• 제목/요약/키워드: Vasodilators

검색결과 28건 처리시간 0.031초

돌발성 난청 완치 직후 수술 및 스트레스로 재발된 임상경험 -2예 보고- (Recurred Cases Related to Operation and Stress Immediately after Recovery of Recent Sensorineural Hearing Loss -Two cases-)

  • 여정은;송선옥;서동혁
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.113-116
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    • 1997
  • Sensorineural hearing loss(SNHL) is defined as a sudden hearing impairment which was develope over a period of hours to days. The definitive cause of SNHL is unknown in most cases. Disturbance of the blood flow of the inner ear is a main causal hypotheses. Most symptomatic treatment is focusing to improving the blood flow of the inner ear. At our hospital, most patients are recommended to bed rest, vasodilators(nicotinic acid, antihistamines) and stellate ganglion block(SGB) for two weeks. We experienced two cases of recurrence immediately after recovery from SNHL. They discontinued SGB after initial recovery. due to associated pain with operation and or psychologic stress. One patient resumed SGB and medication treatment, but the second who gave up treatment was not recovered. Therefore, we recommend to continuance of treatment of stellate ganglion blocks to improve recovery rate of SNHL and avoid further trauma and psychologic stress during the recovery period of SNHL.

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중소병원 입원환자의 낙상발생 시 현황, 낙상위험요인 및 낙상발생 예측요인 (Circumstances, Risk Factors, and the Predictors of Falls among Patients in the Small and Medium-sized Hospitals)

  • 이영진;구미옥
    • 임상간호연구
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    • 제21권2호
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    • pp.252-265
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    • 2015
  • Purpose: This study examined the circumstances, risk factors, and the predictors of fall incidents among patients in the small and medium-sized hospitals. Methods: Fifty patients with any fall experiences were matched by gender, age, and medical departments with 100 patients without fall incident at the same hospital. Data were collected from 5 small and medium-sized hospitals. Data were analyzed using descriptive statistics, a Chi-square test, a Fisher's exact test, and a logistic regression with the SPSS/WIN 21.0 program. Results: In the patients with falls, the largest number of falls occurred during the day shift, in the patients' rooms, and while they were walking. Further 74.0% of the patients had physical injuries, and 34.0% had to take further medical diagnostic tests. Significant differences were found between the patients with falls and the others on 14 variables (cardiovascular disease, anemia, sedative-hypnotics, vasodilators, narcotic analgesics, dizziness, general weakness, unstable gait, walking aids, anger, anxiety, depression, orientation, and fear of fall). Narcotic analgesic use, dizziness, walking aids, and cardiovascular disease were identified as the predictors of fall incidents. Conclusion: These findings are hoped to be used in developing a fall risk assessment tool and fall prevention nursing programs for small and medium-sized hospitals.

Comparison of Prostaglandin E1 and Sildenafil Citrate Administration on Skin Flap Survival in Rats

  • Choi, Ji-An;Lee, Keun-Cheol;Kim, Min-Su;Kim, Seok-Kwun
    • 대한두개안면성형외과학회지
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    • 제16권2호
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    • pp.73-79
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    • 2015
  • Background: Alprostadil and sildenafil are known vasodilators used independently to improve flap survival in animal models. In this study, we investigate whether these agents act synergistically to decrease flap necrosis in rat models. Methods: After acclimation period, 4 groups of 10 male white rats were given a modified McFarlane skin flap. The postoperative treatment included saline control (Group A), sildenafil citrate-only (Group B), alprostadil-only (Group C), and both sildenafil and alprostadil (Group D). The flaps were observed on postoperative days 1, 3, 5 and 7. The animals were euthenized on postoperative day 7, and the flaps were evaluated for inflammation and neovascularization. Results: At each observation, the mean necrotic index was significantly lower for all three treatment groups (Groups A, B, C) and was the lowest for the combined treatment group. On histologic evaluations, combined treatment was associated with decreased inflammation and increased capillary vessel formation, when compared with control group. Conclusion: Both sildenafil-only and alprostadil treatments were independently associated with increased flap survival rate. Sildenafil citrate and alprostadil had a synergistic effect in increasing flap survival rate.

