• Title/Summary/Keyword: Arterial pressure

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Effect of Unilateral Renal Arterial Infusion of Angiotensin II on Renal Function and Renin Secretion in Unanesthetized Rabbit (신동맥내 투여한 Angiotensin II가 신장기능 및 Renin 분비에 미치는 영향)

  • Kim, Jong-Hun;Kang, Nam-Poo;Kim, Young-Jin;Kim, Suhn-Hee;Cho, Kyung-Woo
    • The Korean Journal of Physiology
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    • v.23 no.2
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    • pp.363-375
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    • 1989
  • It has been well known that peripheral infusion of angiotensin II results in an increase of blood pressure, and an elevation of aldosterone secretion, and an inhibition of renin relase. However, the direct effect of angiotensin II on renal function has not been clearly established. In the present study, to investigate the effect of angiotensin II on renal function and renin release, angiotensin II (0.3, 3 and 10 ng/kg/min) was infused into a unilateral renal artery of the unanesthetized rabbit and changes in renal function and active and inactive renin secretion rate (ARSR, IRSR) were measured. In addition, to determine the relationship between the renal effect of angiotensin II and adenosine, the angiotensin II effect was evaluated in the presence of simultaneously infused 8-phenyltheophylline (8-PT, 30 nmole/min), adenosine A 1 receptor antagonist. Angiotensin II infusion at dose less than 10 ng/kg/min decreased urine flow, clearances of para-amino-hippuric acid and creatinine, and urinary excretion of electrolytes in dose-dependent manner. The changes in urine flow and sodium excretion were significantly correlated with the change in renal hemodynamics. Infusion of angiotensin II at 10 ng/kg/min also decreased ARSR, but it has no significant effect on IRSR. The change in ARSR was inversely correlated with the change in IRSR. The plasma concentration of catecholamine was not altered by an intarenal infusion of angiotensin II. In the presence of 8-PT in the infusate, the effect of angiotensin II on renal function was significantly attenuated, but that on renin secretion was not modified. These results suggest that the reduction in urine flow and Na excretion during intrarenal infusion of angiotensin II was not due to direct inhibitions of renal tubular transport systems, but to alterations of renal hemodynamics which may partly be mediated by the adenosine receptor.

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Cardiovascular Neurons Mediating Somatosympathetic Reflex in Rostral Ventrolateral Medulla

  • Goo, Yong-Sook;Kim, Sang-Jeong;Kim, Jun;Sung, Ho-Kyung
    • The Korean Journal of Physiology
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    • v.27 no.2
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    • pp.185-197
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    • 1993
  • The rostral ventrolateral medulla (RVLM) includes vasopressor neurons, which transmit activation signals to the intermediolateral nucleus (IML) of the spinal cord, where the preganglionic sympathetic nucleus is located, to raise arterial blood pressure (BP). However, controversy exists as to the possible depressor area in the RVLM and the pathway involved. The present study persued evidence far the location of depressor neurons and the pathway by simultaneously observing changes in BP and the firing rate (FR) of cardiovascular neurons (CVNs) in the RVLM during the somatosympathetic reflex (SSR) elicited by peripheral nerve stimulation, since CVNs are known to contribute to the generation of the sympathetic nerve discharge. In 42 cats, anaesthetized with $\alpha-chloralose$, single unit recording was performed, using carbon filament electrodes inserted into the RVLM, enabling estimation of the post R wave unit histogram (PR-UNlT) and the spike triggered average of sympathetic nerve discharge (STA-SND), allowing identification of CVNs. Antidromic stimulation of spinal $T_2$ segment was followed to determine whether the identified CVN projects axonal endings to the spinal cord (reticulospinal neuron). The sciatic nerve was electrically stimulated at $A\delta-intensity$ (1 mA, 0.1 ms), 1 Hz and C-intensity (10 mA, 0.5 ms), 20 Hz to elicit the depressor, and pressor responses of the SSR, respectively. Simultaneous measurement of CVN firing rate was made. Experimental results are summarized as follows. 1) 20 out of 98 CVNs had axonal projections to the spinal cord and 17 out of 98 CVNs showed FR changes during SSR. 2) Response patterns of FR and BP during SSR were classified into 8 types. 3) These 8 different response patterns could be further classified into those from pressor and depressor neurons. These results demonstrate that some CVNs were identifiable as reticulospinal neurons responding to anti-dromic stimulation and that CVNs operating as depressor neurons as well as pressor neurons exist in the RVLM, both of which are involved with SSR mediation. Therefore, evidence was found that an independent depressor pathway might be involved in the mediation of SSR.

