There have been some case reports of the coexitence of extraadrenal pheochromocytoma and renal artery stenosis. Some reporters proposed that their coexistence may be associated through a common pathophysiological mechanism mediated by catecholamine secretion. Also some noted that trasient renal artery stenosis due to a spasm was induced by the catecholamines released from pheochromacytoma. We report a case of left paraaortic extraadrenal pheochromacytoma that had a transient oral captopril test positive result. After 5 days alpha-antagonist reduced the vasospastic response of catecholamines. After surgical removal of the tumor, plasma catecholamines and urinary vanillymandelic acid concentrations as well as the blood pressure level, were restored to normal.
Blood Pressure ; Captopril* ; Catecholamines ; Pheochromocytoma* ; Plasma ; Renal Artery Obstruction ; Spasm

Catecholamines ; blood ; Heart Rate ; Humans ; Water Sports ; physiology

OBJECTIVETo study the relationship between pregnancy-induced hypertension (PIH) and catecholamine levels.

METHODSCatecholamines levels in maternal and fetal blood were determined in 116 patients with PIH and 40 normal control subjects using high performance liquid chromatography. The normal control subjects and PIH cases were selected from patients at term pregnancy receiving elective cesarean section.

RESULTSPlasma norepinephrine (NE) levels were significantly higher in patients with severe PIH than those in control subjects (P < 0.05). Both patients and control subjects had higher NE levels in the umbilical artery blood than in the umbilical vein blood (P < 0.05). NE levels in the umbilical artery blood were five times higher than those in the maternal blood.

CONCLUSIONThe pathogenesis of PIH may relate to catecholamine concentrations in fetus.

Catecholamines ; blood ; Female ; Fetus ; physiopathology ; Humans ; Hypertension ; blood ; Pregnancy ; Pregnancy Complications, Cardiovascular ; blood

Although the conclusion is controversial, there has long been an appealing notion that catecholamines may be involved in some way in the pathogenesis of primary hypertension and almost invariably most of hypotensive drugs involve at various sites of the neuron and produce their effect by depletion of norepinephrine in the sympathetic nerve ending. The authors undertook the comparative study on catecholamine depleting action of 3 most effective drugs available for the treatment of hypertension, reserpine, guanethidine and alpha-methyldopa, measuring the plasma catecholamine levels and urinary exceretion of caecholamine by the modified fluorometric method of Weil-Malherbe and Bone during the treatment of hypertension. The results are as follows: 1) Before the administration of hypotensive drugs, mean blood pressure was 180/110mmH, mean psalma epinephrine level was 0.36+/-0.23gamma%, mean plasma norepinephrine level was 0.48+/-0.35gamma%, 24 hours urinary excretion of epinephrine was 3.6+/-0.12gamma/day and 24 hours urinary excretion of norepinephrine was 68.9+/-0.34gamma/day. 2) In group 1 (reserpin administered group), the mean blood pressure was 190/110mmHg before the treatment and which was declined to 155/89mmHg on the last day of 4th week, in group 2 (guanethidine administered group), the mean blood pressure measured before the treatment was 185/110mmHg and which was declined to 150/85mmHg on the last day of 4th week, and in group 3 (alpha-methylodpa administered group), the mean blood measured pressure measured before the treatment was 182/110mmHg and which was declined to 153/88mmHg on the last day of 4th week. 3) After the treatment for 4 weeks with reserpin guanethidine and alpha-methyldopa, the mean plasma epinephrine levels were declined from 0.37+/-0.12gamma% to 0.11+/-0.08gamma% in group 1, from 0.38+/-0.16gamma% to 0.14+/-0.10gamma% in group 2 and from 0.33+/-0.23gamma% to 0.10+/-0.09gamma% in group 3. 4) The mean plasma norepinephrine levels were declined from 0.05+/-0.21gamma% to 0.22+/-0.12gamma% in group 1, from 0.51+/-0.25gamma% to 0.20+/-0.10gamma% in group 2 and from 0.51+/-0.21gamma% to 0.20+/-0.11gamma% in group 3 after the treatment of 4 weeks respectively. 5) Urinary exceretion of epinephine was declined from 32.3+/-0.16gamma/day to 10.4+/-0.10gamma/day in group 1, from 34.5+/-0.34gamma/day to 17.2+/-0.16gamma/day in group 2, and from 28.2+/-0.14gamma/day to 10.3+/-0.11gamma/day in group in group 3 after the treatment of 4weeks duration. 6) The mean value of 24 hours urinary excretion of norepinephrine was declined to from 72.2+/-0.35gamma/day to 28.5+/-0.14gamma/day in group1, from 69.2+/-0.34gamma/day to 22.6+/-0.21gamma/day in group 2 and from 68.6+/-0.34gamma/day to 18.2+/-0.10gamma/day in group 3 after the treatment of 4 weeks duration. 7) From the above result we can summarized as follows: Antihypertensive effect of each drugs was; guanethidine>alpha-methylodopa>reserpin in order but depressing action plasma norepinephrine levels was; alpha-methyldopa>guanethidine>reserpin and depressing effect of urinary norepinephrine excretion was; alpha-methyldopa>guanethidine>reserpin, in order.
Antihypertensive Agents* ; Blood Pressure ; Catecholamines ; Epinephrine ; Guanethidine ; Humans ; Hypertension ; Methyldopa ; Nerve Endings ; Neurons ; Norepinephrine ; Plasma* ; Reserpine

