게이트 심근 SPECT를 이용한 좌심실의 국소탄성률 평가방법 개발 및 재현성 평가

이병일,이동수,이재성,강원준,정준기,이명철,최흥국 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.6

목적: 게이트 심근 SPECT 영상에서 국소부피변화를 얻으면, 요골동맥 긴장도를 측정하여 얻은 중심 동맥의 압력 곡선으로부터 최대탄성률을 얻을 수 있다. 이 연구에서는 좌심실의 국소탄성률을 평가하기 위한 방법을 개발하고 국소탄성률 측정의 재현성을 평가하였다. 대상 및 방법: 게이트 Tc-99m MIBI 심근 관류 SPECT를 두 번 연속으로 시행한 환자 7명(남:여=5:2, 58±11.9세)을 대상으로 하였다. 국소적 부피변화를 측정하기 위하여 개발한 CSA(Cardiac SPECT Analyzer) 소프트웨어를 이용하여 좌심실의 부피변화를 측정하였으며, 시간-압력 곡선과 국소 시간-부피 곡선을 이용하여 반복연산을 통하여 구한 국소 시간-탄성율 곡선에서 국소탄성률을 얻었다. 같은 SPECT 영상에 대해서 두 번 측정한 국소탄성률의 재현성과, 같은 환자에서 연속하여 두 번 얻은 SPECT 영상에 대해서 측정한 국소탄성률의 재현성을 평가하였다. 결과: 평균 국소탄성률은 15분할모델에서 3.36±3.38 mmHg/mL이었으며, 7분할모델과 5분할모델에서 각각 3.16±2.25 mmHg/mL, 3.11±2.57 mmHg/mL이었다. 국소탄성률의 조화평균은 전체탄성률과 일치하였다. 동일한 데이터에서 두 번 측정한 국소탄성률 값의 상관계수는 모든 모델에서 0.97이상이었고, Bland Altman 도표에서 차이의 2-표준편차는 각각 1.5%, 1.0%, 0.9%였다. 동일 환자에서 두 번 연속 촬영한 SPECT 데이터로부터 측정한 국소탄성률의 상관계수는 모든 모델에서 0.95이상이었으며, Bland Altman 도표에서 차이의 2-표준편차는 각각 2.2%, 1.0%, 1.2%였다. 결론: 게이트 심근 SPECT를 이용한 좌심실의 국소탄성률을 측정하였으며 재현성 있는 결과를 얻었다. 심근 SPECT를 이용하여 얻은 국소탄성률의 평가방법은 향후 임상적인 데이터를 바탕으로 새로운 심기능 분석지표로 활용될 수 있을 것이다. Purpose: Regional contractility can be calculated using the regional volume change of left ventricle measured by gated myocardial SPECT image and curve of central artery pressure obtained from radial artery pressure data. In this study, a program to obtain the regional contractility was developed, and reproducibility of regional contractility measurement was assessed. Materials and Methods: Seven patients )male:female=5:2, 58±11.9 years) with coronary artery diseases underwent gated Tc-99m MIBI myocardial SPECT twice without delay between two scans. Regional volume change of left ventricle was estimated using CSA (Cardiac SPECT Analyzer) software developed in this study. Regional contractility was iteratively estimated from the time-elastance curve obtained using the time-pressure curve and regional time-volume curve. Reproducibility of regional contractility measurement assessed by comparing the contractility values measured twice from the same SPECT data and by comparing those measured from the pair of SPECT data obtained from a same patient. Results: Measured regional contractility was 3.36±3.38 mmHg/mL using 15-segment model, 3.16±2.25 mmHg/mL using 7-segment model, and 3.11±2.57 mmHg/mL using 5-segment model. The harmonic average of regional contractility value was almost identical to the global contractility. Correlation coefficient of regional contractility values measured twice from the same data was greater than 0.97 for all models, and two standard deviations of contractility difference on Bland Altman plot were 1.5%, 1.0%, and 0.9% for 15-, 7-, and 5-segment models, respectively. Correlation coefficient of regional contractility values measured from the pair of SPECT data obtained from a same patient was greater than 0.95 for all models, and two standard deviations on Bland Altman plot were 2.2%, 1.0%, and 1.2%. Conclusion: Regional contractility of left ventricle measured using developed software in this study was reproducible. Regional contractility of left ventricle will be a new useful index for myocardial function after analysis of the clinical data.

