• 대한족부족관절학회지
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• 제18권1호
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• pp.1-7
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• 2014

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.1-8
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• 1997

Recently prostaglandin $E_1(PGE_1)$ has been shown to ensure flap survival by producing vasodilation of the peripheral vessels and platelet disaggreation. However, direct observation and detailed quantitative studies of the effects of $PGE_1$ on the cutaneous microcirculation have not been reported. In the present study, we investigated cutaneous microcirculatory changes in the rabbit ear chamber(REC) with an intravital microscope following intravenous administration of $PGE_1$. The results obtained in this study indicate that $PGE_1$ administered intravenously at a rate of 200ng/kg/min might act directly on the vessels and cause dilatation of metarterioles and capillaries without affecting vasomotion and systemic blood pressure. Clinically in order to evaluate the effect of an intravenous administration of $PGE_1$ on the cutaneous microcirculation, cutaneous blood flow, skin temperature and transcutaneous $Po_2$ in the pedicle or free flap of operated patients were evaluated by the combination of several measurements following the administration of $PGE_1$. The present study suggests that improvement of cutaneous microcirculation by $PGE_1$ may enhance the survival rate of flap or replantation. Both vessel arterial ischemia and venous congestion are main factors of tissue necrosis in the flap surgery. Vasodilatory or antithrombotic agents have been used in salvage of flap necrosis. However, the therapeutic effects of those drugs are still not well elucidated. Recently prostaglandin $E_1(PGE_1)$ has been shown to ensure flap survival by producing vasodilatation of the peripheral vessels and platelet disaggregation[1-3]. Emerson and sykes[4] have obtained significant improvement in the flap survival in the rat using $PGI_2$. Suzuki et al.[5] have reported prolonged flap survival length by using $PGE_1$ in the rabbit and concluded that $PGE_1$ improved the microcircuration in the flap. However, direct observation and detailed quantitative studies of the effects of $PGE_1$ on the cutaneous microcirculation have not been reported. In the present study, we investigated microcirculatory changes in the rabbit ear chamber[6,7] with an intravital microscope following intravenous administration of $PGE_1$.

• 생명과학회지
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• 제19권11호
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• pp.1568-1574
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• 2009

본 연구는 고혈압전단계자들에 대한 지속적인 건 스트레치시 시간에 따른 생리학적 반응을 분석하여 정상혈압자와 고혈압전단계자에 대한 EPR의 한 요소인 기계적 수용기가 혈압 및 혈역학 반응에 어떠한 영향을 주는지를 검토하였다. 그 결과, 안정 시와 시간에 따른 혈압 반응은 고혈압전단계자에 있어 SBP, MAP가 평균 20sec에서 통계적으로 가장 높은 경향을 보였으며(p<0.05), 정상혈압자에서는 SBP, DBP, MAP가 평균 45sec에서 가장 높은 경향을 보였다(p<0.05). 이는 고혈압 전단계자의 지속적인 수동적 건 스트레치 시 정상혈압자에 비해 Group III mechanoreceptors의 역기능에 따른 상승된 혈압 반응이 초기에 나타내었다고 사료된다. 또한 혈역학 반응에서 안정 시와 비교하여 지속적인 수동적건 스트레치 시 고혈압전단계자에서의 HR, SV, CO, TPR 모두 유의한 차이를 보이지 않았으나 정상혈압자에서 SV, CO가 통계적으로 유의한 차이를 보였다(p<0.05). 이는 CO, SV, HR, TPR이 정상혈압자에 비해 고혈압전단계자에 있어 높은 경향을 나타내었지만, 혈역학 반응은 본 연구를 통해 차이를 보이지 않아 앞으로 연구가 필요할 것으로 사료된다.

