• Title/Summary/Keyword: Resistant hypertension

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An Experimental Study of Effect on ECV 304 Cells, Platelet Rich Plasma and Rats treated with L-NAME by Ondamtang extract (온담탕이 고혈압 백서와 인간유래 혈관내피세포주(ECV 304)에 미치는 영향)

  • Baek Il-Sung;Park Chang-Gook;Lee So-Yeon;Yoon Hyeon-Deok;Sin Wo-Chul;Park Chi-Sang
    • Herbal Formula Science
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    • v.12 no.2
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    • pp.175-202
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    • 2004
  • Nitric oxide(NO) play an important role in normal and pathophysiological cells including as a messenger molecule, neurotransmitter, microbiocidal agent, or dilator of blood vessels and artheriosclerosis, hypertension, myocardial infarction, respectively. To investigate that Ondamtang in the potential contribution of the levels of nitric oxide generated by endothelial nitric oxide synthase (eNOS) and the mechanisms of protection against L-NAME, human ECV304 cells, which normally do not express eNOS, were expressed by L-NAME. L-NAME stimulated rat or cells were found to be resistant to injury and delayed death following the Ondam-tang. Inhibition of nitric oxide synthesis abolished the protective effect against L-NAME, thrombin and collagen exposure. Interestingly, such effects have bee observed during stimulation with agents such as KCl on L-NAME mediate rats, were damaged by the NOS inhibitor NG-nitro-L-arginine methyl ester (L-NAME). Cardiovascular diseases is one of the blood vessels and renin-angiotensin system dynfunction. So we studied on herbal medicine that have a relation of vessels endothelium necrosis. In Oriental Medicine, Ondam-tang has been used for disease in relation to cardiovascular system. We studied on the protection and inhibitory effects of cardiovascular diseases in L-NAME induced rat or ECV304 cell lines through the Cell morphological pattern, Tunel assay, LDH activity, heart rate, blood pressure and immunohistochemistric analysis by Ondam-tang. As the result of this study, In group, the anti-apoptosis and necrosis in the cardiovascular system have a potential capacity for prevented, protected and treating the diseases of cardiovascular system, against the necrosis of rat and ECV304 cells with eNOS and calpain expression by L-NAME is promoted.

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Salvage of Infected Breast Implants

  • Song, Joon Ho;Kim, Young Seok;Jung, Bok Ki;Lee, Dong Won;Song, Seung Yong;Roh, Tai Suk;Lew, Dae Hyun
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.516-522
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    • 2017
  • Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.

The Effect of Sohaphyangwon water extract on Endothelial cells by Free choleserol in blood (소합향원(蘇合香元)이 혈액내 Free Cholesterol에 의한 혈관내피세포 손상에 미치는 영향)

  • Lee, Sang-Heon;Lee, So-Yeon;Yoon, Hyeon-Deok;Shin, Oh-Chul;Park, Chang-Gook;Park, Chi-Sang
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.575-586
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    • 2005
  • FC(free choresterol) plays an important role in normal and pathophysiological cells including that of messenger molecule or dilator of blood vessels in such illnesses as artheriosclerosis, hypertension and myocardial infarction. Smooth muscle and endothelial cell functions in the arteria wall are unified by complex intercellular signalling processes. In arteria comprised of one layer of smooth muscle cells surrounding the endothelium, the close apposition of the two cell types enables a signal derived from one cell to rapidly diffuse to neighboring cells. Experimentation was conducted to investigate the potential contribution of Sohaphyangwon(SHHW) on levels of FC generated by goaded microphages, and mechanisms of protection against ACAT inhibitor. It was found that J774 macrophages, which normally do not express FC were expressed by oxLDL and ACAT inhibitor. SHHW protected cells were found to be resistant to oxLDL and delayed death following the FC. Inhibition of FC formation abolished the protective effect against ACAT inhibitor exposure. Cadiovascular diseases include abnormalities of blood vessels dysfunction of the renin-angiotension system. What relation herbal medicine may have with vessel endothelium necrosis was here studied. In Oriental Medicine, SHHW water extract used for diseases in relation to cardiovascular systems. The resistence to cardiovascular disease of ACAT inhibitor induced J774 macrophage cells were studied through analysis of cell morphological patterns and immunochemistry of SHHW. The results of this study suggest that SHHW has protective effects on the cardiovascular system, and that it is effective in both prevention and treatment of diseases of the cardiovascular system, particularity against necrosis of blood.

