Objective: Increased aortic and carotid arterial augmentation index (AI) is associated with the risk of cardiovascular disease. The most widely used approach for determining central arterial AI is by calculating the aortic pressure waveform from radial arterial waveforms using a transfer function. But how the change of waveform by applied pressure and the pattern of the change rely on subject's characteristics has not been recognized. In this study, we use a new method for measuring radial waveform and observe the change of waveform and the deviation of radial AI in the same position by applied pressure. Method: Forty-six non-patient volunteers (31 men and 15 women, age range 21-58 years) were enrolled for this study. Informed consent in a form approved by the institutional review board was obtained in all subjects. Blood pressure was measured on the left upper arm using an oscillometric method, radial pressure waves were recorded with the use of an improved automated tonometry device. DMP-3000(DAEYOMEDI Co., Ltd. Ansan, Korea) has robotics mechanism to scan and trace automatically. For each subject, we performed the procedure 5 times for each applied pressure level. We could thus obtain 5 different radial pulse waveforms for the same person's same position at different applied pressures. All these processes were repeated twice for test reproducibility. Result: Aortic AI, peripheral AI and radial AI were higher in women than in men (P<0.01), radial AI strongly correlated with aortic AI, and radial AI was consistently approximately 39% higher than aortic AI. Relationship between representative radial AI of DMP-3000 and peripheral AI of SphygmoCor had strongly correlation. And there were three patterns in change of pulse waveform. Conclusion: In this study, it is revealed the new device was sufficient to measure how radial AI and radial waveform from the same person at the same time change under applied pressure and it had inverse-proportion to applied pressure.
From April 1990 through June 1990, three patients underwent subclavian flap aortoplasty for relief of the coarctation of the aorta. The age of the patients were 13 days, 7 months and 39 months and their weights were 3.3kg, 6.5kg, and 11kg, respectively. Two patients had persistence of the ductus arteriosus and all patients had associated intracardiac anomalies. We used the technique devised by Mendonca, namely, repair of the coarctation of the aorta using the subclavian artery as a flap and preservation of the arterial blood flow to the left arm. In one patient with long narrowing of isthmus, significant residual pressure gradient was remained by this technique and we added patch aortoplasty. There were no hospital deaths and follow-up over a one year period shows all patients in good condition.
Platycodon grandiflorum and Glycyrrhiza uralensis contain several bioactive compounds, such as saponin, oleanolic acid, and flavone. P. grandiflorum and G. uralensis have traditionally been used to treat disorders related to blood pressure, diabetes, and counteracting poison, and they have antinociceptive and antiinflammatory properties. However, the validity of complex saponin's vasodilatory effect has not been scientifically investigated. Therefore, this study explores the vasodilatory effect of complex saponin extracted from P. grandiflorum and G. uralensis mixture extract on rabbit carotid arteries. To this end, arterial rings with intact or damaged endothelium were used in an organ bath experiment and contracted by endothelin. Complex saponins, the major active constituents of P. grandiflorum and G. uralensis mixture extract, exhibited a moderate vasodilatory effect on the rabbit's basilar arteries. Therefore, treatment with complex saponin extracted from P. grandiflorum and G. uralensis mixture extract may selectively accelerate cerebral blood flow through basilar arterial dilation. Overall, the findings suggest that the extracted complex saponins can serve as vasodilator sources.
Objectives & Methods : This present study was performed to investigate the effect of Hwadamtongrak-Tang extract (HTT) on the regulation of cerebral hemodynamics in terms of regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP)] in normal and cerebral ischemic rats. Also the effects of HTT on changes in local blood flow, inhibition of LD H activity in neuronal cells, and levels of cytokine production in the serum were determined in the ischemic rat model. The major findings are summarized below. Results : 1. HTT significantly increased rCBF in a dose-dependent manner, but MABP was not changed by HTT treatment. These results suggest that HTT may increase rCBF by dilating cerebral arterial diameter. 2. HTT-induced increase in rCBF was blocked by pretreatment with cyclooxygenase inhibitor indomethacin (IDN, 1 mg/kg, i.p.) and MABP was significantly increased by ID N. 3. Pretreatment of methylene blue $(MTB,\;10\;{\mu}g/kg,\;i.p.)$, an inhibitor of guanylate cyclase, significantly decreased both rCBP and MABP in HTT-treated rats. 4. HTT treatment significantly increased rCBP to a stable level during the period of cerebral reperfusion. 5. HTT significantly inhibited LD H activity in neuronal cells, suggesting a neuroprotection by HTT. 6. Serum interleukin $(IL)-1{\beta}$ and tumor necrosis factor $(TNF)-{\alpha}$ levels were significantly decreased in the femoral artery 1 hr after middle cerebral arterial occlusion in HTT-treated rats. IL-10 levels in the serum were significantly increased by HTT treatment whereas transforming growth factor $(TGF)-{\beta}$ levels were similar between HTT-treated and control groups. 7. Serum interleukin $(IL)-1{\beta}$ and tumor necrosis factor $(TNF)-{\alpha}$ levels were significantly decreased in the femoral artery 1 hr after reperfusion in HTT-treated rats. Serum IL-10 levels were significantly decreased in HTT-treated rats compared with the control group, and no significant changes in $(TGF)-{\beta}$ in the serum were observed by HTT treatment. Conclusions: The present data suggest that HTT may have an anti-ischemic effect via the improvement of cerebral hemodynamics and thus protect the brain from ischemic damage.
