• Title/Summary/Keyword: Vascular pressure

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Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation

  • Jeong, Hii Sun;Lee, Byeong Ho;Lee, Hye Kyung;Kim, Hyoung Suk;Moon, Min Seon;Suh, In Suck
    • Archives of Plastic Surgery
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    • v.42 no.1
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    • pp.59-67
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    • 2015
  • Background Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. Methods Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. Results Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). Conclusions By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix.

Cerebral Hemodynamics in Premature Infants

  • Rhee, Christopher J.;Rios, Danielle R.;Kaiser, Jeffrey R.;Brady, Ken
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.1-6
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    • 2018
  • Extremely low birth weight infants remain at increased risk of intraventricular hemorrhage from the fragile vascular bed of the germinal matrix; the roles of hypotension (ischemia) and reperfusion (hyperemia) in the development of intraventricular hemorrhage are still debated. Cerebrovascular pressure autoregulation protects the brain by maintaining constant cerebral blood flow despite changes in blood pressure. The ontogeny of cerebrovascular pressure autoregulation has not been well established and uncertainty remains about the optimal arterial blood pressure required to support brain perfusion. Another important aspect of premature cerebral hemodynamics is the critical closing pressure--the arterial blood pressure at which cerebral blood flow ceases. Interestingly, in premature infants, the critical closing pressure approximates the mean arterial blood pressure. Often in this unique population, cerebral blood flow occurs only during systole when the diastolic arterial blood pressure is equal to the critical closing pressure. Moreover, the diastolic closing margin, a metric of cerebral perfusion that normalizes diastolic arterial blood pressure to the critical closing pressure, may be a better measure than arterial blood pressure for defining cerebral perfusion in premature infants. Elevated diastolic closing margin has been associated with intraventricular hemorrhage. This review summarizes the current state of understanding of cerebral hemodynamics in premature infants.

The Simulation of Fatigue Fracture Effect of Arterial Wall on Blood Pressure (노화에 따른 혈관벽의 피로파괴가 혈관 내의 압력변화에 미치는 영향)

  • Shin, Sang-Hoon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.32 no.5
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    • pp.444-450
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    • 2008
  • The conventional studies of the aging effect on cardio-vascular system are mostly obtained from human experiences and can only provide local information. In this study, the effect of fatigue fracture of arterial wall on the blood pressure was investigated by hemodynamic analysis. The aging process was simulated with three stages. The pulse wave velocity increased with age. The systolic blood pressure increases consistently but diastolic blood pressure decreases with age. The simulated results show in good accordance with the clinical ones.

A Study on the Circadian Blood Pressure Rhythm of Diabetic Patients (당뇨병 환자의 혈압 일주기 리듬에 관한 조사연구)

  • 김화순;서화숙
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.741-749
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    • 2000
  • This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( $^2$) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.

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The Relationship between Cardio-Ankle Vascular Index (CAVI), Ankle-Brachial Index (ABI), and Factors Related to Arteriosclerosis (Cardio-Ankle Vascular Index(CAVI), Ankle-Brachial Index(ABI)와 동맥경화 관련 요인과의 상관관계 연구)

  • Lee, Gi-hyang;Kang, Su-bin;Jeon, Sang-woo;Kang, Sei-young
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.434-446
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    • 2020
  • Objectives: The cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) are non-invasive methods to evaluate cardiovascular disease and arteriosclerosis. This study investigated the relationship between CAVI, ABI, and factors related to arteriosclerosis. Methods: This study included 535 healthy adults who underwent health examinations in 2019. We analyzed the correlation between CAVI, ABI and clinical variables. Multiple regression analysis was performed on the independent clinical variables associated with CAVI and ABI. Results: The correlation analysis of CAVI showed that body mass index (BMI) and HDL-cholesterol (HDL-C) had a negative correlation, and the other variables had a significant positive correlation. The correlation analysis with ABI on the right side showed that age, diastolic blood pressure (DBP), gender, and LDL-cholesterol (LDL-C) had a significant positive correlation, while HDL-C had a significant negative correlation. There was no statistical significance on the left. In the multiple regression analysis, DBP, age, BMI, gender, and HDL-C were proved to be independent factors in CAVI (right) (R2=0.365); DBP, age, gender, BMI, fasting blood sugar, and total cholesterol in CAVI (left) (R2=0.357); and age, gender, DBP, and systolic blood pressure in ABI (right) (R2=0.133). There were no statistically significant factors in ABI (left). It could be inferred that smoking and drinking are determinants that play an important role in CAVI. Conclusion: CAVI showed a high correlation with gender, age, and blood pressure. A significant correlation between CAVI and serum lipid values could be observed, but this showed a low correlation coefficient. ABI showed a high correlation with age and DBP. These results support the use of CAVI and ABI as primary diagnostic devices in medical treatment.

