• Title/Summary/Keyword: Diuretics

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A case of canine patent ductus arteriosus showed favorable therapeutic response by surgery combined with needle-acupuncture therapy

  • Kim, Kwang-Shik;Kim, Byung-Young;Kim, Tae-Hwa;Kim, Won-Bae;Liu, Jianzhu;Lee, Jung-Yeon;Kim, Duck-Hwan;Rogers, Philip A.M.
    • Korean Journal of Veterinary Research
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    • v.45 no.4
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    • pp.575-579
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    • 2005
  • A 6-month-old male Poodle was referred with chief complaint of dysponea and cough. Cyanosis was not detected. This dog was diagnosed as a case of canine patent ductus arteriosus (PDA) by X-ray and ultrasonography. Diuretics and bronchodialators were administered for 4 weeks. Clinical symptoms were not improved. Thoracotomy was done at right recumbent position. The length of ductus arteriosus was 8 mm and the diameter was 6 mm, respectively. Double ligation was performed in surgery. Continuous cardiac murmur, cough and strong femoral pulsation were disappeared after surgery. The diameters of the pulmonary artery and vein found to normal by X-ray on 10 days after operation. The diameter of the aorta measured to be larger than that of the main pulmonary artery by ultrasonography. The fractional shortening (FS) on 10 days after surgery was 17.32% by ultrasonography. The needle-acupuncture therapy was used in acupoints BL-15 as local point plus PC-6, HT-7 and HT-5 as distant points for 3 days (15 min/once/a day). The FSs were increased to 21.31% and 29.44% at 1 and on 3 days after acupuncture, respectively. The present patient was a case of typical canine PDA that showed favorable therapeutic responses by surgery combined with needle-acupuncture treatment.

A Case of Refractory Ascites Due To Hepatocellular Carcinoma Treated with Sasang Constitutional Medicine (간세포암에 동반된 난치성 복수를 호전시킨 소양인 환자 치험1례)

  • Jung, Yee-Hong;Kim, Eun-Hee;Seo, Young-Kwang;Choi, Won-Cheol;Lee, Soo-Kyung;Eo, Wan-Kyu
    • Journal of Sasang Constitutional Medicine
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    • v.20 no.2
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    • pp.164-170
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    • 2008
  • 1. Objectives This is a case of refractory ascites due to hepatocellular carcinoma treated with Sasang Constitutional Medication. Refractory ascites, which did not respond to diuretics, was improved with Jeoryeongchajeonja-tang. 2. Methods We recorded the patient's abdominal circumference, body weight and urine output daily. We also investigated the TTKG(transtubular potassium gradient) values 3 times during the treatment course. 3. Results the TTKG value of the patient was siginificantly decreased. TTKG values before administration of Jeotyeongchajeonja-tang were 8.41, 10.82, respectively and 4.25 after administration of Jeotyeongchajeonja-tang. 4. Conclusions We guess that Jeoryeongchajeonja-tang functions as an aldosterone antagonist or increases spironolactone activity through interaction between Jeotyeongchajeonja-tang and spironolactone. But the mechanism of Jeotyeongchajeonja-tang is not clear, so we need more clinical study of refractory ascites improved with Jeotyeongchajeonja-tang and biological study of interaction between Jeotyeongchajeonja-tang and spironolactone.

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A study on the Healing Mechanism of Herbal Medicine, Oryoungsan (오령산의 작용기전(作用機轉)에 대한 고찰(考察))

  • Nam, Hyoung-sin;Cho, Chung-sik;Kim, Chul-jung
    • Journal of Haehwa Medicine
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    • v.10 no.1
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    • pp.157-166
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    • 2001
  • Oryoungsan which first recorded in Sanghanron, the clinical medical book consists of treating acute febrile disease according to its change, is one of the frequently used oriental medicines. these days, it has been prescribed in symptoms accompanied by edema mostly. therefore it is easy to consider it as a type of diuretics. In Sanghanron it was originally used in the symptoms of perspiration, decreased urine volume, thirsty, flatulence. these symptoms indicate loss of body fluid and the prescription which orders "taking warm water sufficiently" supports this. On this background, it is supposed that Oryoungsan treats dehydration after providing water and electrolytes. To consider that herbal medicines consisted of Oryoungsan make electrolytes go out of the body, The healing mechanism of dehydration doesn't meet this. Because Oryoungsan was used in condition of fever or in similar condition, it is more resonable to understand that restoration of increasing blood flow to the subcutaneous venous plexus regulating body temperature in febrile condition into body circulation, resulting into maintaining main blood volume and into treating decreased urine volume and thirsty is Oryoungsan's function in the dehydration or febrile condition. That is, symptoms are decreased or disappeared through restoring unbalance of internal body fluid. The other target is pain controls, especially chronic headache, facial pain and trigeminal neuralgia. it is suggested that the function of pain control of Oryoungsan is related to 5-HT(5-hydroxytrypamine), nerve transmitter in the endogenous analgesic system. Moreover it is also suggested that Oryoungsan is relate to 5-HT, considering the fact that gastroparesis, a symptom of cyclic vomiting syndrome treated with 5-HT1D receptor agonist is similar to the 'bi', symptoms appeared in the Oryoungsan-related disease.

