• The Korean Journal of Physiology
• /
• 제21권2호
• /
• pp.201-210
• /
• 1987

수온변화에 따른 심맥관계 및 신장기능의 변화와 생체실험을 통한 온도에 의한 adrenoceptor의 변형을 알아보기 위해, 무마취 자라에서 $18^{\circ}C$에서 $25^{\circ}C$로 수온을 증가시 나타나는 혈압, 심박동수 및 신장기능의 변화를 관찰하고, epinephrine 1 ug/kg과 10 ug/kg을 상이한 온도에 노출된 자라의 정맥내 투여하여 나타나는 효과를 비교하였다. 1) $18^{\circ}C$에서 $25^{\circ}C$로 수온을 증가시킴에 따라 심박동수는 현저히 증가하여 일정하게 유지되었으나, 혈압 및 혈장 renin 활성도는 변화하지 않았다. 온도증가에 의해 뇨량, 사구체여과율 및 전해질 배설량의 현저한 증가를 보였으나 90분부터는 서서히 감소하기 시작하였다. 2) 수온 $18^{\circ}C$에 노출된 자라에서 epinephrine은 dose-dependent한 양상으로 혈압 및 심박동수를 증가시켰으며, 다량의 epinephrine 투여시 작용시간은 현저히 연장되어 있었다. $25^{\circ}C$에 노출된 자라에서는 epinephrine에 의한 혈압상승 효과 및 심박동수 증가는 나타났으나, dose dependency나 작용시간의 차이는 발견할 수 없었다. 3) 동량의 epinephrine에 의한 혈압 및 심박동수의 증가효과는 $18^{\circ}C$와 $25^{\circ}C$에 노출된 자라에서 유의한 차이를 발견할 수 없었으나, $18^{\circ}C$에 노출된 자라에서 epinephrine의 작용시간 및 반감기가 현저히 연장되어 있었다. 4) Epinephrine 투여에 의해 뇨량, 사구체여과율 및 전해질 배설량의 증가를 관찰하였으며, 이는 dose-dependent 양상이었다. 그러나, 신장효과의 유의한 차이는 상이한 온도에 노출된 두 군에서 발견할 수 없었다. 이상의 결과로, 온도증가에 의한 이뇨 및 sodium 배설효과는 혈관이완에 의한 사구체여과율의 증가에 기인한 것으로 사료되며, 상이한 온도에 노출된 자라에서 epinephrine 효과의 차이를 발견할 수 없었던 것은 본 실험에서 가한 좁은 범위의 온도의 변화 내에서는 adrenoceptor의 변형이 나타나지 않을 것이라고 추론하였다. 그러나 저온에서의 epinephrine의 작용시간의 연장은 아마도 epinephrine의 파괴 효소의 활성도의 감소인 것으로 사료된다.

• 대한치과의사협회지
• /
• 제56권1호
• /
• pp.42-48
• /
• 2018

INTRODUCTION The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in two separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial. Visual analogue scale pain scores obtained immediately after surgical extraction were primarily evaluated for the two groups receiving different epinephrine concentrations. Visual analogue scale pain scores obtained 2, 4, and 6 h after administering an anesthetic, onset and duration of analgesia, onset of pain, intraoperative bleeding, operator's and participant's overall satisfaction, drug dosage, and hemodynamic parameters were evaluated for the two groups. RESULTS There were no statistically significant differences between the two groups in any measurements except hemodynamic factors (P > .05). Changes in systolic blood pressure and heart rate following anesthetic administration were significantly greater in the group receiving 1:80,000 epinephrine than in that receiving 1:200,000 epinephrine ($P{\leq}01$). CONCLUSION The difference in epinephrine concentration between 1:80,000 and 1:200,000 in 2% lidocaine liquid does not affect the medical efficacy of the anesthetic. Furthermore, 2% lidocaine with 1:200,000 epinephrine has better safety with regard to hemodynamic parameters than 2% lidocaine with 1:80,000 epinephrine. Therefore, we suggest using 2% lidocaine with 1:200,000 epinephrine rather than 2% lidocaine with 1:80,000 epinephrine for surgical extraction of impacted mandibular third molars in hemodynamically unstable patients.

