• 제목/요약/키워드: systemic hypertension

검색결과 145건 처리시간 2.132초

Pulmonary Hypertensive Crises After Surgery for Congenital Heart Defects in Children (소아 선천성 개심수술후의 폐동맥 고혈압 발작증)

  • 서필원
    • Journal of Chest Surgery
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    • 제22권6호
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    • pp.944-950
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    • 1989
  • Children with congenital cardiac defects associated with high pulmonary artery pressure may die despite accurate surgery. Postoperative mortality and morbidity have been attributed to acute rises in pulmonary artery pressure and resistance. Acute pulmonary hypertensive crisis is defined as a paroxysmal event in which pulmonary arterial systolic pressure rises to or above systemic levels followed by a rapid fall in systemic pressure and a minor pulmonary hypertensive event is defined as an acute rise in pulmonary arterial pressure to more than 80 % of systemic levels but without a fall in systemic pressure. From Oct. 1988 to Jul. 1989, we experienced 23 patients who showed many pulmonary hypertensive crises after operation in the Department of Thoracic and Cardiovascular Surgery, Seoul National University Children\ulcorner Hospital. Their preoperative PAP/SAPs were 53 to 123 %[mean 93.3%] and diagnoses were VSD[7], TAPVR[5], TGA[4], AVSD[3], MS[1], DORV[1], Truncus arteriosus[1], and AP window[l]. There were 9 deaths among 23 patients and they showed many pulmonary hypertensive crisis episodes during postoperative intensive care, which was managed by sedation, hyperventilation, oxygen, and acidosis correction and which decreased after using tolazoline. In view of our experience, we recommend that pulmonary artery pressure should be monitored in congenital heart defected patient with preoperative pulmonary hypertension to confirm and to manage the pulmonary hypertensive crisis accurately and using tolazoline is helpful in the treatment of pulmonary hypertensive crisis.

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A Sphaghetti Sign in the Abdominal Radiograph Consistent with Spleno-Systemic Shunts in a Cat

  • Oh, Donghyun;Hwang, Jaewoo;Yoon, Junghee;Choi, Mincheol
    • Journal of Veterinary Clinics
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    • 제37권4호
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    • pp.227-230
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    • 2020
  • A 8-year-old spayed female Korean short-haired cat was presented with respiratory distress. CBC, serum chemistry analysis, plain radiography, and abdominal ultrasonography were performed. Besides hypertrophic cardiomyopathy (HCM) suspected by the thoracic radiograph, a tubular, tortuous soft tissue structure was detected at the region of the left retroperitoneal cavity on the abdominal radiograph. On the abdominal ultrasonography, a shunt vessel is identified caudo-lateral to the left kidney region. These findings are consistent with spleno-systemic shunts in cats. Furthermore, portal hypertension and diffuse hepatic lesion were also identified. Although the cause of a shunt vessel is not easy to diagnose, it is important to include spleno-systemic shunt into differential diagnosis list, when convoluted, tubular soft tissue opacity is seen on the digital radiography (DR). This report will allow clinicians to raise awareness of complications of portosystemic shunt (PSS) and better treat PSS suspected feline patients when the advanced modalities such as computed tomography and magnetic resonance imaging are not available.

Korean Herbal Medicine on Hypertension : A Systematic Review in Korean Internal Medicine's Studies (한약 복용이 고혈압에 미치는 영향: 내과학회 학회지 논문에 대한 고찰)

  • Baek, Hye-Ki;An, Jung-Jo;Jo, Hyun-Kyung;Yoo, Ho-Ryong;Kim, Yoon-Sik;Seol, In-Chan
    • Journal of Haehwa Medicine
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    • 제18권2호
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    • pp.81-88
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    • 2009
  • Background : Almost people know hypertension's treatment is taking western medicine. But korean herbal medicine(KHM) also have an effect of turning down blood pressure. Objectives : This study aims to review the influence of KHM on hypertension in korean internal medicine's studies systematically. Additionally, we tried to estimate the change of data of hypertension and let people know a possibility of herbal treatment on hypertension. Methods : Systematic studies searches were performed on one database of korean internal medicine to November 2009. Screening and selection of the studies and extraction of data were performed by one author. Results : Twelve studies were included. All studies were performed retrospectively. Almost studies's object were hypertensive rats. Two studies's object were rabbits and only one study's object was hopitalized patients. Blood pressure and pulse was changed significantly after taking KHM in almost studies, and rest of items, aldosterone, catecholamine, electro, angiotensin converting enzyme inhibitory effect, renin activity were changed significantly after taking KHM. Conclusions : KHM might have an effect of lowering blood pressure, but almost studies's object were animals, so it is necessary to investigate an effect of KHM for people.

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Attenuation of pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum in laparoscopic cholecystectomy (복강경 담낭절제술 시 공기배증 전에 주입한 복강 내 lidocaine의 공기배증 후 혈압상승 완화효과)

  • Song, Sun Ok;Lee, Hae Mi;Yun, Sung Soo;Yu, Hwarim;Shim, Soo Young;Kim, Heung Dae
    • Journal of Yeungnam Medical Science
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    • 제33권2호
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    • pp.90-97
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    • 2016
  • Background: We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. Methods: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. Results: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). Conclusion: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

Medical Treatment of Sleep Apnea Syndrome (수면 무호흡증후군의 내과적 치료)

  • Moon, Hwa-Sik;Choi, Young-Mee
    • Sleep Medicine and Psychophysiology
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    • 제3권2호
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    • pp.77-89
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    • 1996
  • Data collected to date indicate that sleep apnea syndrome is a risk factor in the development of cardiovascular dysfunction such as systemic hypertension, cardiac arrhythmias, pulmonary hypertension, right heart failure, angina, myocardial infarction, and stroke. Several reports suggest that untreated patients with sleep apnea syndrome have a higher long-term mortality than treated patients and than normal subjects. But there are many controversies concerning the treatment of sleep apnea syndrome, and there is no universally accepted standard for effective treatment. We reviewed the current approaches and options in the medical treatment of sleep apnea syndrome.

