• 제목/요약/키워드: arterial hypertension

검색결과 246건 처리시간 0.021초

Hypertensive Encephalopathy with Reversible Brainstem Edema

  • Lee, Sungjoon;Cho, Byung-Kyu;Kim, Hoon
    • Journal of Korean Neurosurgical Society
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    • 제54권2호
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    • pp.139-141
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    • 2013
  • Presented here is a 36-year-old male with arterial hypertension who developed brainstem edema and intracranial hemorrhage. Magnetic resonance scan revealed diffuse brainstem hyperintensity in T2-weighted and fluid-attenuated inversion-recovery images, with an increase in apparent diffusion coefficient values. After a reduction in blood pressure, rapid resolution of the brainstem edema was observed on follow-up. The patient's condition was thus interpreted as hypertensive brainstem encephalopathy. While many consider this a vasogenic phenomenon, induced by sudden, severe hypertension, the precise mechanism remains unclear. Prompt recognition and aggressive antihypertensive treatment in such patients are essential to prevent permanent or life-threatening neurologic injury.

Management of Persistent Pulmonary Hypertension in Preterm Infants

  • Lee, Byong Sop
    • Neonatal Medicine
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    • 제28권1호
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    • pp.1-6
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    • 2021
  • Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygen-carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.

Resolution of Malignant Hypertension after Single-Chamber Permanent Pacemaker Implantation in a Dog with 3rd Degree AV Block

  • Su-Min Park;Woo-Jin Song;Hwa-Young Youn
    • 한국임상수의학회지
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    • 제40권1호
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    • pp.50-55
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    • 2023
  • A 10-year-old spayed female Cocker spaniel weighing 6.64 kg was presented with a sign of syncope. Electrocardiographic findings revealed pathologic atrioventricular (AV) block alternating 3rd degree AV block, non-responsive to atropine. Before pacemaker implantation, several anti-hypertensive medications were administered, but there was no improvement. After pacemaker implantation, the heart rate and systemic arterial systolic blood pressure were immediately improved. This is the first report on the resolution of an AV block and malignant systemic hypertension after a pacemaker implant in veterinary medicine.

Effects of Norepinephrine and Neuropeptide Y on the Contractility of Small Mesenteric Artery from 2K1C and DOCA-Salt Hypertensive Rats

  • Nam, Sang-Chae;Kang, Seong-Su;Kim, Won-Jae;Lee, Jong-Un
    • The Korean Journal of Physiology and Pharmacology
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    • 제4권1호
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    • pp.55-61
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    • 2000
  • The present study was conducted to investigate the possible role of the sympathetic nervous system in two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension. 2K1C and DOCA- salt hypertension were made in Sprague-Dawley rats. Four weeks after induction of hypertension, systolic blood pressure measured in conscious state was significantly higher in 2K1C $(216{\pm}18\;mmHg)$ and DOCA-salt $(205{\pm}29\;mmHg)$ groups than that in control $(128{\pm}4\;mmHg).$ The third branches (<300 ${\mu}m$ in outer diameter) of the mesenteric artery were isolated and cut into ring segments of $2{\sim}3$ mm in length. Each ring segment was mounted in tissue bath and connected to a force displacement transducer for measurement of isometric tension. The arterial rings were contracted by application of norepinephrine (NE) in a dose-dependent manner. The amplitude of the NE-induced contraction of the vessels was significantly larger in hypertension than in control. The NE-induced contraction was significantly enhanced by neuropeptide Y (NPY) in hypertension. Reciprocally, NPY-elicited vasocontraction was increased by NE in hypertension. These results suggest that the sympathetic nervous system contributes to the development of 2K1C and DOCA-salt hypertension.