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Persistent Accelerated Idioventricular Rhythm in a Shih Tzu with Central Neuropathy (중추신경 장애를 가진 시추 종의 개에서 지속적인 가속성 심실고유 율동)

  • Han, Suk-Hee;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.440-444
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    • 2010
  • A 7-year-old neutered male Shih Tzu dog weighing 5.2 kg was presented because of severe neurological signs (paddling, unconsciousness, blindness, seizure). ECG revealed accelerated idioventricular rhythm (AIVR) with ~140 bpm ventricular rate. Based on magnetic resonance imaging (MRI) study and cerebrospinal fluid (CSF) analysis, the neurological condition was tentatively diagnosed as disseminated granulomatous meningoencephalomyelitis (GME). The neurological signs were managed with steroids, anticonvulsive drugs, diuretics and antibiotics with 20% mannitol infusion. The rhythm disturbance (AIVR) was managed with oral medication of mexiletine. Because the heart rhythms were unstable without anti-arrhythmic therapy in spite of improvement of clinical signs after emergency treatment for neurological problems, the anti-arrhythmic therapy was maintained till the neurological signs were abolished.

Ethanol Extract of Forsythiae Fructus Inhibits the Production of Inflammatory Mediators in LPS-stimulated BV-2 Microglial Cells (연교 추출물의 Microglia에서 LPS에 의해 유도되는 염증매개물질 생성 억제 효과)

  • Kim, Sung-Yun;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.23 no.3
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    • pp.93-102
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    • 2008
  • Objectives : Forsythiae Fructus (Forsythia koreana Nakai) has been used anti-inflammatory, diuretics, antidote, and antibacterials in traditional herbal medicine. The present study is focused on the inhibitory effect of Forsythiae Fructus ethanol extract (FF-E) on the production of inflammatory mediators such as NO, iNOS and proinflammatory cytokines ($TNF-{\alpha}$, $IL-1{\beta}$ and IL-6) in LPS-stimulated BV-2 cells, a mouse microglial cell line, and investigated the scavenging activity of FF-E. Methods : BV-2 cells were pre-incubated with FF-E for 30 min and then stimulated with LPS (1 ${\mu}g/m{\ell}$) at indicated times. Cell toxicity of GCF was determined by MTT assay. The levels of NO, PGE2 and cytokines were measured by Griess assay and ELISA. The mRNA and protein expressions of iNOS and cytokines were determined by RT-PCR and Western blotting. Free radical scavenging activity of GCF was determined by DPPH assay in tube test. Results : FF-E significantly inhibited the excessive production of NO, $PGE_2$, $TNF-{\alpha}$, and $IL-1{\beta}$ in LPS-stimulated BV-2 cells. In addition, FF-E attenuated the mRNA and protein expressions of iNOS, and proinflammatory cytokines. FF-E also significantly scavenged the DPPH free radicals in a dose-dependent manner. Conclusions : These results indicate that FF-E exhibits anti-inflammatory property by suppressing the transcription of inflammatory mediator genes, suggesting the anti-inflammatory property of FF-E may make it useful as a therapeutic agent for the treatment of human neurodegenerative diseases.

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Effects of Aspirin and Furosemide on Plasma Aldosterone Level in Rabbits (토끼의 혈장내 Aldosterone 농도에 미치는 Aspirin과 Furosemide의 영향)

