BACKGROUND: Using the urinary bladder as a model, neurophysiological studies of visceral primary afferents supplying inflamed tissue have been studied. In this study we have examined the response of the hypogastric afferents supplying the urinary bladder of the cat to intra-arterially injected algesic chemicals after experimental inflammation. METHODS: Twenty units were recorded from the strands of hypogastric nerve. Once a unit was found, the conduction velocity was determined by extracellular recording of single fiber. When the response of the unit excited by mechanical stimuli was found, chemical stimuli were applied by intra-arterial injection of algesic chemicals (bradykinin, KCl). And then, irritant chemical, 3% mustard oil injected into the urinary bladder for the induction of an experimental inflammation. After removal of the irritant and with the empty bladder, the response of the afferent unit to chemical stimuli by intra-arterially injected bradykinin and KCl were studied again. RESULTS: All units were found to be A delta fibers and responded to both mechanical and chemical stimuli. After experimental inflammation, the basal tone and spontaneous contraction of the urinary bladder were increased and spontaneous nerve activity of the hypogastric afferents appeared. Bladder contraction and nerve activity to intra-arterially injected bradykinin decreased more than those of controls before inflammation. The ratio of nerve activity to the bladder contraction after experimental inflammation was increased. CONCLUSIONS: The hypogastric afferents were sensitized after inflammation, which showed increased nerve response to intra-arterially injected bradykinin comparing to the contraction response of the urinary bladder.
Animals ; Bradykinin ; Cats ; Cystitis* ; Inflammation ; Injections, Intra-Arterial ; Mustard Plant ; Sensory Receptor Cells* ; Urinary Bladder*

One of the complications of direct arterial pressure monitoring is drug injection through an arterial line mistaken for an intravenous line. We experienced a case of accidental intra-arterial vecuronium injection through an arterial line on the right radial artery. The incident was noticed just after the injection and the patient was treated by intra-arterial injection of heparin, papaverine, lidocaine and stellate ganglion block. No color change or edema of the right hand was observed until the end of operation. The patient was closely observed after operation and discharged without complication. We report a case of accidental intra-arterial vecuronium injection which was managed successfully.
Arterial Pressure ; Edema ; Hand ; Heparin ; Humans ; Injections, Intra-Arterial* ; Lidocaine ; Papaverine ; Radial Artery ; Stellate Ganglion ; Vascular Access Devices ; Vecuronium Bromide*

OBJECTIVE: The authors report the safe recanalization after intraarterial injection of abciximab(glycoprotein IIb-IIIa inhibitor) in the acute cerebral vascular occlusion from the thromboembolism. METHODS: Eight patients with acute occlusion of cerebral arteries were treated by using an intraarterial infusion of urokinase and abciximab(Reopro(R)). Six patients had acute thromboembolic complication of endovascular therapy and two patients had acute basilar artery occlusion. Authors used mean 428, 000 units of the urokinase, and mean 6.2mg of the abciximab. In six cases, intraarterial urokinase and abciximab were infused shortly after the event of thrombosis duration endovascular procedure. RESULTS: In all cases, successful recanalization of thrombotic artery was achieved by using intraarterial abciximab and urokinase without bleeding complication. Seven patients recovered without neurologic deficit and one patient remained in locked-in neurological state. CONCLUSION: The authors believe that the intraarterial infusion of abxicimab even in small dose is effective and safe recanalization method in acute thrombotic occlusion of cerebral arteries, but further evaluation and study are needed.
Arteries ; Basilar Artery ; Cerebral Arteries ; Endovascular Procedures ; Hemorrhage ; Humans ; Infusions, Intra-Arterial ; Injections, Intra-Arterial ; Neurologic Manifestations ; Thromboembolism ; Thrombosis ; Urokinase-Type Plasminogen Activator

