• 제목/요약/키워드: cardiovascular toxicity

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Deleterious Effects of Hyperoxemic Extracorporeal Circulation during Cardiovascular Surgery

  • Park, Seok-Cheol
    • 대한의생명과학회지
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    • 제7권1호
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    • pp.7-15
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    • 2001
  • Although extracorporeal circulation (ECC) has been routinely used for cardiovascular surgery, hyperoxemia during ECC may produce oxygen toxicity and cellular injury. This study was performed to investigate the clinical influences of hyperoxemic ECC during cardiovascular operation. 40 adult patients scheduled for elective cardiovascular surgery were classified into normoxemic (arterial oxygen tension: 115 mmHg, n=20) and hyperoxemic (arterial oxygen tension: 380 mmHg, n=20) ECC. At preoperative and postoperative period, total leukocyte and neutrophil counts, platelet counts, iron, glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine in peripheral arterial blood, malondialdehyde (MDA) and troponin-T concentration (TnT) in coronary sinus blood, pulmonary vascular resistance (PVR), and postoperative blood loss volume (BLS) were measured and compared between groups. Hyperoxemic group had postoperatively higher total leukocyte and neutrophil counts, MDA, TnT, PVR total BLS, iron, glucose, AST, ALT, BUN, and creatinine than normoxemic group (p<0.05).0 conclusion, hyperoxemic ECC results in greater inflammatory response and oxidative damaging effects on the heart lung, liver and kidney, probably being adverse to postoperative patient recovery. For reducing these deleterious effects and improving postoperative outcomes, management lowering oxygen tension during ECC is recommended.

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낭탕근의 급성독성 연구 (Acute Toxicity Study on Scopoliae Rhizoma in Mice)

  • 마진열;신현규;성현제;전원경;김인락;고병섭;정규용
    • Toxicological Research
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    • 제13권4호
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    • pp.349-352
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    • 1997
  • Scopoliae rhizoma is a perennial herb which has a similar effect with atropine on the cardiovascular system. It is also known to have a seditive and anticonvulsant activity on the central nerve system. In order to evaluate an acute toxicity of Scopoliae rhizoma, the present study was performed after administration the Scopoliae rhizoma prepared by both decoctional and frozen dried extract through three different routes (oral; 5,000 mg/kg, intraperitoneal; 2,000 mg/kg, subcutaneous; 5,000 mg/kg) to the female ICR mice. In the group treated intraperitoneally with a frozen dried extract, abnormal clinical signs such as decreased activity, crouch, potosis and abnormal walking were observed for 40 rain after administration. With regard to WBC, decreased number of lymphocyte and increased number of monocyte and granulocyte were also observed in the animals received intraperitoneally with Scopoliae rhizoma extract. Taken together, what toxicity of Scopoliae rhizoma was shown differently depending on its type for administration may be resulted in the differency of administered dose. The results provided here support a pharmacological and toxicological consideration for its clinical use in the regard of oriental medicine.

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Safety of radiotherapy in patients with Behcet's disease: a case report and review of the literature

  • Ko, Dahui;Kim, Young Suk;Choi, Yunseon
    • Journal of Medicine and Life Science
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    • 제18권2호
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    • pp.35-39
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    • 2021
  • Exaggerated acute and late toxicities following radiotherapy have been reported in patients with pre-existing connective tissue diseases, such as systemic lupus and scleroderma. Behcet's disease (BD) is a relapsing multisystem connective tissue disease characterized by vasculitis in the mucocutaneous, ocular, gastrointestinal, respiratory, neurologic, urogenital, articular, and cardiovascular systems. Data concerning the relationship between radiotherapy toxicity and BD are limited in the literature. Here, we report a case of lung cancer treated with radiotherapy (60 Gy) in a patient with BD. No severe radiation-induced toxicity was observed. Radiation-induced toxicity in patients with BD has also been discussed.

