This experiment was performed to investigate the effects of Hyeonsamdansameum(HDE) on hypertension. For the study of HDE, we had divided Sprague-Dawley rats to three groups-normal, control, HDE. The control group was injected subcutaneous with monocrotaline(50 mg/kg). The treatment group was injected subcutaneous with monocrotaline(50 mg/kg) and orally administered with HDE extract for 4 weeks(once a day, 208 mg/kg). Then we measured blood pressure, heart rate, on the plasma aldosterone, catecholamine, electrolyte, uric acid, BUN, creatinine, and observed the lung, cardiac muscle. liver. etc. The results of these were as follows: 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity and superoxide dismutase(SOD) - like activity were increased. reactive oxygen species (ROS) was decreased. Angiotensin converting enzyme(ACE) inhibitory activity was increased in a concentration-dependent by HDE. HDE significantly increased body weight in monocrotaline hypertensive rat, so supported nearly normal group. HDE significantly decreased blood pressure and heart rate in monocrotaline hypertensive rat. HOE significantly decreased aldosterone in adrenocortical hormones. HDE significantly decreased dopamine. norepinephrine, epinephrine. Na+. Cl- were intended to decrease. K+ was decreased significantly by HDE. Uric acid. BUN were significantly decreased and creatinine was intended to decrease by HDE. HDE inhibited lung, liver and heart injury connected with hypertension. These results suggest that HDE is usefully applied in treatment and prevention of hypertension.
This 3-year-old girl was observed frequent exertional dyspnea and cyanosis at crying since birth. She was not premature baby and delivered at full term normally. On physical examination, she was underdeveloped-body weight 13.5 kg, height 99 cm.- and cyanotic. There was severe clubbing on fingers. There was grade II/VI ejection systolic murmur on left lateral border of the sternum. The preoperative examinations [EKG, echocardiogram, cardiac catheterization and biventriculogram] showed that complicated T.G.A. combined vena cava[S.D.D.]. Preoperatively, we decided the corrective surgery of Rastelli operation using a. pulmonary valved conduit. The operation was performed under total circulatory arrest using deep profound hypothermia combining with extracorporeal circulation. On operation, the anatomy of the heart showed that, 1. The subaortic conus was seen and subaortic muscles were hypertrophied. 2. The VSD[type II], behind the subaortic conus-about 1 cm. in diameter, was visible only through LV cavity and, 3. The pulmonary valve ring was hypoplastic and pulmonary valvular stenosis was seen also. The subpulmonic area [LV outflow tract] was obstructed with hypertrophied muscle and mitral valve. 4. Left superior vena cava was drained to RA via coronary sinus. 5. LAD coronary artery was originated from right coronary artery and ran anterior to the pulmonary artery. According to above anatomy, we performed the VSD closure with Teflon patch, and Mustard operation combined with LV-to-pulmonary artery bypass graft using the valve contained [Hancock 16 mm] conduit. Postoperatively, adequate blood pressure could be maintained under the state of using inotropic agent [epinephrine]. On the second postoperative day, the patient died of cardiac arrest due to low cardiac output syndrome, acute renal failure and pulmonary edema.
This study was designed to examine the mechanism of penile erection in adult bull by analyzing the responses of bovine proximal retractor penile muscle strips(BRP) to electtical field stimulation(EFS), exogenous nitric oxide(NO), NO synthesis precursor(L-arginine), NO synthase inhibitors(L-NAME, L-NMMA), guanylate cyclase inhibitor(methylene blue) and nonspecific potassium channel blocker(tetraethylammonium, TEA) treatments. Isometric tension of BRP was measured using physiograph. Results were summarized as follows: 1. EFS of nonadrenergic noncholinrgic(NANC) nerve in BRP produced frequency-dependent inhibitory responses to the contraction induced by co-treatment of epinephrine, guanethidine and atropine. The inhibitory responses to EFS were blocked by tetrodotoxin(TTX, $1{\mu}M$). 2. Treatment of L-NAME ($10,\;20{\mu}M$) inhibited the relaxation to EFS whereas L-NMMA ($100{\mu}M$) had no effect. 3. Treatment of NO($20,\;40{\mu}M$; as an acidified solution of $NaNO_2$) induced concentration-dependent relaxation whereas preincubation of TTX($1{\mu}M$) and L-NAME($20{\mu}M$) had no effect on the relaxation response. 4. L-arginine treatment(10mM) blocked the inhibitory effect of L-NAME($20{\mu}M$). 5. Pretreatment of methylene blue($40{\mu}M$) reduced the NANC-induced relaxation of BRP. 6. Tetraethylammonium(TEA, 80mM) reduced NANC relaxation. These results suggest that NO may act as a NANC neurotransmitter in BRP and the effects might be mediated by cGMP and potassium channel.