Alterations of Colonic Contractility in an Interleukin-10 Knockout Mouse Model of Inflammatory Bowel Disease

( Jae Hyung Park ),( Joong Goo Kwon ),( Sun Joo Kim ),( Dae Kyu Song ),( Seok Guen Lee ),( Eun Soo Kim ),( Kwang Bum Cho ),( Byung Ik Jang ),( Dae Hwan Kim ),( Jeong Im Sin ),( Tae Wan Kim ),( In Hwan 대한소화기기능성질환·운동학회 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.1

Background/Aims Inflammatory bowel disease is commonly accompanied by colonic dysmotility and causes changes in intestinal smooth muscle contractility. In this study, colonic smooth muscle contractility in a chronic inflammatory condition was investigated using smooth muscle tissues prepared from interleukin-10 knockout (IL-10./.) mice. Methods Prepared smooth muscle sections were placed in an organ bath system. Cholinergic and nitrergic neuronal responses were observed using carbachol and electrical field stimulation with L-NG-nitroarginine methyl ester (L-NAME). The expression of interstitial cells of Cajal (ICC) networks, muscarinic receptors, neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS) was observed via immunofluorescent staining. Results The spontaneous contractility and expression of ICC networks in the proximal and distal colon was significantly decreased in IL-10./. mice compared to IL-10+/+ mice. The contractility in response to carbachol was significantly decreased in the proximal colon of IL-10./. mice compared to IL-10+/+ mice, but no significant difference was found in the distal colon. In addition, the expression of muscarinic receptor type 2 was reduced in the proximal colon of IL-10./. mice. The nictric oxide-mediated relaxation after electrical field stimulation was significantly decreased in the proximal and distal colon of IL-10./. mice. In inflamed colon, the expression of nNOS decreased, whereas the expression of iNOS increased.Conclusions These results suggest that damage to the ICC network and NOS system in the proximal and distal colon, as well as damage to the smooth muscle cholinergic receptor in the proximal colon may play an important role in the dysmotility of the inflamed colon.

Ameliorative effects of atractylodin on intestinal inflammation and co-occurring dysmotility in both constipation and diarrhea prominent rats

Yu, Changchun,Xiong, Yongjian,Chen, Dapeng,Li, Yanli,Xu, Bin,Lin, Yuan,Tang, Zeyao,Jiang, Chunling,Wang, Li The Korean Society of Pharmacology 2017 The Korean Journal of Physiology & Pharmacology Vol.21 No.1

Intestinal disorders often co-occur with inflammation and dysmotility. However, drugs which simultaneously improve intestinal inflammation and co-occurring dysmotility are rarely reported. Atractylodin, a widely used herbal medicine, is used to treat digestive disorders. The present study was designed to characterize the effects of atractylodin on amelioration of both jejunal inflammation and the co-occurring dysmotility in both constipation-prominent (CP) and diarrhea-prominent (DP) rats. The results indicated that atractylodin reduced proinflammatory cytokines TNF-${\alpha}$, IL-$1{\beta}$, and IL-6 in the plasma and inhibited the expression of inflammatory mediators iNOS and NF-kappa B in jejunal segments in both CP and DP rats. The results indicated that atractylodin exerted stimulatory effects and inhibitory effects on the contractility of jejunal segments isolated from CP and DP rats respectively, showing a contractile-state-dependent regulation. Atractylodin-induced contractile-state-dependent regulation was also observed by using rat jejunal segments in low and high contractile states respectively (5 pairs of low/high contractile states). Atractylodin up-regulated the decreased phosphorylation of 20 kDa myosin light chain, protein contents of myosin light chain kinase (MLCK), and MLCK mRNA expression in jejunal segments of CP rats and down-regulated those increased parameters in DP rats. Taken together, atractylodin alleviated rat jejunal inflammation and exerted contractile-state-dependent regulation on the contractility of jejunal segments isolated from CP and DP rats respectively, suggesting the potential clinical implication for ameliorating intestinal inflammation and co-occurring dysmotility.