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The Effect of Garlic (Allium Sativum L.f. Pekinense Makino) Juice on the Motility of the Isolated Duodenum (척출가토장관운동(剔出家兎腸管運動)에 미치는 마늘(Allium Sativum L.f. Pekinense Makino)의 영향(影響))

  • Ha, Jae-Kyo;Shin, Hong-Kee;Kim, Kee-Soon
    • The Korean Journal of Physiology
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    • v.15 no.1
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    • pp.61-66
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    • 1981
  • In 1944 Cavallito and Bailey first extracted an essential oil, a powerful antibacterial principle, from the garlic and named it allicin. Later Stoll and Seeback elucidated that allicin was produced from alliin by the enzymatic action of arinase. Damaru observed the depressor responses following intraperitoneal administration of garlic juice in cats. And Thiersch presented evidence that garlic had a protective action against experimental arterosclerosis in cholesterol-fed animals. On the other hand it was also reported that anemias were caused by long-term ingestion of garlic as a result of reduction in hemoglobin and RBC. From the experiment in which the effect of garlic on the blood sugar level was studied, Lee insisted garlic elevated blood sugar level. However, August and Jain claimed that hypoglycemia was induced by garlic administration. Recently Bordia and Bansal suggested that essential oils extracted from onion and garlic have a strong preventive effect on hyperlipemia and prolonged coagulation time resulted from fat-feeding. Furthermore Bordia et al indicated that garlic exerted a strong fibrinolytic activity. In early 1920 s Sugihara reported that essential oil of garlic not only decreased arterial blood pressure but also had a paralytic effect on the isolated heart and intestinal strip of animals. The present study was proposed to investigate the effect of garlic juice and the mechanism of its action on the motility of the isolated rabbit duodenum. The motility of the isolated duodenum was recorded on polygraph by means of force transducer connected with Magnus apparatus. And the isolated duodenum was separtely pretreated with $acetylcholine(5{\times}10^{-7}\;gm/ml)$, $pilocarpine(2.5{\times}10^{-6}\;gm/ml)$, $histamine(5{\times}10^{-6}\;gm/ml)$ and barium $chloride(2.5{\times}10^{-5}\;gm/ml)$ in order to find out interations of these drugs with ASJ. The results obtained were as follows; At concentrations of 0.25%, 0.5% and 1.0% ASJ markedly inhibited contractions of isolated duodenum while tonus as well as contractility of the isolated intestine were decreased also with 0.5% and 1.0% ASJ. Since ASJ markedly abolished augmented motility of isolated intestine by histamine and partly reduced that by $BaCl_2$, it is strongly suggested that inhibitory action of ASJ on the intestinal motility is caused mainly by its antihistamine effect and partly by its direct action on the intestinal smooth muscle.

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Hypoalbuminemia as a Predictor of 30-day Mortality in Patients with Acute Organophosphate Insecticide Poisoning (유기인계 살충제 중독환자에서 30일 사망률에 대한 예후 예측인자로서의 저알부민혈증의 유용성)

  • Kim, So Yeon;Lee, Ryun Kyung;Kim, Tae hu;Kim, Dong Hoon;Kim, Taeyun;Lee, Soo Hoon;Jeong, Jin Hee;Lee, Sang Bong;Kang, Changwoo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.11-16
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    • 2017
  • Purpose: The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied. Methods: This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis. Results: A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was $57.3{\pm}17.0$ years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ${\geq}3.5g/dl$) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690-0.881) and the APACHE II score was 0.840 (95% CI, 0.770-0.910). Conclusion: Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.

Studies on the Positive Inotropic Mechanism of Aconiti Tuber (부자 강심성분의 작용기전에 관한 연구)

  • Kim Myung-Suk;Kim Yong-Sik
    • The Korean Journal of Pharmacology
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    • v.17 no.1 s.28
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    • pp.9-15
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    • 1981
  • Aconiti tuber butanol fraction, which is isolated from the chloroform insoluble and water soluble extract of Aconitum volubile, has been recently known to have a potent positive inotropic effect in the isolated cardiac muscle preparations of various animals. The positive inotropic mechanism of Aconiti tuber butanol fraction, in relation with the external calcium, was studied using the isolated cat papillary muscle. The positive inotropic effect was dependent on the calcium concentration in the nutrient medium, and a synergistic relation could be demonstrated between Aconiti tuber butanol fraction and the external calcium. The inotropic effect of $10^{-4}g/ml$ of Aconiti tuber butanol fraction was equivalent to that of 0.06mM of calcium in the medium. After the treatment with a calcium influx inhibitor, Verapamil$(2{\pm}10^{-7}-10^{-6}M)$, the contractile force of the papillary muscle was markedly inhibited. In these preparations, Aconiti tuber butanol fraction restored the decreased contractility in a dose-dependent manner. It was suggested that the positive inotropic effect of Aconiti tuber butanol fraction might be related with the stimulating action on the calcium influx through the slow inward calcium channels in the cardiac cell membrane. In contrast with digitalis cardiac glycoside, Aconiti tuber butanol fraction infused intravenously into the anesthetized rabbit decreased the systemic arterial blood pressure and increased the carotid blood flow, but produced no prominent changes in the heart rate.