This experimental study was designed to investigate the mechanism of Palmul-Tang(PMT) on the changes of cerebral hemodynamics in rats. The changes of cerebral hemodynamics in normal rats were as follows ; The PMT-induced increase in regional cerebral blood flow was significantly inhibited by pretreatment with indomethacin(1㎎/㎏, i.p.), an inhibitor of cyclooxygenase, and was inhibited by methylene blue(10㎍/㎏, i.p.), an inhibitor of guanylate cyclase. The PMT-induced dilation in pial arterial diameter was significantly inhibited by pretreatment with indomethacin and methylene blue. The PMT-induced increase in mean arterial blood pressure was significantly inhibited by pretreatment with indomethacin but was increased by methylene blue. This results were suggested that the mechanism of PMT was mediated by cyclooxygenase. The changes of cytokine production in cerebral ischemic rats were as follows ; In cytokine production of serum by drawing from femoral arterial blood after middle cerebral arterial occlusion 1hr, sample group was decreased IL-1β and TNF-α production compared with control group, IL-10 production of sample group was similar to that of control group, but sample group was significantly increased TGF-β production compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 1hr, sample group was significantly decreased IL-1β production compared with control group and decreased TNF-α production compared with control group. IL-10 production of sample group was similar to that of control group, but sample group was significantly increased TGF-β production compared with control group. In cytokine production of serum by drawing from femoral arterial blood after reperfusion 4 hrs, sample group was significantly decreased IL-1β production compared with control group, but IL-10 production of sample group was similar to that of control group. sample group was increased TNF-α and TGF-β production compared with control group. These results suggested that PMT had inhibitive effect on the brain damage by inhibiting IL-1β and TNF-α production, but by accelerating TGF-β production. The present author thought that PMT had an anti-ischemic effect through the improvement of cerebral hemodynamics and inhibitive effect on the brain damage.
As pointed out by many previous investigators, the cardio-pulmonary system of well trained athletes is so adapted that they can perform a given physical exercise more efficiently as compared to non-trained persons. However, the time course of the development of these cardio-pulmonary adaptations has not been extensively studied in the past. Although the development of these training effects is undoubtedly related to the magnitude of an exercise load which is repeatedly given, it would be practical if one could maintain a good physical fitness with a minimal daily exercise. Hence, the present investigation was undertaken to study the time course of the development of cardio-pulmonary adaptations while a group of non-athletes was subjected to a daily 6 to 10 minutes running exercise for a period of 4 weeks. Six healthy male medical students (22 to 24 years old) were randomly selected as experimental subjects, and were equally divided into two groups (A and B). Both groups were subjected to the same daily running exercise (approximately 1,000 kg-m). 6 days a week for 4 weeks, but the rate of exercise was such that the group A ran on treadmill with 8.6% grade for 10 min daily at a speed of 127 m/min while the group B ran for 6 min at a speed of 200 m/min. In order to assess the effects of these physical trainings on the cardio-pulmonary system, the minute volume, the $O_2$ consumption, the $CO_2$ output and the heart rate were determined weekly while the subject was engaged in a given running exercise on treadmill (8.6% grade and 127 m/min) for a period of 5 min. In addition, the arterial blood pressure, the cardiac output, the acid-base state of arterial blood and the gas composition of arterial blood were also determined every other week in 4 subjects (2 from each group) while they were engaged in exercise on a bicycle ergometer at a rate of approximately 900 kg m/min until exhaustion. The maximal work capacity was also determined by asking the subject to engage in exercise on treadmill and ergometer until exhaustion. For the measurement of minute volume, the expired gas was collected in a Douglas bag. The $O_2$ consumption and the $CO_2$ output were subsequently computed by analysing the expired gas with a Scholander micro gas analyzer. The heart rate was calculated from the R-R interval of ECG tracings recorded by an Offner RS Dynograph. A 19 gauge Cournand needle was inserted into a brachial artery, through which arterial blood samples were taken. A Statham $P_{23}AA$ pressure transducer and a PR-7 Research Recorder were used for recording instantaneous arterial pressure. The cardiac output was measured by indicator (Cardiogreen) dilution method. The results may be summarized as follows: (1) The maximal running time on treadmill increased linearly during the 4 week training period at the end of which it increased by 2.8 to 4.6 times. In general, an increase in the maximal running time was greater when the speed was fixed at a level at which the subject was trained. The mammal exercise time on bicycle ergometer also increased linearly during the training period. (2) In carrying out a given running exercise on treadmill (8.6%grade, 127 m/min), the following changes in cardio·pulmonary functions were observed during the training period: (a) The minute volume as well as the $O_2$ consumption during steady state exercise tended to decrease progressively and showed significant reductions after 3 weeks of training. (b) The $CO_2$ production during steady state exercise showed a significant reduction within 1 week of training. (c) The heart rate during steady state exercise tended to decrease progressively and showed a significant reduction after 2 weeks of training. The reduction of heart rate following a given exercise tended to become faster by training and showed a significant change after 3 weeks. Although the resting heart rate also tended to decrease by training, no significant change was observed. (3) In rallying out a given exercise (900 kg-m/min) on a bicycle ergometer, the following change in cardio-vascular functions were observed during the training period: (3) The systolic blood pressure during steady state exercise was not affected while the diastolic blood Pressure was significantly lowered after 4 weeks of training. The resting diastolic pressure was also significantly lowered by the end of 4 weeks. (b) The cardiac output and the stroke volume during steady state exercise increased maximally within 2 weeks of training. However, the resting cardiac output was not altered while the resting stroke volume tended to increase somewhat by training. (c) The total peripheral resistance during steady state exercise was greatly lowered within 2 weeks of training. The mean circulation time during exorcise was also considerably shortened while the left heart work output during exercise increased significantly within 2 weeks. However, these functions_at rest were not altered by training. (d) Although both pH, $P_{co2}\;and\;(HCO_3-)$ of arterial plasma decreased during exercise, the magnitude of reductions became less by training. On the other hand, the $O_2$ content of arterial blood decreased during exercise before training while it tended to increase slightly after training. There was no significant alteration in these values at rest. These results indicate that cardio-pulmonary adaptations to physical training can be acquired by subjecting non-athletes to brief daily exercise routine for certain period of time. Although the time of appearance of various adaptive phenomena is not identical, it may be stated that one has to engage in daily exercise routine for at least 2 weeks for the development of significant adaptive changes.
Purpose: This study was to evaluate the effect of arterial embolization on survival in patients with pelvic bone fractures and arterial bleeding. Methods: From January 2001 to December 2007, in all, 18 patients with pelvic bone fractures that had been treated with interventional arterial embolization were included in this retrospective study. The Injury Severity Score (ISS), the Revised Trauma Score (RTS), the initial hemodynamic status, the blood gas analysis, blood transfusion data, and mortality were the main outcome measurements. Results: Pelvic bone fractures were classified into lateral compression (LC), antero-posterior compression (APC), vertical shear (VS), and combined (CM) type according to the Young-Burgess classification. The Survivor group included 11 patients (61.1%), and the non-survivor group included 7 patients (38.9%). The mean ages for the survivor and the non-survivor groups were 40.0 and 45.6 years (p=0.517). The types of pelvic bone fractures were LC 11 (61.1%), APC 6 (33.3%), and VS 1 (5.6%): LC 7 (63.6%), and APC 4 (36.4%) in the survivor group and LC 4 (57.1%), APC 2 (28.6%), and VS 1 (14.3%) in the non-survivor group. The internal iliac artery was the predominant injured vessel among both the survivors (n = 5, 45.5%) and the non-survivors (n = 4, 57.1%). No differences in initial blood pressures, ISS, and RTS existed between the two groups, but the arterial pH was lower in the non-survivor group (pH 7.09 (${\pm}0.20$) vs 7.30 (${\pm}0.08$), p=0.018). The number of transfused 24-hour units of packed RBC was greater in the non-survivor group ($24.1{\pm}12.5$ vs $14.4{\pm}6.8$, p=0.046). Conclusion: No differences in initial blood pressure and trauma scores existed between survivors and non-survivors with pelvic bone fractures, who had been treated with arterial embolization, but arterial pH was lower the in non-survivors.