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Association of Uric Acid Levels with Arterial Stiffness in Korean Women and Non-smoking Men

  • Sull, Jae Woong;Koh, Eun Na;Cho, Sung Kweon;Bae, Hyung-Joon;Jee, Sun Ha
    • 대한의생명과학회지
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    • 제23권3호
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    • pp.201-207
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    • 2017
  • Measuring the pulse wave velocity (PWV) is a non-invasive method for evaluating the stiffness of the vessel wall. While previous studies investigated the association of uric acid level with arterial stiffness, most did not consider smoking status and obesity as covariates. The objective of this study was to investigate the relationship between uric acid levels and arterial stiffness, considering smoking status and obesity. We studied 3390 subjects (1940 males and 1450 females). Abnormal PWV was also defined as the highest quartile of values in the subjects. Data were analyzed using Pearson correlation, t-test, and multiple regression analysis. Approximately 41.9% of men and 3.7% of women were current smokers. Prevalence of hypertension was 11.4% in men and 7.0% in women. In women, hyperuricemia was associated with abnormal PWV (OR 1.58; 95% CI 1.03~2.43). Hyperuricemia was also associated with abnormal PWV (OR 2.37; 95% CI 1.01~5.59) in non- or light male smokers with normal blood pressure. This study suggests that uric acid is associated with arterial stiffness in women and non-smoking men.

$^{99m}Tc-DISIDA$를 이용한 간 혈류 중 동맥 분획의 측정 (Estimation of the Arterial Fraction of Total Hepatic Flow from Radionuclide Angiogram Using $^{99m}Tc-DISIDA$)

  • 이해규;임계연;양일권;김학희;임정익;박용휘;한석원;한남익;이영석
    • 대한핵의학회지
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    • 제25권2호
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    • pp.200-206
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    • 1991
  • Arterial fraction of total hepatic blood flow was estimated by a new method, slope method, on radionuclid angiogram using $^{99m}Tc-DISIDA$ and was compared with that from $^{99m}Tc-Phytate$ radionuclide angiogram. This study included 11 of normal subjects, 37 of intermediate group with various liver diseases, and 25 patients with liver cirrhosis. We analyzed the datas with slope method from radionuclide angiograms and the results were compared with hepatic arterial fractions from uptake method, introduced by Lee et al. at 1986. The hepatic arterial fractions from radionuclide angiograms using $^{99m}Tc-DISIDA$ and $^{99m}Tc-Phytate$ were $0.32{\pm}0.09\;and\;0.31{\pm}0.11$ respectively in normal subjects, and $0.75{\pm}0.18\;and\;0.77{\pm}0.21$ respectively in patients with liver cirrhosis. The hepatic arterial fractions by the slope method was well correlated with those of the uptake method on $^{99m}Tc-DISIDA$ scan. There was high correlation between the hepatic arterial fractions from $^{99m}Tc-DISIDA$ and $^{99m}Tc-Phytate$ scans. Hepatic arterial fraction estimated by the slope method is a useful index for the diagnosis of liver cirrhosis and the evaluation of status of portal hypertension.

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식염과잉 섭취 및 시상하체의 장기전기적 자극에 의한 고혈압증 유발에 관한 실험적 연구 (Effects of Chronic Excess Salt Ingestion or/and Electrical Stimulation of the Hypothalamus on Blood Pressure in the Cat)

  • 김기순
    • The Korean Journal of Physiology
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    • 제4권1호
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    • pp.47-54
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    • 1970
  • The effects of excess salt ingestion or/and a prolonged electrical stimulation of the hypothalamus on the arterial blood pressure were studied in cats. The average mean arterial pressure determined in 12 control animals were $112.2{\pm}2.6\;mmHg$. In 15 animals in which 2% NaCl solution (2g/Kg of body wegight/day) was given for 20 days, average mean arterial pressure elevated to $147.7{\pm}6.1\;mmHg$. It was also found in four of them that salt-induced high blood pressure started to decline when salt solution was replaced by tap water. On the other hand, No change in average mean arterial pressure was observed in 10 animals, whose hypothalamus had been electrically stimulated for 28 days. In 11 animals in which the hypothalamus was stimulated with simultaneous excess salt ingestion for 20 days, there was a marked elevation in average mean arterial pressure which, however, does not significantly differ from that observed in excess salt ingested group. From the results obtained from the present experiment, it is concluded that 1) the hypertension is induced by an excess salt ingestion in cats, 2) the mean arterial pressure of cats is not affected at least by an increment of sympathetic tone for 4 weeks resulting from the electrical stimulation of posterior area of the hypothalamus, 3) in sodium·induced high blood pressure cats, four weeks of increment in sympathetic tone by the hypothalamic stimulation does not further elevate mean arterial pressure.