PURPOSE: Hydrofluoric acid (HFA) causes injury via tissue penetration by the free fluoride ion. Methods for treatment of HFA burns include continuous intra-arterial infusion of calcium gluconate, which is especially useful for patients with dermal burns of the digits caused by HFA. However, no comparative study of tissue injury grade with clinical factors among patients with HFA burns treated with continuous intra-arterial infusion of calcium gluconate has been conducted in Korea. METHODS: We conducted a prospective study at the emergency department of a university teaching hospital between January 2011 and June 2013. The subjects enrolled in this study consisted of 33 patients with HFA burns. After completion of treatment, we divided the patients into three groups according to the type of skin lesions. Patients requiring a skin graft or surgical flap were included in the poor outcome group, those who had to undergo incision and drainage in the moderate outcome group, and those who did not require further treatment in the good outcome group. RESULTS: After completion of all treatments, 22 of the 33 patients were included in the good outcome group and seven in the moderate outcome group; the remaining four patients were included in the poor outcome group, as they met the above-mentioned criteria, experienced longer-lasting pain, and were more frequently treated with injection in comparison with the other patients. CONCLUSION: Patients with HFA burns with long-term pain who need frequent arterial injections despite undergoing intra-arterial calcium gluconate treatment are likely to have poor outcome; therefore, they require more proactive interventions.
Burns* ; Calcium Gluconate* ; Drainage ; Emergency Service, Hospital ; Fluorides ; Hospitals, Teaching ; Humans ; Hydrofluoric Acid* ; Infusions, Intra-Arterial* ; Injections, Intra-Arterial ; Korea ; Prospective Studies ; Skin ; Surgical Flaps ; Transplants

PURPOSE: High dose methotrexate (HDMTX) dramatically increases survival rate, which is related to the histologic response of tumornecrosis rate in the treatment of osteosarcoma. But, the study of tumor necrosis rate after preoperative chemotherapy with MTX has notbeen systemically evaluated. We analysed tumor necrosis rate versus related parameters such as the MTX serum peak level, age, sex, location, pathologic type under two chemotherapeutic protocols (modified T10 & T20). MATERIALS AND METHODS: From June 1995 to June 2001, 44 cases of Enneking stage IIB osteosarcoma patients (29 males, 15 females, mean age 18) were treated with two similar neoajuvant chemotherapeutic protocols involving intravenous injections of MTX, ifosphamide, adriamycin and the intra-arterial injection of cisplatin preoperatively. The histologic response to the chemotherapy was graded as complete(100% necrosis) or incomplete (less than 100%). RESULTS: Of 44 patients, 26 showed serum MTX concentrations greater than 1, 000 micromol/L. Complete response was seen in 9 patients with a peak serum MTX level of 1, 000 micromol/L or greater. Complete response was seen in 34.6% of patients with 1, 000 mol/L orgreater MTX serum peak level (p=0.031). Seven of 15 female patients showed complete response. Three of 29 male patients showed complete response. The complete response rate of females was significantly higher than that of males (p=0.019). Histological response was not significantly correlated with other variables. CONCLUSION: In this study, the rate of complete necrosis was significantly higher in patients with a preoperative peak serum MTX levelover 1, 000 micromol/L, especially in females, than in those with a serum MTX below this level. We suggest the preoperative dose of MTXserum peak level should be maintained at over 1, 000 micromol/L, and suggest that the preoperative MTX dose should be maintained at ahigh level in order to increase the tumor necrosis rate.
Cisplatin ; Doxorubicin ; Drug Therapy* ; Female ; Humans ; Injections, Intra-Arterial ; Injections, Intravenous ; Male ; Methotrexate ; Necrosis* ; Osteosarcoma* ; Survival Rate

