No abstract available.
Vasodilation*

BACKGROUND: We hypothesized that induction of general anesthesia using sevoflurane improves the accuracy of non-invasive hemoglobin (SpHb) measurement of Masimo Radical-7(R) Pulse CO-Oximetry by inducing peripheral vasodilation and increasing the perfusion index (PI). The aim of this study is to investigate the change in the SpHb and the PI measured by Rad7 during induction of general anesthesia using sevoflurane. METHODS: The laboratory hemoglobin (Hb(lab)) was measured before surgery by venous blood sampling. The SpHb and the PI was measured twice; before and after the induction of general anesthesia using sevoflurane. The changes of SpHb, Hb(bias) (Hb(bias) = SpHb - Hb(lab)), and PI before and after the induction of general anesthesia were analyzed using a paired t-test. Also, a Pearson correlation coefficient analysis was used to analyze the correlation between the Hb(bias) and the PI. RESULTS: The SpHb and the PI were increased after the induction of general anesthesia using sevoflurane. There was a statistically significant change in the Hb(bias) from -2.8 to -0.7 after the induction of general anesthesia. However, the limit of agreement (2 SD) of the Hb(bias) did not change after the induction of general anesthesia. The Pearson correlation coefficient between the Hb(bias) and the PI was not statistically significant. CONCLUSIONS: During induction of general anesthesia using sevoflurane, the accuracy of SpHb measurement was improved and precision was not changed. The correlation between Hb(bias) and PI was not significant.
Anesthesia, General* ; Perfusion* ; Vasodilation

BACKGROUND: Thoracoscopic T2 sympathicotomy is an effective method for the treatment of palmar hyperhidrosis. Not only are the symptoms of hyperhidrosis abolished but also the temperature of the ipsilateral palm is elevated due to the sympatholytic vasodilation after the completion of the sympathicotomy on the first side. However little is known about the temperature changes in the contralateral palm. This study was performed to evaluate the changes in both palmar temperatures during the thoracoscopic T2 sympathicotomy for palmar hyperhidrosis. MATERIAL AND METHOD: Thoracoscopic T2 sympathicotomy was performed in 15 patients with primary palmar hyperhidrosis. Surface temperatures of both palms were monitored continuously and were recorded simultaneously during the 7 different stages of the operation. RESULT: When T2 sympathicotomy was performed on the first(left) side, an ipsilateral increase with a contralateral decrease of temperature was observed. The difference in the temperature of both palms was greatest just before the sympathicotomy on the contralateral(right) side(Lt. 34.6+/-0.9degree C vs. Rt. 31.6+/-1.3degree C, p<0.0001). After the sympathicotomy on the second(right) side, temperature of the right palm was elevated. The difference in the temperature of both palms was abolished at the end of the operation(Lt.34.7+/-0.9degree C vs. Rt.34.4+/-1.0degree C, P=0.415). CONCLUSION: When T2 sympathicotomy was performed on the first side, an ipsilateral palmar temperature increased due to the sympatholytic vasodilation. However contralateral palmar temperature decreased due to a vasoconstriction. Although the mechanism of vasoconstriction is still unknown, it is postulated that there may be a cross- inhibitory effect by the post-ganglionic neurons innervating blood vessels of the palm.
Blood Vessels ; Humans ; Hyperhidrosis* ; Neurons ; Vasoconstriction ; Vasodilation

No abstract available.
Antioxidants* ; Propofol* ; Reactive Oxygen Species* ; Thiopental* ; Vasodilation*

PURPOSE: This report presents a procedure for performing power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow and illustrates its application to practical patient cases.MATERIALS AND METHODS: The salivary gland was scanned using ultrasound equipment (GE LOGIQ5 Expert® device; GE Medical Systems, Milwaukee, WI, USA) to identify pathological findings related to the patient's chief complaint. To identify the orifice of the main duct, it should be cannulated using a lacrimal dilator. After inserting the catheter into the cannulated main duct, the position of the catheter within the duct was confirmed by ultrasound. A contrast agent was injected until the patient felt fullness, and ultrasound (B-mode) was used to confirm whether the contrast agent filled the main canal and secondary and tertiary ducts. Then, power Doppler ultrasound was performed to determine whether the salivary gland had increased blood flow.RESULTS: In 2 cases in this report, a power Doppler ultrasound scan showed a significant increase in blood flow after contrast medium injection, which was not observed on a preoperative scan.CONCLUSION: Power Doppler ultrasound was found to be a simple, safe, and effective tool for real-time sialography monitoring.
Catheters ; Humans ; Salivary Glands ; Sialography ; Ultrasonography ; Vasodilation