영아기 개심술 (Open Heart Surgery in Infancy)

  • 이상호
    • Journal of Chest Surgery
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    • 제28권1호
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    • pp.11-17
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    • 1995
  • Fourty-three infants underwent intracardiac repairs within the first 12 months of life. Mean age was 7 months and mean weight was 6.7 kg. A quarter of them were below 5 kg. Overall mortality including complex anomalies was 17.9%. Thirty-four infants with a ventricular septal defect[VSD were treated. Three infants[8.8% died in the early postoperative period, but only one[3.7% of the infants without having associated lesions was dead. VSD was repaired either by the incision on the right atrium, pulmonary artery, or right ventricle. Postoperative right bundle branch block[RBBB occurrence were different according to the approach: 30.8 % in pulmonary arteriotomy, 37.5 % in atriotomy, and 42.8 % in ventriculotomy. Surgically induced heart block did not occur in any patient, but 10 had temporary arrhythmia, and 11 patients were under temporary pacing from one day to 4 days without any persisting rhythm disturbances. Pulmonary hypertension was present in 29 infants preoperatively, and seven of them developed postoperative elevation of the pressure. Infants complicated with pulmonary hypertensive crisis were managed successfully. Inotropics were necessary in 55.8 % of the infants and vasodilators in 37.2 %. Platelet transfusion were needed in 10 cases who required 272 ml in average, but one who died from sepsis consumed 5,370cc of platelets. And we discuss complications and causes of deaths.

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Changes in Adrenal Angiotensin II Receptors in Renin-dependent Hypertensive Rats

  • Lee, Sung-Hou;Lee, Byung-Ho;Shin, Hwa-Sup
    • Archives of Pharmacal Research
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    • 제18권3호
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    • pp.169-172
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    • 1995
  • The changes in blood pressure may relate to the alterations of the responsiveness to vasoconstrictors and vasodilators, and these alterations can arise the modifications in the properties of angiotensin II (AII) receptor. In order to examine the changes of AII receptor in the hypertensive mechanism of renin-dependent hypertensive rats (RHRs; two-kidney, one-ligated type), we compared the equilibrium binding characteristics of $[^3H]$All in adrenal cortex and medulla from RHRs and normotensive rats. The dissociation constants of AII binding in both tissues of RHRs were very similar to those in the respective tissue of normotensive rats. However, the maximum binding was increased from 805 to 1050 fmole/mg protein in the adrenal cortex of RHRs, and decreased from 172 to 126 fmole/mg protein in the adrenal medulla of RHRs. These results imply that the up- and down-regulation of the All receptor population on the cell surface of adrenal glands from RHRs are consorted with the elevation of blood pressure and the activation of renin-angiotensin system.

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타액분비 및 선혈류 조절에 대한 내인성 산화질소의 역할 (Role of Endogenous Nitric Oxide in the Control of Salivary Secretion and Blood Flow)