• Journal of Chest Surgery
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• 제6권2호
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• pp.131-142
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• 1973

Studies of cardiopulmonary function and acid-base balance were performed on 29 dogs during control period, during oligemic hypotension and following return of blood to the animals. Intravenous morphine and local anesthesia were used. Fifteen of the 29 animals survived the complete experiment. The 14 animals that failed to survive the experimental period died between 15 to 90 minutes after the onset of bleeding. The results were as follows. 1. The heart rate increased after the onset of bleeding and failed to return to control level following reinfusion. Stroke volume decreased markedly after bleeding and failed to recover after return of blood from the reservoir. Cardiac output also decreased during oligemic hypotension and was maintained at this level after re-infusion. Total peripheral resistance decreased significantly immediately after bleeding, however it increased soon over the pre-bleeding level. Central venous pressure decreased after the onset of bleeding and remained at lower level for the rest of the experimental period. Arterial blood pressure, clown to 40-45 mmHg by acute hemorrhage, was elevated near to control level. Left ventricular work decreased tremendously during oligemic hypotension and failed to return to control level with the re-infusion of blood. Hematocrit value showed no significant decrease after bleeding and increased after re-infusion. Hemoglobin decreased after the onset of bleeding and recovered to control value after re-infusion. 2. The respiratory rate fell rapidly after bleeding from 124 to 29 and remained at this lower level for the remainder of the experiment. The tidal volume increased after bleeding and was maintained at this level for the remainder of the experiment. The respiratory minute volume showed no significant changes throughout the experimental period. Oxygen consumption fell lightly in all animals during oligemic hypotension and returned to normal levels following re-infusion. Arterial oxygen content and arterial oxygen saturation decreased following bleeding and the values returned to normal levels after the return of blood from the reservoir The arterio-venous oxygen difference increased after the onset of bleeding. It failed to return to normal values following re-infusion. Arterial $Pco_2$ decreased in all animals after the beginning of the bleeding. Partial pressure of $Co_2$ continued to fall until re-infusion, after which the values returned toward normal. Animals became acidotic. The pH fell to lower level following bleeding. Lactic acid and lactate: pyruvate ratio also increased during same period. Arterial pH and lactic acid failed to return to control value and lactate: pyruvate ratio increased more after re-infusion. Sodium bicarbonate decreased after bleeding and returned to control value following re-infusion.

• The Korean Journal of Physiology and Pharmacology
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• 제1권2호
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• pp.151-159
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• 1997

In an attempt to investigate whether hemorrhage affects the gene expression of the renin-angioteusin system (RAS) components in the brain and peripheral angiotensin-generating tissues, changes in mRNA levels of the RAS components in response to hemorrhage were measured in conscious unrestrained rats. Wistar rats were bled at a rate of 3 ml/kg/min for 5 min, and then decapitated 7 h after hemorrhage. Levels of mRNA for renin, angiotensinogen and angiotensin $II-AT_1$ receptor subtypes ($AT_{1A}$ and $AT_{1B}$) were determined with the methods of northern blot and reverse transcriptase-polymerase chain reaction (RT-PCR). Hemorrhage produced a profound hypotension with tachycardia, but blood pressure and heart rate recovered close to the basal level at 7 h. Plasma and renal renin levels were significantly increased at 7 h. Hemorrhage induced rapid upregulation of gene expression of both $AT_{1A}$ and $AT_{1B}$ receptor subtypes in the brainstem and hypothalamus, downregulation of them in the adrenal gland and liver. However, renin mRNA level increased in the brainstem, decreased in the liver, but was not changed in the hypothalamus, kidney and adrenals after hemorrhage. Angiotensinogen mRNA level was not significantly changed in any of the tissue except a slight increase in the liver. The kidney and liver did not show any significant change in gene expression of the RAS components. These results suggest that gene expression of the RAS in central and peripheral tissues are, at least in part, under independent control and the local RAS in each organ plays specific physiologic role.