Ameliorative effects of atractylodin on intestinal inflammation and co-occurring dysmotility in both constipation and diarrhea prominent rats

Changchun Yu,Yuan Lin,Yong-jian Xiong,Da-peng Chen,Yanli Li,Bin Xu,Zeyao Tang,Chunling Jiang,Li Wang 대한약리학회 2017 The Korean Journal of Physiology & Pharmacology Vol.21 No.1

Intestinal disorders often co-occur with inflammation and dysmotility. However, drugs which simultaneously improve intestinal inflammation and cooccurring dysmotility are rarely reported. Atractylodin, a widely used herbal medicine, is used to treat digestive disorders. The present study was designed to characterize the effects of atractylodin on amelioration of both jejunal inflammation and the co-occurring dysmotility in both constipation-prominent (CP) and diarrheaprominent (DP) rats. The results indicated that atractylodin reduced proinflammatory cytokines TNF-α, IL-1β, and IL-6 in the plasma and inhibited the expression of inflammatory mediators iNOS and NF-kappa B in jejunal segments in both CP and DP rats. The results indicated that atractylodin exerted stimulatory effects and inhibitory effects on the contractility of jejunal segments isolated from CP and DP rats respectively, showing a contractile-state-dependent regulation. Atractylodininduced contractile-state-dependent regulation was also observed by using rat jejunal segments in low and high contractile states respectively (5 pairs of low/ high contractile states). Atractylodin up-regulated the decreased phosphorylation of 20 kDa myosin light chain, protein contents of myosin light chain kinase (MLCK), and MLCK mRNA expression in jejunal segments of CP rats and down-regulated those increased parameters in DP rats. Taken together, atractylodin alleviated rat jejunal inflammation and exerted contractile-state-dependent regulation on the contractility of jejunal segments isolated from CP and DP rats respectively, suggesting the potential clinical implication for ameliorating intestinal inflammation and co-occurring dysmotility.

흰쥐 적출 대동맥에서의 알파-1 아드레날린성 수용체 탈감작 현상

최도희,한형수,박정숙,김중영 慶北大學校 醫科大學 1994 慶北醫大雜誌 Vol.35 No.4

Newer Insights into the Antidiarrheal Effects of Acacia catechu Willd. Extract in Guinea Pig

Matteo Micucci,Roberto Gotti,Ivan Corazza,Gabriella Tocci,Alberto Chiarini,Marta De Giorgio,Luca Camarda,Maria Frosini,Carla Marzetti,Monica Cevenini,Roberta Budriesi 한국식품영양과학회 2017 Journal of medicinal food Vol.20 No.6

Acacia catechu Willd. is a plant diffused in India and other Asian countries, where it is used as a traditional medicine for the treatment of several ailments including diarrhea, one of the most common pathologies worldwide. In this study, we determined the chemical composition of Acacia catechu Willd. extract (AC) and evaluated its effect on spontaneous and induced contractility in isolated guinea pig ileum and proximal colon. Preliminary data about its antimicrobial effect against some pathogen agents versus some microbiota intestinal strain have been also reported. Chemical analysis revealed the presence of catechins, such as (−)-Epicatechin and (+)-Catechin. AC extract reduced frequency and amplitude of colon smooth muscle spontaneous contractility, in a concentration-dependent manner. A weaker effect of the extract was exerted toward ileum smooth muscle spontaneous contractility. The observed calcium antagonistic effect was more potent in proximal colon than in ileum. The extract showed a noncompetitive reversible antagonism to carbachol, both in proximal colon and ileum, with a higher potency in proximal colon. The antimicrobial effects of AC extract were observed toward Campylobacter jejuni, Escherichia coli, and Salmonella spp., while Bifido and Lactobacillus were not affected by treatment. These effects, however, occurred at concentrations fivefold higher than those inhibiting ileum and colon contractility. In conclusion, our results suggest that AC affects intestinal contractility without affecting intestinal bacterial flora and this may result in clinical benefits in patients suffering from nonbacterial diarrhea.