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Comparison of the hemodynamic effects of propofol and ketamine as anesthetic induction agents during high-dose remifentanil administration: a single-center retrospective comparative study

  • Sanuki, Takuro;Mishima, Gaku;Kurata, Shinji;Watanabe, Toshihiro;Kiriishi, Kensuke;Tachi, Mizuki;Ozaki, Yu;Okayasu, Ichiro;Kawai, Mari;Matsushita, Yuki;Miura, Keiichiro;Ayuse, Takao
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.129-134
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    • 2015
  • Background: We hypothesized that ketamine, when administered as the anesthetic induction agent, may prevent cardiovascular depression during high-dose remifentanil administration, unlike propofol. To test our hypothesis, we retrospectively compared the hemodynamic effects of ketamine, during high-dose remifentanil administration, with those of propofol. Methods: Thirty-eight patients who underwent oral surgery at the Nagasaki University Hospital between April 2014 and June 2015 were included in this study. Anesthesia was induced by the following procedure: First, high-dose remifentanil ($0.3-0.5{\mu}g/kg/min$) was administered 2-3 min before anesthesia induction;next, the anesthetic induction agent, either propofol (Group P) or ketamine (Group K), was administered. Mean arterial pressure (MAP) and the heart rate were recorded by the automated anesthesia recording system at four time points: immediately before the administration of high-dose remifentanil (T1);immediately before the administration of propofol or ketamine (T2);2.5 min (T3), and 5 min (T4) after the administration of the anesthetic induction agent. Results: In Group P, the MAP at T3 ($75.7{\pm}15.5mmHg$, P = 0.0015) and T4 ($68.3{\pm}12.5mmHg$, P < 0.001) were significantly lower than those at T1 ($94.0{\pm}12.4mmHg$). However, the MAP values in the K group were very similar (P = 0.133) at all time points. The heart rates in both Groups P (P = 0.254) and K (P = 0.859) remained unchanged over time. Conclusions: We showed that ketamine, when administered as the anesthetic induction agent during high-dose remifentanil administration, prevents cardiovascular depression.

Discharge Patterns and Peripheral Nerve Inputs to Cardiovascular Neurons in the Medulla of Cats: Comparison between the lateral and medial medulla

  • Kim, Sang-Jeong;Lim, Won-Il;Park, Myoung-Kyu;Lee, Jin;Kim, Jun
    • The Korean Journal of Physiology
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    • v.28 no.2
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    • pp.133-141
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    • 1994
  • The discharge patterns and peripheral nerve inputs to cardiovascular neurons were investigated in rostral ventrolateral medulla (RVLM) and raphe nucleus of cats. The data from the two were compared to determine their roles in cardiovascular regulation and the endogenous analgesic system. Animals were anesthetized with ${\alpha}-chloralose$ and single cell activities were recorded by carbon-filament microelectrode and their relationships with cardiovascular activity were analyzed. In RVLM area, a total of thirty-three cells were identified as cardiovascular neurons. During one cardiac cycle, the mean discharge rate of the neurons was $1.96{\pm}0.29$ and the peak activity was observed 45 ms after the systolic peak of arterial blood pressure. Thirteen cells could be activated antidromically by stimulation of the the $T_2$ intermediolateral nucleus. Forty-three raphe neurons were identified as cardiovascular neurons whose mean discharge rate during one cardiac cycle was $1.02{\pm}0.12$. None of these cells could be activated antidromically. Study of the interval time histogram of RVLM neurons revealed that the time to the first peak was $128{\pm}20.0\;ms$, being shorter than the period of a cardiac cycle. The same parameter found from the raphe neurons was $481{\pm}67.2\;ms$, which was much longer than the cardiac cycle length. Of seventeen RVLM neurons examined ten received only the peripheral $A{\delta}-afferent$ inputs, whereas six RVLM neurons received both $A{\delta}-$ and C-inputs; the remaining one cell received an inhibitory peripheral C-input. In contrast, nine of eleven raphe neurons were found to receive $A{\delta}-inputs$ only. We conclude that the main output of cardiovascular regulatory influences are mediated through the RVLM neurons. The cardiovascular neurons in the raphe nucleus appear to serve as interneurons transferring cardiovascular afferent information to the raphespinal neurons mediating the endogenous analgesic mechanisms.

