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Chronic Obstructive Pulmonary Disease with Severe Pulmonary Hypertension - A Case Report - (중증 폐동맥고혈압이 동반된 만성폐쇄성폐질환 1 예)

  • Park, Chan-Soh;Chin, Hyun-Jung;Kim, Seok-Min;Son, Chang-Woo;Yu, Sung-Ken;Chung, Jin-Hong;Lee, Kwan-Ho
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.50-57
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    • 2008
  • Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.

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Efficacy of subcutaneous granulocyte colony-stimulating factor infusion for treating thin endometrium

  • Banerjee, Kaberi;Singla, Bhavana;Verma, Priyanka
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.1
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    • pp.70-73
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    • 2022
  • Objective: This study was conducted to assess the efficacy of subcutaneous granulocyte colony-stimulating factor (G-CSF) for treating thin endometrium. Methods: Data from 88 infertile women with thin endometrium (<7 mm) aged 23 to 40 years were evaluated retrospectively over a period of 1 year. In group 1, subcutaneous infusion of G-CSF (300 ㎍/mL) was administered to 44 women along with other supplemental treatments. If the lining did not exceed 7 mm within 72 hours, a second infusion was administered. In group 2, which also had 44 women, only estradiol valerate and sildenafil were administered, while subcutaneous G-CSF infusion was not. Embryo transfers were performed once the lining exceeded 7.5 mm. The efficacy of G-CSF was evaluated by assessing the thickness of the endometrium before embryo transfer, pregnancy rates, and clinical pregnancy rates. Results: There were no differences between the groups regarding demographic variables, egg reserves, sperm parameters, the number of embryos transferred, and embryo quality. The pregnancy rate was significantly higher in group 1 (60%, 24 of 40 cases) than in group 2 (31%, 9 of 29 cases) (p<0.001). The clinical pregnancy rate was also significantly higher in group 1 (55%) than in group 2 (24%) (p<0.001). Conclusion: Subcutaneous G-CSF infusion improved the thickness of the endometrium when it was thin. To the best of our knowledge, this is the first documented study to clearly demonstrate the benefits of subcutaneous G-CSF infusion for treating thin endometrium.

Patent Foramen Ovale Complicated with Chronic Mitral Valvular Insufficiency in A Mixed Dog (잡종 개에서 이첨판 폐쇄 부전증이 합병된 난원공 개존증)

  • Lee, Dong-Guk;Han, Suk-Hee;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.468-472
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    • 2013
  • A 12-year-old intact female mixed dog (weighing 6.2 kg) was referred with primary complaints of severe abdominal distension, persistent coughing and exercise intolerance. Diagnostic studies found ascites, jugular distension, loud left and right apical systolic (grade 4/6) murmur, generalized cardiomegaly with caudal vena cava distension and left atrial dilation. Echocardiographic findings were consistent with degenerative mitral and tricuspid valve endocardiosis and bi-ventricular congestive heart failure. There was also a left to right shunting patent foramen ovale. The LV systolic function is depressed relative to the degree of volume overload. Based on diagnostic findings, this case was diagnosed as PFO complicated with mitral and tricuspid valve endocardiosis with ISACHC IIIa heart failure. The dog was treated with furosemide (2 mg/kg, q12hr, PO), sildenafil (1 mg/kg, q8hr, PO), pimobendan (0.3 mg/kg, q12hr, PO), enalapril (0.5 mg/kg, q12hr, PO) and spironolactone (1 mg/kg, q12hr). The clinical signs were gradually improved after medical therapy.

Cor Triatriatum Dexter Complicated with Pulmonic Stenosis and Patent Foramen Ovale in A Pitbull Terrier Puppy (핏불테리어종 자견에서 폐동맥 협착과 난원공 개존증이 합병된우측 삼중심방증)

  • Choi, Ran;Lee, Dong-Guk;Choi, Hyun-Seok;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.112-116
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    • 2014
  • A 2-month-old intact male Pitbull terrier (weighing 1.01 kg) were referred with primary complaints of severe abdominal distension, exercise intolerance, retarded growth, yellow nasal discharge and anorexia. Diagnostic imaging studies found enlarged right atrium partitioned by abnormal membrane, severe pulmonic systolic jets (5.66 m/s of peak velocity) and right-to-left blood shunt at the inter-atrial septum. Based on clinical and diagnostic findings, the case was diagnosed as cor triatriatum dexter complicated with severe pulmonic stenosis and right-to-left shunted patent foramen ovale. Either surgical or interventional therapy has not been attempted, because of unstable patient's condition. Using blood transfusion, oxygen supply and cardiac medications (i.e., sildenafil, spironolactone, enalapril), the dog was recovered.