흰쥐 적출 대동맥에서의 알파-1 아드레날린성 수용체 탈감작 현상

최도희,한형수,박정숙,김중영 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.4

목적 : 흰쥐의 적출 대동맥 절편에서 알파-1 아드레날린성 수용체의 탈감작에 따른 수축력 변화를 확인하고 수축력 변화와 관련된 요인들과의 관계를 검정하기 위해 실시되었다. 대상 및 방법 : Sprague-Dawley rat의 대동맥을 적출하여 알파-1 아드레날린성 수용체 선택적 효현제인 phenylephrine으로 탈감작시킨 뒤 수축력과 이완력의 변화를 확인하였다. 결과 : Phenylephrine에 의한 수축력은 phenylephrine 탈감작에 의해 감소되었다. EDRF와 관련이 있는 이완제인 acetylcholine과 histamine에 의한 이완반응은 phenylephrine 처치로서 변화를 볼 수 없었으나 sodium nitroprusside에 의한 이완은 항진되었다. 탈감작현상은 LNMMA와 methylene blue처치로 인해 영향을 받지 아니하였다. KCl에 의한 수축은 phenylephrine 탈감작으로 억제되었으나 phorbol ester에 의한 수축은 phenylephrine 탈감작으로 인해 영향을 받지 아니하였다. 결론 : phenylephrine에 의해 나타나는 알파-1 수용체 탈감작에 따른 수축력 감소 현상은 이완 작용의 변화와는 관련이 없으며 수축기전의 변화, 특히 calcium에 대한 반응성의 변화에 기인함을 시사하였다. We evaluated alpha 1 adrenergic receptor desensitization and decreased contractility in isolated rat aorta. 4 hour exposure to 10^-5M of phenylephrine (phenylephrine exposure) decreased phenylephrine(10^-10 to 10^-5M)-induced contractility. Phenylephrine exposure had no effect on the relaxation by NO releasing agents, such as acetylcholine(10^-9 to 10^-5M) and histamine(10^-8 to 10^-4M), but enhanced nitroprusside(10^-10 to 10^-6M)-induced relaxation. Phenylephrine-induced desensitization was not altered by the presence of methylene blue and N-monomethyl-L-arginine. After phenylephrine exposure KCl-induced contractility was decreased but phorbol ester-induced contractility was not changed. From these results we can assume that prolonged phenylephrine exposure alter calcium-dependent contraction mechanism and involve in alpha 1 adrenergic receptor desensitization-mediated decrease in contractility.

Adriamycin을 사용한 환아에서 심초음파를 이용한 좌심실 기능의 평가 : 심근 수축력의 부하 비의존족 지표 및 휴식시와 운동시의 비교

박병수,박혜영,이해용,Park, Pyoung Soo,Park, Hye Young,Lee, Hae Yong 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.2

목 적 : Anthracylines계 약물은 매우 효과적이며 널리 사용되고 있는 항암제이다. 그러나 심근손상이라는 중요한 합병증이 있으며 이는 종종 중하거나 심지어는 치명적이다. 본 연구의 목적은 anthracyacline을 사용했던 소아 암환자에서 비침습적이고 비교적 안전한 심장초음파를 이용하여, 기존의 지표에 비해 좀 더 정확하고 주위변수의 영향을 덜 받으면서 심근손상 여부를 판정하기 위해 고안되었다. 방 법 : Adriamycin을 투여 받았던 17명의 환자군과 20명의 대조군을 대상으로 좌심실 내경, 심실벽 긴장도 그리고 수축기능이 평가되었다. 17명의 환자에 대해서는 2번에 걸쳐 검사가 시행되었는데, 휴식상태(group 1)와 운동을 하고 난후(group 2)에 검사를 각각 시행하였다. 결 과 : 이완기 말 좌심실 내경은 두 군에서 모두 정상 대조군에 비해 감소된 소견을 보였고 통계적으로 의미가 있었다. 그러나 두 군간의 통계적인 차이는 없었다. 이완기 말 좌심실 용적과 심실벽 크기는 두군에서 정상 대조군에 비해 감소된 소견을 보였으며, 통계적으로 모두 의미가 있었다. Group 2에서 group 1보다 낮은 값을 보였으나, 두 군간의 통계적인 의미는 없었다. 수축기말 경선 긴장도는 두 군에서 모두 증가하였으며, group 1에서 group 2 보다 낮은 값을 보였으나, 두 군간의 통계적인 의미는 없었다. 분획단축으로 평가된 수축능력은 group 1에서는 17명 중 5명(29%)에서 비정상적인 결과를 나타내었고, group 2에서는 17명 중 6명(35%)에서 수축능력의 이상을 나타내었다. 그러나 nonparametric testing으로 검정한 결과 두 군간의 특이한 차이는 없었다. 한편, 부하 비의존적 지표인 원주상 섬유 단축속도와 수축기말 경선 긴장도와의 관계에 있어서는 두 군간에 차이가 있음이 관찰되었는데, group 1에서 17명 중 7명(41%), group 2에서는 17명 중 12명(71%)에서 현저한 비정상 변화를 보였으며, 이는 통계적으로 의미가 있었다. 결 론 : 분획단축과 같은 부하 의존적 수축기 지표는 전부하 혹은 후부하의 보상적 변화에 의해서 비정상소견을 보이지 않을 수 있으며, 이로 인해 수축력의 장애가 가려질 수 있다. 따라서 부하 비의존적 지표인 수축기 말 압력과 내경과의 기울기 관계 및 운동 후 수축기말 심실벽 긴장에 따른 원주상 섬유 단축속도의 변화를 규명함으로써 심장의 수축능력을 지속적으로 감시하는 것이 심근손상의 조기발견에 도움이 될 것으로 생각된다. Purpose : The aim of this study was to evaluate myocardial injury in children treated with adriamycin by echocardiography, which is non-invasive and safe measurement for children. Methods : Left ventricular dimensions, wall stress, and contractile function were determined by echocardiographic methods in 17 patient recepients with adriamycin chemotherapy at rest(group 1) and during stress(group 2). Twenty age-matched normal subjects were established as control group. Results : End-diastolic dimension was decreased in both groups(group 1; $92{\pm}7%$ of normal, group 2; $87{\pm}8%$ of normal, P<0.05). Left ventricular end diastolic volume and wall mass were also decreased in both groups(group 1; $96{\pm}12mL/m^2$ and $145{\pm}18g/m^2$, group 2; $87{\pm}8mL/m^2$ and $137{\pm}16g/m^2$, respectively, P<0.05 and P<0.05) and group 2 showed lower values than group 1. Meridional end systolic stress(ESSm) was increased in both groups but there was no significant difference between the two groups(group 1; $52.6{\pm}6.2g/cm^2$, group 2; $63.5{\pm}8.5g/cm^2$, P<0.05, normal value $45.7{\pm}3.5g/cm^2$). The load-independent relation of rate-corrected circumferential fiber shortening velocity(Vcfc) to ESSm has a significant abnormal change in 7 out of 17(41%) in group 1 and 12 out of 17(71%) in group 2. Conclusion : The load-dependent systolic index, such as fractional shortening, may fail to show abnormality because of the compensatory changes in preload and afterload which can mask the impaired contractility. Therefore, systolic performance also should be monitored by a load-indepedent contractility index such as slope value of the end-systolic pressure-dimension relation and the position of the left ventricular stress-fiber shortening velocity after exercise.