Dieulafoy's disease, a vascular anomaly mainly in the upper stomach, is a rare but potentially life-threatening cause of upper gastrointestinal bleeding. Pathogenesis is still controversial, but the most accepted theory is that a persistent caliber vessel in the submucosa is exposed by a small mucosal erosion leading to massive bleeding. The bleeding site is usually within 6 cm of the esophagogastric junction in the cardia or fundus of the stomach. The treatment of choice is therapeutic endoscopy or surgery. The age of patients reported is mainly between 50 and 70 years, and patients of pediatric age are extremely rare. We are reporting a 5-year-old male patient who had Dieulafoy's disease which was diagnosed by emergency upper gastrointestinal endoscopy. Endoscopic finding was a nodular lesion with an adherent clot on the lessor curvature of the stomach 2 cm below the esophagogastric junction. Epinephrine and $Beriplast^{(R)}$ was injected in the lesion. On the second day after endoscopic sclerotherapy, the patient had recurred massive hematemesis and accompanying shock. So we performed gastrotomy and ligation. After the operation, he showed an improved general condition and was discharged at the 12th hospital day.
Kamisungihwalhyul-tang(KSHT) has been used for many years as a therapeutic agent for cerebrovascular disease and hypertension in Oriental Medicine. But the effect of KSHT on hypertension and reactive oxygen is not well-known. This study was examined to investigate the effect of KSHT on hypertension and reactive oxygen. After administering KSHT extract to Sprague- Dawley Rat forinjected subcutaneous with deoxycorticosterone acetate(DOCA) 8 weeks, changes in blood pressure, pulse rate, 2,2-diphenyl-1-picrylhydrazyl, reactive oxygen species, angiotensin converting enzyme, aldosterone, catecholamine levels, electrolyte, uric acid, BUN, creatinine in plasma were examined, and immunohistochemical changes and scanning electron microscopic changes were observed. 2,2-diphenyl-1-picrylhydrazyl(DPPH) scavenging activity was increased, reactive oxygen species(ROS) was decreased in a KSHT concentration-dependent. Angiotensin converting enzyme(ACE) inhibitory activity was increased in a concentration-dependent by KSHT. KSHT significantly decreased the blood pressure and heart rate in DOCA-salt hypertensive rat. KSHT significantly decreased the levels of aldosterone in DOCA-salt hypertensive rat. KSHT significantly decreased the level of dopamine, norepinephrine, epinephrine in DOCA-salt hypertensive rat. $Na^+$, $K^+$ and Cl- were decreased significantly, $Ca^{2+}$ was increased significantly by KSHT. KSHT significantly decreased uric acid, BUN, creatinine.
Background: The analgesic efficacy and safety of propacetamol, an injectable prodrug of acetoaminophen, in combination with intravenous morphine PCA were studied in 40 patients after gynecological surgery requiring lower abdominal incision. Methods: Using a double-blind, randomized, parallel-group design, the effects of four(every 6 hr) intravenous injections of 2 g propacetamol(=1 g acetoaminophen) were compared with four injections of placebo(PL) immediately after surgery. Efficacy of cumulative dose of morphine and number of boluses requested was assessed over 24 hours by automated recording on the PCA device. It was assessed on pain scores rated on a ten-point verbal scale along with vital signs, $K^+$, glucose, BUN, creatinine, PT and PTT were measured along with stress hormones(epinephrine, norepinephrine and cortisol). Results: There were no differences in demographic data between two groups. Propacetamol group demonstrated approximately 21% morphine sparing effect compared to placebo group($33.1{\pm}10.4$ mg vs $41.4{\pm}8.0$ mg). No significant differences noted in $K^+$, glucose, BUN, Creatinine, PT and PTT levels. There were significant increases in norepinephrine and cortisol in placebo group postoperatively, compared to preoperative values. At the same time, propacetamol group also showed significant changes in these hormones. Both group revealed high degree of patient satisfaction. Conclusion: Propacetamol showed significant morphine sparing effect to some degree. Side effects were much less in propacetamol group with subsequently high patient satisfaction. The secretion of stress hormone were not blocked by postoperative propacetamol injections. Authors concluded that propacetamol should be considered as an excellent adjuvant analgesics in postoperative pain control in opioid patient controlled analgesia.
This study was designed to introduce free toe tissue transfer using infiltration method of local anesthetic agent. Four toe pulp tissues were transferred to reconstruct finger tip defect in four patients who were not suitable for general anesthesia. Two flaps taken from the lateral side of the great toe was used for reconstruction of thumb defect and two flaps from the medial side of the second toe for resurfacing of the index and fifth finger. Flap sizes were various from $2.0{\times}2.0\;cm^2$ to $1.6{\times}4.0\;cm^2$. Anesthesia was induced by infiltration of 2% lidocaine hydrochloride (with 1:100,000 epinephrine) with dilution of normal saline in same volume unit, as like as in ordinary digital block. All vessels were anastomosed within 2 cm of distance from the proximal margin of the defect. Whole operative procedures were carried out by one team. All flaps were successfully taken without complication. The average operation time was 4 hours 10 minutes. The amount of anesthetic agent used in whole operative procedures was roughly 4 mL in the toe, 8 mL in the finger, and 12 mL totally. In conclusion, free toe tissue transfer using infiltration method of local anesthetic agent would be good strategy for finger tip reconstruction in the patient not suitable for general anesthesia.