  • 남상채;김미원;김원재
    • The Korean Journal of Physiology and Pharmacology
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    • 제1권6호
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    • pp.809-816
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    • 1997
  • The present study was designed to investigate whether endogenous nitric oxide(EDNO) is involved in submandibular vasodilation and salivation induced by parasympathetic nerve stimulation. Effects of $N^w$-nitro-L-arginine-methyl ester (L-NAME) which blocks the synthesis of EDNO from L-arginine on the submandibular vasodilation and salivation induced by chords stimulation or administration of various vasodilators were examined in anesthetized cats. Effect of L-NAME on $K^+$ efflux induced by carbachol was also examined using the excised submandibular slice in vitro. In the submandibular slices, acetylcholine$(10^{-5}\;mol/L)$ or vasoactive intestinal polypeptide$(VIP,\;10^{-5}\;mol/L)$ increased $NO_2$ contents, which was Prevented by pretreatment with L-NAME. Salivary secretion in response to the chords stimulation$(3\;V,\;1\;msec,\;10{\sim}20\;Hz)$ was completely blocked by treatment with atropine(1 mg/kg). Increased blood flow response to the low frequency(1, 2, 5 Hz) stimulation was significantly reduced, whereas the blood flow induced by the higher frequency(10,20 Hz) stimulation was not affected. Lingual-arterial infusion of L-NAME(100 mg/kg) significantly diminished the vasodilatory and salivary responses to the chorda stimulation at all stimuli frequencies used. Intra-arterial infusion of L-NAME(100 mg/kg markedly diminished the vasodilatory responses to acetylcholine$(5\;{\mu}g/kg)$, VIP$(5\;{\mu}g/kg)$ or bradykinin$(5\;{\mu}g/kg)$. In the excised submandibular slice, $K^+$ efflux in response to carbachol$(10^{-5}\;mol/L)$ was significantly decrease by pretreatment with L-NAME$(10^{-5}\;mol/L)$. In the isolated submandibular artery precontracted with phenylephrine$(10^{-5}\;mol/L)$, the vasorelaxation induced by ACh$(10^{-7}\;mol/L)$ was reversed into a contraction by methylene blue$(10^{-4}\;mol/L)$. These results suggest that EDNO may play an important role in vasodilation and secretion of the submandibular gland.

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Pharmacological Evidence that Calcitonin Gene-Related Peptide is Implicated in Cerebral Autoregulation

  • Hong, Ki-Whan;Pyo, Kwang-Min;Yu, Sung-Sook;Rhim, Byung-Yong
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 1994년도 춘계학술대회 and 제3회 신약개발 연구발표회
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    • pp.287-287
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    • 1994
  • In the present study, it was aimed to asses the possibility that calcitonin gene-related peptide (CGRP) released in response to transient hypotension may contribute to the reflex autoregulation of cerebral blood flow as a putative modulator. Changes in pial arterial diameter (mean, 33.0 ${\pm}$ 1.1 $\mu\textrm{m}$) with changes in systemic arterial blood pressure (mean, 101.9 ${\pm}$ 2.7 mmHg) were observed directly through a closed cranial window in anesthetized normotensive rats. Image of the pial vessels was captured with a stereoscope connected to a CCD video camera and the diameter was measured with a microscaler. In the capsaicin-treated rats (one day prior to experiment, 50 nmol capsaicin injected intracisternally), both vasodilater and vasoconstrictor responses evoked by a transient hypotension and the reverse of blood pressure were markedly attenuated or almost abolished. When changes in pial arterial diameter were plotted as a function of changes in blood pressure, the slopes of both regression lines (for vasodilators and vasoconstrictors ) were markedly reduced. Similar reductions were evidenced under treatment wi th the CGRP antibody serum (1:1,000) and following CGRP receptor desensitization. However, the autoregulatory mechanics were neither affected by treatment wi th spantide (1 ${\mu}$M), substance P antagonist, nor by substance P receptor desensitization. Suffusion wi th mock cerebrospinal fluid containing CGRP and cromakalim caused a vasodilatation in a concentration-dependent manner, respectively and their effects were antagonized by glibenclamide. Substance P produced a vasodilatation, which was, however, little affected by glibenclamide. These observations indicate that the CGRP released from the perivascular sensory fibers in response to a hypotension is implicated in the modulation of the autoregulation of cerebral blood flow.

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레이노드 증후군의 치료에 있어서 수부 교감신경절제술 (Digital Sympathectomy for Treatment of Raynaud's Syndrome)