A Study on the Usability of the Vascular Bursting Pressure Test as a Method of Performance Evaluation of Vessel Sealing (혈관결찰기의 성능평가방법으로서 혈관파열압력시험의 유용성 연구)

  • Kang, Bo Ram;Park, A Reum;Kim, Kwang Taek;Kim, Seon Tae;Lee, Dong Hyuk
    • Journal of Biomedical Engineering Research
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    • v.41 no.5
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    • pp.210-218
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    • 2020
  • Vessel sealing is a medical device that converts electrical or ultrasonic energy into thermal energy and leads to seal, coagulate, and cut the vessel by protein modification within the walls or surrounding connective tissues. As most of surgeries have recently been conducted with minimally invasive surgery, the demand and market for vessel sealing are expected to get bigger. However, there is a problem that electrosurgical or ultrasonic surgical is applied and we have a high risk to evaluate the strength of seal, because the collateral and particular standards currently in force follows have not been establish. Therefore, in this study, we investigated some papers studied on the efficacy and safety of the device, the guidance of FDA and test papers previously conducted from 3 individual subject device made in Korea. We found there is a relationship between burst pressure and the performance of the device, therefore, we propose the vascular bursting pressure test for evaluating the safety and performance of the vessel sealing.

Characterization of $ET_B$ Receptor-mediated Relaxation in Precontracted Mesenteric Artery from Streptozotocin-induced Diabetic Rats

  • Eom, Yang-Ki;Kim, Koan-Hoi;Rhim, Byung-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.9 no.5
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    • pp.305-314
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    • 2005
  • Diabetes mellitus is associated with vascular complications, including an impairment of vascular function and alterations in the reactivity of blood vessels to vasoactive substances in various vasculature. In the present study, the authors have observed endothelin-B ($ET_B$) receptor agonist-induced relaxation in precontracted mesenteric arterial segments from streptozotocin (STZ)-induced diabetic rats, which was not shown from control rats or in other arterial segments from diabetic rats. Accordingly, the goal of this study was to investigate in what way STZ-induced diabetes altered reactivity of the mesenteric arterial bed and to examine the causal relaxation, if any, between this $ET_B$ receptor-mediated relaxation and endothelial paracrine function, especially nitric oxide (NO) production. The relaxation induced by $ET_B$ agonists was not observed in mesenteric arteries without endothelium. The relaxation to $ET_B$ agonists was completely abolished by pretreatment with BQ788, but not by BQ610. $N_{\omega}-nitro-L-arginine$ methyl ester and soluble guanylate cyclase inhibitors, methylene blue or LY83583 significantly attenuated the relaxant responses to $ET_B$ agonists, respectively. When the expression of eNOS and iNOS was evaluated on agarose gel stained with ethidium bromide, the expression of eNOS mRNA in diabetic rats was significantly decreased, but the expression of iNOS was increased compared with control rats. Furthermore, the iNOS-like immunostaining was densely detected in the endothelium and slightly in the arterial smooth muscle of diabetic rats, but not in control rats. These observations suggest that $ET_B$ receptor may not play a role in maintaining mesenteric vascular tone in normal situation. However, the alterations in $ET_B$ receptor sensitivity were found in diabetic rats and lead to the $ET_B$ agonist-induced vasorelaxation, which is closely related to NO production. In the state of increased vascular resistance of diabetic mesenteric vascular bed, enhanced NO production by activation of iNOS could lead to compensatory vasorelaxation to modulate adequate perfusion pressure to splanchnic area.