PURPOSE: Intracavernous injection of PGE1 or papaverine is widely used in the diagnosis and treatment of erectile dysfunction. However, these drugs have several side effects such as pain, priapism, and fibrotic lesions. In this study, we assessed the effects of pinacidil (a K+ -ATP - channel opener) as an alternative for inducing penile erection. METHODS: Using a feline model, the magnitude of penile erection caused by pinacicil was compared with that caused by other drugs, namely acetylcholine, PGE1 and L-arginine. The effects of K+ -channel blockers(4-aminopyridine, glibenclamide, and tetraethylammonium; TEA) and pinacidil on the induced erections were investigated. RESULTS: Intra-arterial injection of pinacicil increased the intracavernous pressure (ICP) in a dose-dependent fashion, and the increase in ICP induced by pinacicil plus acetylcholine, PGE1 or L-arginine was more pronounced than that induced by any of these drugs alone. Furthermore, pinacicil (10(-3)M/mL) effectively reversed the inhibitory effects of the K+-channel blockers on cavernous relaxation induced by acetylcholine, PGE1 or L-arginine (P<0.01). Notably, pinacidil induced cavernous relaxation even in cases refractory to a higher concentration <10(-1) M/mL) of erectics (n = 11; p<0.01). CONCLUSIONS: These results suggest that pinacidil is effective in relaxing feline erectile tissue in vivo, probably via increased K+ permeability and subsequent hyperpolarization. Further comparative studies with human erectile tissue and clinical testing are required to show whether K+-channel openers can be used in the diagnosis and treatment of erectile dysfunction.
Acetylcholine ; Alprostadil ; Arginine ; Diagnosis ; Erectile Dysfunction* ; Glyburide ; Humans ; Injections, Intra-Arterial ; Male ; Papaverine ; Penile Erection ; Permeability ; Pinacidil ; Priapism ; Relaxation ; Tetraethylammonium

PURPOSE: Intracavernous injection of PGE1 or papaverine is widely used in the diagnosis and treatment of erectile dysfunction. However, these drugs have several side effects such as pain, priapism, and fibrotic lesions. In this study, we assessed the effects of pinacidil (a K+ -ATP - channel opener) as an alternative for inducing penile erection. METHODS: Using a feline model, the magnitude of penile erection caused by pinacicil was compared with that caused by other drugs, namely acetylcholine, PGE1 and L-arginine. The effects of K+ -channel blockers(4-aminopyridine, glibenclamide, and tetraethylammonium; TEA) and pinacidil on the induced erections were investigated. RESULTS: Intra-arterial injection of pinacicil increased the intracavernous pressure (ICP) in a dose-dependent fashion, and the increase in ICP induced by pinacicil plus acetylcholine, PGE1 or L-arginine was more pronounced than that induced by any of these drugs alone. Furthermore, pinacicil (10(-3)M/mL) effectively reversed the inhibitory effects of the K+-channel blockers on cavernous relaxation induced by acetylcholine, PGE1 or L-arginine (P<0.01). Notably, pinacidil induced cavernous relaxation even in cases refractory to a higher concentration <10(-1) M/mL) of erectics (n = 11; p<0.01). CONCLUSIONS: These results suggest that pinacidil is effective in relaxing feline erectile tissue in vivo, probably via increased K+ permeability and subsequent hyperpolarization. Further comparative studies with human erectile tissue and clinical testing are required to show whether K+-channel openers can be used in the diagnosis and treatment of erectile dysfunction.
Acetylcholine ; Alprostadil ; Arginine ; Diagnosis ; Erectile Dysfunction* ; Glyburide ; Humans ; Injections, Intra-Arterial ; Male ; Papaverine ; Penile Erection ; Permeability ; Pinacidil ; Priapism ; Relaxation ; Tetraethylammonium