Balloon dilation of double chambered right ventricle in a dog (우심실 양분증 이환견에 대한 풍선확장술 시술 증례)

  • Kim, Jin-Wook;Yoon, Byung-Gook;Park, Jun-Seok;Kim, Jung-Kuk;Lee, Ki-Ho;Park, Hyung-Jin;Hur, Chan;Seo, Kyoung-Won;Song, Kun-Ho
    • Korean Journal of Veterinary Service
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    • v.40 no.1
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    • pp.67-70
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    • 2017
  • A 4 months old, intact male Shih-tzu was referred to the Veterinary Medical Teaching Hospital of Chungnam National University for evaluation of the cause of cardiac murmur and syncope. Thoracic radiography revealed right-sided cardiomegaly. Echocardiography showed marked hypertrophy of right ventricular free wall and obstruction of right ventricular outflow tract, indicating double chambered right ventricle (DCRV). The dog was medicated with atenolol and sildenafil for DCRV, however, clinical signs did not control by medication. Balloon dilation for DCRV was performed to ameliorate patient's clinical signs. The peak systolic pressure gradient across the obstruction region was decreased and clinical signs was improved by balloon dilation procedure. This is the first case report of balloon dilation for the treatment of canine DCRV in South Korea.

Quercetin Relaxed the Smooth Muscle of Rabbit Penile Corpus Cavernosum by Activating the NO-cGMP Signaling Pathway

  • Choi, Bo Ram;Kim, Hye Kyung;Park, Jong Kwan
    • Natural Product Sciences
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    • v.23 no.3
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    • pp.169-174
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    • 2017
  • The aim of this study was to investigate the effect and action mechanism of quercetin on penile corpus cavernosum smooth muscle (PCCSM). PCCSM precontracted with phenylephrine (Phe) was treated with four different concentrations of quercetin ($10^{-7}$, $10^{-6}$, $10^{-5}$ and $10^{-4}M$). PCCSM were preincubated with N-Nitro-L-arginine methyl ester hydrochloride (L-NAME) and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ) to block nitric oxide synthase and guanylate cyclase, respectively. The changes in PCCSM tension were recorded, and cyclic nucleotides in the perfusate were measured by radioimmunoassay. The interactions of quercetin with phosphodiesterase type 5 inhibitors (PDE5-Is) such as sildenafil, udenafil and mirodenafil, were also evaluated. PCCSM relaxation induced by quercetin occurred in a concentrationdependent manner. The application of quercetin to PCCSM pre-treated with L-NAME and ODQ significantly inhibited the relaxation. Quercetin significantly increased cGMP in the perfusate. Furthermore, quercetin enhanced PDE5-Is-induced relaxation of PCCSM. Quercetin relaxed the PCCSM by activating the NO-cGMP signaling pathway, and it may be a therapeutic candidate or an alternative treatment for patients with erectile dysfunction who do not completely respond to PDE5-Is.

Management of Pulmonary Hypertension Due to Brachycephalic Obstructive Airway Syndrome in a Dog

  • Song, Yunji;Kim, Yeji;Kim, Jihyun;Kim, Kwon-Neung;Oh, Songju;Kim, Ha-Jung
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.240-245
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    • 2022
  • A 15-year-old, neutered male, Shih-Tzu, was presented at the Chonnam National Veterinary Medical Teaching Hospital for evaluation of acute onset of persistent coughing, exercise intolerance, and abnormal heart sound. On thoracic auscultation, a split-second heart sound and a wheezing sound were detected on both sides of the chest walls. On physical examination, the dog's body condition score (BCS) was 7/9, and had stenotic nares. Thoracic radiographs revealed right-sided enlargement of the cardiac silhouette (vertebral heart score (VHS) 11.2; reference interval = 8.9-10.1), mild main pulmonary artery (MPA) bulging, mild interstitial infiltration, and hepatomegaly. The electrocardiogram showed right axis deviation, suggesting right ventricular hypertrophy. The echocardiographic study showed moderate pulmonary hypertension and moderate tricuspid regurgitation. There were no findings of a tracheobronchial disease, pulmonary thromboembolism, congenital shunt, left heart disease, or parasitic disease. Based on clinical signs and diagnostic findings, the dog was diagnosed with pulmonary hypertension secondary to brachycephalic syndrome. To rectify respiratory exacerbating factors, the dog was recommended weight control by restricting dietary intake and managing concurrent Cushing's syndrome. Treatments included sildenafil, pimobendan, furosemide, and ramipril. After five months of taking medications and weight control, the severity of pulmonary hypertension improved from moderate to mild. The clinical signs of the patient, including coughing and exercise intolerance, improved a lot. For 5 months of follow-up, the patient has not reported further recurrence of respiratory distress.

