No abstract available.
Epinephrine*

No abstract available.
Epinephrine*

Pheochromocytoma is usually associated with a combination of various clinical manifestations caused by the overproduction of catecholamines. It is frequently accompanied by impaired glucose tolerance operating through 2-and-adrenergic mechanisms. A 41-year-old-woman was admitted to the hospital because of poorly-controlled diabetes mellitus and hypertension. She had suffered intermittent paroxysmal attacks of headache and chest discomfort and had been treated intermittently over a 2 year period for diabetes mellitus and hypertension. At admission, the levels of serum epinephrine, norepinephrine urinary excretion of total metanephrine, and VMA were all abnormally elevated. Adrenal CT showed a well-defined, homogenous mass in the right adrenal region and the tumor was diagnosed as pheochromocytoma. After tumor resection, the increased blood level of catecholamines, the urinary excretion of total metanephrine, and VMA were normalized, as was the hyperglycemia state. Diabetes mellitus of the patient was considered permanently resolved after tumor removal by the result of glucose tolerance in 75g oral glucose tolerance test.
Catecholamines ; Diabetes Mellitus* ; Epinephrine ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Headache ; Humans ; Hyperglycemia ; Hypertension ; Metanephrine ; Norepinephrine ; Pheochromocytoma* ; Thorax

The purpose of this study is to evaluate the effects of Chu-ma therapy and to suggest that the therapy is an effective nursing intervention tool to reduce blood pressure. The research design employed was the non-synchronized research method with non- equivalent control group. A total of 30 people with essential hypertension, who were from forty to sixty five years old, participated in the study. The Chu-ma therapy was administered by every day for ten or fifteen minutes for eight weeks from 19, April to 13, June in 1999. In order to evaluate the effects of Chu-ma therapy, blood pressure of the two groups were measured once a week, and physiological parameters (epinephrine, norepinephrine, total cholesterol, HDL-cholesterol, triglycerides) were measured before and after the treatment. Collected data was analyzed by SAS package. The results of this study can be summarized as follows: 1) There were significant decrease in systolic blood pressure and diastolic blood pressure in the experimental group. 2) There were no significant changes in epinephrine, norepinephrine of the two groups. 3) There were significant decrease in total cholesterol and triglycerides, and HDL- cholesterol increased significantly in the experimental group. 4) The effect of Chu-ma therapy on the measured time on the blood pressure in experimental group was as follows: Both of systolic and diastolic blood pressures were significantly decreased after 5weeks. The result proved that Chu-ma therapy is an effective nursing intervention tool for clients with essential hypertenion. However further research is still necessary to compare the effect with the different periods and number of times for Chu-ma therapy.
Blood Pressure* ; Cholesterol ; Epinephrine ; Hypertension* ; Norepinephrine ; Nursing ; Research Design ; Triglycerides

PURPOSE: The purpose of this study was to identify effects of the SP-6 acupressure on dysmenorrhea, and level of cortisol, epinephrine and norepinephrine in the college students. METHOD: Data were collected from May 1 to August 31, 2002. A total of 58 students from two universities participated in the study. Both groups were pretested before the intervention for three variables, the intensity of dysmenorrhea, level of cortisol, epinephrine and norepinephrine. Then, SP-6 acupressure was provided for 20 minutes for students in the experimental group. The instruments used in this study included the Visual Analogue Scale developed by Johnson(1974), Menstrual Attitudes Questionnaire Scale developed by Brooks-Gunn & Ruble(1980), and Stress scale developed by Cheun and Kim(1990). RESULT: There were statistically significant differences in the intensity of dysmenorrhea at the time immediately after, 30minutes after, one hour after, and two hours after the intervention. The experimental group had a lower intensity than the control group. There was a statistically significant difference in level of norepinephrine at the time 30minutes after the intervention with the experimental group. CONCLUSION: The SP-6 acupressure reduced the subjective perception of dysmenorrhea and the levels of norepinephrine. It was found out that the lasting period of 20 minutes of the SP-6 acupressure was two hours for college students.
Acupressure* ; Dysmenorrhea* ; Epinephrine* ; Female ; Humans ; Hydrocortisone* ; Methods ; Norepinephrine*

