• Title/Summary/Keyword: hypotensive

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Influence of Isoproterenol on Intra-renal Blood Flow in the Dog (개의 신내혈류(腎內血流)에 미치는 Isoproterenol의 영향(影響))

  • Park, Ki-Dong
    • The Korean Journal of Pharmacology
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    • v.5 no.2
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    • pp.141-148
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    • 1969
  • The direct effect of isoproterenol on renal function, when given intravenously, is usually obscured by its potent hypotensive action. To obviate the latter action, isoproterenol was infused directly into one renal artery of the dog, the other kidney serving as a control for the general action. And following results were obtained. In the first series of experiments, the directic action of isoproterenol was ascertained. $1.0\;{\mu}g/kg/min$. reduced on both kidneys the urine flow, clearances of PAH and creatinine, as well as the amount of sodium excreted, but the effect was weaker on the experimental side than on contralateral side. With $0.1\;{\mu}g/kg/min$., two cases among 6 experiments showed marked diuresis, two cases no apparent effect, and another two marked antidiuresis on the experimental kidney, whereas the contralateral kidney exhibited antidiuresis in all cases. Further reducing the dose unmasked the diuretic action on the ,experimental kidney. In another series, the effects of isoproterenol on the blood flow distribution within the kidney and on sodium concentration gradient within the kidney tissue were observed. $0.05\;{\mu}g/kg/min$ isoproterenol markedly increased the medullary plasma flow and slightly increased total renal plasma flow and glomerular filtration rate, along with concomitant increase in the amount of sodium excreted and osmolar clearance, and decrease in reabsorption of free water. Sodium concentration gradient markedly decreased in the experimental kidney, reaching 2/3 of the value observed in the contralateral kidney at the papilla. It is thus concluded that isoproterenol exerts a diuretic action, when infused directly into a renal artery, and the mechanism of the action rests on its hemodynamic action, substantiated as the increase in glomerular filtration and in the medullary blood flow, resulting in washout of hyperosmolality produced by the coutercurrent multiplier system.

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Successful Use of Extracorporeal Membrane Oxygenation for Severe Lung Contusion and Stress-induced Cardiomyopathy Caused by Multiple Trauma (다발성 외상으로 인한 심한 폐 좌상과 스트레스성 심근병 환자에서 체외막형 산화기의 치료 경험)

  • Lee, Dae-Sang;Gil, Eun Mi;Lee, A Lan;Ha, Tae Sun;Chung, Chi-Ryang;Park, Chi-Min;Cho, Yang Hyun
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.229-232
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    • 2014
  • A 55 year-old man hit a vehicle while riding a bicycle. He was diagnosed as left hemopneumothorax, multiple rib fracture, cerebral hemorrhage, and skull fracture. Initially he suffered from hypoxia requiring 100% oxygen with a mechanical ventilator. Finally he became hypotensive. Venovenous extracorporeal membrane oxygenation (ECMO) was initiated to support patient's gas exchange. Because hypotension and left ventricular dysfuction persisted, we converted the mode of support to veno-arterio-venous ECMO. Over four days of intensive care, we could wean off ECMO. The patient went to rehabilitation facility after 45 days of hospitalization. Although trauma and bleeding are considered as relative contraindication of ECMO, careful decision making and management may enable us to use ECMO for trauma-related refractory heart and/or lung failure.

Clinical Evaluation of Radionuclide Esophageal Transit Studies using Liquid and Solid Foods (유동식 및 고형식을 이용한 동위원소 식도통과검사의 임상적 의의에 대한 연구)

  • Choe, Jae-Gol;Lee, Min-Jae;Song, Chi-Wook;Hyun, Jin-Hai;Suh, Won-Hyuck
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.61-72
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    • 1995
  • The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophageal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT<24 sec, MRR<9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT<35 sec, MRR<9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2 % and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically showed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm (DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in transit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.

