• Title/Summary/Keyword: Raynaud's phenomenon

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Intra-arterial Administration of Reserpine and Procaine with Stellate Ganglion Block for Raynaud's Phenomenon (Raynaud 증후군을 위한 Reserpine, Procaine의 동맥주사와 성상교감신경절 차단)

  • Jeon, Jae-Kyu;Chung, Jung-Gil;Choi, Kyu-Taek;Song, Sun-Ok
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.16-19
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    • 1988
  • Effects from many different approaches have been made to cure Raynaud's phenomenon, such as a dorsal sympathectomy, topical injection of nitroglycerin, phentolamin and procaine, and oral or parentral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial administration ill normal subjects as well as patients with Raynaud's syndrome has demonstrated a significant rise in blood flow to the lands. We used intermittent stellate ganglion blocks in conjunction with intra-arterial injections of reserpine and procaine in 10 patients suffering from finder necrosis. The stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine purposely mixed with adrenaline followed by the administration of reserpine 1 mg and procaine 50 mg through a butterfly needle inserted in the radial or brachial artery. The administration of reserpine and procaine was done only twice at intervals of 1 week because of the development of suspected arteriosclerosis. The stellate ganglion block was carried out once a week for about 3 months, then once a month as needed for 6 to 12 months. As the procedure was carried out and the necrotic tissue sloughed off, oozing appeared and new granulation tissue was observed. 5 out of 10 patients were healed completely and the rest improved considerably but were not followed to the end. We concluded that the intra-arterial administration of reserpine and procaine helped initiate and accelerate increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds.

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Raynaud Phenomenon due to Buerger’s Disease: A Case Report (버거씨병으로 인한 레이노이드 현상 환자 치험 1례)

  • Lee, Hyun-joong;Lee, Bo-yun;Lee, Young-eun;Yang, Seung-bo;Cho, Seung-yeon;Park, Jung-mi;Ko, Chang-nam;Park, Seong-uk
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.427-435
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    • 2015
  • Here we report a case of a patient with Raynaud phenomenon due to Buerger’s disease to present the curative effects of herbal medicine in Buerger’s disease. The patient presented with pain, redness, and cyanosis of hands and feet. We used Korean medicine treatment modalities including acupuncture, moxibustion, and herbal medicines. We observed changes in symptoms through digital infrared thermographic imaging, taking photos of both hands and feet. After treatment, the symptoms of pain, redness, and cyanosis of both hands and feet were decreased and digital infrared thermographic imaging proved a rise in temperature of fingers and toes.

LOCALIZED SCLERODERMA IN A CHILD : CASE REPORT (소아 피부 경화증 환자의 치험례)

  • Kim, Eun-Young;You, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.256-261
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    • 2005
  • Scleroderma is a connective tissue disease of unknown etiology, but known as a kind of auto-immune disease. It is most common in women especially in $30{\sim}50$ years, and very rare in childhood. It can be classified into two main classes : localized scleroderma & systemic sclerosis. Localized type has better prognosis, and usually involves skin only, or in some cases, the muscle below, except inner organs. Systemic type involves skin, oral mucosa and major internal organs. Involving facial skin, we can see small and sharp nose, expressionless stare and narrow oral aperture. Usually they have Raynaud's phenomenon, and in progress, show mouth opening limitation and sclerosis of tongue and gingiva. It is called CREST syndrome showing calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangioectasia. Treatment of scleroderma is systemic and localized steroid therapy, use of collagen-link inhibitor (D-penicillamine), immune depressor and etc. Mouth opening limitation can be improved by mouth stretching exercise. We report a 6 years old boy, diagnosed with localized scleroderma who had mouth opening limitation. We could get additional mouth opening, and have done successful restorative treatment of mandibular and maxillary 1st and 2nd deciduous molar under deep sedation with nitrous oxide and enflurane.

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Usefulness of Flow Composite Image in Raynaud Scan ($^{201}Tl$) ($^{201}Tl$을 이용한 레이노 검사에서 동적 Composite 영상의 유용성)

  • Kim, Dae-Yeon;Shin, Gyoo-Seol;Oh, Eun-Jung;Kim, Gun-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.101-104
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    • 2010
  • Purpose: Raynaud scan is divided to flow, blood pool and local-delay image. Usually, we evaluate comparison through blood pool and local-delay image. We will evaluate about usability when comparative observe blood image and local-delay image in Raynaud scan that used $^{201}Tl$ as making flow image to one sheet of images. Materials and Methods: We have selected 29 Raynaud phenomenon patients aged 14~68 years who visited department of vascular surgery between Feb. 2008 and Aug. 2009. An intravenous injection $^{201}Tl$ of 111 MBq (3 mCi) to opposite side diagonal line limbs above an internal auditing department. Equipment used Philips gamma camera forte A-Z, and collimator used LEHR. Matrix size set up to each $64{\times}64$, $128{\times}128$, $256{\times}256$ and zoom factor used to full field. Protocol of dynamic is 2 second to 155 frames. Blood pool and delay count to 300 second. We set up ROI by a foundation to data acquired in PEGASYS processing program. Each results were analyzed with the SPSS 12.0 statistical software. Results: Each averages of count ratio (Rt / Lt) to have been given at composite image, a blood pool image, delay images analyzed at Raynaud phenomenon patients is $1.25{\pm}0.39$, $1.20{\pm}0.33$, $1.11{\pm}0.17$. The sample analysis results of blood pool image and delay image contented itself with p<0.029. Also, there don't have been each difference, and blood pool image, delay image regarding composite image was able to know. Conclusion: We were able to give help for comparison to evaluate a blood pool image and a local delay image at the Raynaud scan which used $^{201}Tl$ while making a flow image to one sheet image. Identification to be visual too was possible. If you are proceeded a researcher that there was further depth, you are more appropriate for, and you may get useful information.