Various anesthetic agents have been recommended for pheochromocytoma surgery. However, in general, no ideal anesthetic agent has been accepted as yet. The use of the well known agents, halothane still remains a contraversial issue for pheochromocytoma surgery. According to our experience and a review of the literature, it is strongly suggested that halothane is the anesthetic agent of choice among the anesthetic agents currently available. We believe that the incidence of arrythmia from halothane is not higher than that from other anesthetic agents and arrthmia is not caused primarily by halothane, but results mostly from endogenous catecholamines during surgery. In addition to these advantages, it is a rapid induction agent accompained by a peripheral vessel dilating effect. Lidocaine also is readily available to counteract the disadvantages of the arrythmic effect of halothane. We have had two uneventful cases of pheochromocytoma surgery. One was prepared with phenoxybeaxamine preoperatively and anesthetized with halothane. The other was not prepared with phenoxybeaxamine, but was anesthetized with halothane. The patient prepared with phenoxybeaxamine had prolonged hypotension for two days postoperatively and was treated with Neo-Synephrine drip. However, the patient wihout preoperative phenoxybeaxamine had no problem with his blood pressure post operatively. As a result of this experience, we believe the preoperative use of phenoxybeaxamine is not necessary, plus it also creates more problems with postoperative hypotension. Halothane can act as a vasodilator in place of phenoxybeaxamine during anesthesia. Therefore, halothane is currently the ideal anesthetic agent of choice without phenoxybeaxamine preparation when lidocaine is available.
Anesthesia* ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Catecholamines ; Halothane* ; Humans ; Hypotension ; Incidence ; Lidocaine ; Phenylephrine ; Pheochromocytoma*

BACKGROUND: Patients experience preoperative anxiety which stimulates the release of catecholamines. They have influences on serum K+ level by shifting them into the intracellular space. The purpose of this study is to determine whether there is a correlation between anxiety and the serum potassium level immediately before induction of anesthesia. METHODS: Thirty patients were asked about their anxiety levels at 7 : 00 pm of the day before surgery and immediately before induction of anesthesia : 0; nil, 1; slight, 2; moderate, 3; marked. At those times, arterial blood was taken for checking serum K+ level and blood gas analysis. RESULTS: There was no significant correlation between anxiety level and serum potassium level. At 7 : 00 pm of the day before surgery, the anxiety levels of patients had no significant correlation with the changes of serum potassium level ("K1-K2"; K1 = serum potassium level of patient at 7 : 00 pm of the day before surgery, K2 = serum potassium level of patient immediately before induction of anesthesia). Definite correlation between the anxiety level immediately before induction of anesthesia and the changes of serum potassium level has been documented. Immediately before induction of anesthesia, 43% of patients had hypokalemia (K+ < 3.5 mEq/L). CONCLUSIONS: Anxiety level has no correlation with serum potassium level, but the anxiety level immediately before induction of anesthesia has the changes of serum potassium level. If a patient has high anxiety level immediately before induction of anesthesia, the possibility of hypokalemia is increased.
Anesthesia* ; Anxiety* ; Blood Gas Analysis ; Catecholamines ; Humans ; Hypokalemia ; Intracellular Space ; Potassium*

