ; Humans

This report dealt with the case of 58 year old male with thrombotic thrombocytopenic purpura syndrome. The patient had an occlusion of the left middle cerebral artery on the carotid angiogram. The clinical course of the case with disseminated intravascular coagulation was fulminant. Literatures on pathophysiology, treatment, pathology and clinical course disseminated intravascular coagulation were reviewed.
Disseminated Intravascular Coagulation* ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery* ; Pathology ; Purpura, Thrombotic Thrombocytopenic