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Review on the Potential Therapeutic Roles of Nigella sativa in the Treatment of Patients with Cancer: Involvement of Apoptosis - Black cumin and cancer -

  • Mollazadeh, Hamid;Afshari, Amir R.;Hosseinzadeh, Hossein
    • Journal of Pharmacopuncture
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    • v.20 no.3
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    • pp.158-172
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    • 2017
  • Nigella sativa (N. sativa, family Ranunculaceae) is a medicinal plant that has been widely used for centuries throughout the world as a natural remedy. A wide range of chemical compounds found in N. sativa expresses its vast therapeutic effects. Thymoquinone (TQ) is the main component (up to 50%) in the essential oil of N. sativa. Also, pinene (up to 15%), p-cymene (40%), thymohydroquinone (THQ), thymol (THY), and dithymoquinone (DTQ) are other pharmacologically active compounds of its oil. Other terpenoid compounds, such as carvacrol, carvone, 4-terpineol, limonenes, and citronellol, are also found in small quantities in its oil. The main pharmacological characteristics of this plant are immune system stimulatory, anti-inflammatory, hypotensive, hepatoprotective, antioxidant, anti-cancer, hypoglycemic, anti-tussive, milk production, uricosuric, choleretic, anti-fertility, and spasmolytic properties. In this regard, we have searched the scientific databases PubMed, Web of Science, and Google Scholar with keywords of N. sativa, anti-cancer, apoptotic effect, antitumor, antioxidant, and malignancy over the period from 2000 to 2017. The effectiveness of N. sativa against cancer in the blood system, kidneys, lungs, prostate, liver, and breast and on many malignant cell lines has been shown in many studies, but the molecular mechanisms behind that anti-cancer role are still not clearly understood. From among the many effects of N. sativa, including its anti-proliferative effect, cell cycle arrest, apoptosis induction, ROS generation, anti-metastasis/anti-angiogenesis effects, Akt pathway control, modulation of multiple molecular targets, including p53, p73, STAT-3, PTEN, and $PPAR-{\gamma}$, and activation of caspases, the main suggestive anti-cancer mechanisms of N. sativa are its free radical scavenger activity and the preservation of various anti-oxidant enzyme activities, such as glutathione peroxidase, catalase, and glutathione-S-transferase. In this review, we highlight the molecular mechanisms of apoptosis and the anti-cancer effects of N. sativa, with a focus on its molecular targets in apoptosis pathways.

BLOOD LOSS AND HEMATOLOGIC CHANGE AFTER ORTHOGNATHIC SURGERY (악교정 수술후 출혈양과 혈액학적 변화에 대한 임상연구)

  • Chang, Hyun-Ho;Ryu, Sung-Ho;Kang, Jae-Hyun;Lee, Seung-Ho;Kim, Jae-Seung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.435-441
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    • 2001
  • Orthognathic surgery for the correction of dentofacial deformities is a common elective procedure. That has proven over the years to be a safe operation with minimal long-term morbidity. But, there are many surgical complication including mal-union of the bone, TMJ problem, excessive bleeding, and permanent damage of inferior alveolar nerve. Among them excessive bleeding which focus is not clear is one of the serious complication because that is fatal and so a transfusion is performing for the prevention and management of that. Until the end of the 1980's, homologous blood transfusions were routinely necessary because of the large amounts of blood lost during surgery. Recently several blood-saving measures can be undertaken for orthognathic surgery patients before, during, and after the operation. We made a comparative study of an amount of blood loss, hematologic change and transfusion requirements based on a series of 40 consecutive patients undergoing single-jaw and double-jaw surgery. The purpose of this investigation was to make a comparative analysis of an amount of blood loss, post-operative hematologic change and duration of the procedure under induced hypotensive anesthesia in healthy orthognathic patients.

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Different Clinical Courses for Poisoning with WHO Hazard Class Ia Organophosphates EPN, Phosphamidon, and Terbufos in Humans (WHO 분류 1 등급 EPN, Phosphamidone, Terbufos 유기인계 중독환자의 임상 양상)

  • Mun, Jong Gu;Moon, Jeong Mi;Lee, Mi Jin;Chun, Byeong Jo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.1
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    • pp.1-8
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    • 2018
  • Purpose: Extremely hazardous pesticides are classified as World Health Organization (WHO) hazard class Ia. However, data describing the clinical course of WHO class Ia OP (organophosphate) poisonings in humans are very scarce. Here, we compare the clinical features of patients who ingested hazard class Ia OPs. Methods: This retrospective observational case study included 75 patients with a history of ingesting ethyl p-nitrophenol thio-benzene phosphonate (EPN), phosphamidon, or terbufos. The patients were divided according to the chemical formulation of the ingested OP. Data regarding mortality and the development of complications were collected and compared among groups. Results: There were no differences in the baseline characteristics and severity scores at presentation between the three groups. No fatalities were observed in the terbufos group. The fatality rates in the EPN and phosphamidon groups were 11.8% and 28.6%, respectively. Patients poisoned with EPN developed respiratory failure later than those poisoned with phosphamidon and also tended to require longer mechanical ventilatory support than phosphamidon patients. The main cause of death was pneumonia in the EPN group and hypotensive shock in the phosphamidon group. Death occurred later in the EPN group than in the phosphamidon group. Conclusion: Even though all three drugs are classified as WHO class Ia OPs (extremely hazardous pesticides), their clinical courses and the related causes of death in humans varied. Their treatment protocols and predicted outcomes should therefore also be different based on the chemical formulation of the OP.

