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The effects of carvedilol (an alpha.beta-blocker) on lipid metabolism were assessed in addition to its hypotensive effect. The subjects were 18 men and 18 women, 20 with hypertension and 16 normotensives with other conditions requiring carvedilol treatment. They were aged from 31 to 79 years and were given a daily dose of 5-20 mg carvedilol (average, 9.7 mg/day) for 12 weeks. Significant falls were seen in blood pressure and heart rate after 12 weeks in the hypertensive subjects (mean +/- SE) (systolic: from 164 +/- 2 to 141 +/- 2 mm Hg, P less than 0.001; diastolic: from 98 +/- 1 to 85 +/- 2 mm Hg, P less than 0.001; heart rate: from 71 to 65 beats/min, P less than 0.001). Smaller changes in blood pressure and heart rate were seen in the normotensive subjects, with the fall in systolic pressure being significant (from 143 +/- 3 to 135 +/- 2 mm Hg, P less than 0.01). There were no significant changes in the overall serum total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, and phospholipid levels. In the subgroup with a pretreatment serum triglyceride level of greater than 150 mg/dl, a significant fall of 52.1 mg/dl was seen (P less than 0.05). Lipoprotein analysis showed a significant fall in alpha-lipoprotein levels (P less than 0.05). The atherogenic index did not change significantly, and it was concluded that carvedilol was an effective antihypertensive agent that produced no adverse effects and possibly had beneficial effects on lipid metabolism.

To investigate the prevalence and characteristics of depressed patients living in a Japanese leprosarium who have been isolated by national law and are now becoming very elderly.We surveyed the prevalence of depressed patients living in the National Tamazenshouen Sanatorium, a major leprosarium in Japan. We also investigated the characteristics of patients who had suffered a depressive episode during the last 5 years (2000-2004). The characteristics of residents who committed suicide were also studied.At the time of the investigation, 48 out of 385 (12.5%) patients were depressed or had experienced a depressive episode. Forty-one residents had committed suicide since the leprosarium was established in 1907. Somatic symptoms and depressive moods were the predominant symptoms and were not limited to symptoms unique to leprosy. The period of isolation was not statistically correlated with the GDS-SF or PGC morale scale scores.The findings of this study emphasize the importance of consultation psychiatric for elderly leprosy residents and could be used as a reference for treatment in countries with ageing leprosy residents.

To evaluate coronary artery disease, a new quantitative thallium-201 (201T1)-tomographic scintigraphic score (TSS: modified Massie's score) using oxygen consumption (METS) was developed and compared with coronary angiographic score (CAG-S) in 27 patients (eight patients with normal coronary angiograms, and five, eight and six patients with one, two and three vessel disease, respectively) without previous myocardial infarction. All patients received both coronary angiography and the treadmill exercise test using 201T1-myocardial single photon emission computed tomography (SPECT) within two weeks. The redistribution area (RA) and washout rate area (WA) were derived from the circumferential profile analysis using apical (A), midventricular (M) and basal (B) short-axis images. To obtain TSS values, the sum of these values was divided both by percentage of the age-predicted maximal heart rate (%PMHR) and the METS value as follows: TSS = [RA (A, M, B) + WA (A, M, B)]/(%PMHR x METS). The results were as follows: 1. TSS values were 6.4 +- 1.6, 9.4 +/- 2.2, 24.2 +/- 12.0 and 30.6 +/- 5.0 (mean +/- SD) in normal, one, two and three vessel disease groups, respectively. Significant differences were found among each group except between two and three vessel disease groups. 2. The detectability of significant coronary artery disease was 89% (17/19) except in two patients with one vessel disease. 3. A high correlation coefficient was found between TSS (X) and CAG-S (Y), i.e., Y = 0.8X - 3.5 (r = 0.944, p less than 0.001). It was concluded that the tomographic scintigraphic score (TSS) is useful not only for detecting, multivessel disease but also for totally-evaluating its severity, extent and influence on collateral supply, and could be used for analyzing prognosis and the selection of therapeutic interventions.