Percutaneous thrombolysis with angioplasty is commonly used to treat thrombosed hemodialysis grafts. Arterial embolism is a rare but yet potentially serious complication. Here we report a case of symptomatic embolism of radial artery after percutaneous thrombolysis for the treatment of thrombosed graft in a hemodialysis patient. A 77-year old man was admitted because of numbness and coldness on the right hand and color change on the 4th of the right finger. He had been treated with percutaneous thrombolysis with angioplasty for the treatment of thrombosed graft 2 days before. Arteriograhy showed total occlusion of proximal radial artery. After intraarterial injection of urokinase and a subsequent angioplasty, the radial artery was recanalized and his symptom and sign had also been completely recovered.
Aged ; Angioplasty ; Embolism* ; Fingers ; Hand ; Humans ; Hypesthesia ; Injections, Intra-Arterial ; Radial Artery ; Renal Dialysis* ; Transplants* ; Urokinase-Type Plasminogen Activator

PURPOSE: We present our experiences of intra-arterial tirofiban injection through a deployed Solitaire stent as a rescue therapy after failed mechanical thrombectomy in patients with acute ischemic stroke. MATERIALS AND METHODS: Data on 18 patients treated with adjunctive tirofiban injection through a temporarily deployed Solitaire stent after failed mechanical thrombectomy were retrospectively reviewed. Solitaire stent was used as a primary thrombectomy device in 16 of 18 patients. Two patients received manual aspiration thrombectomy initially. If initial mechanical thrombectomy failed, tirofiban was injected intra-arterially through the deployed Solitaire stent and then subsequent Solitaire thrombectomy was performed. RESULTS: Fourteen patients had occlusions in the middle cerebral artery, 2 in the distal internal carotid artery, and 2 in the basilar artery. Successful recanalization was achieved in 14 patients (77.7%) after intra-arterial injection of tirofiban and subsequent Solitaire thrombectomy. Three patients without successful recanalization after rescue method received angioplasty with stenting. Overall, successful recanalization (TICI grades 2b and 3) was achieved in 17 (94.4%) of 18 patients. Periprocedural complications occurred in 5 patients: distal migration of emboli in 5 patients and vessel perforation in 1. Three patients died. Good functional outcome (mRS < or = 2) was achieved in 9 patients (50.0%) at 3 months. CONCLUSION: Rescue intra-arterial injection of tirofiban through a temporarily deployed Solitaire stent may facilitate further recanalization in cases of failed mechanical thrombectomy in patients with acute ischemic stroke.
Angioplasty ; Basilar Artery ; Carotid Artery, Internal ; Humans ; Injections, Intra-Arterial ; Mechanical Thrombolysis ; Middle Cerebral Artery ; Retrospective Studies ; Stents* ; Stroke* ; Thrombectomy*

To understand the pathophysiology of the intracranial pressure changes, the Monro-Kellie doctrine has been to be a useful concept. By recent reports it has possibly been suggested that prostaglandins may pathophysiologically contribute to the inherent response of intracranial pressure. Although the cardiovascular effects of several postaglandins have well been studied, little is known about their effects on cerebral blood vessel and cerebrospinal fluid pressure. The author observed the effect of prostaglandins injected intra-arterially and intravenously on the intracranial pressure and systemic blood pressure and compared with those of norepinephrine or 5-hydroxytryptamine. The result were summarized as the follows : 1. The intra-arterial and intravenous injections of a single dose of norepinephrine increased not only the intracranial pressure but also systemic blood pressure with dose-dependant response. 2. The intra-arterial injection of PGA2 caused the increase in the intracranial pressure, but on the contrary, the blood pressure was decreased. The intra-arterial injection of PGE1 and PGE2 caused the increase in the intracranial pressure, which was not related to the used doage. 3. The intra-arterial and intravenous injections PGF2 alpha decreased the intracranial pressure but increased the blood pressure, both of which were not related to the dosage used.
Alprostadil ; Blood Pressure ; Blood Vessels ; Cerebrospinal Fluid Pressure ; Dinoprost ; Dinoprostone ; Injections, Intra-Arterial ; Injections, Intravenous ; Intracranial Pressure* ; Norepinephrine ; Prostaglandins* ; Rabbits* ; Serotonin