• Korean Journal of Radiology
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• 제21권12호
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• pp.1285-1293
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• 2020

Objective: To evaluate the effects of vasodilators on contrast enhancement and transluminal attenuation gradient (TAG) of coronary arteries at coronary computed tomography angiography (CCTA). Materials and Methods: We retrospectively reviewed CCTA scans of patients who underwent double-acquisition CCTA; CCTA without a vasodilator, and CCTA during a intravenous (IV) infusion of nitrate. Among them, we enrolled 19 patients who had no significant atherosclerotic lesions or coronary spasms. In the control group, 28 patients were enrolled who showed normal coronary arteries on CCTA, which was acquired by a conventional method (sublingual vasodilator). We measured the TAG and Hounsfield units for each of the three major epicardial coronary arteries (reported as 'ProxHU') and then compared the results between the nitrate administration methods (CT without vasodilator [CT_pre], CT with IV vasodilator [CT_iv], and CT with sublingual vasodilator [CT_sub]). Results: The mean TAG showed a significant difference between the coronary arteries (right coronary artery [RCA] > left anterior descending artery [LAD] > left circumflex artery [LCX], p < 0.05), while there was no difference in ProxHU of each coronary artery in all three types of nitrate administration methods (p > 0.05). The TAG of CT_pre group showed steeper slope than those of vasodilator groups (CT_iv and CT_sub) on LAD and LCX ([LAD: CT_pre = -22.1 ± 6.66, CT_iv = -16.76 ± 5.78, and CT_sub = -16.47 ± 5.78, p = 0.005], [LCX: CT_pre = -31.26 ± 17.43, CT_iv = -23.74 ± 14.06, and CT_sub = -20.94 ± 12.15, p = 0.051]), while that of RCA showed no significant differences (p = 0.600). When comparing proxHU, CT_iv showed higher proxHU than that of CT_pre or CT_sub, especially on LCX (CT_pre = 426.7 ± 68.3, CT_iv = 467.9 ± 84.9, and CT_sub = 404.9 ± 63.3, p = 0.013). ProxHU showed a negative correlation with TAG on all three of methods (r = -0.280, p < 0.001). Conclusion: TAG in CCTA was significantly affected by vasodilator administration. Both TAG and ProxHU of coronary arteries tend to increase with vasodilator administration on CCTA.

• Clinical and Experimental Pediatrics
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• 제50권11호
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• pp.1041-1048
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• 2007

Not a few patients in children and adolescents are suffering from right ventricular (RV) dysfunction resulting from various conditions such as chronic lung disease, left ventricular dysfunction, pulmonary hypertension, or congenital heart defect. The RV is different from the left ventricle in terms of ventricular morphology, myocardial contractile pattern and special vulnerability to the pressure overload. Right ventricular failure (RVF) can be evaluated in terms of decreased RV contractility, RV volume overload, and/or RV pressure overload. The management for RVF starts from clear understanding of the pathophysiology of RVF. In addition to correction of the underlying disease, management of RVF per se is very important. Meticulous control of volume status, inotropic agents, vasopressors, and pulmonary selective vasodilators are the main tools in the management of RVF. The relative importance of each tool depends on the individual clinical status. Medical assist device and surgery can be considered selectively in case of refractory RVF to optimal medical treatment.

• Archives of Plastic Surgery
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• 제42권6호
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• pp.695-703
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• 2015

Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of random-pattern skin flaps were studied. Methods Forty female Sprague-Dawley rats were divided into two equal groups. Caudally based dorsal random-pattern skin flaps were elevated, including the panniculus carnosus. In the study group, 1.5 mL of a cream containing menthol and methyl salicylate was applied to the skin of the flap, and saline solution (0.9%) was used in the control group. Upon completion of the experiment, flap necrosis was analyzed with imaging software and radionuclide scintigraphy. Histopathological measurements were made of the percentage of viable flaps, the number of vessels, and the width of the panniculus carnosus muscle. Results According to the photographic analysis, the mean viable flap surface area in the study group was larger than that in the control group (P=0.004). According to the scintigrams, no change in radioactivity uptake was seen in the study group (P>0.05). However, a significant decrease was observed in the control group (P=0.006). No statistically significant differences were observed between the groups in terms of the percentage of viable flaps, the number of vessels, or the width of the panniculus carnosus muscle (P>0.05). Conclusions Based on these results, it is certain that the cream did not reduce the viability of the flaps. Due to its vasodilatory effect, it can be used as a component of the dressing in reconstructive operations where skin perfusion is compromised.