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Clinical Characteristics of Unstable Pelvic Bone Fractures Associated with Intra-abdominal Solid Organ Injury (불안정성 골반골 골절 손상에서 동반 복부 고형장기 손상의 임상적 특성)

  • Lee, Sang Won;Kim, Sun Hyu;Hong, Eun Seog;Ahn, Ryeok
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.1-6
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    • 2012
  • Purpose: This study analyzed the characteristics of unstable pelvic bone fractures associated with intra-abdominal solid organ injury. Methods: Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality. Results: The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group. Conclusion: A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.

Aortocaval Fistula - A case report - (대동맥-대정맥루 -치험 1예-)

  • Cho Kwang-Hyun;Kwon Young-Min;Han Il-Yong;Jun Hee-Jae;Lee Yang-Haeng;Hwang Youn-Ho;Yoon Young-Chul
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.721-724
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    • 2005
  • Aortocaval fistula is a rare complication of abdominal aortic aneurysm, involving less than $1\%$ of all abdominal aortic aneurysms. A 64-years old man with a long history of hypertension and abdominal aortic aneurysm had chest pain, dyspnea, epigastric discomfort and palpable abdominal pulsating mass. Physical examination revealed hypo­tension with a systolic blood pressure of 70 mmHg, a large pulsatile mass and a systolic abdominal bruit. Laboratory data revealed a hemoglobin values of 11.0 g/dL, blood urea nitrogen (BUN) value of 5 mg/dL, and creatine value of $2.5 mg\%$. Abdominal Angio CT showed a 10cm infrarenal abdominal aortic aneurysm with dilatation of the IVC and aortocaval fistula from the aortic aneurysm, which was confirmed at emergency surgery. When the aneurysm was opened and the thrombus was removed, a 1 cm communication was identified between the aorta and IVC. This was controlled with Foley catheters ballooning, and the fistula was closed by continuous suture placed outside the aneurysm. A bifurcated aorto-iliac graft was used to restore arterial continuity. The patient was discharged home after uncomplicated postoperative course.

Bioequivalence of Stapin ER Tablet to Splendil ER Tablet (Felodipine 5 mg) (스프렌딜 지속정(펠로디핀 5 mg)에 대한 스타핀 지속정의 생물학적동등성)

  • Cho, Hea-Young;Kang, Hyun-Ah;Lee, Suk;Baek, Seung-Hee;Park, Eun-Ja;Choi, Hoo-Kyun;Moon, Jai-Dong;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.33 no.4
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    • pp.311-317
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    • 2003
  • Felodipine is a calcium antagonist that lowers blood pressure by reducing peripheral resistance by meas of a direct, selective action on smooth muscle in arterial resistance vessels. Futhermore, it have been approved for the effective in angina pectoris and cardiac failure. The purpose of the present study was to evaluate the bioequivalence of two felodipine extended release (ER) tablets, Splendil (YuHan Corporation) and Stapin (Hana Pharmaceutial Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). The felodipine release from the two felodipine formulations in vitro was tested using KP VIII Apparatus II method at pH 6.5 buffer solution. Twenty six healthy male subjects, $22.73{\pm}1.78$ years in age and $66.66{\pm}7.28\;kg$ in body weight, were divided into two groups and a radomized $2{\times}2$ cross-over study was employed. After two tablets containing 5 mg as felodipine were orally administered, blood sample was taken at predetermined time intervals and the concentrations of felodipine in serum were determined using column-switching HPLC method with UV detector. The dissolution profiles of two formulations were similar at pH 6.5 buffer solution. Besides, the pharmacokinetic parameters such as $AUC_t,\;C_{max}\;and\;T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t\;and\;C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the Splendil were 2.53%, 1.32% and 18.32% for $AUC_t,\;C_{max}\;and\;T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance rage of log(0.86) to log(1.25) $(e.g.,\;log(0.86){\sim}log(1.20)\;and\;log(0.89){\sim}log(1.23)\;for\;AUC_t,\;C_{max},\;respectively)$. Thus, the criteria of the KFDA guidelines for the bioequivalence was satisfied, indicating Stapin ER tablet and Splendil ER tablet are bioequivalent.