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Consideration on Flap Surgery in Vegetative Patients Having Nosocomial Infection (병원 감염 창상을 가진 식물 인간 상태에서의 피판술시 고려사항)

  • Kim, Jeong Tae;Kim, Kee Woong;Kim, Yeon Hwan;Kim, Chang Yeon
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.277-282
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    • 2009
  • Purpose: The vegetative state is a clinical condition with complete unawareness of self and environment, but with preservation of brain - stem functions. Vegetative patients may have nosocomial infections in their wounds, like pressure sores and infected craniums after cranioplasties. Usually flap surgery is necessary for those wounds, but decision of undergoing surgery is difficult because of various adverse conditions of vegetative patients. We share our experience of several successful flap surgeries in vegetative patients, and evaluate obstacles and requirements to get satisfactory results. Methods: From December 2005 to September 2008, a total of 4 vegetative patients underwent surgeries. In 2 patients with infected artificial craniums, scalp reconstructions with free flaps were performed. In other 2 patients with huge pressure sores with sepsis, island flap coverage of wounds was done. Retrospective study was done on hospital day, vegetative period, number of surgeries done, underlying diseases, causative bacteria, and contents of informed consent. Results: Mean hospital day was 14 months and mean vegetative period was 17.5 months. Patients underwent average of 4.5 surgeries under general anesthesia. There were several underlying diseases like hypertension, DM, CHF and chronic anemia. MRSA(Methicilin - resistant Staphylococcus Aureus) was cultured from every patient's wounds. Informed consent included a warning for high mortality and a need of attentive familial cooperation. Conclusion: There are three requirements for doing flap surgeries in vegetative patients. First, to prevent aggravation of brain damage and underlying diseases by general anesthesia, multidisciplinary team approach is needed. Second, operation should be beneficial for prolonging patient's lifespan. Third, because postoperative care is very difficult and long hospitalization is needed, detailed informed consent and highly cooperative attitude of family should be confirmed before operation.

Gerneral concept of dietary fiber and it's functionality (식품 중 식이섬유(Dietary fiber)의 의미와 기능성 고찰 -식이섬유의 특성과 기능을 중심으로-)

  • Shin, Dong-Hwa
    • Food Science and Industry
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    • v.52 no.1
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    • pp.84-99
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    • 2019
  • Dietary fiber is defined as soluble and insoluble polysaccharide consisted in the plant cell wall-associated fibers naturally occurring in fruits, vegetables, and cereal products, and of isolated fibers that are added to processed foods which are also artificially modified. There are so many difference types of dietary fibers as arabinoxylan, polydextrose chicory, oligosccharide. inulin, pectin, bran, cellulose, ${\beta}$-glucan, resistant starch and some seaweed polymers as alginate. Most of them provide many biological benefits in the intestine, as lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity and some of the gastrointestinal disease like as colon cancer. And also lowering cholesterol levels, improves glycemic and insulin sensitivity to non-diabetic and diabetic persons including immune system. Beside of many benefits, average consumers in developed and under developing countries take far less amounts of dietary fiber that international organization recommended. Adequate intake of dietary fiber is 14g/1,000kcal base using the energy guide line of 2,000kcal/day for women and 26,000 kcal/day for men, dietary intake is 28g/day of adult women and 36g/day for adult men. The mechanisms behind the reported effects of dietary fiber on metabolic health are not fully well established. It is suggested that changes in intestinal viscosity resulting mucus increasing, macro-nutrients absorption, rate of passage of large intestinal, production of short chain fatty acids by fermentation. Production of gut hormones and changes of microbiota in intestine. It is necessary to do more research in this field in the future and combined interdisciplinary works together.

An Experimental Study of Effect on ECV 304 Cells, Platelet Rich Plasma and Rats treated with L-NAME by Boonsimgieum extract (분심기음(分心氣飮)이 고혈압 백서와 인간유래 혈관내피세포주(ECV 304)에 미치는 영향에 대한 연구)

  • Jeon, Yeon-Yi;Park, Chang-Gook;Lee, So-Yeon;Yoon, Hyeon-Deok;Shin, Wo-Cheol;Park, Chi-Sang
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.182-198
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    • 2005
  • Object : This study was designed to research whether the protection and inhibitory effects of cardiovascular diseases in L-NAME induced rat or ECV 304 cell lines through the Cell morphological pattern, Tunel assay, LDH activity, heart rate, blood pressure and immunohistochemistric analysis by Boonsimgieum water extract Methods : Nitric oxide(NO) play an important role in normal and pathophysiological cells including as a messenger molecule, neurotransmitter, microbiocidal agent, or dilator of blood vessels and artheriosclerosis, hypertension, myocardial infarction, respectively. Endothelial cell products can modulate the magnitude of a response to a vasoconstrictor, as evinced by the greater constriction after endothelium removal or NO synthesis blockade. To investigate that Boonsimgieum in the potential contribution of the levels of nitric oxide generated by endothelial nitric oxide synthase (eNOS) and the mechanisms of protection against NG-nitro-L-arginine methyl ester (L-NAME), human ECV 304 cells, which normally do not express eNOS, were expressed by L-NAME. L-NAME stimulated rat or cells were found to be resistant to injury and delayed death following the Boonsimgieum. Inhibition of nitric oxide synthesis abolished the protective effect against L-NAME, thrombin and collagen exposure. Interestingly, such effects have been observed during stimulation with agents such as phenylephrine and KCl on L-NAME mediate rats, were damaged by the NOS inhibitor L-NAME. Result : As the result of this study, In group, the anti-apoptosis and necrosis in the cardiovascular system have a potential capacity for prevented, protected and treating the diseases of cardiovascular system, against the necrosis of rat and ECV 304 cells with Caspase 3 and calpain expression by L-NAME is promoted. Conclusion : these results demonstrate neuroprotective and memory enhancing effects of ZIBU, suggesting its beneficial actions for the treatment of AD.