The Effect of Far Infrared Heat Therapy on Vascular Access Function of Patients receiving Hemodialysis (원적외선 온열요법이 혈액투석 환자의 혈관통로 기능에 미치는 효과)

  • Choi, Hyang Mi;Choi, Eun Duck;Jang, So Hyeong;Kim, Eun Hee;Choi, Mi Jung;Back, Song Yi;Han, Bok Hee
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.215-222
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    • 2015
  • Purpose: For hemodialysis, a vascular access which can maintain a certain speed for a long time is required. The prevention of the vascular access dysfunction is very important to decrease morbidity and to improvethe quality of life of patients receiving hemodialysis It is reported that far infrared heat increases the blood flow by expanding capillaries and micro-arteriovenouses. This study aimed to evaluate the effect of far infrared heat therapy as a new nursing intervention for maintaining vascular access function and improving the blood flow of patients receiving hemodialysis. Methods: The quasi-experimental research of nonequivalent control group pre-post test design was carried out for 59 patients receiving hemodialysis 3 times per week at K medical center. A far infrared heat was applied to the experimental group for 3 months. Results: The arteriovenous fistula blood flow of the experimental group (far infrared heat therapy group) increased significantly when compared to the control group (p=.047). However, static intra-access pressure ratio(SIAPR)was not different statistically (p=.101). Conclusion: The far infrared therapy could be considered as nursing intervention of choice as it demonstrated increase in the arteriovenous fistula blood flow in the patients receiving hemodialysis.

Influence of Nicorandil on Aortic Strip's Contractility and Blood Pressure of the Rat

  • Lim, Dong-Yoon;Kim, Yong-Jik;Hong, Soon-Pyo
    • Biomolecules & Therapeutics
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    • v.13 no.1
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    • pp.48-58
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    • 2005
  • The present study was conducted to investigate the effects of nicorandil on arterial blood pressure and vascular contractile responses in the normotensive anesthetized rats and to establish the mechanism of action. Nicorandil (30~300 ${\mu}g/kg$) given into a femoral vein of the normotensive anesthetized rat produced a dose-dependent depressor response. These nicorandil-induced hypotensive responses were not affected by pretreatment with atropine (3.0 mg/kg, i.v.) or propranolol (2.0 mg/kg, i.v.), while markedly inhibited in the presence of chlorisondamine (1.0 mg/kg, i.v.) or phentolamine (2.0 mg/kg, i.v.). Futhermore, after the pretreatment with 4-aminopyridine (1.0 mg/kg/30 min, i.v.) or glibenclamide (50.0 ${\mu}g/kg$/30min) into a femoral vein made a significant reproduction in pressor responses induced by intravenous norepinephrine. In he isolated rat aortic strips, both phenylephrine (10$^{-5}$ M)- and high potassium (5.6 ${\times}\;10^{-2}$ M)-inducedcontractile responses were dose-dependently depressed in the presence of nicorandil (25~100 ${\mu}M$). Collectively, these experimental results demonstrate that intravenous nicorandil causes a dose-dependent depressor action in the anesthetized rat at least partly through the blockade of vascular adrenergic ${\alpha}_1$-receptors, in addition to the well-known mechanism of potassium channel opening-induced vasorelaxation.

Studies of Evodiae Fructus on the blood pressure in spontaneously hypertensive rats (오수유(吳茱萸)가 선천성고혈압(先天性高血壓)흰쥐의 혈압(血壓)에 미치는 영향(影響))

  • Kang, Sin-In;Kim, Ho-Cheol;Rheu, Hang-Mook;Yang, Ji-Seon;Jung, Soo-Yeon
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.50-58
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    • 1998
  • The effects of the Evodiae fructus on the cardiovascular function were assessed in spontaneously hypertensive rats, and isolated preparation of spontaneously hypertensive rats aortic strip. In spontaneously hypertensive rats, intraperitoneal administration of methanol crude extract of Evodiae Fructus (0.5mg/kg) lowered aterial blood pressure which lasted for at least 4 hours. The hypotensive effect of Evodiae Fructus was more stronger with ${\alpha}-adrenoreceptor$ inhibitor(Phentholamine) and it was not affected by ${\beta}-adrenoreceptor$ inhibitor(Propranolol). The hypotensive effect of Evodiae Fructus was abolished by NAME. It is suggested that the hypotensive effect of Evodiae Fructus may be concern with endothelium-derived relaxing factor and it may be mediated through NO synthesis. Evodiae Fructus showed a vasorelaxing effect on denude aortic strip. It is suggested that Evodiae Fructus has a direct relaxing effect on vascular smooth muscle cells. Judging from above results, it was proved that hypotensive effect of Evodiae Fructus. The mechanism of hypotensive action may be concern with endothelium-derived relaxing factor and direct relaxing effect on vascular smooth muscle cells. Therefore, it is suggested that Evodiae Fructus is applicable to hypertension.

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