• Restorative Dentistry and Endodontics
• /
• 제38권4호
• /
• pp.187-193
• /
• 2013

Epinephrine is one of the most widely-used vasoconstrictors in dental treatment including endodontic microsurgery. However, the systemic safety of epinephrine has been in debate for many years because of its potential risk to cause cardiovascular complications. The purpose of this review was to assess the cardiovascular effect of epinephrine use in endodontic microsurgery. Endodontic microsurgery directly applies epinephrine into the bone cavity, and the amount is reported to be much larger than other dental surgeries. Moreover, when considering that systemic potency of intraosseous application is reported to be comparable to intravenous application, the systemic influence of epinephrine could be increased in endodontic microsurgery. Besides, pre-existing cardiovascular complications or drug interactions can enhance its systemic influence, resulting in increased susceptibility to cardiovascular complications. Although clinical studies have not reported significant complications for patients without severe systemic complications, many epinephrine-induced emergency cases are warning the cardiovascular risk related with pre-existing systemic disease or drug interactions. Epinephrine is a dose-sensitive drug, and its hypersensitivity reaction can be fatal to patients when it is related to cardiovascular complications. Therefore, clinicians should recognize the risk, and the usage of pre-operative patient evaluation, dose control and patient monitoring are required to ensure patient's safety during endodontic microsurgery.

• 대한약리학회지
• /
• 제19권1호
• /
• pp.37-60
• /
• 1983

The uterus receives adrenergic terminals from the mesenteric ganglia and considerably large amount of catecholamines have been shown to be contained in this organ. On the other hand, the activities of epinephrine, norepinephrine or adrenergic nerve on uterine motility is so complicated that many controversial results have been reporter. Recently, a large number of reports concerning the changes of uterine catecholamines content have appeared, but little is known about the role of uterine catecholamines in their activities on uterine motility. The present experiments were undertaken to determine the significance of the intrinsic uterine catecholamines in the physiology of uterus. Female albino rabbits weighing approximately 2 kg were employed in this experiment. uterine strip3 were prepared and suspended in a constant temperature $bath(38^{\circ}C)$ containing 100 ml of Locke's solution aerated with 95% oxygen and 5% carbon dioxide. Spontaneous motility was recorded on a smoked drum with an isotonic lever. The catecholamines concentration of the uterus was determined according to the Procedure described of Shore and Olin (1958). Human uterus obtained from patients was also used to determine the catecholam ines content of myometrium. Followings are summarized results. 1) On the non-pregnant rabbit uterine strips, epinephrine and norepinephrine significantly elevated the tonus and stimulated the spontaneous motility. Pretreatment with dichloroisoproterenol(DCI), an adrenergic beta-receptor blocker, enhanced the stimulatory activity of epinephrine or norepinephrine. On the other hand, pretreatment with dibenamine, an adrenergic alpha-receptor blocker, rendered the uterine muscle to exhibit inhibition after the administration of epinephrine or norepinephrine. Following the treatment with both DCI and dibenamine, epinephrine or norepinephrine produced no appreciable effects on the spontaneous motility of the uterus. These results suggest there exist both alpha and beta-adrenergic receptors in the uterine muscle and the response to epinephrine of the former is predominant over that of latter in the non-pregnant uterus of rabbits. The total catecholamines concentration of the non-pregnant uterus was $351\;m{\mu}g/g$ and the fractional concentrations of epinephrine and norepinephrine were $125\;m{\mu}g/g(35.7%)$ and $226\;m{\mu}g/g$ respectively. It is interesting to note that the catecholamines content of uterus was characterized by a high fractional corcentration of epinephrine relative to norepinephrine. 2) On the pregnant rabbit uterine strips, the effects of epinephrine and norepinephrine varied according to the period of pregnancy. The response to epinephrine of adrenergic beta receptor of uterus increased during pregnancy, and the effect of catecholamine was inhibitory in the early pregnancy but became stimulatory as the pregnancy progressed. This stimulating action on the uterine motility was found to occur through the action of norepinephrine. The uterine catecholamines concentration was markedly reduced during pregnancy. The catecholamines concentration was started to decrease in the early pregnancy, reached the lowest level in the mid-pregnancy and then started to increaae again in the late pregnancy when the total catecholamines content became the highest level of all. This increase of catefholamines in late pregnancy was chiefly due to the increase of norepinephrine. These results suggest that the uterine motility may be related to the catecholamines content, especially norepinephrine content in the uterus. 3) Bilateral oophorectomy of rabbits results in a marked shrink of the uterus in size. The spontaneous motility of the uterine segment of these animals was very weak and irregular. Norepinephrine produced inhibitory effect, whereas epinephrine was stimulatory or inhibitory effect on the uterine segment. The total catecholamines tontent in whole uterus was markedly reduced. The injection of estrogen into the oophorectornized rabbit increased the weight of uterus to approximately three times of that of oophorectornized animal. The apontaneous motility and the response to epinephrine and norepinephrine of the uterine segment were greatly enhanced. Both epinephrine and norepinephrine produced a marked stimulatory effects of the uterine motility. The uterine content of catecholamines, particularly epinephrine, was markedly increased. The injection of progesterone into the oophorectornized rabbit increaeed the weight of uterus to approximately 2.5 times of that of eophorectornized animal. The spontaneous motility of the uterine segment was weak and irregular. Epinephrine produced stimulatory effect at high concentrations but norepinephrine always prcdnced inhibitory effect on the uterine segment. The uterine content of catecholamines, particularly of norepinephrine, was markedly reduced. These results suggested that ovarian hormones play an important role not only on the growth and spontaneous norepinephrine of uterus but also on the catecholamines content and responee to epinephrine and norepinephrine of the uterus. 4) The intraperitoneal injection of reserpine(3 mg/kg) into the non-pregnant, pregnant and oophorectornieed rabbits markedly decreased the uterine content of catecholamines, particularly of the norepinephrine. The stimulatory response to epinephrine and. norepinephrine of the uterine segment of these reserpinized ratbits was markedly reduced whereas the inhibitory response to these catecholamines was enhanced. This finding further support the close relationship between the uterine catecholamines content and uterine response to epineptrire and norepinephrine. 5) In the human uterus, the concentration of epinephrine was actrally greater than that of norepinephrine and it was significantly greater during the proliferative phase of the menstrtal cycle. In the human pregnant uterus, the concentrations of toth epinephrine and ncrefinephrine were markedly reduced and showed about 45 percent rednction after 6-8 weeks of ectopic Pregnancy. At full term ana during labor, the concentrations of epinephrine and norepinephrine at placental sites were less than those found in the non-pregnant group. Of interest was the finding that the norepinephrine concentration of uterus from toxemic patients was two and half times higher than that of lower uterine segment of the nontoxemic pregnant individuals. Also the epinephrine concentraticn was slightly increaeed.