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Beneficial effect of Combination with Korean Red Ginseng and Morus alba in metabolic syndrome (고과당식이 랫드모델에서 홍삼과 상엽 혼합투여에 의한 대사증후군 개선효과)

  • Lee, Yun Jung;Kim, Hye Yoom;Yoon, Jung Joo;Lee, So Min;Ahn, You Mee;Kho, Joung Hyun;Kho, Min Chul;Lee, Ho Sub;Choi, Kyung Min;Kang, Dae Gill
    • The Korea Journal of Herbology
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    • v.27 no.6
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    • pp.99-105
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    • 2012
  • Objectives : Korean red ginseng and Morus alba L. are used as a traditional treatment for diabetes. This study was designed to elucidate whether combination with Korean red ginseng and Morus alba L. (MPM) ameliorates metabolic syndrome in fructose-fed rats. Methods : Animals were divided into four groups; Control receiving tap water, fructose-fed, rosiglitazone-treated fructose-fed rats, and MPM-treated fructose-fed rats both receiving supplemented with 60% fructose (n=10). The MPM or rosiglitazone groups initially received a high-fructose (HF) diet alone for 8 weeks, with supplementation with MPM or rosiglitazone occurring during the final 6 weeks. Results : MPM and rosiglitazone, synthetic $PPAR{\gamma}$ agonist, treatment significantly prevented the increase in fasting serum glucose, leptin, triglyceride, and low density lipoprotein in the HF group when comparing with the control group. MPM and rosiglitazone also led to an increase in high density lipoprotein level in the HF group. The administration of MPM and rosiglitazone prevented the development of the metabolic disturbances such as impaired glucose tolerance, and blood pressure. MPM suppressed increased expressions of endothelin-1 (ET-1) in HF rat aorta. In addition, MPM significantly increased IR-${\beta}$ and PPAR-${\gamma}$ expression in muscle. Conclusions : Based on these results, we suggest that the administration of MPM improves metabolic syndrome through the alteration in lipid profiles and suppression of insulin resistant and blood pressure.

Renal Sympathetic Denervation Induces Acute Myocardial Inflammation through Activation of Caspase-1 and Interleukin-1β (교감신경절제술(RDN) 후 caspase-1과 interleukin-1β 활성화로 인해 유발된 염증성 급성심근손상)

  • Lee, Dong Won;Kim, Il Young;Kwak, Ihm Soo
    • Journal of Life Science
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    • v.28 no.2
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    • pp.240-246
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    • 2018
  • Efferent and afferent sympathetic nerves are closely related to the development of hypertension and heart failure. Catheter-based renal sympathetic denervation (RDN) is implemented as a strategy to treat resistant hypertension. We investigated whether RDN procedure causes inflammatory damage on myocardium in the early phase of sympathetic denervation. Twenty-five female swine were divided into 3 groups: normal control (Normal, n=5), sham-operated control (Sham, n=5), and RDN groups (RDN, n=15). The RDN group was further subdivided into 3 subgroups according to the time of sacrifice: immediately (RDN-0, n=5), 1 week (RDN-1, n=5), and 2 weeks (RDN-2, n=5) after RDN. There were no significant changes in the clinical parameters between the normal control and sham-operated group using contrast-media. In the myocardium, inflammatory cytokines, $IL-1{\beta}$ and $TNF-{\alpha}$ increased at the first week, and then decreased at the second week after RDN. Anti-inflammatory cytokine, IL-10 increased immediately, and then decreased at the second week after RDN. Caspase-1 activity and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) expression increased immediately after RDN until the second week. However, nucleotide-binding oligomerization domain, leucine rich repeat and pyrin domain containing protein 3 (NLRP3) expression did not show any significant differences among the groups. The RDN can cause acute myocardial inflammation through activation of caspase-1 and $IL-1{\beta}$. We should pay attention to protecting against early inflammatory myocardial damage after RDN.