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Change of voltage-gated potassium channel 1.7 expressions in monocrotaline-induced pulmonary arterial hypertension rat model

  • Lee, Hyeryon;Kim, Kwan Chang;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • 제61권9호
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    • pp.271-278
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    • 2018
  • Purpose: Abnormal potassium channels expression affects vessel function, including vascular tone and proliferation rate. Diverse potassium channels, including voltage-gated potassium (Kv) channels, are involved in pathological changes of pulmonary arterial hypertension (PAH). Since the role of the Kv1.7 channel in PAH has not been previously studied, we investigated whether Kv1.7 channel expression changes in the lung tissue of a monocrotaline (MCT)-induced PAH rat model and whether this change is influenced by the endothelin (ET)-1 and reactive oxygen species (ROS) pathways. Methods: Rats were separated into 2 groups: the control (C) group and the MCT (M) group (60 mg/kg MCT). A hemodynamic study was performed by catheterization into the external jugular vein to estimate the right ventricular pressure (RVP), and pathological changes in the lung tissue were investigated. Changes in protein and mRNA levels were confirmed by western blot and polymerase chain reaction analysis, respectively. Results: MCT caused increased RVP, medial wall thickening of the pulmonary arterioles, and increased expression level of ET-1, ET receptor A, and NADPH oxidase (NOX) 4 proteins. Decreased Kv1.7 channel expression was detected in the lung tissue. Inward-rectifier channel 6.1 expression in the lung tissue also increased. We confirmed that ET-1 increased NOX4 level and decreased glutathione peroxidase-1 level in pulmonary artery smooth muscle cells (PASMCs). ET-1 increased ROS level in PASMCs. Conclusion: Decreased Kv1.7 channel expression might be caused by the ET-1 and ROS pathways and contributes to MCT-induced PAH.

고폐동맥압을 동반한 선천성 심기형 환자에서 술후 폐동맥압과 혼합정맥혈 산소분압의 변화에 관한 분석 (An analysis of change in pulmonary arterial pressure and mixed venous oxygen tension after correction of congenital heart disease associated with pulmonary hypertension)

  • 김기봉;김용진
    • Journal of Chest Surgery
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    • 제22권6호
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    • pp.894-900
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    • 1989
  • It has been suggested that mixed venous $O_{2}$ tension is a predicor of cardiac output especially in a critically ill patient after an open heart surgery. From April 1988 through September 1989, we monitored mixed venous $O_{2}$ tension and pulmonary arterial pressure in 48 patients with acyanotic congenital heart disease at postoperative 1 hour, 6 hour, 12 hour, 24 hour, and 48 hour respectively. They were divided into Group I, with severe pulmoary hypertension, and Group II, without severe pulmonary hypertension. In Group I, mixed venous $O_{2}$ tension and cardiac index showed significant increase with time (p<0.05), but the ratio of pulmonary-aortic systolic pressure didn't show significant change. The increase was significant only 24 hour after operation, and so this low cardiac performance in early postoperative period should be considered when postoperative management is being planned in the risky patient. In Group II, all of the three variables didn't show any significant change with time. The correlation coefficient between mixed venous $O_{2}$ tension and cardiac index was significantly different from zero in both Group I (p<0.001) and group II (p<0.05) at each imeperiod, but the ratio of pulmonary-aortic systolic pressure didn't correlated well with the other 2 variables. Our study showed that serial determination of mixed venous $O_{2}$ tension in acyanotic congenital heart disease could be used as a guide in estimating the cardiac index postoperatively.

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