The coexistence of extraadrenal pheochromocytoma and renal artery stenosis is extremely rare. The mechanisms of renal artery stenosis with pheochromocytoma include direct compression of the tumor mass on the renal artery and catecholamine-induced vasospasm, fibromuscular hyperplasia, and fibrous adhesion. We report a rare case of renal artery stenosis caused by extraadrenal pheochromocytoma in a 29- year-old female. She was admitted to the hospital because of palpitation and headache. She had been treated for hypertension for 2 years. On admission, her plasma epinephrine and norepinephrine levels were elevated as were her plasma renin activity, urinary vanillylmandelic acid (VMA) and metanephrine levels. Through the use of abdominal computed tomography, 131I-MIBG scan, and renal arteriography, a mass was found in the hilus of the left kidney which affected left renal artery stenosis. Surgical removal of the mass and left kidney restored the catecholamine excretion, plasma renin activity, and blood pressure to normal. Electronmicroscopic examination of the mass confirmed the pheochromocytoma.
Angiography ; Blood Pressure ; Epinephrine ; Female ; Headache ; Humans ; Hyperplasia ; Hypertension ; Kidney ; Metanephrine ; Norepinephrine ; Pheochromocytoma* ; Plasma ; Renal Artery Obstruction* ; Renal Artery* ; Renin ; Vanilmandelic Acid

Serum epinephrine and norepinephrine concentrations were measured in 7 patients during fentanyl-oxygen anesthesia, who were undergoing elective open heart surgery(single valvular replacement operations) in Seoul National University Hospital. Sampling times and corresponding total fentanyl doses were as follows; 1) after arterial cannulation 2) 5 minutes after intubation(50 ug/kg of B. Wt) 3) 5 minutes after sternotomy(65 ug/ka) 4) after aortic dissection(75 ug/kg) 5) 15 minutes after initiating bypass 6) 60 minutes after initiating bypass [20 ug/kg of fentanyl was added to the priming solution before initiation of Cardio-pulmonary bypass(CP bypass)]. High Performance Liquid Chromatography(HPLC) was used to analyze hormones. Epinephrine concentrations(pg/ml) corresponding to the sampling times were as follows (mean+/-SE); 1) 213+/-59 2) 199+/-62 3) 246+/-83 4) 173+/-35 5) 270+/-70 6) 269+/-70 Norepinephrine concentrations(pg/ml) were as follows(mean+/-SE); 1) 609+/-107 2) 500+/-73 3) 645+/-152 4) 470+/-82 5) 494+/-65 6) 955+/-311 There were no significant hormonal changes except the 6th norepinephrine value. There were no significant hemodynamic changes except blood pressure decrease at the beginning of CP bypass. It is concluded that high dose fentanyl-oxygen anesthesia was limitedly effective to block the stress of open heart surgery, general anesthesia and CP bypass.
Anesthesia* ; Anesthesia, General ; Blood Pressure ; Catheterization ; Epinephrine ; Fentanyl* ; Heart* ; Hemodynamics ; Humans ; Norepinephrine ; Oxygen* ; Seoul ; Thoracic Surgery*

BACKGROUND: In this prospective, randomized, double-blind, placebo-controlled trial, we investigated the effect of a single dose of esmolol on the bispectral index (BIS) to endotracheal intubation during desflurane anesthesia. METHODS: After induction of anesthesia, 60 patients were mask-ventilated with desflurane (end-tidal 1 minimum alveolar concentration) for 5 min and then received either normal saline, esmolol 0.5 or 1 mg/kg, 1 min prior to intubation (control, esmolol-0.5 and esmolol-1 groups, n = 20/group). BIS, mean arterial pressure, and heart rate were measured prior to anesthesia induction and esmolol administration, immediately preceding intubation (time point 0), and every minute for 5 min after intubation (time point 1 to 5). At time point 0, 1 and 5, 5 ml of arterial blood was taken to measure plasma concentrations of norepinephrine and epinephrine. RESULTS: BIS increased significantly at 1 min after intubation when compared with pre-intubation values in all groups. Both mean arterial pressure and heart rate increased significantly 1 min after intubation when compared with preintubation values for all groups. Plasma epinephrine concentrations did not increase significantly after tracheal intubation in any of the groups. Norepinephrine increased at 1 min after intubation when compared with the preintubation values in the esmolol groups (P < 0.05). CONCLUSIONS: A single bolus of esmolol was unable to blunt the increase in BIS to endotracheal intubation during desflurane anesthesia.
Anesthesia ; Arterial Pressure ; Epinephrine ; Heart Rate ; Humans ; Intubation ; Intubation, Intratracheal ; Isoflurane ; Norepinephrine ; Plasma ; Propanolamines ; Prospective Studies