The purposes of this study were to evaluate and compare the pulpal anesthesia induced by an inferior alveolar nerve block and that by Gow-Gates technique, and to investigate the relationship between pulpal anesthesia and intraoral soft tissue responses. After one side of mandibule was anesthetized with inferior alveolar nerve block or Gow-Gates technique using 2 % lidocaine with 1 : 100,000 epinephrine in 19 volunteers of ages between 24 and 29 (16 males and 3 females, average age 25.9 yrs.), electric pulp tests were done on the canine teeth of the anesthetized side and contralateral one before, at 1 min, continued at every 5 minutes until 60 min, and every 10 minutes until 100 min after completion of local anesthetic injection. Degree of pulpal anesthesia was classified as anesthetic failure, possible anesthesia and complete anesthesia by the criteria based on the thresholds to electric pulp test of contralateral canine and the currents of the electric pulp tester. Subjective signs on the lower lip and tongue were checked and prick-pin tests were done on the buccal gingiva of the first molar, buccal and lingual gingiva of the canine tooth at 5, 10 and 20 min after the completion of anesthetic injection. Thresholds to electric pulp test, degree of pulpal anesthesia and relationship between the pulpal anesthesia and soft tissue responses were analyzed with SPSS, paired t-test, Wilcoxon matched-pairs signed-ranks test and correlation analysis. The results were as follows : No significant differences were found in the peak thresholds to electric pulp test, in the induction time to it and in the depth of pulpal anesthesia between inferior alveolar nerve block and Gow-Gates technique (p>0.05). There was no significant relationship between pulpal anesthesia and soft tissue responses in both inferior nerve block and Gow-Gates technique.
Objective : The goal of the present study was to investigate the protective effect of Gamiheechum-tang (Jiaweixiqian-tang; GHCT) on brain tissue damage from chemical or ischemic insults. Methods : Levels of cultured cortical neuron death caused by toxic chemicals were measured by LDH release assay. Neuroprotective effects of GHCT on brain tissues were examined in vivo by ischemic model of middle cerebral artery (MCA) occlusion. Results : Animal groups treated with GBCT showed significantly decreased hypertension, and reduced levels of aldosterone, dopamine, and epinephrine in the plasma. GHCT treatments ($l0-200\mu\textrm{g}/ml$) significantly decreased cultured cortical neuron death mediated by AMPA, kainate, BSO, or Fe2+ when measured by LDH release assay. Yet, cell death mediated by NMDA was effectively protected by GHCT at the highest concentration examined ($200\mu\textrm{g}/ml$). In the in vivo experiment examining brain damage by MCA occlusion, affected brain areas by ischemic damage and edema were significantly less in animal groups administered with GHCT compared to the non-treated control group. Neurological examinations of forelimbs and hindlimbs showed that GHCT treatment improved animals' recovery from ischemic injury. Moreover, the extent of injury in cortical and hippocampal pyramidal neurons in ischemic rats was much reduced by GHCT, whose morphological features were similarly observed in non-ischemic animals. Conclusion : The present data suggest that GBCT may play an important role in protecting brain tissues from chemical or ischemic injuries.
Sochenda, Som;Vorakulpipat, Chakorn;Kumar, K C;Saengsirinavin, Chavengkiat;Rojvanakarn, Manus;Wongsirichat, Natthamet
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제46권4호
/
pp.250-257
/
2020
Objectives: Palatal infiltration is the most painful and uncomfortable anesthesia technique for maxillary impacted third molar surgery (MITMS). This approach could cause patients distress and aversion to dental treatment. The aim of this study was to evaluate the anesthetic efficacy of a buccal infiltration injection without a palatal injection in MITMS. Materials and Methods: This prospective research study was a crossover split mouth-randomized controlled trial. Twenty-eight healthy symmetrical bilateral MITMS patients (mean age, 23 years) were randomly assigned to two groups. Buccal infiltration injections without palatal injections were designated as the study group and the buccal with palatal infiltration cases were the control group, using 4% articaine and 1:100,000 epinephrine. The operation started after 10 minutes of infiltration. Pain assessment was done using a visual analogue scale and a numeric rating scale after each injection and extraction procedure. Similarly, the success rate, hemodynamic parameters, and additional requested local anesthetic were assessed. Results: The results showed that the pain associated with local anesthetic injections between both groups were significantly different. However, the success rates between the groups were not significantly different. Postoperative pain was not significant between both groups and a few patients requested an additional local anesthetic, but the results were not statistically significant. For hemodynamic parameters, there was a significant difference in systolic pressure during incision, bone removal, and tooth elevation. In comparison, during the incision stage there was a significant difference in diastolic pressure; however, other steps in the intervention were not significantly different between groups. Conclusion: We concluded that buccal infiltration injection without palatal injection can be an alternative technique instead of the conventional injection for MITMS.
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