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Malignant Anterior Uveal Melanoma Masquerading as Limbal Melanoma in a Shih-Tzu Dog with Recurrences of Hyphema

  • Susanti, Lina;Seo, Kangmoon;Kang, Seonmi
    • Journal of Veterinary Clinics
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    • 제37권5호
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    • pp.282-285
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    • 2020
  • A 14-year-old neutered-male Shih-Tzu was referred for glaucoma and hyphema accompanied by systemic hypertension. After topical corticosteroid and antiglaucoma medications, the left eye (OS) progressed phthisically, but ocular hypertension redevelop one-year-and-seven-months later. Suspected limbal melanoma developed in peripheral cornea/limbal sclera with heavily pigmented cornea OS. Ultrasound biomicroscopy and ocular ultrasonography differentiated ciliary body origin-heterogeneous mass from limbal mass. Persistent hyphema and pigmented cornea might obscure intraocular lesion and advanced diagnostic methods played a crucial role. Unlike the generally benign limbal melanoma, aggressive treatment was recommended for uveal tumor. Histopathology of enucleated OS confirmed malignant uveal melanoma with chronic hypertensive vasculopathy.

Radiography and ct features of atherosclerosis in two miniature schnauzer dogs

  • Lee, Eunji;Kim, Hyun Woo;Bae, Hyeona;Yu, DoHyeon;Choi, Jihye
    • Journal of Veterinary Science
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    • 제21권6호
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    • pp.89.1-89.6
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    • 2020
  • Two miniature Schnauzer dogs with chronic pancreatitis were investigated. Both dogs showed systemic hypertension and increased concentrations of triglycerides and C-reactive protein. Abdominal radiography revealed cylindrical calcification in the retroperitoneum, and computed tomography (CT) showed extensive calcification of the abdominal and peripheral arteries in both dogs. Metastases and other dystrophic conditions that can cause arterial calcification were excluded based on the laboratory tests, and the dogs were diagnosed with atherosclerosis ante mortem. Atherosclerosis should be considered when extensive arterial calcification is observed on abdominal radiography or CT in miniature Schnauzers.

Type 4 Tetralogy of Fallot with Pulmonary Hypertension in an American Shorthair Cat

  • Hyeon-Jin Kim;Jihyun Kim;Tae Jung Kim;Ha-Jung Kim
    • Journal of Veterinary Clinics
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    • 제39권6호
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    • pp.366-372
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    • 2022
  • A 2-year-old, spayed female, American shorthair cat presented with acute weight loss, tachypnea, and dyspnea. The cat had grade V holosystolic murmur and systemic hypotension. Echocardiography showed a 9 mm defect in the ventricular septum, left-to-right dominant bi-directional shunt, right ventricular hypertrophy, pulmonary stenosis, pulmonary hypertension, and overriding aorta. The cat was diagnosed with a Tetralogy of Fallot. The cat was treated with furosemide, pimobendan, ramipril, and sildenafil. Treatment reduced pulmonary infiltration, pulmonary vessel enlargement, and main pulmonary artery bulging. However, right-to-left flow increased over time and right ventricular outflow tract velocity was elevated. Currently, the patient has maintained an improved state for 1 year. This case report described a severe inherited feline Tetralogy of Fallot case that was successfully managed for a long time.

Eisenmenger syndrome: report of 3 cases (Eisenmenger 증후군 3례 보)

  • Song, Won-Yeong;Lee, Jong-Tae;Lee, Gyu-Tae
    • Journal of Chest Surgery
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    • 제17권2호
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    • pp.250-256
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    • 1984
  • Eisenmenger syndrome is a condition which systemic arterial blood oxygen unsaturation occurs if obstruction in the pulmonary capillaries raises the pulmonary vascular resistance and pulmonary arterial pressure to or beyond systemic levels and then a significant right to left shunt develops across a preexisting cardiac septal defect or an aortopulmonary communication-We have experienced 3 cases of similar condition. Case I is 24 year old man who has had cyanosis and dyspnea on exertion since childhood. His pulmonary arterial pressure was 110/80mmHg. He was operated under diagnosis of the mitral stenosis and tetralogy of Fallot, but it was finally discovered that he had patent ductus arteriosus and ventricular defect was closed with perforated prosthetic patch, but the patient expired due to right heart failure low cardiac output. Case II was 16 year old female who had pulmonary hypertension of 110/85mmHg. She was diagnosed as Eisenmenger syndrome combining with atrial septal defect and patent ductus arteriosus. Case III was 20 year old male. His pulmonary arterial pressure was 110/70mmHg and the underlying defect was patent ductus arteriosus.

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Considerations for the Dental Management of Older Adults (임상가를 위한 특집3 - 노인 환자의 치과 치료시 고려 사항)

  • Kho, Hong-Seop
    • The Journal of the Korean dental association
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    • 제49권10호
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    • pp.609-617
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    • 2011
  • The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing, orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.