Laser acupuncture is defined as the stimulation of traditional acupuncture points with low-intensity, nonthermal laser irradiation. Possible advantages in using laser acupuncture are the noninvasive, painless and low risks of infection treatment. The purpose of this study is to assess the effect of laser acupuncture on the quality and waveform of arterial pulses. Ten acupuncture points were stimulated repeatedly three times in 30 individuals by laser with emission in the near infrared spectral region (808 nm) using an out power and power density of 45 mW and $143W/cm^2$. The analysis of pulse quality and waveform was performed based on the measurement of arterial pressure of the left and right wrist, using a 3-dimensional blood pressure pulse analyzer. Excess-like pulse quality of subjects before laser acupuncture changed significantly to balanced pulse quality after 10, 20, and 30 minutes of laser acupuncture; coefficient of deficient or excess, $C_{DE}$, decreased significantly from 0.68 before acupuncture to 0.61, 0.55, and 0.55 after 10, 20, 30 minutes of laser acupuncture ($$p{\leq_-}0.006$$), respectively. Other pulse qualities, floating or sinking, slow or rapid, choppy or slippery did not change significantly by laser acupuncture (p > 0.05). Pulse waveform analysis showed that amplitude of main peak (systolic function or aortic compliance, $h_1$) of left and right artery pulse waves decreased significantly after 10, 20, and 30 minutes of laser acupuncture (p < 0.05). Other parameters, duration of one cardiac cycle (T), duration of rapid systolic ejection ($T_1$), duration of the systolic phase ($T_4$), and duration of the diastolic phase ($T_5$) of left and right artery pulses did not change significantly after laser acupuncture (p > 0.05).
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by vascular remodeling of pulmonary arteries (PAs) and increased vascular resistance in the lung. Monocrotaline (MCT), a toxic alkaloid, is widely used for developing rat models of PAH caused by injury to pulmonary endothelial cells; however, characteristics of vascular functions in MCT-induced PAH vary and are not fully understood. Here, we investigated hypoxic pulmonary vasoconstriction (HPV) responses and effects of various vasoconstrictors with isolated/perfused lungs of MCT-induced PAH (PAH-MCT) rats. Using hematoxylin and eosin staining, we confirmed vascular remodeling (i.e., medial thickening of PA) and right ventricle hypertrophy in PAH-MCT rats. The basal pulmonary arterial pressure (PAP) and PAP increase by a raised flow rate (40 mL/min) were higher in the PAH-MCT than in the control rats. In addition, both high $K^+$ (40 mM KCl)- and angiotensin II-induced PAP increases were higher in the PAH-MCT than in the control rats. Surprisingly, application of a nitric oxide synthase inhibitor, L-$N^G$-Nitroarginine methyl ester (L-NAME), induced a marked PAP increase in the PAH-MCT rats, suggesting that endothelial functions were recovered in the three-week PAH-MCT rats. In addition, the medial thickening of the PA was similar to that in chronic hypoxia-induced PAH (PAH-CH) rats. However, the HPV response (i.e., PAP increased by acute hypoxia) was not affected in the MCT rats, whereas HPV disappeared in the PAH-CH rats. These results showed that vascular contractility and HPV remain robust in the MCT-induced PAH rat model with vascular remodeling.
Background and Objectives: The purpose of this study was to examine the relationship between between one's quality of life (QoL) level and the arterial stiffness estimated by the second derivative of photoplethysmogram (SDPTG) for women patients. Methods: A retrospective chart review was performed on charts of 407 women patients (38.38±11.82 years) who visited Gangdong Kyung Hee Hospital between April 1st and September 30th, 2011. Vascular aging index (VAI, (b-c-d)/a), b/a, c/a, and d/a were considered as the arterial stiffness indexes, and the Korean version of the Short-Form 36 (SF-36) were completed to estimate one's physical and mental QoL. Results: Physical and mental components of the SF-36 in older group (50, 60, and 70 years-group) were lower than those in younger group (20 and 30 years-group). Large arterial stiffness-related b/a in older group was higher that in younger group, while small arterial stiffness-related d/a in older group was lower that in younger group. Physical and mental component scores of the SF-36 had the negative correlations with VAI and b/a (r; -0.153~-0.195), while had the positive correlations with c/a and d/a (r; 0.147~0.228). Conclusions: In conclusion, this study suggests that convenient and cost-effective SDPTG test may serve as an auxiliary tool to estimate one's physical and mental QoL.