The aim of this study is to investigate the effects of onion vinegar on the cerebral blood flow by measuring the changes of regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP) and by observing the recovery of focal ischemic brain injury in rats. Rats are divided into thee groups depending on the medication; control group (no medication), 8.8-OV group (vinegar using 8.8 brix onion medication), 14.6-OV group (vinegar using 14.6 brix onion medication). The medication of onion vinegar significantly increased rCBF but decreased MABP. This result suggests that onion vinegar significantly increased rCBF by dilating arterial diameter. In addition, focal ischemic brain injury is induced in rats by middle cerebral arterial occlusion. The recovery from focal ischemic brain injury is more significantly improved in the groups using onion vinegar compared to the control group. The amount of recovery is measured by the GAP-43 and the medication of onion vinegar significantly increased GAP-43. This result suggests that onion vinegar is effective on the nerve regeneration. After the medication, the change of body weight, outcomes of renal and liver function test, and outcomes of CBC are analysed for safety examination. There are no statistical differences among control group and all experimental groups in the body weight, renal and liver function test, and CBC. In conclusion, these results suggest that onion vinegar can increase rCBF in normal state, and improve the stability of rCBF in ischemic state.
Objectives : Geopungjeseub-tang(Gufengchushi-tang) has been used in oriental medicine for many centuries as a therapeutic agent for hemiplegia caused by deficiency of qi(氣虛) and damp phlegm(濕痰). This study was performed to evaluate effects of Geopungjeseub-tang extract(GJT) on hemodynamics[regional cerebral blood flow(rCBF), pial arterial diameter(PAD), mean arterial blood pressure(MABP), heart rate(HR)] in normal rats and in rats with cerebral ischemia by middle cerebral artery(MCA) occlusion. Also, effects of adrenergic ${\beta}-receptor$, cyclooxygenase on response to GJT were evaluated. Methods : Laser-doppler flowmetry(LDF) measured changes of rCBF, MABP and HR. Video microscope and width analyzer measured changes in PAD. Results : rCBF and PAD increased after treatment with GJT(10mg/kg, i.v.) during the period of cerebral reperfusion, and pretreatment with indomethacin raised rCBF and PAD increased after treatment with GJT during the same period as above. Pretreatment with propranolol decreased rCBF, but increased after GJT treatment, but raised PAD increased after GJT treatment during this period of reperfusion. Conclusion : CR caused diverse responses were observed in rCBF and PAD after treatment with GJT. ACF action is mediated by adrenergic ${\beta}-receptor$ and cyclooxygenase. Result suggest that GJT has an anti-ischemic effect through the improvement of cerebral hemodynamics and has theraputic potential for cerebral apoplexy.
Cold $(0^{\circ}C)$ or warm $(25^{\circ}C)$ fresh and sea water were flooded into the lungs of rabbits through tracheal canule. Respiratory arrest ensued in 19.5 minutes in the warm fresh water flooded rabbits and was the longest survival time among the experimental groups. The survival times in the other groups were: 2.32 minutes in cold fresh water group, 2.75 minutes in .warm sea water group, and 4.57 minutes in cold sea water group. Cardiac output was measured by means of T-1824 dilution technique after 2 or 3 minutes of flooding in 27 rabbits. Blood pressure was observed by mercury manometer throughout the survival time in 40 rabbits. The following results were obtained. 1. Cardiac output in the warm fresh water flooded and sea water flooded animal was smaller than that of control rabbits. In the cold fresh water flooded animal cardiac output was greater than that of the control animal. 2. Time constants of T-1824 dilution curve of experimental group were elongated than the normal curve. 3. Central blood volume showed an increase in the fresh water group, a decrease in cold sea water group and no change in warm sea water group. 4. In all of the experimental groups arterial blood Pressure showed an abrupt and great variations after flooding of lungs and lasted about 30 seconds. Thereafter, arterial pressure remained at a plateau level until the sudden fall to zero and this was almost coincided with the time of respiratory arrest. The Plateau level of arterial Pressure in fresh water group was about 10 mmHg higher than the control value, and it was lower than the control value in warm sea water group. In cold sea water group the plateau was made up by fluctuations around the control value. 5. Osmosis of water through the lung alveolar membrane occured in all animals. Fresh water caused hemodilution and sea water caused hemoconcentration. 6. In sea water flooded animal more volume of water was recovered through the tracheal canule than the volume injected into trachea. This was interpreted as the consequence of the shift of water from plasma to alveolar sac. 7. Relative freight of lung was greater in fresh water group than sea water group. In all animal lung edema ensued. 8. The mechanisms of cardiac output variations were discussed.
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