• 대한물리치료과학회지
• /
• 제7권2호
• /
• pp.567-577
• /
• 2000

In human body, catecholamines, such as epinephrine and norepinephrine, can be increased anxiety, blood pressure and pain etc. The inhibitory effects of TENS, electroacupuncture and massage on the release of epinephrine, norepinephrine from sympathetic nerve endings has already been known. However, the effects of silver spike point stimulation on the catecholamines was not well understood. Therefore, the purpose of this study was to characterize the SSP-induced inhibitory effects of catecholamines. The following results were obtained. (1) The studies on urinary catecholamines released that the levels of epinephrine and norepinephrine of continue type SSP stimulation group were significantly lower than those in the control group in human in vivo. (2) The dose-response curves of epinephrine and norepinephrine in rat aortic smooth muscle strips were increased dose dependent manner respectively. However, the contractile response of norepinephrine in rat aortic smooth muscle strips were slightly differentiated. It is concluded that the SSP stimulation reflects to the inhibitory effects of epinephrine and norepinephrine in men. Especially, we believe that the amplitude-frequency modulation, such as continue type a)1d frequency modulation type, of SSP stimulation plays a role in regulating catecholamines.

• BMB Reports
• /
• 제35권3호
• /
• pp.283-290
• /
• 2002

The glycogen-associated protein phosphatase (PP1G/$R_{GL}$) may play a central role in the hormonal control of glycogen metabolism in the skeletal muscle. Here, we investigated the in vivo epinephrine effect of glycogen metabolism in the skeletal muscle of the wild-type and $R_{GL}$ knockout mice. The administration of epinephrine increased blood glucose levels from 200±20 to 325±20 mg/dl in both wild-type and knockout mice. Epinephrine decreased the glycogen synthase -/+ G6P ratio from 0.24±0.04 to 0.10±0.02 in the wild-type, and from 0.17±0.02 to 0.06±0.01 in the knockout mice. Conversely, the glycogen phosphorylase activity ratio increased from 0.21±0.04 to 0.65±0.07 and from 0.30±0.04 to 0.81±0.06 in the epinephrine trated wild-type and knockout mice respectively. The glycogen content of the knockout mice was substantially lower (27%) than that of both wild-type mice; and epinephrine decreased glycogen content in the wild-type and knockout mice. Also, in Western blot analysis there was no compensation of the other glycogen targeting components PTG/R5 and R6 in the knockout mice compared with the wild-type. Therefore, $R_{GL}$ is not required for the epinephrine stimulation of glycogen metabolism, and rather another phosphatase and/or regulatory subunit appears to be involved.