Anesthetized dogs were tilted from horizontal to the upright and head down position. Tilting to the upright position was followed by an increase in heart rate. In the head down position a decreased heart rate was obtained. The arterial blood pressure was decreased in the upright position and was decreased markedly in the head down position. The central venous pressure was decreased in the upright position and was markedly decreased down to the negative pressure in the head down position. The respiratory rate was slightly increased in the upright position comparing to that in the horizontal position. No remarkable changes were noted in the head down position. From the above results the following factors were discussed The decreased arterial blood pressure during the upright position was supposed to be the secondary effect from the diminished venous return that was suggested by the decreased central venous pressure. The decreased arterial blood pressure in the head down position was also supposed as the above reason as the diminished central venous pressure during the tilt. In addition the cardioinhibitory effects originated from the baroreceptors might have been operated during head down tilting. In the heart rate there was slight tachycardia in the upright position this was assumed as the abolished cardioinhibitory impulses from the baroreceptor in the upright position. On the contrary, despite of the decrease of arterial blood pressure in the head down position as well as in the upright, the bradycardia have been appeared. This was suggestive of cardioinhibitory impulses from the baroreceptors which was stretched during head down tilting. From the above findings there is a possibility of continous cardioinhibitory responses during head down tilting for this kind of the short period of 10 minutes which was chosed in this study.
Human circulatory system between heart and tissue is not directly connected in normal condition but mandatory to go through the capillary system in order to fulfill its physiologic aim to deliver oxygen and nutrients, etc. to the tissue and retrieve used blood together with waste products from the tissue properly. When abnormal connection between arterial and venous system (AV fistula), these two circulatory systems respond differently to the hemodynamic impact of this abnormal connection between high pressure (artery) and low pressure (vein) system. Depending upon the location and/or degree (e.g. size and flow) of fistulous condition, each circulatory system exerts different compensatory hemodynamic response to this newly developed abnormal inter-relationship between two systems in order to minimize its hemodynamic impact to own system of different hemodynamic characteristics. Pump action of the heart can assist the failing arterial system directly to maintain arterial circulation against newly established low peripheral resistance by the AV fistula during the compensation period, while it affects venous system in negative way with increased venous loading. However, the negative impact of increased heart action to the venous system is partly compensated by the lymphatic system which is the third circulatory system to assist venous system independently with different hemodynamics. The lymphatic system with own unique Iymphodynamics based on peristaltic circulation from low resistance to high resistance condition, also increases its circulation to assist the compensation of overloaded venous system. Once these compensation mechanisms should fail to fight to newly established hemodynamic condition due to this abnormal AV connection, each system start to show different physiologic ${\underline{de}compensation}$ including heart and lymphatic system. The vicious cycle of decompensation between arterial and vein, two circulatory system affecting each other by mutually negative way steadily progresses to show series of hemodynamic change throughout entire circulation system altogether including heart. Clinical outcome of AV fistula from the compensated status to decompensated status is closely affected by various biological and mechanical factors to make the hemodynmic status more complicated. Proper understanding of these crucial biomechanical factors iii particular on hemodyanmic point of view is mandatory for the advanced assessment of biomechanical impact of AV fistula, since this new advanced concept of AY fistula based on blomechanical information will be able to improve clinical control of the complicated AV fistula, either congenital or acquired.
The incidence of the Buerger's disease is higher for the far-East Asian population that for western people, but the surgical outcomes have been documented to be unsatisfactory. So, more aggressive and multi-focused treatment modalities should be warranted such as stopping smoking or intravenous vasodilator infusion with surgery. We report here on a successful surgical case of intra-arterial direct infusion of Prostaglandin E1 concomitant with surgical bypass and lumbar sympathectomy to treat Buerger's disease.