Purpose of this study is to evaluate the temperature lowering effects of the local cold air application on the skin surface and the muscle of different depth, and to observe whether the rebound rise of the temperature occurs after the cold air application. Subjects were prepared in a relaxed prone position. Cold air of CRAis(Kyung-won Century, Korea) was applied to the gluteal area of 20 healthy subjects for 5 minutes. The skin and intramuscular temperatures were measured by a thermogram(Infrared system, Sweden) and digital thermometers(Barnant company, USA). The temperatures were measured before and 30 seconds after the cold air application, and then every 5 minutes for the next 110 minutes. The few variables were considered that might affect the temperature changes. The thermometer-probes were inserted into the outer quadrant of the gluteal muscle below 5 cm from the iliac crest with the depth of 2 cm, 4 cm, and 6 cm respectively. ANOVA was used for the analysis of the data. The resting temperature of the skin surface was 32.6+/-1.2oC, and the lowest temperature was 12.9+/-3.3oC after 5 minutes of cold air application. The resting intramuscular temperatures with 2 cm, 4 cm, and 6 cm depth were 36.5+/-0.2oC, 36.9+/-0.2oC, and 37.1+/-0.2oC respectively (p<0.05). The lowest temperature in 2 cm, 4 cm, and 6 cm depth was 35.1+/-0.7oC, 36.2+/-0.4oC, and 36.9+/-0.3oC respectively(p<0.05). The mean duration to reach the lowest temperature was 20, 25, and 45 minutes respectively. The temperatures in the skin and the muscle with the depth of 2 cm, 4 cm, and 6 cm after 2 hours on cold air application were 32.2+/-1.1oC, 36.2+/-0.5oC, 36.6+/-0.3oC, and 36.9+/-0.3oC(p<0.05) respectively. The temperatures in the skin and the muscle were significantly lower after 2 hours than before the cold air application(p<0.05). The change of skin surface temperature was more rapid than that of the muscle and the deeper the muscle was the lesser the temperature change. In conclusion, the effect of cold air application for 5 minutes lasts up to 2 hours and the rebound rise of the temperature due to reactive vasodilatation seems not to occur in the gluteal muscle.
Cryotherapy ; Prone Position ; Skin Temperature ; Skin* ; Vasodilation

The mechanism of vasodilation induced by fentanyl was investigated using isolated rat thoracic aortic rings. Rings were contracted with norepinephrine(10(-7) M, NE) and potassium chloride(40 mM, KC1) with and without endothelium Fentanyl (10(-9)-10(-5) M) produced dose-dependent relaxation and had no significant effect from endothelium(intact and denuded rings, test with 3X10(-4) M LNAME, N-nitro-L-arginine methyl ester). Pretreatment of indomethacin(2.5X10(-3) M, inhibitor of cyclooxygenase) failed to influence of cumulative dose-response curves. RD(50)(50% relaxation dose) and KC1/NE ratio as potency difference of fentanyl, verapamil(10(-8)-10(-5) M, Ca2+ channel blocker), nitroglycerin(10(-10)-10(-5) M, activator of guanylate cyclase) were not similar. Fentanyl and control(distilled water) were not demonstrated any different contraction produced by incremental addition of Ca2+ to aortic rings exposed to Ca2+ free, K+ -depolarized(100 mM KCl) solution(extracellular Ca2+ influx). But fentanyl had effect on intracellular Ca2+ release elicited by caffeine(20 mM) and NE(10(-7) M) indicated by dose-dependent inhibition of contraction in Ca2+ free solution. We conclude that, in rat aorta, fentanyl-induced relaxation is endothelium-independent but mediated by inhibition of alpha-adrenoceptors operated intracellular Ca2+ release (inhibition of contraction by NE) and caffeine-induced Ca2+ release from store.
Animals ; Aorta* ; Endothelium ; Fentanyl* ; Muscle, Smooth* ; Potassium ; Rats* ; Relaxation* ; Vasodilation

BACKGROUND AND OBJECTIVES: Flow-mediated brachial artery vasoactivity has been proposed as a noninvasive means for assessing endothelial function. The present study is designed to assess the influence of aging on endothelial function and when vasoactivity developed initially, peaked. MATERIALS AND METHOD: We measured brachial artery diameter for 60 seconds continuously using 7.5 MHz ultrasound following 5 minutes of lower arm occlusion in 22 normal volun-teers (young group: 10 volunteers, 26.5+/-1.9 years; old group: 12 volunteers, 55.9+/-3.3 years). After sublingual administration of 0.6 mg nitroglycerine, 240 seconds continuously. And then we measure vasoactivity every 3 seconds. RESULTS: Flow-mediated vasodilation (FMD) was started earlier in young group (24.3+/-2.8 sec; old group 28.8+/-3.6 sec, p=0.017). After release of occlusion, peak vasoacitivity time was at 35.5+/-4.7 seconds and peak vasoactivity was 8.4+/-1.7% in young group (old group 6.9+/-1.5%, p=0.099). Endothelial independent vasodilation (EID) was started at 80.7+/-13.3 seconds after sublingual nitroglycerine in young group (vs 80.0+/-19.0 sec), peaked at 177.5+/-16.9 seconds (vs 171.3+/-13.8 sec). Peak vasoactivity was higher in young group (19.1+/-3.1%; old group 15.9+/-2.5%, p=0.033). CONCLUSION: We conclude that 1) Aging has influence on endothelial function about initiating time of vasoactivity as well as peak vaso- activity. 2) FMD can be measured around 50 seconds after release of brachial artery occlusion and EID at 180 seconds after application of sublingual nitroglycerine. 3) The initiating time of vasoactivity (under 30 seconds) can be used for evaluation of endothelial function.
Administration, Sublingual ; Aging* ; Arm ; Brachial Artery ; Nitroglycerin ; Ultrasonography* ; Vasodilation ; Volunteers

