|
1
|
Cui HC, Chang ZQ, Zhao SK. Atypical cervical spondylotic radiculopathy resulting in a hypertensive emergency during cervical extension: A case report and review of literature. World J Orthop 2024; 15:981-990. [DOI: 10.5312/wjo.v15.i10.981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 09/06/2024] [Accepted: 09/14/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.
CASE SUMMARY We here present a 57-year-old woman diagnosed as having cervical spondylotic radiculopathy (CSR) who was scheduled for anterior cervical decompression and fusion. During post-anesthetic positioning, a sudden hypertensive surge was observed when the patient was in a supine position with the neck being slightly extended. This surge was promptly reversed through cervical flexion and head elevation. This event however required an alternate surgical approach for recovery—posterior laminoplasty and endoscopy-assisted nucleus pulposus removal. Following the 6-month outpatient follow-up period, cervical flexion and extension activities substantially improved in the patient without any episodes of increase in acute blood pressure.
CONCLUSION Maintaining a safe hypotensive posture and performing rapid, thorough decompression surgery may serve as effective interventions for patients presenting symptoms similar to those of CSR accompanied by hypertensive emergencies (HE). This would mitigate the underlying causes of these HEs.
Collapse
Affiliation(s)
- Hao-Cheng Cui
- Department of Orthopedic Surgery, 960th Hospital of PLA, Jinan 250031, Shandong Province, China
| | - Zheng-Qi Chang
- Department of Orthopedic Surgery, 960th Hospital of PLA, Jinan 250031, Shandong Province, China
| | - Shao-Ke Zhao
- Department of Orthopedic Surgery, 960th Hospital of PLA, Jinan 250031, Shandong Province, China
| |
Collapse
|
|
2
|
Chen YH, Lei SS, Li B, Luo R, He X, Wang YZ, Zhou FC, Lv GY, Chen SH. Systematic Understanding of the Mechanisms of Flos Chrysanthemi Indici-mediated Effects on Hypertension via Computational Target Fishing. Comb Chem High Throughput Screen 2021; 23:92-110. [PMID: 31969096 DOI: 10.2174/1386207323666200122105410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/29/2019] [Accepted: 12/31/2019] [Indexed: 02/08/2023]
Abstract
AIMS AND OBJECTIVE Hypertension-induced stroke and coronary artery disease are significant causes of global morbidity and mortality. Metabolic hypertension has recently become the leading cause of hypertension. Flos Chrysanthemi Indici (CIF) has a long history as a treatment of hypertension as part of traditional Chinese medicine. However, its mechanisms of activity remain largely unknown. This study was aimed to uncover the potential anti-hypertensive mechanisms of CIF based on network pharmacology. MATERIALS AND METHODS In this research, a systems pharmacology approach integrating the measurement of active compounds, target fishing, gene screening, Gene Ontology (GO) pathway analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) Orthology Based Annotation System (KOBAS) database analysis, and compound-target network construction were performed to explore the anti-hypertensive mechanisms of CIF. RESULTS These studies revealed that 12 bioactive compounds in CIF had good druggability, 5 of which were flavonoids. After screening, 8 of those 12 bioactive compounds interacted with 118 hypertensionrelated target genes, which were mapped to 218 signal pathways. Network analysis showed that these targets were associated with improving insulin resistance, improving vascular function, inhibiting renninangiotensin- aldosterone system (RAAS), inhibiting the sympathetic nervous system (SNS) and regulating other physiological processes. CONCLUSION In summary, CIF is predicted to target multiple proteins and pathways to form a network that exerts systematic pharmacological effects in order to regulate blood pressure and metabolic disorder.
Collapse
Affiliation(s)
- Ye-Hui Chen
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Shan-Shan Lei
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Bo Li
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Rong Luo
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Xinglishang He
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Yu-Zhi Wang
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Fu-Chen Zhou
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Gui-Yuan Lv
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
| | - Su-Hong Chen
- Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| |
Collapse
|
|
3
|
Wu CM, Liao HE, Hsu SW, Lan SJ. Cervicogenic exophthalmos: Possible etiology and pathogenesis. World J Clin Cases 2020; 8:318-324. [PMID: 32047780 PMCID: PMC7000940 DOI: 10.12998/wjcc.v8.i2.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/17/2019] [Accepted: 12/22/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Unilateral exophthalmos is often caused by inflammation, neoplasm, infection, metabolic disease, vascular disorder and several other less common conditions. Reflex sympathetic dystrophy related to unilateral exophthalmos has not been reported in the past literature.