Antiarrhythmic effects of ginsenoside Rg2 on calcium chloride-induced arrhythmias without oral toxicity

  • Gou, Dongxia;Pei, Xuejing;Wang, Jiao;Wang, Yue;Hu, Chenxing;Song, Chengcheng;Cui, Sisi;Zhou, Yifa
    • Journal of Ginseng Research
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    • 제44권5호
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    • pp.717-724
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    • 2020
  • Background: Malignant arrhythmias require drug therapy. However, most of the currently available antiarrhythmic drugs have significant side effects. Ginsenoside Rg2 exhibits excellent cardioprotective effects and appears to be a promising candidate for cardiovascular drug development. So far, the oral toxicity and antiarrhythmic effects of Rg2 have not been evaluated. Methods: Acute oral toxicity of Rg2 was assessed by the Limit Test method in mice. Subchronic oral toxicity was determined by repeated dose 28-day toxicity study in rats. Antiarrhythmic activities of Rg2 were evaluated in calcium chloride-induced arrhythmic rats. Antiarrhythmic mechanism of Rg2 was investigated in arrhythmic rats and H9c2 cardiomyocytes. Results: The results of toxicity studies indicated that Rg2 exhibited no single-dose (10 g/kg) acute oral toxicity. And 28-day repeated dose treatment with Rg2 (1.75, 3.5 and 5 g/kg/d) demonstrated minimal, if any, subchronic toxicity. Serum biochemical examination showed that total cholesterol in the high-dose cohort was dramatically decreased, whereas prothrombin time was increased at Day 28, suggesting that Rg2 might regulate lipid metabolism and have a potential anticoagulant effect. Moreover, pretreatment with Rg2 showed antiarrhythmic effects on the rat model of calcium chloride induced arrhythmia, in terms of the reduced duration time, mortality, and incidence of malignant arrhythmias. The antiarrhythmic mechanism of Rg2 might be the inhibition of calcium influx through L-type calcium channels by suppressing the phosphorylation of Ca2+/calmodulin-dependent protein kinase II. Conclusion: Our findings support the development of Rg2 as a promising antiarrhythmic drug with fewer side effects for clinical use.

한국삼, 중국삼, 서양삼이 고혈압 환자의 혈압에 미치는 영향 (The Effect of korean, Chinese and American Ginseng on Blood Pressure of Hypertensive Patients)

  • 이차로;이상호;이준우;나병조;김태훈;정우상;문상관;조기호;배형섭;김영석
    • 대한한의학회지
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    • 제26권3호
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    • pp.228-238
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    • 2005
  • Objectives : We conducted a randomized, double-blinded clinical trial to assess the anti-hypertensive effect of Ginseng and to know the difference of the effect according to it's growing districts md species by 24-hour ambulatory blood pressure measurement (ABPM). Methods : We allocated 96 hypertensive patients enrolled in this trial to Korean ginseng(KG), American ginseng (AG), Chinese ginseng (CG), and Korean red ginseng (KRG) groups by randomization. Each subject was administered 4.5mg/day of encapsulated ginseng for 4 weeks. We assessed anti-hypertensive effect, blood pressure variability using ABPM and toxicity by blood chemistry before and after treatment. We also evaluated changes of symptoms due to hypertension and adverse effect in all groups at the first visit, 2 weeks later and 4 weeks later. Results : Blood pressure after treatments showed significant decrease of systolic blood pressure (sBP) in the CG-group (p<0,05) and diastolic blood pressure (dBP) in the KRG-group (p<0.05). However, there were no significant changes of sBP (or dBP) after treatment in the other groups and no significant difference in changes of BP between before and after treatment among the 4 groups. Blood pressure variability in the CG-group showed significant decrease after treatment but not in the KRG-group. Symptoms such as headache or neck stiffness and heating sensation due to hypertension improved significantly in all groups, especially in the KRG-group. A3l patients had no adverse effect after treatment and there was no liver or kidney toxicity. Conclusions : CG and KRG seem to have anti-hypertensive effects, but there was no significantly different effect depending on growing district and species of Ginseng.