• Journal of Chest Surgery
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• 제28권8호
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• pp.742-746
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• 1995

The present study was aimed at investigating possible transmitter mechanisms in the endothelial cell layer in regulating the tone of the vascular smooth muscle. The thoracic aorta was isolated from the anesthetized male white rabbits and its helical strips were prepared. Electrical field stimulation was delivered to platinum wire electrodes positioned parallel to the vessel segment preconstricted with phenylephrine [3.5x10-6 mol/L at a distance of 1.5-2.0 mm. The electrical stimulation [70 V, 5 msec, 0.5-200 Hz caused either relaxation only [34% or a biphasic response [prolonged relaxation following a weak and transient contraction, 66% . The relaxation response was frequency- dependent, and at 200 Hz a complete relaxation was noted. Mechanical rubbing of the endothelial layer abolished or greatly attenuated the relaxation. The relaxation was also markedly attenuated in the presence of NG-nitro- L-arginine methyl ester [10-3mol/L or procaine hydrochloride [3.5x10-4mol/L . Tetrodotoxin,guanethidine, atropine or indomethacin failed to block or enhance the relaxation response to electrical field stimulation. It is concluded that the vascular endothelium in the aorta contains diffusible substances that regulates the function of the smooth muscle layer, in which relaxation is more prominent than contraction. Their release by the electrical stimualtion in vitro may not involve classic neuronal transmitter release mechanisms or metabolism of arachidonic acids by cyclooxygenase. The release of the relaxing agents may require an increase in cytosolic calcium level. The chemical nature of the relaxant may be, to a large extent, nitric oxide.

• Journal of Chest Surgery
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• 제31권2호
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• pp.102-107
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• 1998

L-Arginine이 산화질소 생성의 전구물질로서 공헌하는 것 이외에 다른 기전에 의하여도 혈관이완을 일으키는가 구명하기 위하여 적출 흰쥐 흉부대동맥 표본에서 L-arginine에 의한 장력, 조직 산화질소 및 cGMP 함량 변동 등을 조사하여 다음과 같은 결과를 얻었다. 1. Phenylephrine(3.5$\times$10－6 mol/L) 수축 대동맥 표본은 L-arginine(10－9~10－3 mol/L)에 의해 용량의존 이완되었다. NG-Nitro-L-arginine methyl ester(L-NAME, 10－5 mol/L) 전처치에 의해 저농도 L-arginine(10－9~10－6 mol/L)에 혈관이완 효과는 소실되었으나 고농도 L-arginine(10－4~10－3 mol/L)의 이완효과는 도리어 증강되었다. 내피층 파괴 혈관 표본은 L-arginine에 대해 이완반응을 보이지 않았다. 2. L-NAME(10－5 mol/L) 존재하에 일어나는 L-arginine 이완효과는 indomethacin 전처치에 의해 영향받지 않으나, ouabain 전처치에 의해 유의하게 감약되었다. 또한 L-arginine 이완효과는 methylene blue에 의해 부분적으로 길항되었다. KCl(3.5$\times$10－2 mol/L) 수축 대동맥 표본은 L-arginine(10－9~10－3 mol/L)에 의해 L-NAME (10－5 mol/L) 처치와 무관하게 이완반응을 보이지 않았다. 3. L-NAME는 혈관조직 산화질소 함량을 감소시키며 이 감소효과는 L-arginine(10－4 mol/L)에 의해 영향받지 않았다. 또한 L-NAME는 혈관조직 cGMP 함량을 감소시키나 이 감소효과는 L-arginine에 의해 영향받지 않았다. 이상의 실험성적은 L-arginine이 내피세포의 산화질소 및 cGMP 생성과 무관한 기전을 통해서도 내피의존 혈관이완효과를 나타냄을 시사하였다.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.95-102
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• 1985

대구 및 그 인접지역의 질병 발생 경향을 추정하고, 영남대학교 의과대학 부속병원의 약제수급 계획을 위한 참고자료를 얻기 위하여, 1985년 3월부터 동년 8월까지 당 병원 외래에 내원한 환자들을 위하여 내려진 약물 처방을 전산 집계하여 다음과 같은 결과를 얻었다. 가장 빈번히 처방된 약물로 부터 100종의 약물을 처방빈도 순으로 나열하였던 바, diazepam, aluminum compound, acetaminophen, isoniazid, metoclopramide, $polaranine^{(R)}$, carboxymethylcystein, ephedrine, codeine, caroverine (이하생략) 등의 순으로 나타났으며, 이와 같이 선정된 100종의 약물을 임상용도별로 분류하여 총 처방회수 521,855회에 대한 백분율을 조사한 결과는 다음과 같다. 중추신경계약물 (20.57%)이 가장 많았고, 다음은 위장관 및 평활근에 작용하는 약물 (18.64%), 호흡기계약물 (16.11%), 항균제 (15.12%), 심혈관 계약물 (5.64%)의 순으로 많았으며, 그 다음은 소염제 (4.33%), 단독비타민제 (3.76%), 호르몬 및 항호르몬제 (3.29%), 감기치료제 (3.12%), 이뇨제 (2.81%), 간기능이상치료제 (2.02%), 자율신경계약물 (1.89%), 항히스타민제 (1.02%) 및 소독약 (0.74%) 등의 순으로 나타났다.