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한국형 출혈열 환자에서 병기에 따른 혈중 Atrial Natriuretic Polypeptide 농도의 변화
박정의(Jeong Euy Park),송치욱(Chi Wook Song),송관규(Gwan Gyu Song),표회정(Heui Jung Pyo),박승철(Seung Chull Park),이창홍(Chang Hong Lee),김대원(Dae Won Kim),이갑노(Kap Ro Lee),양영선(Yung Sun Yang),황흥곤(Heung Kon Hwang),문정식(Jung 대한내과학회 1987 대한내과학회지 Vol.33 No.6
N/A The plasma atrial naturiuretic polypeptide (ANP) was repeatedly measured in each clinical phases in 20 patients (20.8±7.2yr) with Korean Hemorrhagic Fever (KHF). The study purpose was to see whether there is any relationship between the clinical course of KHF and the changes of plasma level of ANP. In three patients the plasma ANP could be repeatedly measured from the early oliguric to diruetic phases. In these three patients the plasma level of renin activity and aldosterone were very high in the early oliguric phase. Then the plasma renin activity and aldosterone level decreased steeply in remarkable degree to near normal level while the patient is still in oliguric phase and stayed at this level during the diuretic phase. The plasma ANP level was low (30-80pg/ml) in the early oliguric phase. Then with the sudden remarkable decrease of plasma renin activity and aldosterone the plasma ANP increased rapidly to high level (230-280pg/ml), then was decreased to near normal level (90-190pg/ml) making a narrow peaked plasma ANP concentration curve, and then the level stayed at near normal level during the diuretic phase. Around the time when the plasma renin activity and aldosterone concentrations were decreased to their low level and the plasma ANP was increased to it's peak level the oliguric phase was changed to the diuretic phase. The changes of plasma cortisol level followed the pattern of changes of plasma renin and aldosterone. It is possible that the increase of plasma ANP level might have had some role in the initiation of diuretic phase in these patients. It is not certain whether these changes are the unique changes seen only in patients with KHF or the changes seen also in patients with acute renal failure of other causes.
관상동맥질환 환자 , 운동선수 및 정상 대조군에서 혈청지질 및 Apolipoproteins 에 대한 연구
박정의(Jeong Euy Park),김우주(Woo Joo Kim),최인석(In Suok Choi),김대원(Dae Won Kim),이갑노(Kap No Lee),김성수(Sung Soo Kim),유원상(Won Sang Yoo),최석구(Suck Koo Choi),이건주(Kun Joo Rhee),서순규(Soon Kyu Suh),이영(Young Lee),고영박(You 대한내과학회 1991 대한내과학회지 Vol.40 No.5
N/A To investigate the usefulness of serum lipids and apolipoproteins as indices of risk factors for coronary artery disease (CAD) and to know the effects of regular exercise on the serum lipids and apolipoproteins, we measured the serum lipids and apolipoproteins in the patients with coronary artery disease, athletes and normal control persons. The study subjects included 67 patients with CAD (57. 8±11.2yr), 22 athletes (21.5±2.1yr) and 62 normal control persons (34.3±11.4yr). 1) In the patients with CAD the serum total cholesterol (TC) was 177. 2±38.5 mg/dl and the HDL-cholesterol (HDL-C) was 39.0±11.2mg/dl. In the normal control persons TC was 162.5±33.5 mg/dl and HDL-C was 42.4±12.6mg/dl, which were not significantly different from the values of CAD patients. 2) The serum apolipopratein A (Apo-A) was significantly lower (201.9±39.6mg/dl, p<0.05), and the apolipoprotein B (Apo-B) was significantly higher (132.3±29.7 mg/dl, p<0.05) in the patients with CAD, compared with normal control persons (age over 40 years; Apo-A: 246.3±39.9 mg/dl, Apo-B: 117.9±26.4 mg/dl). 3) The TC/HDL-C ratio and Apo B/A ratio were significantly higher (4.9±1.6, 0.67±0.17, p<0.005 for TC/HDL-C ratio and p<0.05 for Apo B/A ratio) in the CAD patients compared with normal control persons (age over 40 years; 3.6±1.1, 0.49±0.10). 4) The TC/HDL-C ratio ≥4.0 and Apo B/A ratio ≥0.55 were the good discriminating criteria separating the CAD patients from the normal control persons. 5) In the athletes, the serum triglyceride (TG) was significantly lower (65.7±20.7mg/dl, p<0.001), and the HDL-C was significantly higher (57.8±11.2 mg/dl, p<0.001) compared with normal control persons (age under 30 years; TG; 119.8±94.3 mg/dl, HDL-C: 44.6±11.0mg/dl). The Apo-A, Apo-B, TC/HDL-C ratio and Apo B/A ratio were all significantly lower (p<0.01) compared with those in the normal control persons. 6) Among the athletes, the HDL-C was highest and the TG was lowest in the swimmers compared with fencing players and wrestlers. The Apo B/A ratio and TC/HD1-C ratio were better discriminating indices of risk factors for CAD compared with individual lipids or apolipoprotein values. The Apo-A and Apo-B were considered to be good indices of risks for CAD. The athletes had lowest risks for CAD.
