A Case of Duodenal Mucormycosis in a Immunocompetent Patient / 대한소화기내시경학회지

Mucormycosis is a rare and fulminating opportunistic fungal infection that occurs almost in immunocom-promised patients. It is also a highly virulent and rapidly progressive disease with poor prognosis. Its incidence has been increasing in recent years. We have experienced a case of solitary duodenal mucormycosis in a 45 year-old male patient. Mucormycosis was diagnosed by pathology & culture and he was treated with amphotericin B and discharged with clinical improvement. We report this case with a literature review.

A Clinical Study of Amosulalol Hydrochloride(YM-09538) on the Antihypertensive Effects in Essential Hypertension

BACKGROUND: Newly developed alpha-, beta-receptor blocker, Amosulalol HCI(YM-09538) was evaluated for its hypotensive efficacy, safety and usefulness in patients with mild to moderate essential hypertension. METHODS: Thirty patients of essential hypertension(male 8, female 22), mean age 55 years were included for the study. Amosulalol HCI was administered 20-60mg daily for 10 weeks and initial starting dose was 10mg twice daily and dose was increased 40mg and 60mg daily in cases of insatisfactory hypotensive effect ever 2 weeks interval. Patients were evaluated every two weeks on blood pressure, pulse rate, improvement of subjective symptoms and side effects. Laboratory examinations were carried out routinely in principle two times before trial and after completion of study. RESULTS: Blood pressure began to fall significantly after tow weeks of administration and changed from initial 172.4mmHg of systolic pressure to final 149.3mmHg and from 104.7mmHg of diastolic pressure to final 92.5mmHg. The response rates were marked fall in 30%, satisfactory fall in 40%, thus overall hypotensive effect was observed in 70%. Pulse rate decreased slightiy but significantly from 4 weeks of administration. Improvement of subjective symptoms were observed in 7 cases out of 12 cases and no significant side effects were observedd except of two mild transitory cases of polyuria and indigestion. Laboratory examination also did not show any significant changes before and after medication. CONCLUSION: The daily administration fo 20-60mg of Amosulalol HCI to moderate essectial hypertension seems to be effective and safe with clinical usefulness.

A Clinical Trial on Antihypertensive Effect of Tripamide(Normonal(R))

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.

An Echophonocardiographic Study on Left Ventricular Isovolumic Relaxation Time

Cardiac relaxation is impaired in many cardiac disorders and is the subject of extensive investigation. Though measurement of isovolumic relaxation time ought to prove a simple means of quantifying such abnormalities in clinical practice, the problem of defining the timing of mitral valve opening at the onset of ventricular filling has been a difficulty. previous studies have used the 'O' point of the apexcardiogram, but more recently it has been shown that this may be open to considerable error. It was the purpose of the present study to determine the duration of true isovolumic relaxation and the factors influencing its duration, and to evaluate its use as a simple noninvasive measurement of cardiac dynamics in terms of the present approach. True isovolumic relaxation time (IRT) was measured noninvasively from the onset of the aortic component of the second heart sound to the onset of rapid opening of the mitral leaflets from simultaneous recording of echocardiogram, phonocardiogram, electrocardiogram and carotid tracing in 60 normal subjects, 30 male and 30 female and in 50 with hypertension, 28 male and 22 female ranging in age from 20 to 45 years. 1. The duration of IRT was 53.6+/-9.9 msec in normal subjects with no relation to sex. 2. IRT was related to heart rate, systemic blood pressure, and systolic and diastolic time intervals. 1) IRT tended to decrease with increasing heart rate and a regression equation for predicting it in relation to heart rate was 'IRT(msec)=88.97-0.466xH.R.(beats/min)' (P<0.01). 2) IRT tended to increase with increasing systemic blood pressure and a regression equation for predicting it in relation to aortic closing pressure was 'IRT(msec)=5.09+0.459xaortic closing pressure(mmHg)' (P<0.01). IRT was prolonged in patient with hypertension. 3) IRT was in close relation to left ventricular contraction indices such as preejection period(PEP), isovolumic contraction time and preejection period/left ventricular ejection time ratio. 4) There was no relation between IRT and left ventricular pump performance indices such as stroke volume, ejection fraction, fractional shortening and left ventricular dimension. 5) There was strong association between IRT and diastolic time intervals. Authors were impressed through this study that IRT is a useful measurement of left ventricular dynamics in early diastole.