  • Suh, Y.J.;Lee, K.H.;Kim, O.N.;Lee, S.B.;Cho, K.C.
    • The Korean Journal of Pharmacology
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    • v.20 no.2
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    • pp.1-6
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    • 1984
  • It has been generally recognized that the secretion of aldosterone is mainly regulated by angiotensin II in animals and humans, however, potassium and ACTH are also proposed as other humoral factors involved in the aldosterone secretory process. Recently, stress, anesthesia, adrenergic stimulation, low sodium intake or water deprivation stimulate plasma renin activity, while high sodium intake and deoxycorticosteroid have been reported to cause suppression of renin activity in animals. It seems that overall response of aldosterone secretory mechanisms reflects complex interactions both intrarenal and extrarenal components. Furosemide has been widely used to investigate the control of renin secretion by the kidney, and the relationship between diuretics and the disposition of endogenous aldosterone were reported (Oh, 1984). The sequential with 10 min interval samples of plasma were collected following administration of furosemide(1 mg/kg), aspirin(10 mg/kg), respectively. And also similar experiment was performed in the propranolol (10 mg/kg) pretreated rabbits. The results were as follows : 1) The concentration of plasma aldosterone was average of $426.I{\sim}485.5pg/ml$ in normal rabbits. Plasma concentrations of aldosterone rised significantly after injection of furosemide during 50 min, and the rise of plasma aldosterone was blocked by the propranolol pretreatment 2) Significant fall in the plasma level of aldosterone after injection of aspirin was noted. This result indicates that the increased secretion of aldosterone induced by furosemide administration is mediated through ${\beta}-receptors$, and the possible role of prostaglandin is substantiated.

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A Prospective Clinical Study of Crystalloid and Colloid Solutions as Priming Additive Fluids for Cardiopulmonary bypass of the Small Children (소아에서 인공심폐기 충전액의 첨가용액으로서 사용한 crystalloid와 colloid 용액에 관한 임상연구)

  • Han, Jae-Jin;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.469-479
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    • 1992
  • Searching for the clinical effects of colloid solutions that used to increasing the oncotic pressure of priming solutions at the cardiopulmonary bypass, 29 patients [who were diagnosised as simple VSD around 10kg of body weight and scheduled to be operated from June 1990 to December 1990 at Sejong General Hospital] were divided randomly and prospectively to the two groups: A group [15] was received 4gm% albumin as addition to the priming solutions and B Group [14] the same amount of Ringer`s lactated solution. 34 clinical parameters [Body weight, sex, age, body surface area, Qp/Qs, pulmonary arterial pressure, cardiopulmonary bypass time, anesthetic time, intraoperatively infused crystalloid and colloid amount, hemoglobin, hematocrit, serum sodium concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum protein, serum albumin concentration, urine output, central venous pressure, postoperatively infused colloid amount, immedediate post-operative peak inspiratory pressure, cardiac index, blood pressure and pump flow during cardiopulmonary bypass, inotro-pic assist, diuretics, extubation period, total drain amount, duration of ICU] were measured and compaired between the two groups. There were no differences of preoperative and operative clinical parameters. And postoper-atively, practically there were no nearly differences at the clinical outcomes between the two groups, but some parameters [cardiac index, PIP, BP and pumpflow during CPB, etc] contributed to being preferable to the Group A at certain times [P<0.05]. Conclusively, it might be thought that the priming solution of cardiopulmonary bypass added by colloid solution had some beneficial effects on the patients, especially younger and associated with complex anomaly to be expected taken longer time of cardiopulmonary bypass, and more studies about the neonatal and complex anomaly cases were needed in that points.

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Pulmonary artery rupture due to bacterial endocarditis complicated by patent ductus arteriosus. (동맥관개존증에 합병한 심내막염에 의한 폐동맥파열 실험 1례)

  • 조순걸
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.537-541
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    • 1985
  • Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

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A Case Study of Taeeumin Patient with Edema Treated with Gunyuljejo-tang (태음인 부종 환자의 건율제조탕 치험 1례)

  • Han, Suzy;Yu, Jun-Sang
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.3
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    • pp.138-145
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    • 2021
  • Objectives Edema occurs in various disorders, such as heart failure, nephrotic syndrome, renal failure, liver cirrhosis, and cancer. The excessive accumulation of interstitial fluid in limb tissue will often manifest with ankle and knee swelling and lowers patient's quality of life. But the conventional treatment includes restricting dietary sodium and using diuretics. The purpose of this study is about significant improvement of a patient with edema who had suffered from dependent gait accompanied by mild pain, after treatment by herbal medicine based on SCM(Sasang constitutional medicine). Methods The pattern identification of the patient was diagnosed with a superficial disease of Taeeumin. So after the admission, Gunyuljejo-tang was used, almost two times per day during 2 weeks. Also, we applied acupuncture routinely every day and western medicine as needed. We measured the circumferences of Lt. thigh and followed up the bioelectrical impedance analysis and checked the appearance of lower limb. Results and Conclusions The therapy was effective, and the circumferences, which was 59.69cm at onset time, decreased to 52.07cm almost same to the healthy side of her thigh. There was no more edematous sign on the body, either. This case showed that management of Taeeumin's healthy energy(呼散之氣, the energy of exhalation) could be effective in treating edema.

Implications of Managing Chronic Obstructive Pulmonary Disease in Cardiovascular Diseases

  • Deshmukh, Kartik;Khanna, Arjun
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.1
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    • pp.35-45
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    • 2021
  • Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.