Kim, Kyu-Soo;Oh, Sang-Yu;Choi, Byung-Ok;Lee, Joong-Kil
The Korean Journal of Physiology
/
v.3
no.2
/
pp.25-31
/
1969
Effects of graded increase of positive lung inflation upon heart rates and arterial blood pressure were observed in the anesthetized dogs to analyze the mechanical and neural regulatory factor in response to the positive inflation of the lung. The results obtained were summarized as followings: 1) When the low grade of positive lung inflation was employed under the mild to moderate anesthesia, central venous pressure was linearly increased while heart rate was decreased. After bilateral vagotomy, central venous pressure was obviously increased while heart rate was constant. 2) When the high degree of positive lung inflation was employed, changes of central venous pressure and heart rate were not significant. 3) The low grade of intrapulmonary pressure increase caused reflex tachycardia in phase 2 and overshooting in phase 4 in response to the systemic arterial blood pressure change. 4) On the other hand, the high degree of intrapulmonary pressure increase caused paradoxical bradycardia in phase 2 and lack of overshooting in phase 4 in response to the systemic arterial blood pressure change. 5) It may be noted that the experimental model employed in the present study is a useful tool to evaluate and analyze the neural and mechanical regulatory factor in response to the graded increase of the positive lung inflation.
We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.
During the period from November 1981 through June 1986, 18 cases of coronary arterial bypass graft were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. They consisted of 13 males and 5 females with the mean age of 49 [range: 28-69 years]. History of myocardial infarction was noted in 50% of the patients and cardiomegaly on chest PA in 2 patients with preserved LV function. On resting EKG, except the evidences of old myocardial infarction, the findings of LVH were noted in 7 cases, acute myocardial infarction in 2, diffuse myocardial ischemia in 1, and significant ventricular arrhythmia in 2 cases. The angina by type of presentation is stable in 3 patients, unstable in 15 patients with resting, postinfarction and progressive angina as the criteria of unstability. The patterns of involvement of significant disease were single vessel involvement [5 cases] double vessel involvement [8 cases], and triple vessel involvement [5 cases] including 5 cases of left main coronary arterial diseases. The pattern of coronary arterial disease in individual patient was one or more stenosis of the proximal left coronary arterial system with or without right coronary involvement, in every case. We performed 9 cases of double bypass and 9 cases of triple bypass with great saphenous vein using single anastomosis technique except in 4 cases, One of the 4 cases is our first case, sequential anastomosis between LAD and diagonal was performed due to shortage of the prepared vein graft. In the other 3 cases, our latest experience, we adopted the left internal mammary artery for the left anterior descending coronary revascularization. The distribution of sites of distal anastomosis revealed more striking predilection to LAD, showing our attention on the significance of the revascularization of LAD system. The ischemic time was 35 minutes per graft and mean number of grafts per patient was 2.5. Of the 18 patients, 13 [77.2%] had complete revascularization, and incomplete in 5 cases with the causes of incompleteness as presented. The early results of operation were as followed: surgical death in 2 [11%], perioperative infarction 2 [11%], need of inotropic support 5 [28%], arrhythmia 2 [11%], wound problem, bleeding, and emotional dysfunction. The actuarial anginal free survival during the period of 6 months through 2 years was 85.2% with excellent symptomatic control according to the angina classification of Canadian Cardiovascular Society.
Purpose : This study evaluated the effect of VEGF in the arterial anastomosis by using light and electron microscopy. Marerials and method : Rats underwent femoral arterial end-to-end anastomosis after transection and topical VEGF treatment. The proximal and distal segments of the femoral arteries was drenched with 1 drop of VEGF $(100ng/100{\mu}l/bottle)$. and when half of the repair was finished, the other 1 drop was drenched and then the repair was continued to complete the anastomosis. Gross and histologic characteristics of arterial wall were assessed after 3 days, 1, 3 and 5 weeks. In the control group, normal saline solution instead of VEGF was dropped with the same method in the anastomosis. Results : The histologic findings of the arterial wall were the vascular remodeling with the infiltration of inflammatory cells at early stages and the tissue fibrosis at lately stages in the anastomotic sites of the control and the VEGF-treated groups. The scanning electron microscopic results were; (1) the anastomotic sites were covered by many irregular cells with long cytoplasmic processes at the early stages. (2) After 1 week, endothelial cells started to cover the anastomotic sites. (3) After 3 weeks, the anastomotic sites were partially covered by endothelial cells in the control group. (4) After 5 weeks, the anastomotic sites were completely covered by endothelial cells in the control and VEGF-treated groups. (5) In the VEGF-treated group, the anastomotic site was completely covered by endothelial cells which directed parallel to longitudinal axis of arteries after 3 weeks. Conclusion : Topical VEGF maintained luminal integrity by decreasing fibrosis and increasing re-endothelialization. These findings suggest that topical VEGF may be a promising new strategy to enhance healing and improve the outcome of vascular anastomosis.
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