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심혈관질환약물과 향정신성약물의 약물상호작용 (Drug Interactions between Cardiovascular Agents and Psychotropic Drugs)

  • 박주언;정경희
    • 정신신체의학
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    • 제19권2호
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    • pp.57-65
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    • 2011
  • 많은 심혈관질환약물과 향정신성약물 간에 다양한 약물상호작용이 존재하며 이러한 약물들의 대부분이 시트크롬(cytochrome, CYP)450 효소의 기질, 억제제, 유도제로 작용하면서 약물상호작용이 일어나게 된다. 주로 CYP2D6와 CYP3A4를 억제하는 향정신성약물로 인해 같이 투여되는 심혈관질환약물의 효과가 변할 수 있고 부작용까지 나타날 수 있다. 이런 상황을 고려하고 반대의 경우도 포함하여 흔히 처방되는 두 종류의 약물을 병용 투여하는 경우 고려해야 할 부분에 대해서 심혈관질환약물 분류에 따라 논하였다. 대부분의 베타차단제는 CYP2D6의 대사에 의존하므로 이 대사를 억제하는 bupropion, chlorpromazine, haloperidol, SSRIs, quinidine 등을 사용했을 때 베타차단제의 독성이 나타날 수 있다. 앤지오텐신 관련 약물과 이뇨제가 lithium의 농도를 변화시키는 점도 고려하여야 한다. 칼슘통로차단제 및 콜레스테롤강하제를 CYP3A4의 강력한 억제제인 amiodarone, diltiazem, fluvoxamine, nefazodone, verapamil 등과 함께 사용하였을 때 약물 상호작용에 따른 부작용에 유의하여야 한다. 항부정맥제를 복용하는 환자에서 QT 간격 증가를 야기하는 약물이나 관련 CYP450 효소를 억제하는 약물을 동시에 투여하는 것은 삼가거나 적극적인 관찰이 필요하다. Digoxin과 warfarin이 병용 투여되는 향정신성약물로 인해 혈중 농도가 변하는 것도 임상적으로 중요하다.

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당귀(Angelica sinensis)의 임상활용에 대한 효능 및 부작용연구 (Pharmacological action and Toxicity of Angelica sinensis)

  • 박영철;이지선;김민희;김동윤;이선동
    • 대한한의학방제학회지
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    • 제19권2호
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    • pp.93-108
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    • 2011
  • Objectives : Angelica sinensis has been used extensively in Korean traditional medicine. Although thorough clinical trials are lacking, Various pharmacological actions for Angelica sinensis has been identified newly using animal models. In addition, it was reported that reactive intermediates, potentially causing toxic effects, was isolated from components in Angelica sinensis. In this article, it was purposed for explanation and introduction of new studies for Angelica sinensis. in terms of Pharmacological action and Toxicity. Methods : New studies for Angelica sinensis were reviewed and summarized in terms of pharmacological action and toxicity. Results and Conclusions : Angelica sinensis and its components including phthalide, phthalide dimers, polysaccharides, polyacetylenes, ligustilide와 butylidenephthalide as well as organic acid showed a variety of pharmacological actions on uterine, cardiovascular system and immune system. In addition, it was identified that three components of such as ligustilide, caffeic acid and safrole was biotransformed to reactive intermediates causing possibly toxicity.

