• Title/Summary/Keyword: intravascular

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Development of an Ex Vivo Model for the Study of Cerebrovascular Function Utilizing Isolated Mouse Olfactory Artery

  • Lee, Hyung-Jin;Dietrich, Hans H.;Han, Byung Hee;Zipfel, Gregory J.
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.1-5
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    • 2015
  • Objective : Cerebral vessels, such as intracerebral perforating arterioles isolated from rat brain, have been widely used as an ex vivo model to study the cerebrovascular function associated with cerebrovascular disorders and the therapeutic effects of various pharmacological agents. These perforating arterioles, however, have demonstrated differences in the vascular architecture and reactivity compared with a larger leptomeningeal artery which has been commonly implicated in cerebrovascular disease. In this study, therefore, we developed the method for studying cerebrovascular function utilizing the olfactory artery isolated from the mouse brain. Methods : The olfactory artery (OA) was isolated from the C57/BL6 wild-type mouse brain. After removing connective tissues, one side of the isolated vessel segment (approximately $-500{\mu}m$ in length) was cannulated and the opposite end of the vessel was completely sealed while being viewed with an inverted microscope. After verifying the absence of pressure leakage, we examined the vascular reactivity to various vasoactive agents under the fixed intravascular pressure (60 mm Hg). Results : We found that the isolated mouse OAs were able to constrict in response to vasoconstrictors, including KCl, phenylephrine, endothelin-1, and prostaglandin $PGH_2$. Moreover, this isolated vessel demonstrated vasodilation in a dose-dependent manner when vasodilatory agents, acetylcholine and bradykinin, were applied. Conclusion : Our findings suggest that the isolated olfactory artery would provide as a useful ex vivo model to study the molecular and cellular mechanisms of vascular function underlying cerebrovascular disorders and the direct effects of such disease-modifying pathways on cerebrovascular function utilizing pharmacological agents and genetically modified mouse models.

Nifedipine Enhances Vasodepressor and Natriuretic Responses to Atrial Natriuretic Peptide in Anesthetized Rats (Nifedipine이 Atrial Natriuretic Peptide의 혈압내림효과에 미치는 영향)

  • Lee, Jong-Eun;Choi, Ki-Chul
    • The Korean Journal of Physiology
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    • v.24 no.1
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    • pp.115-121
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    • 1990
  • The interaction between a calcium channel blocker nifedipine and atrial natriuretic peptide (ANP) was examined in normotensive and renal hypertensive rats. The infusion of either ANP or nifedipine produced a significant decrease in mean arterial pressure (MAP). The combined infusion of ANP with nifedipine resulted in a greater fall of MAP than did the infusion of each drug alone. ANP significantly increased urinary volume and excretion of sodium, while nifedipine was without effects. The diuretic/natriuretic effects of ANP were potentiated by the combined infusion with nifedipine. The vasodepressor and renal effects of ANP or nifedipine were qualitatively similar between the normotensive and hypertensive rats. Nifedipine caused an upward and leftward shift of the ANP dose-relaxation curve of the phenylephrine-precontracted thoracic aortic rings isolated from the normotensive rats , suggesting that the vasodilation sensitivity to ANP is increased in the presence of nifedipine. These results indicate that nifedipine enhances the vasodepressor effect of ANP, the likely mechanisms being attributable to a contraction of effective intravascular volume as a consequence of potentiated renal excretion and a greater peripheral vasodilation.

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The Clinical Characteristics and Prognosis after Acute Ingestion of Glacial Acetic Acid (급성 빙초산 음독의 임상 양상 및 예후)

