Causative Diseases of 108 Dementia Patients

Underlying caustive diseases were observed on 108 patients with dementia diagnosed on DSM-III, who were admitted to Keimyung university Dongsan hospital during January 1985 to September 1988. The results were summarized as follows. 1. Male to female ratio was approximately 5 to 1. In all diseases causing dementia, male outnumbered female. In particular, alcoholic dementia, multi-infarct dementia, posttraumatic dementia, infection, hydrocephalus and subdural hematoma were almost limited to males. 2. The important causative diseases were alcoholic dementia (21.3%), multi-infarct dementia(18.5%), postanoxic encephalopathy (14.8%), dementia of Alzheimer type (12.1%), head trauma(8.3%), brain tumor (6.5%), pseudodementia(6.5%), infection(4.6%), hydrocephalus (4.6%), and subdural hematoma(2.8%) in the order of frequency. 3. Cerebral trauma was the most common cause of dementia in young adulthod, and alcoholic dementia, multiinfarct dementia and dementia of Alzheimer type were important in middle adulthood. In old age, multiinfarct dementia was noted to be the most common cause. 4. Thorough diagnostic evaluation has uncovered reversible disorders in 19.4% of the total patients and disorders which, though not reversible, nevertheless require active therapeutic intervention in an additional 60.2%.

Antianginal Effect of Fenalcomine Hydrochloride

Antianginal and untoward effects of fenalcomine hydrochloride were studied in 24 cases of angina pectoris. Following discontinuation of all medications for 2 weeks except for liberal use of sublingual nitroglycerin for the relief of anginal attack, fenalcomine, 150mg a day in 3 divided doses, was given for 8 to 16 weeks. In 20 cases, routine blood counts including platelets, serum electrolytes and cholesterol as well as blood sugar level were checked before and at the completion of the medication. hepatic and renal functions were also studied. The effect of fenalcomine on severity, frequency and duration of anginal attack was excellent to good in 17 cases(70.9%), and was fair in 5 cases(20.8%). In the remaining 2 cases(8.3%), who responded poorly had angina pectoris for more than 3 years. It appeared that fenalcomine was similarly effective in those with or without associated hypertension or diabetes mellitus, or history of previous myocardial infarction. The comparison of the results of post-treatment laboratory tests with pre-treatment data revealed no significant changes. Furthermore, no untoward clinical reactions attributable to the drug was noted in all cases. These facts suggest that fenalcomine is a reliable and well tolerated antianginal agent which can be used singly or in combination with other agents.

Hypotensive Effect of Cardioselective Beta-Blockade with Once-Daily Atenolol Therapy in Essential Hypertension

Antihypertensive and untoward effects of atenolol were studied in 20 cases of essential hypertension with their average pre-treatment systolic and diastolic blood pressures of approximately 160mmhg and 100mmhg, respectively. All patients were assigned to a single dose of 50mg atenolol once daily for a period of four weeks, and a weekly complete history and physical examination. Besides routine blood counts and urinalysis, blood chemistry relating to hepatic and renal functions, and electrolytes balance as well as fasting blood sugar levels were checked before and at the end of medication. In addition, in 10 cases, pulmonary function was studied before and after one week of treatment. With the therapy, the diastolic blood pressure fell to 90mmHg or below in 17 out of 20 cases(85%), and the pre-treatment diastolic blood pressure in the remaining three cases who responded poorly was 108mmHg or above. However two cases of the 17, who responded well and whose blood pressure became normal, had an initial diastolic pressure of 110mmHg each. The hypotensive effect of atenolol on both systolic and diastolic blood pressures was essentially similar, and the effect appeared during the first week with its peak effect occurring during the third week. There was no significant difference during treatment between recumbent and sitting blood pressures, both systolic and diastolic; thus no postural hypotension was observed. The comparison of the results of post-treatment laboratory tests with pre-treatment data revealed no significant changes. These suggest that atenolol can be used in patients with diabetes mellitus, chronic obstructive pulmonary disease or cerebral sclerosis, which are frquently associated with essential hypertension. Also a once-daily dose with satisfactory hypotensive response is one of very practical advantages of atenolol, particularly from the patient's point of view, in the treatment of hypertension, in which a life-long therapy is needed in most cases. Thus atenolol seems to be one of the most attractive choices of drugs for the treatment of mild to moderate hypertension.