BACKGROUND AND OBJECTIVES: The achievement of maximal vasodilatation is mandatory for obtaining valid measurements of the coronary flow reserve (CFR) and the fractional flow reserve (FFR). Recent studies have indicated that an incremental dose or a high dose of adenosine is necessary to achieve maximal hyperemia. We performed this study to examine the response of the physiologic parameters to different doses and to different methods of administration of adenosine in Koreans. SUBJECTS AND METHODS: CFR: The CFR was measured in 25 consecutive patients with angiographically normal coronary arteries by using a Doppler wire. Three different doses (9, 18 and 36 microgram in the left coronary artery (LCA), and 6, 12 and 24 microgram in the right coronary artery (RCA)) of adenosine were used. FFR: In a phase I study, 102 consecutive patients with 188 intermediate lesions (160 LCA and 28 RCA lesions) underwent FFR measurements with using a pressure wire. Three different bolus doses (20, 40 and 80 microgram) were administered in an incremental fashion. In a phase II study, the hyperemic efficacy of 3 different doses of intracoronary (IC) infusion (180, 240 and 300 microgram/min) and of 3 methods of administration (IC infusion, intravenous infusion and IC bolus) were compared. RESULTS: CFR: The higher 2nd dose of adenosine had a tendency to achieve a higher CFR than the lower 1st dose. But when we increased the adenosine to more than 20 microgram (LCA 36 and RCA 24 microgram), there was a tendency towards obtaining a lower CFR than that obtained after the 2nd dose of adenosine (LCA: 2.78+/-0.71 vs. 2.66+/-0.60, p=0.055, RCA: 3.19+/-0.88 vs. 3.04+/-0.80, p=0.86). FFR: Phase I: The dose of adenosine that achieved maximal hyperemia was 51+/-16 microgram in the LCA and 35+/-20 microgram in the RCA. In 73 (46%) of the LCA lesions and 12 (42%) of the RCA lesions, a further reduction of the FFR occurred when a higher dose of adenosine was used (LCA>40 ug, RCA>20 microgram). Phase II: The FFR obtained after an IC bolus injection (0.83+/-0.06) was significantly higher than obtained with an IV infusion (0.79+/-0.07) and an IC (0.78+/-0.09) infusion (p<0.01). However, no difference in the FFR was observed for the IC and IV infusions. CONCLUSION: This study suggests that more than 20 microgram adenosine does not have an additive effect on measuring the CFR. Adenosine 40 microgram for the LAD and 20 microgram for the RCA seems to be optimal as a intracoronary bolus injection for measuring the FFR in most cases. However, for the patients with borderline FFR, a higher bolus adenosine dose or an adenosine continuous infusion may be necessary.
Adenosine* ; Coronary Vessels ; Humans ; Hyperemia ; Infusions, Intravenous ; Vasodilation

BACKGROUND AND OBJECTIVES: alpha-Lipoic acid (ALA) is known to improve endothelial function in patients with diabetes. However, the effect of ALA on endothelial function in hypertensive patients is unknown. The aim of this study was to investigate whether ALA improves endothelial function in diabetic and hypertensive patients. SUBJECTS AND METHODS: This study included 40 patients who were treated with ALA (Group I: 20 diabetic patients, 54.9+/-10.2 years, Group II: 20 hypertensive patients, 56.5+/-9.0 years). ALA was administered in 600 mg/day doses during the first four weeks, and 1,200 mg/day doses during the second four weeks. Clinical characteristics and endothelial function were assessed at baseline, 4 weeks and 8 weeks after ALA administration. Evaluation of patients included: assessment of the brachial artery for flow mediated vasodilation (FMD) and the inflammatory marker (high sensitive CRP: hsCRP). RESULTS: Clinical characteristics (body mass index, total cholesterol/HDL-cholesterol and hsCRP) were unchanged in each group. However, FMD was significantly improved at 8 weeks after ALA therapy in both groups. Group I-baseline: 4 weeks : 8 weeks = 4.1+/-3.3 : 6.5+/-2.2 : 8.0+/-2.7, Group II-baseline: 4 weeks : 8 weeks = 5.5+/-3.7 : 7.4+/-3.3 : 9.3+/-2.7, p<0.05. The level of fibrinogen was observed to have an inverse correlation with FMD at 8 weeks after ALA therapy in Group I (p<0.05). CONCLUSION: ALA improves endothelial function in both diabetic and hypertensive patients.
Brachial Artery ; Fibrinogen ; Humans ; Hypertension ; Thioctic Acid ; Vasodilation