The Effect of Pressing at Kyeun-Jung, Gok-Ji and Zok-Sam-Li with Si-Acupuncture on the Decreasing of Blood Pressure and Headache for the Patients with Stroke. (견정(肩井), 곡지(曲池), 족삼리(足三里) 시침이 뇌졸중(腦卒中) 환자(患者)의 혈압(血壓)과 두통(頭痛)에 미치는 효과)

  • Kang, Kwi-Yeum;Lee, Ji-Won;Youn, Hyoun-Min
    • Korean Journal of Acupuncture
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    • v.22 no.3
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    • pp.27-40
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    • 2005
  • Objective : The purpose of this study was to verify the effect of pressing at Kyeun-Jung$(G_{21})$, Gok-Ji$(LI_{11})$ and Zok-Sam-Li$(S_{36})$ with Si-acupuncture on the decreasing of blood pressure and headache on the stroke patients. Methods : This study was one-group pretest-posttest experimental design. The subjects of this study were 30 patients who were hospitalized in stroke center of hospital located in Ulsan from September 27, to November 12, 2004. They had over 160/90mmHg blood pressure but didn't take any hypotensive drugs. The instruments were the Si-acupuncture. the blood pressure and headache scale using Visual Analogue Scale(VAS). Results : 1. With administration of Si-acupuncture, the blood pressure intensity decreased statistical significantly(systolic blood pressure: t=13.310, p=0.000, diastolic blood pressure: t=11.788, p=0.000). After 30 minutes with administration of Si-acupuncture, the blood pressure intensity decreased statistical significantly(systolic blood pressure: t=15.130, p=0.000, diastolic blood pressure: t=12.479, p=0.000). 2. With administration of Si-acupuncture, the headache intensity not decreased statistical significantly'(t=0.372, p=0.712). After 30 minutes with administration of Si-acupuncture, the headache intensity decreased statistical significantly'(t=7.370, p=0.000) Conclusion : According to above, it was verified that the pressing at Kyeun-Jung, Gok-Ji and Zok-Sam-Li with Si-acupuncture was effective in decreasing of blood pressure and headache on the stroke patients.

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The Effects of Cortex Mori on NO, $TNF-{\alpha}$ and $IL-1{\alpha}$ production by macrophage (상백피(桑白皮)가 대식세포의 NO, $TNF-{\alpha}$$IL-1{\alpha}$ 생산에 미치는 영향)

  • Ahn, Jae-Kyu;Ahn, Duk-Kyun;Cho, Jae-Chon
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.485-501
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    • 1998
  • Cortex Mori (Moros alba L.), the root bark of mulberry tree has been used as an autiphlogistic, diuretic and expectorant in herval medicine. Recently, a few papers reported that phenolic extract of Cortex Mori had the hypotensive, hypoglycemic, antiviral and anticancer effects, and hot water extract of Cortex Mori(CM) had inhibitory effect on the degranulation and histamine release from activated mast cells. These previous studies suggest a possibility that CM has an antidotal activity against inflammation which was mediated mainly by macrophage-secreting inflammatory factors. This study was performed to evaluate the influences of CM on carrageenan-induced edema in vivo and release of inflammatory mediators such as NO, TNF and IL-1 by macrophages stimulated with LPS or $IFN-{\gamma}$ in vitro. Subcutaneous injections of carrageenan into the mouse paw rapidly induced local edema by increasing vascular permeability, but single intraperitoneal injection of CM extract at 30 minutes before carrageenan suppressed the development of edema. NO and TNF production from macrophage stimulated by LPS or $IFN-{\gamma}$ were significantly suppressed, especially TNF secretion by up to 3-4 folds. LPS stimulated IL-1 production was also inhibited, but not significantly. Cell viability assay verified that the inhibition was not due to general cell toxicity. These results suggest that reduction of NO, TNF and IL-1 production may be one of the means by which CM prevent inflammation associated diseases.

