| Yang Hee Lim | 5 Articles |
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[English]
An elevated serum lipoprotein(a) level is an independent risk factor for atherosclerotic diseases, and the lipoprotein(a) level is correlated to preclinical atherosclerosis. To evaluate the association between lipoprotein(a) and aortic selerosis, mitral sclerosis, and abdominal aorta thickness, we measured the aortic valve thickness, mitral valve thickness and abdominal aorta thickness. Also, we assessed the relationship between the aortic valve sclerosis, mitral valve sclerosis, abdominal aorta thickness and other coronary risk factors. We measured serum lipoprotein(a) in 116 patients(52 men, 64 women) with mean age of 58.7±13.9 years. Aortic valve thickness was assessed by parasternal long and short axis two dimensional echocardiography, mitral valve thickness was measured by apical 4 chamber view. The abdominal aorta thickness was measured by the subcostal view. The level of lipoprotein(a) was significantly correlated with the aortic valve thickness, but not with the miral valve thickness and the abdominal aorta thickness. lipoprotein(a) level was higher in smoking patients(p<0.05), and not related to other ariables such as blood pressure, age, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. Coronary angiography was performed in 18 paitents, and there was a tendency of the coronary artery disease with high level of the lipoprotein(a)(p<0.005). There was no significant difference in the thickness of aortic valve in terms of sex, blood pressure, total cholesterol, high density lipoprotein, triglyceride or blodo sugar. We conclude that increased serum levels of lipoprotein(a) are closely related to aortic valve sclerosis and may be a risk factor for coronary artery disease.
[English]
The Measurement of blood pressure by a doctor may trigger a pressor response, so there are marked differences between office and ambulatory or self-measured blood pressure and the subjects may misdiagnosed as hypertensives and receive unneccesary medication. The study is designed to evaluate the charicteristic of white coat hypertension, the degree of white coat effect and the relationship between the white coat hypertension and persistent hypertension. Thirteen patients with office hypertension receiving no medication, were recruited from 434 patients experienced in ambulatory blood pressure. Past history, physical examination, office blood pressure, 12-channel standard electrocardiography, chest X-ray, plasma lipid battery, echocardiography and 24-hr ambulatory blood pressure monitoring with BP3 MEDIANA were performed. 1) White coat hypertensive patients were 13 of 434 patients(2.99%) who were performed 24-hr ambulatory blood pressure monitoring. The mean age was 45±12 years with 6 men and 7 women and rage of age was 26-65 years. 2) The lipid battery, chest X-ray and 12-channel standard electrocardiographty showed no significant finding. 3) The LV mass index was 90.7±11.0g/m3 but one of 8 who performed echocardiography showed concentric hypertrophty. 4) The LV ejection traction was 60.8±8.7% which normal range. 5) The mitral flow velocity parameters were E velocity 0.71±0.14m/sec, A velocity 0.54±0.24m/sec, E/A ratio 1.6±0.8, mitral valve deceleration time 214±27.6msec and isovolumic relaxation time 104±11.4msec but one of 8 showed LV relaxation abnormality. 6) The mean office systolic blood pressure was 159±13.8mmHg, mean office diastolic blood pressure 101±9.0mmHg, 24-hr mean ambulatory systolic blood pressure 128±4.9mmHg and 24-hr diastolic bliid pressure 82±8.6mmHg. 7) The night day ratio of systolic blood pressure was 0.93±0.06 and the night day ratio of diastolic blood pressure was 0.92±0.06 suggestive of blunted diurnal variation. The Dipper were 5 of 13 patients(38.5%) and the non-Dipper were 8 of 13 patients(61.5%). 8) Two of 13 white coat hypertensives were diagnosed as persistent hypertensives in follow-up periods and antihypertensive drug had been initiated. White coat hypertension can be diagnosed by 24-hr ambulatory blood pressure monitoring. The influence of white coat effect to cardiovascular system was not established. Sixty-two percent of white coat hypertensives showed blunted diurnal variation in 24-hr ambulatory blood pressure monitoring and two of 13 were diagnosed as persistent hypertensives in our F/U study, so white coat effect cannot be merely innocent and need strict evaluation and regular follow-up.
[English]
It is known that the morphologic expression or progression of hypertrophy in hyertrophic cardiomyopathy(HCMP) occurs mostly during childhood, when the body growth is considerable, but nearly not occurs in adult life. Apical hypertrophic cardiomyopathy is an uncommon variant of HCMP which is characteristic apical hypertrophy of the left ventricle showing characteristic ace of spade diastolic configuratioin of the left ventriculogram. It has not yet been clarified when the progression or development of hypertrophy occurs in apical HCMP. The possibliity of the morphologic changes in apical HCMP has been poposed in previous study, but not proved yet. We experienced a case of apical HCMP in 62-year-old female, which evolved during 6 years from mild, diffuse left ventricular hypertrophy to more progressed diffuse hypertrophy associated with marked hypertrophy of the apex of left ventricle showing ventriculopraphic picture of apical HCMP. The present case shows the morphologic change in HCMP with progression of hypertrophy during adult life.
[English]
The utilization of acetate & bicarbonate dialysate and their effects on acid-base balance, blood pressure, pulse rate, serum cholesterol, triglyceride, HDL and free fatty acid were investigated during regular hemodialysis. Eight patients with chronic renal failure were studied during two successive dialysis treatments for which either acetate or bicarbonate were used as a buffer anion in the dialysate. The result obtained as follows : 1) There was no significant difference in arterial pH between acetate and bicarbonate hemodialysis patients. 2) Arterial HCO3 was higher significantly in patients with bicarbonate hemodialysis than acetate hemodialysis from 60 to 240 minutes (p<0.01) 3) Arterial pCO2 fell significantly from 34.0 mmHg to 31.7 mmHg during acetate hemodialysis patient (p<0.01) 4) Heart rate rose signifificantly from 69 b.p.m to 82 b.p.m. during acetate hemodialysis(p<0.01). 5) Serum fatty acid increased significantly during acetate and bicarbonate hemodialysis, but no difference between two groups. 6) There were no significant changes in systolic and diastolic blood pressure in two groups during hemodialysis. 7) There were no significant changes in serum cholesterol, triglyceride and HDL in two groups during hemodialysis.
[English]
Ketoconazole-induced hepatitis was found in 36-year-old woman who developed easy fatiguability and jaundice, with abnormal liver function tests after taking ketoconazole 400mg a day for 6 months. All of the viral hepatitis serologic markers were negarive. Clinical and biochemical abnormalities spontaneously improved within 3 weeks after cessation of drug administration.
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, Keun Bae You