Hyperglycemia during either global or regional ischemia is widely known to be detrimental, and ischemia induced release of diverse neurotransmitters and the ensuing activation of specific postsynaptic receptors have been suggested to play a important role in the development of ischemic selective vulunerability. This study was undertaken to investigate the influence of blood glucose change on tissue concentration of some catecholamines ; dopamine, norepinephrine, serotonin, of the transient ischemic rat's brain, estimated by high performance liquid chromatography(HPLC) assay system, following transient bilateral forebrain ischemia in the rat's model subjected to 20 minutes of normothermic ischemia by two vesseles occulusion plus profound cortex, hippocampus and striatum respectively by HLPC. The concentrations of catecholamines were significantly decreased in all sampled areas in experimental groups compared with the control group(p<0.05), respectively(average decrease rate : norepinephrine 71%, dopamine 89%, serotonin 80% in frontal cortex ; norepinephrine 71%, dopamine 93%, serotonin 81% in hippocampus ; norepinephrine 33%, dopamine 35%, serotonin 78% in striatum). Dopamine was relatively decreased in concentration in frontal cortex and hippocampus, and serotonin was relatively decreased in striatum. But no statistic significancy(p>0.05) of catecholamines level between each experimental group(hyper-, hypo- and normoglycemic group) according to the change of blood sugar. The results suggested that blood glucose level did not influence the tissue concentration of dopamine, norepinephrine and serotonin in frontl cortex, hippocampus and striatum of transient ischemic rat's brain.
Blood Glucose* ; Brain* ; Catecholamines ; Dopamine* ; Frontal Lobe* ; Hippocampus* ; Hyperglycemia ; Ischemia ; Neurotransmitter Agents ; Norepinephrine* ; Prosencephalon ; Serotonin*

Nevus anemicus is a congenital anomaly characterized by pale macules of varying size and shape, and it is due to the increased sensitivity of blood vessels to catecholamines. However, the clinical features of nevus anemicus are not yet fully established. A clinical observation was made analyzing 26 cases of nevus anemicus over a 10-year period. Histopathological investigation in 6 cases, stain with Fontana-Masson in 4 cases, irradiation of ultraviolet B in 5 cases, digital infrared thermal imaging in 5 cases and color analysis using true-color imaging in 12 cases were also performed. The results were as follows: 1. The ratio of men to women was 1.2:1. The lesions were mostly(80%) present before the age of 18, but only 15% of the patients' lesions were present at birth. 2. The lesions were most frequently found on the face(33.3%) and neck(33.3%), followed by the chest(14.8%), lower extremities(7.4%) and back(7.4%). 3. Most patients(92.3%) had a single lesion. The extent of the lesions did not exceed 10% of the body surface area and the lesions did not show any progression or resolution. 4. The stainability of Fontana-Masson in nevus anemicus lesions showed no significant change compared with perilesional normal skin. 5. Irradiation of ultraviolet B ray(minimal erythemal dose to 80mJ/cm2) did not induce erythema on nevus anemicus lesions. 6. There was no significant temperature difference between nevus anemicus lesions and perilesional normal skin. 7. There was no significant correlation between chrominance and age. In conclusion, nevus anemicus in Korea shows the same incidence in both sexes, it usually arises at birth or childhood, but it may also develop later in life. Most patients show focal lesions that do not progress or resolve.
Blood Vessels ; Body Surface Area ; Catecholamines ; Erythema ; Female ; Humans ; Incidence ; Korea ; Male ; Nevus* ; Parturition ; Skin

The following is a report of the anesthetic experience in the surgical management of two cases of surgery for pheochromocytoma performed at Maryknoll Hospital, Busan, between the dates of June and July, 1982, The report covers the pre-surgical tests and the laboratory results on the two cases, which was similar, and the anesthetic agents halothane and enflurane, was used on the cases, respectively. During surgery using the anesthetic agent halothane, which was chosen because of the high blood pressure of the patient, and our effect to control it, we encountered dangerous arrythmia. In the case where enflurane was the anesthetic agent uaed, it was found that while the blood pressure of the patient was more difficult to control, the incidence of arrythmias was much less frequent. In one of the cases, becsuse of hemorrhage from the operative site during the immediate surgical period, re-exploration was done with adequate replacement of whole blood and catecholamines administered as needed during the anesthetic management. In comparing the two cases, the one case in which alpha-sdrenergic blockers were not administered during the pre-surgical period, when compared with the case in which the the blockers were used, showed, after removal ef the tumor, a decrease in the need for alpha-adrenergic stimulators.
Anesthesia* ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Busan ; Catecholamines ; Enflurane ; Halothane ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Pheochromocytoma*

Pheochromocytoma, the catecholamine-producing tumor of chromaffin tissue, is associated with a curable form of hypertension. Recently we report the case of a 59 year-old male admitted for an acute myocardial infarction and who subsequently developed late recurrent severe ventricular arrhythmia coincident with transient hypertensive episodes. A pheochromocytoma was diagnosed on the basis of the urinary concentration of catecholamines and computerized tomography of the adrenal glands. After stabilization of his cardiac rhythm and blood pressure with alpha adrenergic blockade, the left adrenal gland, which contained the tumor, was subsequently resected. The diagnosis of a pheochromocytoma should be considered when recurrent ventricular arrhythmia are associated with intermittent hypertension after acute myocardial infarction.
Adrenal Glands ; Arrhythmias, Cardiac ; Blood Pressure ; Catecholamines ; Diagnosis ; Humans ; Hypertension ; Male ; Middle Aged ; Myocardial Infarction* ; Pheochromocytoma*