• Archives of Plastic Surgery
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• v.40 no.3
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• pp.251-255
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• 2013

We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.

• Korean Journal of Veterinary Research
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• v.31 no.3
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• pp.253-258
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• 1991

The aims of this study were to investigate the effect of adenosine triphosphate (ATP), which has been known as the neurotransmitter of nonadrenergic, noncholinergic nerves, and the source of $Ca^{\sharp}$ in the effect of ATP on the isolated renal artery of pig. The results of this study were summarized as follows: 1. ATP caused the contraction and the contractile responses were increased in a dose-dependent manner between the concentration of ATP $2{\times}10^{-3}M$ and $10^{-2}M$ on the isolated renal artery of pig. 2. The contractile responses induced by ATP $(5{\times}10^{-3}M)$ were not blocked by pretreatment with cholinergic receptor blocker (atropine, $10^{-6}M$), $\alpha$-adrenergic recptor blocker(phentolamine, $10^{-6}M$) or $\beta$-adrenergic receptor blocker (propranolol, $10^{-6}M$), and $H_1$-receptor blocker (pyrilamine, $10^{-6}M$) or $H_2$-receptor blocker (cimetidine, $10^{-6}M$) on the isolated renal artery of pig. 3. The contractile responses induced by ATP $(5{\times}10^{-3}M)$ were not appeared in $Ca^{\sharp}$-free medium. As the concentration of $Ca^{\sharp}$ in $Ca^{\sharp}$-free medium was increased, the contractile responses induced by ATP $(5{\times}10^{-3}M)$ were enhanced but were completely inhibited by pretreatment with $Ca^{\sharp}$-channel blocker, papaverine $(5{\times}10^{-5}M)$ or verapamil $(5{\times}10^{-5}M)$ on the isolated renal artery of pig.

• Journal of Ginseng Research
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• v.20 no.3
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• pp.339-343
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• 1996

The effect of ginseng on the reactivity of penile corpus cavernosal smooth muscle strips of rabbits was investigated to support the clinical application of ginseng for the treatment of erectile dysfunction. New Zealand white rabbits were randomly divided into two groups, normal diet group (n=9) and ginseng saponin diet group (n=5). Then, each group was fed normal diet and Korean red ginseng saponin diet (50 mg/kg/day) for 10 weeks. We measured concentration dependent relaxation of corporal smooth muscle to acetylcholine (10-8 M to 10-4M) in organ chamber. The degree of relaxation was expressed as percentage of maximal relaxation obtained by papaverine (10-4M). Dose dependent relaxation of corpus cavernosal smooth muscle to acetylcholine, at the concentration of 10-8 M to 10-4M by half log increment, was 4.06$\pm$0.00, 4.30$\pm$1.30, 5.32$\pm$0.68, 11.64$\pm$1.74, 16.24$\pm$1.61, 23.33$\pm$ 2.29, 26.45$\pm$2.25, 30.43$\pm$2.40 and 33.41 $\pm$2.48 (%), respectively in normal diet group and 9. 83$\pm$4.15, 20.60$\pm$4.62, 24.1815.12, 35.75$\pm$5.71, 43.35$\pm$6.11, 51.30$\pm$6.22, 56.33$\pm$6.22, 54.30$\pm$4.17 and 51.98$\pm$3.92 (Vc), respectively in ginseng group. These data suggest that ginseng enhances ondothelium-dependent acetylcholine-induced relaxation of penile corpus cal.ernosal smooth muscle in rabbits.

• Journal of Pharmacopuncture
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• v.12 no.2
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• pp.67-75
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• 2009

Objectives : This study was performed to developing orally administered analgesics and locally injected pharmacopuncture analgesics like opioids. Methods : Literary investigation on the origin of poppy (Papaver somniferum L) and other narcotics was conducted to examine the potential of developing orally administered analgesics and locally injected pharmacopuncture analgesics. Opium is a gum-like mass derived from air-dried white fluid of immature fruit of the poppy. Opium contains approximately 20 types of alkaloids including morphine, codeine, thebaine, papaverine and others. Natural opioids and synthetic alkaloid derivatives are the constituents of opioid analgesics and their effects and side-effects depend on the peculiarities of receptors. An extreme caution is required in the selection of proper dosage, proper analgesic types, and indications for successful pain management. Results and Discussion : With the enactment of "Narcotic control protocol", herbs such as cannibis and poppy are no longer available for use by Korean medicine doctors, and these doctors are faced with difficulty in managing severe pain in the clinical environment. A systematic consideration is inevitable for overcoming the limitation on these analgesics.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.671-677
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• 1995