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Effect of Epidural Morphine and Dose-Related Droperidol for Postoperative Pain (수술후 통증에 대한 경막외 morphine과 용량에 따른 Droperidol 효과)

  • Yeom, Gun-Young;Lee, Sung-Kyun;Suh, Jae-Hyun;Kim, Seung-Nyeun
    • The Korean Journal of Pain
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    • v.4 no.1
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    • pp.20-25
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    • 1991
  • During the past decade the use of epidural opioids for treatment of chronic as well as postoperative pain has increased Epidural droperidol significantly reduced the side effects of epidural morphine without any appreciable toxicity, except possibly sedation. The purpose of this study was to assess the side effects and potentiation of analgesia of epidural morphine by dose-related droperidol. The results were as follows: 1) Duration of analgesia and pain score: There was no significant difference between morphine and dose-related droperidol groups. 2) Pruritus: Droperidol did not affect the incidence of pruritus with epidural morphine (P>0.05). 3) Nausea and vomiting: Significantly fewer patients experienced nausea and vomiting (16.7%) with droperidol 2.5mg(P<0.001). 4) Hypotensive episode Hypotension occurred in the groups with droperidol 1.25 mg (27. 8%) and 2.5mg(33.3%). 5) Sedation: It there was increased severity and incidence of sedation with dose related epidural droperidol. 6) Respiratory depression: There was no patient with respiratory depression in the morphine or droperidol group. 7) Extrapyramidal symptoms and others: There was no extrapyramidal symptom in the group with morphine and 0.25 mg droperidol, but 3 patients in the group with l.25 mg droperidol and 5 patients in the group with 2.5 mg droperidol how extrapyramidal symptoms. One patient in droperidol 2.5 mg developed suspicious NMS. It is suggested that the use of epidural droperidol to reduce the side effects of morphine may not be appropriate.

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Experimental Studies on the Cardiovascular Effects of Haloperidol in Cat and Rabbit (Haloperidol 이 심혈관계에 미치는 영향)

  • Ahn, Young-Soo
    • The Korean Journal of Pharmacology
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    • v.11 no.2
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    • pp.19-27
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    • 1975
  • Haloperidol, a butyrophenone, was synthetized by Janssen and introduced for the treatment of psychosis. Although structurally different from the phenothiazines, the butyrophenones share many of their pharmacological properties, such as inhibition of conditioned avoidance response, blocking effect of amphetamine reaction, producing catalepsy, antishock effect and protection against the lethal effects of catecholalmines. Chlorpromazine can lower the arterial blood pressure through its adrenergic blocking activity, its direct effect in relaxing vascular smooth muscle, its direct effect in depressing the myocardium and its action in a complex manner on the central nervous system. In the case of haloperidol, however, was not clarified the mechanism of lowering the blood pressure. The present paper describes the effects of haloperidol on cardiovascular system to investigate the mechanisms of its actions on the arterial blood pressure. The results are followings; 1. In anesthetized cats, intravenous administration of haloperidol and chlorpromazine in the dose of 0.1mg/kg produced a slight decrease in the blood pressure, which followed by complete recovery within $30{\sim}60$ minutes. In the dose of 3mg/kg, however, both produced an abrupt and marked decrease of the blood pressure, which followed by delayed recovery. 2. Haloperidol in the dose ranges of 0.1mg to 3.0mg/kg tended to produce the heart rate slowing in the cats, while chlorpromazine has no effect on the rate. 3. Following administration of haloperidol or chlorpromazine, epinephrine reversal in the arterial blood pressure was observed in the cat, however the responses of norepinephrine and acetylcholine were little affected. 4. In the isolated rabbit atrium the contractility was depressed by haloperidol in the doses over 0.5mg per 100ml, but the rate was not affected. In contrast, the epinephrine-induced contractility was not depressed after haloperidol treatment. However, the increased rate of atrium by epinephrine was partially blocked after haloperidol. 5. In the isolated rabbit aortic strip, epinephrine-induced contraction was blocked by haloperidol. With the above results, it may be concluded that the hypotensive effect of haloperidol was largely due to ${\alpha}$-adrenergic blocking properties and the direct effect in depressing the myocardium as well as its action on central nervous system.

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