The 5 Years Follow Up Study on Serum Total Cholesterol Levels in Normal Adult Korean Male Workers Resident in Pohang / 대한내과학회지

OBJECTIVES: The serum total cholesterol is supposed to be increased as dietary pattern is westernized recently in our country. We studied the longitudinal change of serum total cholesterol levels in normal adult Korean male workers and analyzed the influence of lifestyle on change of serum total cholesterol levels. METHODS: The 7677 healthy adult male workers were studied during recent 5years(1992 and 1997). Those who suffered from hypertension, diabetes mellitus, ischemic heart disease, nephritis were excluded. Those who ingested antilipidemic drugs were also excluded. Serum total cholesterol were measured by the same enzymatic method and their levels were analyzed during fasting state. Data on lifestyle were obtained using self administered questionnaires. RESULTS: 1) The serum total cholesterol levels increased by 9.45+/-23.99mg/dl(1.89mg/dl per year) between 1992 and 1997 surveys. 2) The increment of serum total cholesterol levels was most prominent in the twenties (3.45mg/dl per year) and less prominent in 5th, 6th decades. 3) A change of 1kg/m2 in body mass index contributed a change of 3.449mg/dl in serum total cholesterol. 4) The change of body mass index(BMI) was most significantly correlated with that of serum total cholesterol levels among the influencing variables.( =3.449 p=0.0001 r2=0.035) 5) The changed value of serum total cholesterol levels was significantly correlated with smoking and exercise, however, was not significantly correlated with the amount of alcohol ingestion. CONCLUSION: The serum total cholesterol levels increased by 9.45mg/dl(1.89mg/dl per year) during recent 5 years. The increment of serum total cholesterol levels was more prominent in younger age group. The changed value of BMI was most strongly correlated with that of serum total cholesterol levels of all influencing variables.

Doppler Echocardiographic Evaluation of Left and Right Ventricular Filling in Young Chronic Alcoholics / 대한내과학회지

OBJECTIVES: It is well known that many chronic alcoholics manifest diastolic dysfunction of left ven tricle in its early stage. But the effects of chronic alcohol drinking on right ventricular function are not well understood. Thus left ventricular filling impair ment and its effects to right ventricular diastolic function were evaluated in young chronic alcoholics. METHODS: For the evaluation of left and right ventricular diastolic function in chronic alcoholics, 30 young chronic alcoholics and 28 control subjects were studied by pulsed Doppler echocardiography at the left and right ventricular inflow. Peak E velocity, peak A velocity, E/A velocity ratio, acceleration time and deceleration time were measured as diastolic filling parameters. RESULTS: 1) In the chronic alcoholics, the interventricular septum and posterior wall were thicker and left ventricular muscle mass was significantly increased than that in controls. 2) Among 30 cases of chronic alcoholics, 8 cases(26.7%) showed that the E/A ratio of the left ventricle was less than 1.0 and the deceleration time of the left ventricle was more than 240msec, where as 12 cases(40.0%) showed that the E/A ratio of the left ventricle was less than 1.0. 3) Among 30 cases of chronic alcoholics, 8 cases (26.7%) showed that the E/A ratio of the right ventri cle was less than 1.0 and the deceleration time of the right ventricle was more than 232msec, whereas 14 cases(46.7%) showed that the E/A ratio of the right ventricle was less than 1.0. 4) The RV E/A ratio was significantly correlated with the LV E/A ratio(r=0.697, p<0.001). 5) Blood pressure, ejection fraction, left ventricular mass, E/A ratio and deceleration time of both ventricles were not significantly different in comparison with the daily average amount, duration of ingestion, and total lifetime dose of alcohol. CONCLUSION: In all chronic alcoholics less than 50 years of age, the left ventricular systolic function was normal. But Doppler echocardiography showed that diastolic dysfunction of the left and right ventricles was present in 8 cases of 30 chronic alcoholics. Right ventricular diastolic dysfunction was closely related with left ventricular diastolic dysfunction. In conclu sion, diastolic dysfunction of both ventricle in chronic alcoholics may be the earliest functional sign of preclinical alcoholic cardiomyopathy.

The Comparison of Antihypertensive Effects among Hydralazine, Clonidine and Nifedipine in Hypertensive Emergency

If hypertensive emergencies are left untreated, multiple damages on heart, brain and kindney can develop. So rapid control of blood pressure within safty with effective antihypertensive agents is mandatory. For the comparison of antihypertensive effects among hydralazine (IV or IM), clonidine (IV), and nifedipine (sublingual) in hypertensive emergency, which were frequently used in our hospital, we performed propective study with hypertensive emergency patients(243 cases) who visited emergency room from Oct. 1986 until Aug. 1987. The results are as follows ; 1) For 58 patients who recieved hydralazine (IV or IM), initial mean arterial blood pressure(MAP) was 167.2+/-21.5mmHg and 15 minutes later 138.9+/-24.4mmHg, 45 minutes later 141.7+/-21.1mmHg, 90 minutes later, 133.9+/-26.6mmHg and, respectively. For 55patients who recived clonidine(IV), initial MAP was 164+/-21.9mmHg and 15minytes later 137.4+/-18.9mmHg, 45 minutes later 127.5+/-34.9mmHg, respectively. For 130 patients who recived nifedipine(sublingual), initial MAP was 159.8+/-21.4mmHg and 15 minutes later 143.0+/-22.8mmHg, 45 minutes later 127.5+/-21.1mmHg, 90 minutes later 119.3+/-20.0mmHg, respectibely. 2) Pulse rate showed 12.9% increase afer administration of hydralazine, 15.8% decrease in clonidine, 5.6% increase in nifedipine, respectively. 3)Severe reduction of blood pressure(systolic BP<130mmHG) after administration of following antihypertensive agents was found. i.e., hydralazine 5.2%, clonidine 1.8%, nifedipine 1.5%, respectively. 4) In 4 cases(6.9%) out of the 58 cases using hydralazine, 3 cases(5.5%) out of the 55 cases using clonidine, 9 cases(6.9%) out of the 130 cases using nifedipine, acute paradoxic hyertensive effects were observed.