• Title/Summary/Keyword: arterial hypertension

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Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report (폐동맥 고혈압 환자의 치과치료에서 세보플루란 흡입 진정의 사용 : 증례보고)

  • Chi, Seongin;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.75-79
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    • 2015
  • Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

A Study on the Automatic Pressure Controller Using Adaptive Control Algorithma (적응 제어 방식을 이용한 혈압자동 조절기에 관한 연구)

  • 이상훈;김영철;민병구
    • 제어로봇시스템학회:학술대회논문집
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    • 1986.10a
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    • pp.648-651
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    • 1986
  • Sometimes, there are conditions when rapid control of the hypertension needed such as malignant hypertension, and the preoperative pereparation of the hypertensive patient requiring emergency operation, etc. Using the adaptive control algorithm, the mean arterial pressure reduction is achived rapidly and safely in hypertensive rabbit. Among the adaptive control algorithms the pole assignment self tuning control algorithm is superial to the one step ahead minium variance control algorithm. The convergence time is less than 600 sec, and the standard deviation of experimental data are less than 4 mmHg.

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Comparison of Clinical Laboratory Data and Prevalence according to Arterial Stiffness in Stroke Patients

  • Jin, Bok Hee;Han, Min Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.46 no.4
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    • pp.143-149
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    • 2014
  • Pulse wave velocity (PWV) is used to non-invasively estimate the severity of arteriosclerosis by measuring the patient's arterial stiffness comparing with each normal reference range according to their ages. Increased arterial stiffness is closely related to both atherosclerosis and arteriosclerosis, which have been known for causes of cardiovascular disease and stroke, also negatively affects the prognosis and the re-occurrence in patients with stroke. The study is focused on how brachial-ankle pulse wave velocity (baPWV) is related to cardiovascular disease risk factors in patients with acute stroke. There were 114 subjects, 69 males and 45 females, all in their 60's and had PWV test for acute stroke. The results are as follows: the group with increased arterial stiffness showed significant increase in HbAlc, total cholesterol, RSBP (resting systolic blood pressure), CSBP (central systolic blood pressure) and CDBP (central diastolic blood pressure). Cross tabulation test showed that there was a significant relationship only between the group with increased arterial stiffness and diabetes mellitus (DM). Therefore, it might be useful for preventing re-occurrence and making a favorable prognosis to promptly adjust DM and hypertension-related risk factors in patients with acute stroke.

Late Results of Operation for Patent Ductus Arteriosus with Preoperative Pulmonary Hypertension (폐동맥고혈압을 동반한 동맥관개존증의 장기관찰 성적)

  • O, Bong-Seok;Jo, Wan-Jae;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.775-780
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    • 1989
  • This study concerns the late results observed at follow-up[average: 32.5 months] of 23 patients, in whom Patent Ductus Arteriosus with pulmonary hypertension among 55 patients. They were operated from May 1984 to July 1987 in Chonnam University Medical School. There was predominance of woman [2.5:1]. No operative death occurred. All of patients subside preoperative symptoms, but 1 patient diagnosed recannalization of duct at follow-up. Systolic murmur was found over the pulmonary area in 5 patients [22 %], but it may be not related to systolic pulmonary arterial pressure[SPAP]. Also, SPAP were normalized in 74 % of patients and had mild hypertension in 26 % of patients. Although the patients had Patent Ductus Arteriosus with pulmonary hypertension, successful surgical correction was carried out safely in all instance but one, by ligation and facilitated by hypotensive anesthesia.

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Potts Shunt in Patients with Primary Pulmonary Hypertension

  • Kim, Sue Hyun;Jang, Woo-Sung;Lim, Hong-Gook;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.48 no.1
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    • pp.52-54
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    • 2015
  • Idiopathic pulmonary arterial hypertension eventually leads to right-sided heart failure and sudden death. Its mortality rate in children is still high, despite improvements in pharmacological therapy, and therefore novel treatments are necessary. The Potts shunt, which creates an anastomosis between the left pulmonary artery and the descending aorta, has been proposed as a theoretically promising palliative surgical technique to decompress the right ventricle. We report the case of a 12-year-old girl with suprasystemic idiopathic pulmonary hypertension and right ventricular failure who underwent a Potts shunt for palliation with good short-term results.

Hypoxic pulmonary vasoconstriction and vascular contractility in monocrotaline-induced pulmonary arterial hypertensive rats