  • 이세환;안희창;최승석;김창연
    • Archives of Plastic Surgery
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    • 제32권4호
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    • pp.479-484
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    • 2005
  • Raynaud's syndrome causes discolorization, ischemic claudication(pain) and necrosis of the digits through insufficiency in the circulation which is induced by intermittent spasms of the digital arteries. From January, 2002 to December, 2004, 10 patients were surgically treated for Raynaud's syndrome. 9 patients were female and 1 patient was male. 2 patients showed unilateral involvement, 8 patients were operated on both hands. 6 patients had necrotic changes on the finger tips due to the disease. Ages ranged from 21 to 60 with an average of 39.1. Ischemic pain, discolorization, and cold intolerance of the digits were the common symptoms. All patients were evaluated with color doppler before the surgery. Two different procedures were applied according to the severity of the disease: Patients with decreased circulation received, what we call a limited digital sympathectomy, i.e. stripping of the adventitia of the ulnar, radial and common digital arteries. An extended procedure, radical digital sympathectomy, was performed on patients with a complete block of circulation. Stripping of the adventitia in these patients also involved the proper digital arteries. Symptoms like discolorization, ischemic pain, and cold intolerance improved immediately after the surgery. The patients did not suffer from pain even with exposure to cold weather. We conclude that digital sympathectomy could improve the symptoms in Raynaud's patients who do not respond to conservative treatment such as calcium channel blocker and other vasodilators.

이중판막 재치환술 시 발생한 급성 대동맥 박리증으로 인한 비폐쇄성 장간막 허혈 (Nonocclusive Mesenteric Ischemia That Developed during Redo-double Valve Replacement Surgery, and This Was Caused by Acute Aortic Dissection)

  • 이삭;송석원;조상호;송승준;김관욱;장병철
    • Journal of Chest Surgery
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    • 제42권2호
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    • pp.248-251
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    • 2009
  • 비폐쇄성 장간막 허혈(nonocclusive mesentericic ischemia, NOMI)은 개심술 후 약 0.05%에서 발생하는 아주 드문 합병증으로 주요 장 혈관의 폐색 없이 내장 말초 혈관의 심한 혈관 경련(vasospasm)에 의해 장 허혈이 발생하는 것을 일컫는다. 본 증례에서는 상행 대동맥을 통한 동맥관 삽입시 발생한 급성 대동맥 박리로 수분간의 저혈압 상태에서 상대적으로 중요한 심장과 뇌의 혈류를 유지하기 위한 장 혈관의 수축으로 NOMI가 발생한 경우로 비교적 빠른 진단과 치료가 이루어졌음에도 장 경색으로 진행되어 사망하였다. 임상적으로 NOMI가 의심되는 경우 조기 진단 및 치료만이 생존률을 높일 수 있으므로, 빠른 대동맥 조영술 및 혈관 확장제의 선택적 주입이 필요할 것으로 생각된다.

이명(耳鳴)의 동(東)·서의학적(西醫學的) 문헌(文獻) 고찰(考察) (A Literature study about comparison of Eastern-Western medicine on the Tinnitus)

  • 허은선;황충연
    • 한방안이비인후피부과학회지
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    • 제29권4호
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    • pp.114-130
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    • 2016
  • Objectives : This study is performed to investigate the therapy on tinnitus through the literature of Eastern and Western medicine. Methods : This study review the definition, etiology, classification, internal and external methods of treatment of tinnitus based on 50 articles of Eastern medicine, 16 articles of Western medicine about the treatment of tinnitus. Results : The results were as follows. 1. In Eastern medicine, the cause and mechanism of disease of tinnitus arose from the state of qi-blood deficiency, internal dampness-heat and depression stagnation. In Western medicine, there are mainly caused by damage to the auditory system the lower induced changes in the upper. 2. In Eastern medicine, differentiation of syndromes classifies clinical aspects, and cause and mechanism of disease. In Western medicine, it divides into an generating region, clinical and associated symptoms aspects. 3. In Eastern medicine, internal method of treatments of tinnitus are divided into four treatments. In Western medicine, internal methods of tinnitus are vasodilators, blood-flow improvers, Metabolism improvers etc. 4. In Eastern medicine, external method of treatments of tinnitus are paste preparation method, powder preparation method, pill preparation method, acupuncture & moxibustion method. In Western medicine, external method of treatments of Tinnitus are divided into injection, other surgical therapies and adjuvant therapy. Conclusions : Until now, there is no perfect, effective single treatment. We think that Eastern medicine approach and treatment can be helpful to overcome the limitations of tinnitus cure.