• 한국어병학회지
• /
• 제9권1호
• /
• pp.41-51
• /
• 1996

경골어류의 혈관평활근에 대한 adrenaline성 조절기작을 규명의 일환으로 틸라피아의 배대동맥을 사용하여 Adrenergic agonist의 효과와 그 매개에 관여하는 수용체의 subtype에 대한 연구를 하였으며 그 결과는 다음과 같다. 1. Epinephrine, norepinephrine, phenylephrine, clonidine 및 methoxamine은 tilapia의 배대동맥에 대하여 농도의존적인 혈관수축효과만을 나타내었으며, 효력은 epinephrine, norepinephrine, phenylnephrine, clonidine, methoxamine의 순이었으며, 이들 수축반응은 혈관내피세포의 존재유무에 영향을 받지 않았다. 2. Epinephrine, norepinephrine, phenylephrine 및 clonidine 의 농도의존적인 혈관수축반응곡선은 선택적인 $\alpha_2$-adrenergic 수용체 길항제인 yohimbine의 농도가 증가함에 따라 오른쪽으로 평행이동 되었으며, epinephrine과 norepinephrine은 선택적인 $\alpha_1$-수용체 길항제인 prazosin의 농도가 증가함에 따라 오른쪽으로 평행이동되었다. 3. Epinephrine과 norepinephrine의 혈관수축반응은 calcium제거 생리적 완충용액에서는 각각 약 41%, 51% 소실되었며, calcium 유입차단제인 verapamil에 의해서도 거의 유사한 경향을 보였다. 이상의 실험결과들을 종합하면 Catecholamine류는 수축효과만을 나타내었으며 혈관내피세포 존재유무와는 무관하였다. 이러한 수축작용은 $\alpha_1$- 및 $\alpha_2$-adrenergic receptor가 모두 매개하였으며 voltage dependent $Ca^{2+}$ channel을 통하여 유입된 세포외액의 $Ca^{2+}$과 세포내 $Ca^{2+}$의해 일어난다고 사료된다.

• 한국동물학회지
• /
• 제27권2호
• /
• pp.73-84
• /
• 1984

근원세포가 분화하는 과정에서 신경전달물질의 영향을 연구하기 위하여 배양한 근세포에 dopamine과 epinephrine을 처리하여 근원세포의 융합과 세포내 cAMP의 농도에 미치는 효과를 조사하였다. Dopamine $(3\\times10^{-5}M)$과 epinephrine $(3\\times10^{-5}M)$을 세포배양후 34시간에 처리했을 때 근원세포의 융합이 크게 억제되었으며, 특히 dopamine의 효과가 epinephrine보다 현저하게 나타났다. 한편, 세포내 cAMP농도는 dopamine과 epinephrine을 처리해도 거의 변화가 없었다. 근원세포의 분화에 cAMP가 관계하는지를 조사하기 위해 dbcAMP, $PGE_1$ 및 aspirin을 처리하였는데, dbcAMP $(1\\times10^{-4}M)$는 근원세포의 융합을 억제한 반면, $PGE_1 (3\\times10^{-6}M)$은 오히려 융합을 촉진하였고, PG 합성효소의 억제물질인 aspirin은 융합 억제효과를 보였다. Dopamine과 epinephrine이 근원세포의 융합과정에 작용하는 가능성있는 기작에 대해서 고찰하였다.

• Archives of Plastic Surgery
• /
• 제37권6호
• /
• pp.795-800
• /
• 2010

Purpose: According to various medical publications, it is believed that epinephrine should not be injected in fingers. However numerous articles show the successful use of local anesthetic with epinephrine in the digits. Epinephrine-mixed lidocaine solution enables to maintain a bloodless field for operation and provides long duration of local anesthesia when patient was wide awake. Methods: From May 2009 to December 2009, ten patients underwent flexor tendon reconstruction with local anesthesia using epinephrine. No tourniquet was necessary. Before operation, all patients were injected with local anesthetics using 1% lidocaine 20 mL and 0.1% epinephrine 0.1 mL. Results: There was no case of digital necrosis nor gangrene in the epinephrine injection. All 10 patients actively could move the finger through a full range of motion. All procedures were performed without sedation nor tourniquet and we could obtain a good vision of operative field and patients were comfortable. The patient make his or her fingers move through a full range of active motion before the skin is closed. Phentolamine was not required to reverse the vasoconstriction in any patients. Conclusion: The assertation that epinephrine should not be injected into the fingers is clearly no longer valid. The epinephrine injection allowed the authors to adjust flexor tendon surgery without risks associated with general anesthesia. It also enables to ensure longer anesthetic duration and bloodless operative field, and prevent post operative complications. In case of flexor tendon surgery, the use of epinephrine injection is recommended because of the advantages of local anesthesia.

• Bulletin of the Korean Chemical Society
• /
• 제28권12호
• /
• pp.2315-2318
• /
• 2007

Epinephrine was determined using a lab-made chemiluminescence (CL) system with air pump. Luminolsodium IO4? chemiluminescence system was employed to produce the luminescence of epinephrine. In the reaction, epinephrine was oxidized to produce superoxide or singlet oxygen by periodate in alkaline solution, which enhanced CL of luminol. For optimization, various buffers, such as phosphate, borate, and tris, were studied in this experiment. Compared to NaOH, the phosphate and borate buffer showed better reproducibility with similar sensitivity. Small amount of sample, 22 μL, was required for a measurement. The limit of quantification for epinephrine was obtained to be ~10?9 g/mL after optimization.