NADPH Oxidase and the Cardiovascular Toxicity Associated with Smoking

  • Kim, Mikyung;Han, Chang-Ho;Lee, Moo-Yeol
    • Toxicological Research
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    • 제30권3호
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    • pp.149-157
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    • 2014
  • Smoking is one of the most serious but preventable causes of cardiovascular disease (CVD). Key aspects of pathological process associated with smoking include endothelial dysfunction, a prothrombotic state, inflammation, altered lipid metabolism, and hypoxia. Multiple molecular events are involved in smoking-induced CVD. However, the dysregulations of reactive oxygen species (ROS) generation and metabolism mainly contribute to the development of diverse CVDs, and NADPH oxidase (NOX) has been established as a source of ROS responsible for the pathogenesis of CVD. NOX activation and resultant ROS production by cigarette smoke (CS) treatment have been widely observed in isolated blood vessels and cultured vascular cells, including endothelial and smooth muscle cells. NOX-mediated oxidative stress has also been demonstrated in animal studies. Of the various NOX isoforms, NOX2 has been reported to mediate ROS generation by CS, but other isoforms were not tested thoroughly. Of the many CS constituents, nicotine, methyl vinyl ketone, and ${\alpha}$,${\beta}$-unsaturated aldehydes, such as, acrolein and crotonaldehyde, appear to be primarily responsible for NOX-mediated cytotoxicity, but additional validation will be needed. Human epidemiological studies have reported relationships between polymorphisms in the CYBA gene encoding p22phox, a catalytic subunit of NOX and susceptibility to smoking-related CVDs. In particular, G allele carriers of A640G and $-930^{A/G}$ polymorphisms were found to be vulnerable to smoking-induced cardiovascular toxicity, but results for C242T studies are conflicting. On the whole, evidence implicates the etiological role of NOX in smoking-induced CVD, but the clinical relevance of NOX activation by smoking and its contribution to CVD require further validation in human studies. A detailed understanding of the role of NOX would be helpful to assess the risk of smoking to human health, to define high-risk subgroups, and to develop strategies to prevent or treat smoking-induced CVD.

Review of cases of patient risk associated with ginseng abuse and misuse

  • Paik, Doo Jin;Lee, Chang Ho
    • Journal of Ginseng Research
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    • 제39권2호
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    • pp.89-93
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    • 2015
  • Ginseng has long been used as a functional food or therapeutic supplement and it is empirically known to be safe and nontoxic. During recent decades, a number of in vitro and in vivo experiments, as well as human studies have been conducted to prove the safety of various types of ginseng samples and their components. Clinical trials, case reports, and in vitro and in vivo research articles addressing the safety, toxicity, and other adverse events of ginseng application were selected and reviewed. Patient risks associated with ginseng abuse and misuse such as affective disorder, allergy, cardiovascular and renal toxicity, genital organ bleeding, gynecomastia, hepatotoxicity, hypertension, reproductive toxicity, and anticoagulant-ginseng interaction were reviewed and summarized. There are some cases of patient risk associated with ginseng abuse and misuse depending on patients' conditions although further investigation in more cases is required to clarify these issues.

Use of Antioxidants to Prevent Cyclosporine A Toxicity

  • Lee, Jin-Hwa
    • Toxicological Research
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    • 제26권3호
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    • pp.163-170
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    • 2010
  • Cyclosporine A (CsA) is a potent immunosuppressor that is widely used in transplant surgery and the treatment of several autoimmune diseases. However, major side effects of CsA such as nephrotoxicity, hepatotoxicity, neurotoxicity and cardiovascular diseases have substantially limited its usage. Although molecular mechanisms underlying these adverse effects are not clearly understood, there is some evidence that suggests involvement of reactive oxygen species (ROS). In parallel, protective effects of various antioxidants have been demonstrated by many research groups. Extensive studies of CsA-induced nephrotoxcity have confirmed that the antioxidants can restore the damaged function and structure of kidney. Subsequently, there have appeared numerous reports to demonstrate the positive antioxidant effects on liver and other organ damages by CsA. It may be timely to review the ideas to envisage the relationship between ROS and the CsA-induced toxicity. This review is comprised of a brief description of the immunosuppressive action and the secondary effects of CsA, and a synopsis of reports regarding the antioxidant treatments against the ROS-linked CsA toxicity. A plethora of recent reports suggest that antioxidants can help reduce many CsA's adverse effects and therefore might help develop more effective CsA treatment regimens.