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Assessment of Vibration Produced by the Grinder Used in the Shipbuilding Industry and Development of Prospective Prevalence Model of Hand-arm Vibration Syndrome (선박건조업에서 사용되는 그라인더의 진동평가와 수지진동증후군 예측 모델 개발)

  • Yim, Sanghyuk;Lee, Yunkeun;Park, Hee-Sok
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.16 no.4
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    • pp.398-412
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    • 2006
  • The purpose of this study is to investigate the relationship between the acceleration of vibration by the powered hand tools used in the shipbuilding industry, and to develop the prospective prevalence model for the hand-arm vibration syndrome among the shipbuilding workers.The acceleration levels and frequencies of six types of grinder were measured using the ISO5349 method along with the time of exposure to the vibration from the powered hand tools. Medical examination for 114 workers were performed using the cold provocation test. Comparisons were made between the estimated prevalence of hand-arm vibration syndrome from ISO5349 and the observed values from the medical examinations. By multiple regression, we developed the prospective prevalence model of hand-arm vibration syndrome produced by the hand tools used in the shipbuilding industry. 4 hour-energy-equivalent frequency-weighted accelerations were $6.23m/s^2$ in the grinding job done after welding, and $13.39m/s^2$ in the grinding job done before painting. The mean exposure time while holding powered hand tools was 4.64 hours. Prevalence rates of Raynaud's Phenomenon were 12.04% in the grinding after soldering, and 42.9% in the grinding before painting measured using the ISO5349 method. After exposure to vibration for 10.79 years, about a half of the workers in the grinding after welding could developed Raynaud's Phenomenon. For the workers in the grinding before painting, the latency was 5.02 years. The ISO equation for dose response relationship was not significantly correlated with observed recovery rates of finger skin temperatures, blood flows and amplitudes of nerve conduction velocities. A multiple regression model for dose-response relationship was proposed from the results. Recovery rate of the skin temperatures = -0.668+ 0.337 ${\times}$ 4 hour energy equivalent frequency-weighted accelerations + 0.767 ${\times}$ duration of vibration exposure(years) The validity was proved by multiple regression analysis after correlation transformation and regression results based on model-building data and validation data.

A Case of Antisynthetase Syndrome (항 Synthetase 증후군 1예)

  • Kim, Min-Jeong;Kim, Min Ah;Kim, Eung-Gyu;Kim, Chan-Hwan;Kim, Sang-Jin
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.196-198
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    • 2006
  • It has been reported that antisynthetase syndrome belongs to the idiopathic myositis group which includes pulmonary interstitial disease, arthritis, Raynaud's phenomenon, and mechanic's hand, associated with the anti-Jo1 antibody. A 60- year-old man presented with one month history of lower limbs weakness, rapidly progressive exertional dyspnea, and arthralgia. A markedly increased titers of anti-Jo1 antibodies were found. Chest CT showed idiopathic pulmonary fibrosis. Muscle biopsies were consistent with polymyositis. A high dose corticosteroids and cyclosporine were not effective. We report a case of antisynthetase syndrome, in which immunosuppressive agents could not rescue the deteriorating disease course.

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Finger Necrosis Resulting from Inadvertent Arterial Infection of Antibiotic (동맥내 항생제 주입으로 발생한 수지괴사)

  • Choi, Kyu-Taek;Kim, Jin-Mo;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.211-213
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    • 1988
  • Efforts from many different approaches have been made to cure Raynaud's phenomenon using dosal sympathectomy and topical injection of nitroglycerine, phentolamine or procaine and oral or parenteral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial adminstriation of various drugs in normal subjects as well as patients with Raynaud's syndrome, had emonstrated a significant increase in blood flow to the hands. We used an intermittent stellate ganglion block in conjunction with intra-arterial injection of reserpine and procaine in the patient suffering from finger necrosis caused by accidental intraarterial antibiotic (cephamezine) injection. The stellate ganglion block was performed via a paratracheal approach by injection of 0.5% bupivacaine 6 ml, and 1% lidocaine 6 ml, and followed by administration of reserpine 1 mg and procaine 50 mg through a butterfly needle inserted in the radial artery. The administration of reserpine and procaine was done twice. The stellate ganglion block was performed every day for about 3 days, then once every a 5 days as needed for 15 days. As the procedure was carried out, the discolored tissue improved and the pain was progressively relieved. In conclusion, it was suggested that the intra-arterial administration of reserpine and procaine helped initiate and accelerate the increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds.

