Six year-old female having TGA, VSD with severe PHT which was considered inoperable for anatomical correction, received palliative Senning procedure. During follow-up, she was given prostacyclin and at the age of 21, she received Senning takedown, arterial switch and VSD closure after a reevaluation of the hemodynamic status. Significant reduction in PHT was found and she is doing well without complication 3 months after the operation.
Epoprostenol ; Female ; Follow-Up Studies ; Hemodynamics ; Humans

No abstract available.
Angiotensin II ; Angiotensins ; Endothelial Cells ; Endothelins ; Epoprostenol ; Thrombin ; Umbilical Veins

BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the efficacy of prostaglandin I2 (PGI2) in the patients with chronic nonspecific vertigo using questionnaires of dizziness handicap inventory (DHI) and vertigo symptom scale (VSS). MATERIALS AND METHODS: Forty two patients with chronic nonspecific vertigo from May to December 2010 were enrolled in this study. We administered Berast (synthetic PGI2, beraprost sodium) 2 tablets (0.04 mg) twice a day to patients. Before and after 2, 4 weeks the end of administration patients underwent DHI and VSS for evaluation of state of the vertigo. RESULTS: Twenty four of 42 patients completed this clinical trial. Mean DHI scale score decreased significantly from 23.00 (+/-21.75) to 17.75 (+/-19.78) (p=0.004). All DHI subscales, physical, functional, and emotional factors, decreased after treatment of prostaglandin I2. VSS scale also showed significant decrease from 3.63 (+/-2.55) to 2.50 (+/-2.95) (p=0.044). CONCLUSION: Prostaglandin I2 may be one of the treatments to improve symptoms in the patient s with chronic nonspecific vertigo.
Dizziness ; Epoprostenol ; Humans ; Prostaglandins ; Surveys and Questionnaires ; Tablets ; Vertigo

BACKGROUND: Prostacyclin (PGI2) is a commonly used protective agent against pulmonary ischemia-reperfusion injury. In this study, it was postulated that the protective effect of PGI2 on pulmonary ischemia-reperfusion injury would differ according to the state of pulmonary expansion during ischemic injury. METHODS: Under general anesthesia, left pulmonary ischemia was induced by occluding the left hilum in 40 New Zealand white rabbits. They were allocated to four groups (n = 10 in each group). In groups I and II, ischemia was started with lungs inflated, and in groups III and IV, ischemia was started with lungs collapsed. PGI2 was infused only in groups II and IV at 250 ng/kg/min for 20 minutes just before and after the ischemic period. After 60 minutes of ischemia, reperfusion was maintained for 2 hours, and then the left lung was resected. ABGA and lung water fraction were measured to assess the severity of the ischemia-reperfusion injury. RESULTS: Compared to groups I and II, PaO2 decreased markedly in group III and moderately in group IV (P < 0.05). The PaCO2 of groups III and IV significantly differed from those of groups I and II (P< 0.05). The percent changes in lung water fraction were significantly higher in group III than in the other groups (P < 0.05). CONCLUSIONS: PGI2 infused before and after pulmonary ischemia produced a significant protective effect on ischemia- reperfusion injury in the collapsed lung group. In the expanded lung group, however, the effect of PGI2 was masked by lung expansion, which itself led to excellent pulmonary preservation against ischemia-reperfusion injury.
Anesthesia, General ; Epoprostenol* ; Inflation, Economic* ; Ischemia ; Lung Transplantation ; Lung* ; Masks ; Prostaglandins ; Rabbits ; Reperfusion ; Reperfusion Injury*