Skeletonization of the internal mammary artery [IMA during myocardial revascularization procedures may provide some advantages, compared with the pedicle graft of the artery. In 17 patients undergoing IMA grafting by skeletonization technique, flow through the artery was measured on mean arterial pressure of 50-55 mmHg immediately after cardiopulmonary bypass started [first flow and just before its anastomosis to left anterior descending artery [second flow . In 16 patients except 1 patient whose graft was injured during mobilization, the first flow of IMA graft was 32.3 $\pm$ 7.4 ml/min and the second flow increased to 59.6$\pm$25.9 ml/min without any treatment and the site for anastomosis of the IMA graft was more than 1.0 cm above the bifurcation. On the basis of previous clinical studies, the flow of the skeletonized IMA was greater than that of the pedicle graft [59.6 $\pm$ 25.9 ml/min versus 37.7$\pm$ 14.1 ml/min, p < 0.05 . In comparison between the skeletonized IMA and the IMA graft intraluminally dilated with papaverine solution, there was no significant difference between two flows[59.6 $\pm$25.7 ml/min versus 74.7 $\pm$31.4 ml/min, not significant , but the former showed longer graft and anastomosis of more proximal portion of the graft to left anterior descending artery. In conclusion, the technique of internal mammary artery skeletonization has consistently produced a satifactory conduit for myocardial revascularization procedures. We have adopted IMA skeletonization not only because of the flow, diameter, and vessel length obtained but also because of limited perivascular tissue disruption that occurs during the dissection.

• Biomolecules & Therapeutics
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• v.27 no.1
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• pp.101-106
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• 2019

Most diabetic patients experience diabetic mellitus (DM) urinary bladder dysfunction. A number of studies evaluate bladder smooth muscle contraction in DM. In this study, we evaluated the change of bladder smooth muscle contraction between normal rats and DM rats. Furthermore, we used pharmacological inhibitors to determine the differences in the signaling pathways between normal and DM rats. Rats in the DM group received an intraperitoneal injection of 65 mg/kg streptozotocin and measured blood glucose level after 14 days to confirm DM. Bladder smooth muscle contraction was induced using acetylcholine (ACh, $10^{-4}M$). The materials such as, atropine (a muscarinic receptor antagonist), U73122 (a phospholipase C inhibitor), DPCPX (an adenosine $A_1$ receptor antagonist), udenafil (a PDE5 inhibitor), prazosin (an ${\alpha}_1$-receptor antagonist), papaverine (a smooth muscle relaxant), verapamil (a calcium channel blocker), and chelerythrine (a protein kinase C inhibitor) were pre-treated in bladder smooth muscle. We found that the DM rats had lower bladder smooth muscle contractility than normal rats. When prazosin, udenafil, verapamil, and U73122 were pre-treated, there were significant differences between normal and DM rats. Taken together, it was concluded that the change of intracellular $Ca^{2+}$ release mediated by PLC/IP3 and PDE5 activity were responsible for decreased bladder smooth muscle contractility in DM rats.

• The Korean Journal of Pharmacology
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• v.11 no.1 s.17
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• pp.33-38
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• 1975

The clinical efficacy of Ethaverine, a peripheral vasodilator, was studied according to a double-blind, non-cross over method in 29 diabetic patients with peripheral arterial diseases. The clinical improvement was assessed from the history of patients including the incidence and frequency of intermitten claudication. Ethaverine, after 4 weeks of therapy, was not effective in improving clinical symptoms compared to placebo. Ethaverine, however, was an efective vasodilator than placebo. The quality of vasodilation induced by Ethaverine, was similar to that of alcohol. A new clinical method of studying peripheral vasodilator was presented. The clinical symptoms of peripheral vascular arterial disease in the lower extrimities include reduced intensity of palpable pulses, coldness, and discoloration of the skin. Intermittent claudication may be present. Pathologic changes in vessel architecture precede the symptoms, and recognition of impending vascular insufficiency is a determining factor in selecting vasodilating therapy or surgical management. Also, post-operative patients who have chronic peripheral vascular arterial disease may be candidates for subsequent vasodilating therapy. Peripheral vasodilators, according to the series of reports, may be indicated in vasospastic peripheral vascular condition rather than an occlusive vascular disease and the vessel responds best when a relatively large vascular beds are involved rather than a small, capillary beds. Recently, the clinical efficacy of peripheral vasodilators have been challanged by many clinical investigators and clinicians. In this study, we have re-evaluated the efficacy of Ethaverine HCl as peripheral vasodilator in patients with vasospastic peripheral arterial disease. Ethaverine is claimed to be two to four times as potent a spasmolytic agent as papaverine in a variety of laboratory and clinical work.