출혈성 신증후군 환자의 혈장 Atrial Natriuretic Polypeptide 농도 변화
박정의(Jeong Euy Park),차대룡(Dae Ryong Cha),김종웅(Jong Woong Kim),표희정(Heui Jung Pyo),이호왕(Ho Wang Lee),문정식(Jung Sik Moon),황흥곤(Heung Kon Hwang),김대중(Dai Joong Kim) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A Hemorrhagic fever with renal syndrome (HFRS) is characterized clinically by acute renal failure and pathologically by dense hemorrhage in the right atrium and medulla of the kidneys. To investigate whether there is any significant relationship between the changes of plasma atrial natriuretic polypeptide (ANP) and the clinical course, the plasma ANP was measured in 21 patients with HFRS. The plasma ANP was normal to low during the early oliguric phase (94.6±37.0 pg/ml), went up to a very high level (292.4±190.4 pg/ml) at the beginning of diuresis, then fell to a near normal level in a few days. The plasma renin activity (PRA) was very high during the early oliguric phase and fell rapidly in an opposite direction to the plasma ANP as the patients began diuresis. The rapid increase of plasma ANP and decrease of PRA seem to play an important role in the beginning of diuresis in HFRS.
백서 심근에서 plasmid 벡터를 이용한 유전자 전달 및 VEGF 유전자 발현의 특성
정진옥 ( Jin Ok Jeong ),박선진 ( Sun Jin Park ),허정은 ( Jeong Eun Huh ),정은아 ( Eun Ah Jung ),오주현 ( Ju Hyeon Oh ),권현철 ( Hyeon Cheol Gwon ),이영주 ( Young Joo Lee ),김선영 ( Sun Young Kim ),박정의 ( Jeong Euy Park ),이원로 대한내과학회 2001 대한내과학회지 Vol.60 No.1
N/A Background : The purpose of this study was to compare gene expression among newly designed eukaryotic expression vectors, and to characterize the pattern of vascular endothelial growth factor(VEGF) expression using the most potent plasmids DNA vector. Methods : After exposure of a beating rat heart (Sprague-Dawley, 250-300g), 5 different types of plasmid DNA was injected directly into the myocardium. Reporter protein was analyzed by ELISA in the extracted heart. Results : The vector harboring cytomegalovirus (CMV) promoter and enhancer induced the strongest expression of reporter gene (chloramphenicol acetyl transferase; CAT) compared to those of pC3.1, pEF1a, RSV, pActin in the rat heart via direct injection of plasmid DNA into the apex (p<0.001). Using pCN-CAT, gene expression showed a dose-dependent response over a range of 0.3-10 ㎍. CAT expression could be detected up to 30 days after 10 ㎍ of pCN-CAT injection with the maximal expression on day 5. In X-gal staining of injected pCN-lacZ gene, β-galactosidase was found only around the needle track in the apex. The expressed hVEGF121 had biologic activity with vascular permeability assay (Miles assay) in guinea pigs. After injection of pCN-hVEGF121 into the apex of the rat heart, the expression of VEGF protein was dose-dependent over the range of 25 and 500 ㎍. VEGF expression was detected up to 14 days with its peak on day 2 after injection of 250 ㎍ of pCN-hVEGF121. When plasmid was injected into the apex of the rat heart, the expression of VEGF in the heart showed concentration gradient from the apex to the base. However, the expression of CAT was detected only in the apex. Conclusion : Plasmids vector with hCMV IE promoter/enhancer will provide clear advantages over other previously developed plasmids and the information regarding the behaviors of VEGF expression may be useful in angiogenic gene therapy of the heart.(Korean J Med 60:3-15, 2001)
심근허혈의 지표로서 운동부하 심전도에서 PR 절 경사의 의의
박창규(Chang Gyu Park),김영훈(Young Hoon Kim),서홍식(Hong Seog Seo),임도선(Do Sun Im),김혜경(Hea Kyung Kim),진동규(Dong Gyu Jin),심완주(Wan Joo Shim),오동주(Dong Joo Oh),박정의(Jeong Euy Park),노영무(Young Moo Ro) 대한내과학회 1993 대한내과학회지 Vol.45 No.4
N/A Objectives: It was postulated that exaggerated atrial repolarization waves seen during exercise may extend from the PR segment into the ST segment and T wave, and thus can produce ST segment depressions mimicking myocardial ischemia. The aim of this study is to investigate whether or not there is any association between P-R segment slope and ST segment depression in exercise ECG for predicting accuracy of myocardial ischemia. Method: The treadmill exercise test was performed using the modified Bruce Protocol (Korea University Hospital Protocol) in 62 patients with chest pain. The P wave amplitude, PR segment slope and duration, the ST segment duration, and the J point depression were studied in Lead II and V5 in 39 patients whose exercise ECG suggested myocardial ischemia. The PR segment slope was determined by measuring the velocity of descent in mm/sec. Coronary arteriography was performed in all patients, and≥50% stenosis in a major cornary artery was considered a significant lesion. Results: The overall sensitivity and specificity of the exercise test in 62 patients was 74% and 43%, respectively. The exercise test results in 10 patients were deemed false positive because of normal coronary arteriograms and left ventricular function. The false positive group was characterized by more marked downsloping PR segments in Lead II at peak exercise (15.9±9.3 mm/ sec vs 4.8±5.6mm/sec, p<0.05) and more rapid peak exercise heart rates than those of the true positive group (151±26 vs 131±25, p<0.05). The sensitivity and specificity of exercise-induced ST depression for CAD were changed as following if positive exercise test with increased PR segment slope is considered as false positive test: 1) with PR segment is slope over 5mm/s: snsitivity 78%, specificity 39% 2) with PR segment slope over 10 mm/s: sensitivity 83%, specificity 45% 3) with PR segment slope over 15 mm/s: sensitivity 79%, specificity 46%. Conclusion: These findings suggest that markedly downsloping PR segment seen in otherwise positive exercise test by ST segment depression criteria is a sign predicting false positive exercise test.