CASE SUMMARY We describe a 45-year-old female with unilateral exophthalmos caused by reflex sympathetic dystrophy and its unexpected spontaneous disappearance after a standard anterior cervical discectomy and fixation operation with two PEEK interbody cages and a plate. To our surprise, the patient’s left unilateral exophthalmos improved spontaneously in the morning on postoperative day 2-with no relapse, without any further medication, as of seven years. We have named this condition “cervicogenic exophthalmos.”
CONCLUSION We would inform other clinicians that unilateral exophthalmos was caused not only by inflammation, vascular disorder, infection, neoplasm, or metabolic disease, but also by reflex sympathetic dystrophy related with cervicogenic spondylosis. To the best of our knowledge, ours is the first related case report and use of the term “cervicogenic exophthalmos” after reviewing previous literature.
Collapse
Affiliation(s)
- Chi-Ming Wu
- Orthopaedic Department, Jen-Ai Hospital, Taichung 40041, Taiwan
- Orthopaedic Department, National Defense Medical Center, Taipei 11465, Taiwan
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
| | - Hung-En Liao
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
| | - Shang-Wei Hsu
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
| | - Shou-Jen Lan
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
| |
Collapse
|
|
4
|
Lin SY, Chen DC, Lin CL, Lee HC, Lin TC, Wang IK, Hsu CY, Kao CH. Risk of acute coronary syndrome in patients with cervical spondylosis. Atherosclerosis 2018. [PMID: 29518745 DOI: 10.1016/j.atherosclerosis.2018.02.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Cervical spondylosis (CS) is reported to be associated with increased sympathetic activity and hypertension. However, the cardiovascular (CV) outcomes of patients with CS are largely unknown. METHODS A national insurance claims dataset of 22 million enrollees in Taiwan during 1999-2010 was used as the research database. We identified 27,948 patients with CS and age-, sex-, and comorbidity-matched controls. By using multivariate logistic regression analysis after adjustment for potential cardiovascular (CV) confounders, we calculated odds ratios (ORs) with 95% confidence intervals (CIs) to quantify the association between CS and acute coronary syndrome (ACS). RESULTS A total of 744 ACS events were identified among the 27,948 patients with CS. The overall incidence of ACS was 4.27 per 1000 person-years in the CS cohort and 3.90 per 1000 person-years in the non-CS cohort, with an adjusted hazard ratio (aHR) of 1.13 (95% CI = 1.08-1.18). The aHRs of ACS were 1.08 (95% CI = 1.03-1.15) in the CS cohort without myelopathy and 1.20 (95% CI = 1.13-1.28) in the CS cohort with myelopathy, compared with the non-CS cohort. Compared with patients with CS without neurological signs, patients with CS receiving rehabilitation exhibited a 0.67 aHRs of ACS (95% CI = 0.59-0.76), whereas those with neurological signs receiving spinal decompression exhibited 0.73 aHRs of ACS (95% CI = 0.63-0.84). CONCLUSIONS CS is associated with an increased risk of ACS. Receiving treatment for CS, either rehabilitation or spinal decompression, is associated with less risk of ACS.
Collapse
Affiliation(s)
- Shih-Yi Lin
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Der-Cherng Chen
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Neurosurgery, China Medical University Hospital and China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Han-Chung Lee
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Neurosurgery, China Medical University Hospital and China Medical University, Taichung, Taiwan
| | - Tsung-Chih Lin
- Department of Orthopedics, St. Martin De Porres Hospital, Chiayi, Taiwan
| | - I-Kuan Wang
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y Hsu
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
| |
Collapse
|
|
5
|
Atlantoaxial Misalignment Causes High Blood Pressure in Rats: A Novel Hypertension Model. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5986957. [PMID: 28791307 PMCID: PMC5534292 DOI: 10.1155/2017/5986957] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/30/2017] [Accepted: 06/07/2017] [Indexed: 02/08/2023]
Abstract
Atlantoaxial disorders are often correlated with hypertension in practice. In order to study the relationship between atlantoaxial disorder and hypertension, we attempted to construct an animal model. In this work, we presented an animal model where their atlantoaxial joints were misaligned. We investigated the changes of blood pressure before and after treatments of the modeled rats. We had the following results. (1) SBP and DBP of each surgery group were significantly higher than those of control and sham groups. (2) After the second operation (the fixture was removed), SBP and DBP of both surgery groups decreased and got closer to the control and sham groups after 7 days. (3) Heart rates got significantly higher in both surgery groups, compared to control and sham groups. (4) The blood Ach levels of the surgery groups were significantly lower than those of control and sham groups. With these results, we concluded that we successfully constructed cervical atlantoaxial disorder models in rats that showed hypertension symptom. However, the underlying mechanism connecting atlantoaxial disorder and hypertension still requires further study.
Collapse
|