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Acute Respiratory Distress Syndrome as the Initial Clinical Manifestation of an Antisynthetase Syndrome

  • Kim, Seo-Hyun;Park, I-Nae
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.3
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    • pp.188-192
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    • 2016
  • Antisynthetase syndrome has been recognized as an important cause of autoimmune inflammatory myopathy in a subset of patients with polymyositis and dermatomyositis. It is associated with serum antibody to aminoacyl-transfer RNA synthetases and is characterized by a constellation of manifestations, including fever, myositis, interstitial lung disease, mechanic's hand-like cutaneous involvement, Raynaud phenomenon, and polyarthritis. Lung disease is the presenting feature in 50% of the cases. We report a case of a 60-year-old female with acute respiratory distress syndrome (ARDS), which later proved to be an unexpected and initial manifestation of anti-Jo-1 antibody-positive antisynthetase syndrome. The present case showed resolution of ARDS after treatment with high-dose corticosteroids. Given that steroids are not greatly beneficial in the treatment of ARDS, it is likely that the improvement of the respiratory symptoms in this patient also resulted from the prompt suppression of the inflammatory systemic response by corticosteroids.

Mitigative Effect of Sipjeondaebo-tang on RhoA Activation in Cold-Exposed Vascular Cells (저온 노출된 혈관 세포 내 RhoA 단백질 활성화에 대한 십전대보탕의 억제 효과)

  • Lee, Kangwook;Kim, Myeong-Sun;Kim, Yun-Gyung;Hwang, Hyun-Ha;Go, Ho Yeon;Sun, Seung-Ho;Choi, You-Kyung;Yang, Seung-Bo;Song, Yun-Kyung;Jeon, Chan-Yong;Ko, Seong-Gyu
    • The Journal of Internal Korean Medicine
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    • v.41 no.4
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    • pp.553-562
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    • 2020
  • Objective: To investigate the vasodilatory effect of Sipjeondaebo-tang by inhibiting RhoA activity in vascular cells during cold exposure. Methods: Human vascular endothelial cells and pericytes were pretreated with Sipjeondaebo-tang for 30 min, followed by incubation at 37 ℃ (control) or 25 ℃ (cold exposure) for 30 min. Activation of endothelin-1-mediated RhoA in pericytes was assessed by pretreating the cells with Sipjeondaebo-tang for 30 min, followed by incubation with endothelin-1 at 37 ℃ for 30 min. Western blotting was performed to measure the expression of active RhoA. Endothelin-1 and nitric oxide release from endothelial cells was examined with enzyme-linked immunosorbent assay kits. The formation of stress fibers and focal adhesion complexes was analyzed by immunocytochemistry. Results: Cold treatment activated RhoA in both pericytes and vascular endothelial cells, whereas Sipjeondaebo-tang treatment inhibited this activation. Sipjeondaebo-tang treatment also reversed the cold-mediated production of endothelin-1 and nitric oxide. Cold exposure promoted the formation of stress fibers and focal adhesion complexes by increasing the expression of phospho-focal adhesion complex kinase, whereas Sipjeondaebo-tang treatment suppressed this response. Conclusions: These findings suggested that Sipjeondaebo-tang inhibits cold-induced RhoA activation and its related pathway components, including endothelin-1 and nitric oxide, in vascular cells. Therefore, Sipjeondaebo-tang could be beneficial for the treatment of Raynaud's phenomenon.

Change of Skin Temperature of Workers Using Vibrating Tools in Anthracite Mines (진동공구 사용근로자의 피부온도 변화)

  • Roh, Jae-Hoon;Moon, Young-Hahn;Shin, Dong-Chun;Cha, Bong-uk;Cho, Soo-Nam
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.357-364
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    • 1988
  • By implementing epoch-making policies for industrial promotion, the national economy has made a remarkable development. As a result of such economic growth, industrial accidents and occupational diseases have become a serious problem in Korean society. In the presidential order for the execution of the Korean Labor Standard Law, neuritis and other diseases stemming from health impairments due to vibrations in industrial processes are designated to be dealt with as vibration diseases. In the case of vibration disease, industrial accident compensation is not effectively paid. In order to investigate the vibration hazards of rock-drill operation, the authors studied the subjective symptoms and performed physical function tests on a total of 79 persons (vibration exposed group) who used rock-drills, and 39 persons (control group) who did not use rock-drills at anthracite mines. The results of the physical function test were as follosws : 1. The right hand was more affected by white finger than the left hand. 2. Independent variables such as duration of rock-drill operation, age, drinking and smoking were indentified as statistically significant factors for the occurrence of white finger. 3. In the pain sense threshold, the group with Raynaud's phenomenon showed a statistically higher level than that of the control group. 4. The skin temperature of the group with Raynaud's phenomenon was lower than that of the control group. The recovery time of skin temperature aftr cooling was delayed compared with the value of the control group.

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