  • Choi, Gab-Yong;Min, Young-Gi;Jung, Yoon-Seok;Cho, Joon-Pil;Choi, Sang-Cheon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.2
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    • pp.91-96
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    • 2012
  • Purpose: A retrospective study with a literature review was conducted to identify the clinical characteristics and prognosis after the acute ingestion of glacial acetic acid. Methods: The medical records of 20 patients,who had presented to the emergency department of Ajou University Hospital complaining of the acute ingestion of glacial acetic acid between January 2006 and December 2011, were examined retrospectively. Results: Among the 172 patients admitted for caustics injury, 20 patients ingested glacial acetic acid. The mean age of the patients was $55{\pm}23.5$, and the mean volume of the acid was $84.5{\pm}71.3$ ml. The clinical features included 1) oral ulcers in 12 patients (63.2%), 2) respiratory difficulties in 11 patients (57.9%), 3) oliguria in 8 patients (42.1%), 4) renal toxicity in 7 patients (36.8%), 5) hepatic failure in 7 patients (36.8%), 6) disseminated intravascular boagulopathyin 7 patients (36.8%), 7) low blood pressure in 8 patients (42.1%), and 8) mental changes in 9 patients (47.4%). Ten patients required endotracheal intubation. Nine patients were admitted to the intensive care unit, and 5 patients expired. Conclusion: The ingestion of glacial acetic acid can cause severe symptoms, such as metabolic acidosis, multiple organ failure and upper airway swelling frequently and has a high mortality rate. Therefore, aggressive treatment, including endotracheal intubation, should be considered at the early stages.

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A Study on Home Nursing Care Requirement and Activities of Daily Life Among the Elderly at Home (재가노인의 가정간호요구도 및 일상생활능력에 관한 연구)

  • 조선화;김병성;김공현;박형종
    • Korean Journal of Health Education and Promotion
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    • v.11 no.2
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    • pp.125-145
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    • 1994
  • The objectives of this study were to characterize the health status, the requirement of home nursing care, and dependency of daily life of the elderly so that the result could be used to provide basic data necessary for establishing home nursing care practices. The study subjects were 249 elders over 65 years old who resided at home in low income areas of three districts in Pusan. The field survey was conducted from December 27, 1993 through January 27, 1994, with a structured questionnaire. Statistical analysis was done by X²-test and Student's T-test using SPSS/PC/sup +/ program. The result were as follows; 1. Alcohol drinking rate was 50.0% for men and 27.7% for women, and cigarette smoking rate was 77.8% for men and 27.1% for women. 92.9% of elders aged 65-75 exercised regularly as compared to 81.9% of elders aged 75 and over(p<0.05). 2. 63.9% of male and 85.9% of female elders had chronic diseases showing singnificant differences(p<0.01), and both sexes had 1.7 kinds of chronic diseases in average; musculoskeletal diseases were the most common in 25.7%, while 6.8% of the elderly had cardiovascular diseases. 3. Partially movable elderly was 6.9% for men and 6.8% for woman, showing 47.1% of causes being cerebrovascular accidents. 4. The home nursing requirement was the highest for medication(66.3%), intramuscular injection(53.8%), and measurement of blood pressure·body·temperature·pulse rate(47.0%). 5. Among Physical Activities of Daily Life, bathing(10.4%) and movement(4.0%) showed high dependency rates, and among Instrumental Activities of Daily Life, phone calling(25.3%), shopping(24.5%), going out by bus(22.5%) showed high dependency rates. 6. For five categories of home nursing showing high requirements such as physical health examination, blood pressure·temperature·pulas rate measurements, medication, and intravascular injection, the requirements were different by age groups, education, and marital status(p<0.05).

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A Case of Phlegmasia Cerulea Dolens as a Complication Caused by Placement of Inferior Vena Cava Filter (하대정맥 필터 삽입 후 합병증으로 발생한 Phlegmasia Cerulea Dolens 1예)

  • Cho, Young Sin;Kim, Jong Hwa;Lee, Ho Sung;Choi, Jae Sung;Na, Ju Ock;Seo, Ki Hyun;Kim, Yong Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.225-229
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    • 2008
  • Inferior vena cava filters are increasingly being used as an alternative to anticoagulation therapy for the prevention of pulmonary embolism. However, using an Inferior vena cava filter may result in clinically significant complications. Phlegmasia cerulea dolens is a rare disease that presents with acute complete venous occlusion due to extensive thrombosis in the lower extremity. It is characterized by intense pain, edema, decreased pulses and a cyanotic extremity. We report here on a case of phlegmasia cerulea dolens that was accompanied with disseminated intravascular coagulation (DIC) as a complication of the placement of an inferior vena cava filter in a patient who had been previously diagnosed with pulmonary embolism, and the patient had recently developed a cerebral hemorrhage due to a traffic accident.