Histopathologic Diagnosis and Outcome of Renal Biopsied Pediatric Nephrotic Syndrome (신생검을 받은 소아 신증후군에서 조직병리 소견과 치료 성과)

  • Chung Hye-Jeon;Youn Suk;Kim Sung-Do;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.149-158
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    • 2005
  • Purpose : To determine the histological findings and treatment outcome in cases of child hood nephrotic syndrome which required renal biopsy. Methods : We retrospectively reviewed the clinical, laboratory, pathologic findings and therapeutic outcomes of 159 nephrotic children who received a renal biopsy at the Department of Pediatrics, Kyunghee Medical University Hospital, Seoul from 1984 to 2004 over a period of 21 years. The renal biopsy was performed in nephrotic children who showed atypical features at presentation, or needed cytotoxic therapy because of frequent-relapsing, steroid-dependent, or steroid-resistant nephrotic syndrome(SRNS). Results : Minimal change disease(MCD) was found in 52.1$\%$ of the patients, followed by diffuse mesangial proliferation(33.1$\%$), focal segmental gomerulosclerosis(5.3$\%$), membranoproliferative glomerulonephritis(2.4$\%$), membranous nephropathy(2.4$\%$), and IgA nephropathy(1.8$\%$). In MCD children, 14.8$\%$ had hematuria, 22.7$\%$ had hypertension, 5.7$\%$ showed decreased renal function, and no patient was found to have an abnormal complement level. Among patients diagnosed with diseases other than MCD, 43.2$\%$ had hematuria, 21.0$\%$ was found to be hypertensive, 7.4$\%$ of children showed decreased renal function and only 3(3.7$\%$) had decreased complement level; the rates of hematuria and SRNS were found to be significantly higher than MCD patients. Among 37 SRNS patients, 30(81.0$\%$) showed a final remission state with long-term steroid therapy, including methylprednisolone pulse therapy, over 4 months, with or without cytotoxic therapy. Conclusion : Almost half of the cases of childhood nephrotic syndrome requiring renal biopsy were not diagnosed with MCD. Among atypical features, hematuria and steroid-resistance would be the most probable indicators for a diagnosis other than MCD. Even in patients with SRNS, long-term methylprednisolone pulse therapy may result in a good remission rate. (J Korean Soc Pediatr Nephrol 2005;9:149-158)

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Incidence and Risk Factors of Recurrent Urinary Tract Infections during Antibiotic Prophylaxis in Children with Primary Vesicoureteral Reflux (일차성 방광요관역류 소아에서 항생제 예방요법 중에 발생한 재발성 요로감염의 빈도와 위험인자)

  • Cho Su-Jin;Kim, Hyun-Jin;Lee Jeong-Won;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.46-55
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    • 2005
  • Purpose : Recurrent urinary tract Infection(UTI) in primary vesicoureteral reflux(VUR) may lead to serious renal scarring, a major cause of childhood hypertension and end-stage renal disease. To prevent recurrent UTI, low-dose long--term antibiotic prophylaxis has been recommended. However, recurrent UTI still develops during antibiotic prophylaxis, the efficacy of which is now being disputed. The emergence of resistant bacteria has also raised concerns. To evaluate the effect of antibiotic prophylaxis, we investigated recurrent UTI during prophylactic antibiotic use in children with primary VUR Materials : The incidence and risk factors of recurrent UTI were retrospectively evaluated in ninety-one children with primary VUR on trimethoprim- sulfamethoxazole(TMP/SMX) prophylafis during the year following their index febri]e UTI. Results : Recurrent UTI occurred in 31.9%(29/91) children and comprised 0.32 episodes/patient year. Febrile UTI was 0.26 episode/patient year and afebrile UTI was 0.07 episodes/patient year. The recurrent rate of UTI in male patients with phimosis was 37.2%(19/51), which was significantly higher than in males without phimosis 0%(0/5)(P=0.025). In the logistic regression analysis for recurrent UTI, renal scar was the significant risk factor for recurrent UTI [RR 3.8(95% CI 1.0-14.1) P=0.04]. For other well-known risk factors such as sex, age, degree of VUR, APN, and voiding dysfunction, the differences were not significant. Conclusion : TMP/SMX prophylaxis did not prevent recurrent UTI in children with primary VUR. Phimosis and renal scars were the risk factors for recurrent UTI but the grade of primary VUR was not. In VUR without phlmosis and renal scar, a randomized controlled study without antibiotic prophylaxis is required. (J Korean Soc Pediatr Nephrol 2005;9:46-55)

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