Acute stroke has been associated with a variety of cardiac abnormalities. Data derived from EGC monitoring have suggested that cardiac arrhythmia may be more common in stroke patient. Acute stroke such as cerebral infarction has been reported to increase serum cardiac enzyme and histologic changes, focal myocardial myocytolysis. Also, plasma norepinephrine was significantly elevated in a group of stroke patients compared with non-stroke control. These observations led to the hypothesis that acute stroke may increase sympathetic activity with resultant electrocardiographic abnormalities and myocardial cell necrosis. In order to test this hypothesis, we evaluated 24 acute stroke patients for several cardiac parameter including arrythmias defected by 24 hour Holter monitoring, serum cardiac enzymes such as CK, LDH, SGOT and plasma catecholamine values. Similar studies were also performed in 15 control subjects matched with stroke patients for age. The result were as follows; 1) Arrhythmias such as VPB, SVPB in the acute stroke group were more common than in the non-stroke group. VPB(209+/-61/24hr, P<0.005) SVPB(232+/-54/24hr, P<0.005). 2) Plasma norepinephrine, epinephrine and CK was significantly elevated in a group of stroke patients compared with non-stroke controls. norepinephrine(715.3+/-93.8 pg/ml, P<0.005) epinephrine(346.1+/-63.1 pg/ml, P<0.005). 3) Stroke patients with abnormal serum CK values(above 80 IU/L) had a higher(P<0.05) mean norepinephrine concentration(776.6+/-142.0 pg/ml) than remaining stroke patients(406.3+/-101.7 pg/ml). 4) Stroke patients with high plasma norepinephrine did not exhibit an increase in cardiac arrhythmias.
Arrhythmias, Cardiac* ; Aspartate Aminotransferases ; Cerebral Infarction ; Electrocardiography ; Electrocardiography, Ambulatory ; Epinephrine ; Humans ; Necrosis ; Norepinephrine ; Plasma* ; Stroke*

Activation of the sympathetic nervous system in mediating the stress response attends traumatic brain injury. Plasma dopamine(DA), epinephrine(E), norepinephrine(NE) levels were measured in 26 severe traumatically brain injured patients to determine whether catecholamine levels obtained within 24 hours after injury provide reliable prognostic endogenous markers of outcome. Patient outcome was determine at 1 week using the Glasgow Coma Scale(GCS) and at the time of discharge the Glasgow Outcome Scale(GOS), 7 patients with diseases except those with a severe traumatic brain injury were selected as a control group. Firstly, we analyzed the difference of the average DA, E, and NE between the control group and severe traumatic brain injury patients. Secondly, we analyzed the difference of the average catecholamine levels in the 3 groups according to admission GCS scores(respectively 3~4, 5~7, 8~9). Third, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS scores at 1 week(respectively dead, 3~4, 5~7, 8~11, >11). Finally, we analyzed the difference of the average catecholamine levels in the 5 groups according to GOS at the time of discharge. As a result, there was no statical difference between the level of DA in the control group and those of the severe brain injury patients. But the level of E an NE in the experimental group were higher than the control group(respectively p<0.03, p<0.04). The admission GCS score correlated highly with the catecholamine levels(NE : r=0.69, p<0.001 ; E ; r=0.42, p<0.03 ; DA ; r=0.42, p<0.03). In patients with admission GCS of 3 to 4, NE levels increaed fourfold above other group(p<0.005). In the 13 patients with GCS scores of 3 or 4 on admission. NE levels predicted outcome at 1 week. All two patients with NE levels less then 750 pg/ml were survived, while 10 of 11 with NE levels greater than 750 pg/ml were died(p<0.02). The levels of NE was significantly higher in patients who died than in those with better outcome(p<0.02). Therefore, these findings indicated that the level of circulating NE is an excellent endogenous marker that appear to reflect the extent of brain injury and that may predict the likelihood of recovery.
Brain ; Brain Injuries* ; Coma ; Dopamine ; Epinephrine ; Humans ; Negotiating ; Norepinephrine ; Plasma* ; Prognosis* ; Sympathetic Nervous System