  • Kim, Hae Jin;Yoo, Hae Young
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.6
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    • pp.641-647
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    • 2016
  • Pulmonary arterial hypertension (PAH) is a progressive disease characterized by vascular remodeling of pulmonary arteries (PAs) and increased vascular resistance in the lung. Monocrotaline (MCT), a toxic alkaloid, is widely used for developing rat models of PAH caused by injury to pulmonary endothelial cells; however, characteristics of vascular functions in MCT-induced PAH vary and are not fully understood. Here, we investigated hypoxic pulmonary vasoconstriction (HPV) responses and effects of various vasoconstrictors with isolated/perfused lungs of MCT-induced PAH (PAH-MCT) rats. Using hematoxylin and eosin staining, we confirmed vascular remodeling (i.e., medial thickening of PA) and right ventricle hypertrophy in PAH-MCT rats. The basal pulmonary arterial pressure (PAP) and PAP increase by a raised flow rate (40 mL/min) were higher in the PAH-MCT than in the control rats. In addition, both high $K^+$ (40 mM KCl)- and angiotensin II-induced PAP increases were higher in the PAH-MCT than in the control rats. Surprisingly, application of a nitric oxide synthase inhibitor, L-$N^G$-Nitroarginine methyl ester (L-NAME), induced a marked PAP increase in the PAH-MCT rats, suggesting that endothelial functions were recovered in the three-week PAH-MCT rats. In addition, the medial thickening of the PA was similar to that in chronic hypoxia-induced PAH (PAH-CH) rats. However, the HPV response (i.e., PAP increased by acute hypoxia) was not affected in the MCT rats, whereas HPV disappeared in the PAH-CH rats. These results showed that vascular contractility and HPV remain robust in the MCT-induced PAH rat model with vascular remodeling.

Long-Term Result of Surgical Treatment for Renovascular Hypertension (신혈관성 고혈압의 외과적 치료 결과)

  • 우건화;김창호
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.393-396
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    • 1996
  • During the past eight years, we have encountered 9 patients, aged between 2 and 61 years, with renovascular hypertension. The renovascular hypertension In this series included Takayasu's disease with renal artery stenosis, arteriosclerosis of renal artery, fibromuscular dysplas a of renal artery Aortd-renal bypass was performed In 8 patients, iliac-to-renal bypass in 1 patient. 9 patients have been followed form 2 months to 5.1 years. Postoperatively, all patients'hypertension was improved. Only 2 patients need to take small dose of antihypertensive medication after discharge. These data indicated the good results of renovascular reconstruction for the patients with renovascular hypertension.

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Increased Expression of Nitric Oxide Synthase Coincides with Reversal of Renovascular Hypertension

  • Park, Yun-Woong;Park, Yung-Hyun;Kim, Soo-Wan;Lee, Jong-Un
    • The Korean Journal of Physiology and Pharmacology
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    • v.4 no.2
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    • pp.143-147
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    • 2000
  • The present study was aimed at investigating whether there are changes in the expression of nitric oxide synthase (NOS) in relation with the unclipping-induced fall of blood pressure in two-kidney, one clip (2K1C) hypertension. Male Sprague-Dawley rats were made 2K1C hypertensive by clipping the left renal artery for four weeks. Sham-clipped rats served as control. The expression of endothelial constitutive (ec) NOS proteins and tissue levels of NO metabolites were determined in the kidney. Systolic blood pressure was significantly increased in clipped rats compared with that in the control. The development of hypertension was associated with decreases in the expression of ecNOS proteins and tissue levels of NO metabolites in the clipped kidney. The blood pressure at twenty-four hours after removal of the renal arterial clip fell to the control level. Accordingly, in the unclipped kidney, the expression of ecNOS proteins and tissue contents of NO metabolites were increased to the control level. The contralateral kidney was not affected by the development or reversal of hypertension. It is suggested that an enhanced expression of ecNOS in the unclipped kidney is an important component in the reversal of renovascular hypertension.

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Thromboembolectomy in Acute Arterial Occlusion (급성 동맥폐색증에서 혈전색전 제거술 -48례 경험-)

  • 김진희
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.792-797
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    • 2000
  • Background : Even though there were developments in various treatment techniques for acute arterial occlusion this disease still has high rate of mortalities and limb amputations. We investigated the combined diseases symptoms location of occlusion type of treatment complication and prognosis in our patients. Meterial and methods: This study recruited 48 patients(42 men, 6 women, mean age 57.7 years) who received the operation from January 1995 toDecember 1998. We investigated the post-operation course via medical record review or telephone interview with patients or their family members. Result: The most common combined diseases were atherosclerosis in 30 patients. other diseases were 17 diabetes mellitus 16 hypertension and 12 atrial firillation. Pain and clod sensation were noticed in all patients paresthesia in 5 patients fibrillation. Pain and cold sensation were noticed in all patients paresthesia in 5 patients and lower extremity paralysis in 11 patients. In 29 patients the time interval from the onset of symptom to admission was over 72 hours and 15 patients were admitted within 24 hours. The distribution of arterial occlusion location was at 28 femoral arteries 14 popliteal arteries and 6 iliac arteries. All the patients were received embolectomy and 5 patients were received additional bypass grafting. Postoperative complications were 12 reocclusions. 6 compartment syndromes 6 skin necrosis and 2 acute renal failure. The mortality rate was 16.7%(8/48) and the amputation rate was 25% Conclusion : This study revealed 25% reocclusion 25% limb amputation and 16.7% mortaliyt. To improve the prognosis of acute lower extrements arterial occlusion early diagnosis and understand the underlying diseases prompt treatment and operation additional operation including interventional radiologic examination and thorough postoperative care would be appreciated.

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