The author investigated the cerebral circulatory and metabolic effects of systemic and intracisternal administration of nicardipine in a canine model of chronic cerebral vasospasm. Twenty-one dogs were assigned to one of three groups; control, intravenous nicardipine, and intracisternal nicardipine. All animals received a total of 12 ml of fresh unheparinized autologous blood via three cisternal injections. Sequential measurements of cerebral blood flow(CBF), cerebral metabolic rate of oxygen(CMRO2), and cerebral metabolic rate of glucose(CMRG) were chacked four times in nine days. Animals were sacrificed at Day 9 and amount of clot remained in brainstem and basal cistern was graded accordingly. Significant improvement of cerebral blood flow was noted in Day 6, Day 9 of intracisternal group and in Day 3, Day 6 of intravenous group(each, p<0.05) with slight better results seen in intracisthernal group. Results of sequential changes of CMRO2 and CMRG indicated possible role of nicardipine in protective effects on deleterious neuronal damage following ischemic changes after vasospasm, but definitive statements on this subject matter should be reserved until further study, espedially on morphologic examinations is carried on, Significantly less amount of clot remained in intracisthernal group may be due to effects of nicardipine in its inhibitory action on platelet aggregation, and/or stimulatory effect on prostacyclin production. These factors along with other possible factors should be speculated.
Animals ; Brain Stem ; Calcium* ; Dogs ; Epoprostenol ; Neurons ; Nicardipine ; Platelet Aggregation ; Vasospasm, Intracranial

PURPOSE: Raynaud's phenomenon is characterized by recurrent episodes of arterial vasospasm of the digits upon exposure to cold, and this can occur alone or in association with other underlying conditions. The aim of this study was to investigate the clinical course of Raynaud's phenomenon and the effects of treatment. METHOD: Between September 1994 and December 2004, 69 patients with Raynaud's phenomenon were retrospectively evaluated. The symptoms of the patients and the results of photoplethysmography were reviewed before and after medical treatment. RESULT: The mean age of the patients was 47.4 years and 33 patients (47.8%) were in their 30s and 40s. Thirty seven patients (53.6%) were male and 32 patients (46.4%) were female. Twelve patients (17.4%) had combined disease and the majority of the total patients (n=58, 84%) presented with bilateral lesions. After treating with aspirin, cilostazol, PGI2 and PGE1, the symptoms improved in 27 cases (39.1%) and the photoplethysmographic findings improved in 20 cases (45.5%). However, there was no association between the period of treatment and the clinical results or the results of performing photoplethysmography. CONCLUSION: The majority of patients with Raynauds phenomenon develop bilateral symptoms without the presence of any underlying diseases. Antiplatelet agents and vasodilator drugs can have a positive effect on the management of Raynaud's phenomenon.
Alprostadil ; Aspirin ; Epoprostenol ; Female ; Humans ; Male ; Photoplethysmography ; Platelet Aggregation Inhibitors ; Retrospective Studies* ; Vasodilator Agents

BACKGROUND: Cicletanine is a new antihypertensive agent, derived from the furopyridine family. It acts directly on vascular smooth muscle by increasing prostacyclin synthesis and decreasing intracytosolic calcium. In order to investigate the efficacy and safety of cicletanine, a clinical study was performed in the patients with mild to moderate essential hypertension. METHOD: The study subject consisted of 30 patients with diastolic blood pressure of 95mmHg~114mmHg(mean age : 55.1+/-7.9 years, 13 males and 17 females). Cicletanine was administrated orally in a daily dose of 100mg Q.D. for 12 weeks after the administration of a placebo for 2 weeks. During cicletanine medication, antihypertensive efficacy, clinical side effects and laboratory changes were monitored. RESULT: Cicletanine decreased mean blood pressure from the baseline value of 123.6+/-3.4mmHg to 108.6+/-7.5mmHg(p<0.001) after 2 weeks, 105.0+/-7.4mmHg after 4 weeks, 103.9+/-6.6mmHg after 6 weeks, 102.5+/-8.9mmHg after 8 weeks, 101.4+/-6.8mmHg after 10 weeks and 99.6+/-6.6mmHg after 12 weeks of medication. There was a highly significant decrease in blood pressure at each of the assessments after 2,4,6,8,10 and 12 weeks of medication when compared to the baseline value(p<0.001). Mean blood pressure after 4 weeks of medication showed a significant decrease when compared to the value after 2 weeks of medication, and the value after 12 weeks of medication showed a significantly decrease when compared to the value after 8 weeks of medication. Heart rate did not change significantly with cicletanine monotherapy for 12 weeks. There was no significant changes in blood chemistry, glucose, lipid and electrolytes. The side effect was pruritus(1 case, 3.3%). CONCLUSION: Cicletanine monotherapy with 100mg once a day regimen was effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Epoprostenol ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Muscle, Smooth, Vascular