• Childhood Kidney Diseases
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• 제15권1호
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• pp.22-28
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• 2011

고혈압은 소아 청소년시기에 발생하는 흔한 만성질환 중 하나이다. 고혈압을 치료하지 않으면 여러가지 소아의 장기에 악영향을 미칠 수 있다. 여기서는 고혈압이 중추신경계에 미치는 영향에 대해 알아 보았다. 혈압의 변화에 따라 대뇌가 받는 영향은 다른 장기에 비해 덜 하다. 그것은 대뇌 자동 조절 기전때문이다. 즉 혈압의 변화에 따라 뇌혈관의 저항이 변하기 때문에 뇌혈류량이 일정하게 유지 된다. 그러나 이런 자동 조절 기전의 항상성이 파괴되면 급성으로 또는 만성으로 급성 고혈압 뇌병증, 허혈성, 출혈성 뇌경색, 학습 장애와 인지 기능 장애 등이 발생한다. 이에 고혈압이 대뇌에 미치는 영향에 대해 숙지하고 빠른 시일 내에 적절한 치료를 하면 이런 합병증을 예방할 수 있다.

• 대한의생명과학회지
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• 제11권2호
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• pp.227-235
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• 2005

It has been reported that endurance performance is influenced by various environmental and genetic factors. In view of an important role of human mitochondrial DNA (mtDNA) as a candidate for endurance performance, this study focused on the relationships between $VO_{2max}$ value as a measure of endurance performance or other associated phenotypes and four mtDNA restriction fragment length polymorphisms (RFLPs) (Bam HI, Hinc II1, Hinc II2 and Nci I) in the NADH dehydrogenase subunit 5 and one (Kpn I) in the D-loop region of mtDNA. MtDNA was purified from buffy coat in human peripheral blood, and PCR-RFLP analysis was performed to estimate the allele frequencies of each polymorphism in the mtDNA. There were no significant differences in allele distributions of all polymorphisms studied between male athletes and controls, respectively (P>0.05). However, the Kpn I polymorphism was significantly associated with diastolic blood pressure level in male athletes, respectively (P<0.05). Therefore, our results suggest that this polymorphism might be one of the factors modifying inter-individual difference in cardiovascular risk. Further studies using larger sample size will be required to generalize these results from the study described herein.

• 대한한방내과학회지
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• 제24권2호
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• pp.260-268
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• 2003

Object : This study was undertaken to define the mechanism of GwakHyangJungGiSan-induced relaxation in rabbit common carotid artery contracted by agonists. Method : In order to investigate the effect of GwakHyangJungGiSan on rabbit's contracted vascular ring detached from common carotid artery, vascular ring intact or damaged endothelium was used for the experiment using organ bath. To analyze the mechanism of GwakHyangJungGiSan-induced relaxation, GwakHyangJungGiSan extract was infused into contracted vascular ring which had been pretreated by pretreatment of indomethacin(IM), tetraethylammonium chloride(TEA), $N{\omega}-nitro-L-arginine(L-NNA)$. Result : GwakHyangJungGiSan blocks an inflow of $Ca^{2+}$ and relaxes vascular ring by the action of Nitric oxide from endothelium. Consequently when GwakHyangJungGiSan is prescribed, a rise in blood pressure by the resistance of peripheral vessel may be controlled to some extent and so it is anticipated that hypertension, a disorder of blood flow from the vascular contraction and vascular disease will be treated well.

• 한국식품영양학회지
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• 제36권6호
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• pp.452-461
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• 2023

Hypertension caused by high-fat and high-salt diets is is a well-known significant risk factor for cardiovascular and cerebrovascular diseases. In this study, to confirm the relationship between hypertension and immune cells, angiotensin (Ang) II was administered to Dahl salt-sensitive (SS) rats and Dahl salt-resistant (SR) rats. Then the expression of immune cells and the proinflammatory cytokines were compared between the SS and SR rats. It was observed that after administration of Ang II (50ng/kg/min) for three weeks, blood pressure was increased in the SS rats, but there was no significant change in the SR rats. In addition, the expression of T helper (Th) cells and Th 17 cells in the spleen and the expression of Th cell Rorγt and regulatory T regulatory (Treg) cells in the peripheral blood mononuclear cells did not show a significant difference between the two experimental groups even after the administration of Ang II.IL-1β expression was significantly increased in the kidney tissue of the SS rats, while there was no significant difference in the IL-6 expression in all the experimental groups. The results of this study suggest that Ang II induces hypertension by stimulating IL-1β secretion from renal macrophage in SS rats.

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.128-131
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• 2017

Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.