A Case of Vivax Malaria Complicated by Adult Respiratory Distress Syndrome and Successful Management with Extracorporeal Membrane Oxygenation

  • Lee, Hyun-Jung;Baek, Ji-Hyeon;Chae, Myoung-Hun;Joo, Hoyeon;Lee, Jin-Soo;Chung, Moon-Hyun;Park, Yun-Kyu;Kim, Joung-Teak
    • Parasites, Hosts and Diseases
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    • v.51 no.5
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    • pp.551-555
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    • 2013
  • Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.

Values of Three Different Preoperative Regimens in Comprehensive Treatment For Young Patients with Stage Ib2 Cervical Cancer

  • Zhao, Yi-Bing;Wang, Jin-Hua;Chen, Xiao-Xiang;Wu, Yu-Zhong;Wu, Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1487-1489
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    • 2012
  • Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

Pulmonary artery sarcoma manifesting as a main pulmonary artery stenosis diagnosed by 18F-FDG PET/CT (18F-FDG PET/CT를 통해 진단된 주폐동맥 협착 소견의 폐동맥 육종)

  • Lee, Hoonhee;Park, Han-bit;Cho, Yun Kyung;Ahn, Jung-Min;Lee, Sang Min;Lee, Jae Seung;Kim, Dae-Hee
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.279-284
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    • 2017
  • Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

Association of vitamin D deficiency with clinical outcomes in critically ill Korean children

  • Jhang, Won Kyoung;Kim, Da Hyun;Park, Seong Jong
    • Nutrition Research and Practice
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    • v.14 no.1
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    • pp.12-19
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    • 2020
  • BACKGROUND/OBJECTIVES: Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children. SUBJECTS/METHODS: Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019. RESULTS: A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality. CONCLUSION: There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

The Determination of Blood-Brain Barrier Permeability and Pharmacokinetics of a Rat Transferrin Receptor Monoclonal Antibody by Brain Perfusion Method and Intravenous Injection Technique in Mice (마우스에서 뇌관류법과 정맥투여법에 의하여 흰쥐 트란스페린 단일항체의 체내동태 및 혈액-뇌 관문 투과성의 검토)

  • 강영숙
    • Biomolecules & Therapeutics
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    • v.10 no.1
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    • pp.37-42
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    • 2002
  • Brain drug targeting through the blood-brain barrier (BBB) in vivo is possible with peptidornirnetic monoclonal antibodies that undergo receptor-mediated transcytosis through the BBB. Monoclonal antibody to the rat transferrin receptor, such as the OX26 was studied in rats as a transport vector through BBB on the transferrin receptor. But, OX26 is not an effective brain delivery vector in mouse. In the present studies, rat monoclonal antibody, 8D3 to the mouse transferrin receptor were evaluated for brain drug targeting vector intransgenic mouse model. Pharrnacokinetic parameters in plasma and organ uptakes were determined at varioustimes after i.v. bolus injection of [$^{}125}I$] 8D3 in Balb/c mice. Brain uptake of [$^{}125}I$] 8D3 was also studied with an internal carotid artery perfusioncapillary depletion method. After i.v. injection of [$^{}125}I$] 8D3, plasma concentrations declined biexponentially with elimination half lift of approximately 2.2 hours. Brain uptake of [$^{}125}I$] 8D3 was $0.50{\pm}0.09$ persent of injected dose per g brain after 2 hours i.v. injection. After perfusion 5 min the apparent volume of distibution of [$^{}125}I$] 8D3 in brain was $22.3 {\mu}l/g,$ which was 4.8 fold higher than the intravascular volume. These studies indicate rat monoclonal antibody to the mouse transferrin receptor, 8D3 may be used for brain drug targeting vector in mice.