Idiopathic pulmonary arterial hypertension (previous primary pulmonary hypertension) was a progressive disease with high mortality. Many patients with idiopathic pulmonary arterial hypertension did not show vasoreactivity, rapidly resulted in marked disability, right heart failure and death. Recent advances of therapeutic modalities have revolutionized the treatment of idiopathic pulmonary arterial hypertension. Irrespective of pulmonary arterial vasoreactivity, new vasodilatng agents, such as epoprostenol, treprostinil, iloprost, bosentan, and sildenafil, significantly improved hemodynamics, symptoms, exercise capacities, quality of life, and survival. The median survival of patients with idiopathic pulmonary arterial hypertension has been prolonged from 2.8 years to more than 5 years. In a near future, pulmonary arterial hypertension could be easily controlled like a systemic arterial hypertension.
Diagnosis* ; Epoprostenol ; Heart Failure ; Hemodynamics ; Humans ; Hypertension* ; Iloprost ; Mortality ; Quality of Life ; Sildenafil Citrate

Inhaled iloprost, a stable carbacyline derivative of prostacyclin, has been used recently for the treatment of adults with pulmonary hypertension but only few reports are available about its use in neonatal critical care. We report therapeutic trial of inhaled iloprost in newborn infants with persistent pulmonary hypertension of the newborn (PPHN) who did not respond to inhaled nitric oxide (iNO). Inhaled iloprost (Ventavis(R), Bayer Shering Pharma, Germany) was effective in neonates with severe PPHN who showed inadequate response to iNO. We suggest that inhaled iloprost could be considered as an additional therapeutic option in PPHN refractory to iNO.
Adult ; Critical Care ; Epoprostenol ; Humans ; Hypertension, Pulmonary ; Iloprost ; Infant, Newborn ; Nitric Oxide

BACKGROUND: The gingko biloba extracts (GBE) are known to inducing vasodilation by increasing NO or PGI2. However, the effects on the endothelial function and clinical symptoms of patients with coronary artery disease (CAD) are not clear. METHODS: The flow-mediated endothelium-dependent brachial artery vasodilation using high-resolution ultrasound was measured before and 2 hours after intake of GBE (120 mg single PO) and 1 month after regular intake of GBE (80 mg bid PO) in 33 patients (mean: 60 yrs, 26 males) with CAD who had been diagnosed by coronary angiogram and managed with medication for more than 1 month. RESULTS: The only one patient could not continue to take GBE due to severe nausea. The frequency or severity of chest pain was decreased in 31 patients among the other 32 patients. The flow-mediated brachial artery vasodilation (mean+/-SD) were significantly (p<0.001) improved from 8.9+/-3.9% before to 13.4+/-4.5% and 13.7+/-4.0% 2 hours and 1 month after taking GBE, respectively. The brachial artery diameter was increased from 4.42+/-0.67 mm before to 4.45+/-0.66 mm and 4.64+/-0.60 (p<0.005) after taking GBE, respectively. The endothelial function in patients with diabetes mellitus (5 from 33) was not improved 2 hours after taking GBE, but improved 1 month after GBE. The improvement of endothelial dysfunction in patients with hyperlipidemia or hypertension was less than patients without it. CONCLUSION: GBE has favorable short- and long-term effects on the endothelial function and clinical symptoms as well as long-term vasodilatation in patients with CAD without serious side effects.
Brachial Artery ; Chest Pain ; Coronary Artery Disease* ; Coronary Vessels* ; Diabetes Mellitus ; Epoprostenol ; Ginkgo biloba* ; Humans ; Hyperlipidemias ; Hypertension ; Nausea ; Ultrasonography ; Vasodilation