Simultaneous Determination of 80 Unapproved Compounds using HPLC and LC-MS/MS in Dietary Supplements

  • Kwon, Jeongeun;Shin, Dasom;Kang, Hui-Seung;Suh, Junghyuck;Lee, Gunyoung;Lee, Eunju
    • Mass Spectrometry Letters
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    • v.13 no.3
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    • pp.58-83
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    • 2022
  • We developed analytical methods using high performance chromatography (HPLC) and liquid chromatography tandem mass spectrometry (LC-MS/MS) for the simultaneous determination of 80 unapproved compounds in dietary supplements. The target compounds for analysis were unapproved ingredients (e.g., pharmaceuticals) that have potential adverse effects on consumers owing to accidental misuse, overuse, and interaction with other medication in dietary supplement. Two analytical methods were tested to identify the optimal validation results according to AOAC guideline. As a result, limit of quantification (LOQ) was 0.14-0.5 ㎍ mL-1; linearity (r2) was ≥ 0.99; accuracy (expressed as recovery) was 78.9-114%; precision (relative standard deviation) was ≤ 4.28% in the HPLC method. In the LC-MS/MS method, LOQ was 0.01-2 ng mL-1, linearity (r2) was ≥0.98, accuracy was 71.7-119%; precision was ≤ 12.5%. The developed methods were applied to 51 dietary supplements collected from 2019 to 2021 through MFDS alert system. Based on our previous monitoring study, major compounds were icariin, sibutramine, yohimbine, sildenafil, tadalafil, sennosides (A, B), cascarosides (A, B, C, D), and phenolphthalein. In this study, we re-analyzed samples of detected compounds, and evaluated the statistical difference using Bland-Altman analysis to compare two analytical approaches between HPLC and LC-MS/MS. These results showed a good agreement between two methods that can be used to monitor the unapproved ingredients in dietary supplements. The developed two methods are complementarily suitable for monitoring the adulteration of 80 unapproved compounds in dietary supplements.

Proficiency test for analyzing illegal compounds in food (식품 중 부정유해물질의 분석 능력평가)

  • Chang, Moonik;Yoon, Taehyung;Hong, Mooki;Choi, Dongmi
    • Analytical Science and Technology
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    • v.20 no.1
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    • pp.78-83
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    • 2007
  • To perform proficiency test for determining anti-impotence drug-like compounds in food, interlaboratory test has been done. Targets were 6 such as sildenafil, tadalafil, vardenafil, homosildenafil, hydroxy-homosildenafil and pseudo-vardenafilI. Total 13 institutes were participated and all is in charging of food analysis. To do double blind test, the reference materials were made as 13 different ginseng drink samples and each sample had random 3 targets. By the official method for anti-impotence drug-like compounds in food code, sample was just diluted in water, extracted in organic solvents, determined by HPLC/UV and then confirmed by LC/MS. The analytical duration was 60 days after receiving sample. Ten out of 13 institutes were satisfied by evaluation of Z-score and RSZ according to the regulation for managing analytical quality assurance.

Structure elucidation and determination of illegal compounds (Anti-impotance drug analogues) in foods (식품 중 부정유해물질 (발기부전치료제 유사물질) 구조규명 및 분석)

  • Choi, Dongmi
    • Analytical Science and Technology
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    • v.21 no.2
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    • pp.65-83
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    • 2008
  • It is noted that illegal hazardous foods containing unauthorized drugs or synthetic drung analogues are increasing. Especially, reported are unknown compounds that have the modified chemical structures of the anti-impotence drugs such as sildenafil, vardenafil, and tatalafil. In addition, it is very reserved, since illegal synthetic compounds having similar chemical structures modified from anti-impotence drug to avoid the government inspection are not proved their safety at all. This review in ulation to food safety, lists the illegal compounds added to foods and describes about the analytical methods to chanacterize 16 anti-impotence drug analogues such as homosildenafil, hongdenafil, pseudovardenafil, aminotadalafil, hydroxyhomosildenafil, hydroxyhongdenafil, dimethylsildenafil, xanthoanthrafil, hydroxyvardenafil, norneosildenafil, demethylhongdenafil, piperidinohongdenafil, carbodenafil, thiosildenafil, dimethylthiosildenafil, and acetylvardenafil.