Analysis of the Growth Characteristics of Cardiac Cells According to Mechanical Properties of Substrates Using the Simplified Measurement Technique of Tracker

( Abdullah ),( Pooja P. Kanade ),( Nomin-erdene Oyunbaatar ),( Yun-jin Jeong ),( Dong-su Kim ),( Dong-weon Lee ) 한국센서학회 2022 센서학회지 Vol.31 No.1

To date, various techniques have been utilized to assess the contractility of cardiomyocytes and their response to drug-induced toxicity. However, these techniques are either invasive or involve complex fabrication methods and expertise. Here, we introduce the use of video-based analysis software to track the motion of cardiomyocytes and assess their contractility. The software, called “Tracker”, is freely available and this is the first attempt at using it for cardiac contractility measurement. We used the software to measure the contractile properties of cells cultured on a rigid substrate and two flexible polydimethylsiloxane (PDMS) substrates having different elastic moduli day-wise up to eight days. Contractility was found to be highest in the most flexible substrate. Subsequently, the cardiotoxicity response of the cells on three different substrates was analyzed with verapamil. It was observed that the cells on rigid substrate were primarily affected by drug-induced toxicity, while the drug had a lesser impact on cells on the more flexible PDMS substrate. Evidently, the flexible substrate aided the maturation of cells and had lower drug toxicity, while the cells on PS could not fully mature. The assessment of cardiomyocytes using “Tracker” proved to be simple and reliable.

A Comparison of Mathematical Models of Left Ventricular Contractility Derived from Aortic Blood Flow Velocity and Acceleration: Application to the Esophageal Doppler Monitor

Glen Atlas,John K-J. Li,John B. Kostis 대한의용생체공학회 2014 Biomedical Engineering Letters (BMEL) Vol.4 No.3

Purpose The esophageal Doppler monitor (EDM) hastraditionally been used for minimally-invasive and continuousassessment of both cardiac output and intravascular volume. These measurements are based upon a beat-to-beat analysisof the velocity of distal thoracic aortic blood flow. Thepurpose of this paper is to compare different mathematicalmodels of LV contractile function which could utilize theEDM and subsequently be determined on a continuous basis. Methods This study investigated velocity-based contractilitymodels: peak velocity, (PV); ejection fraction, EF; meanejection fraction, ; and maximum LV radial shorteningvelocity, . Also examined are acceleration-basedmodels: mean acceleration, (MA); force, (F); the maximumrate of rise of systolic arterial blood pressure, ; andkinetic energy, (KE). Results When normalized and subsequently observed on adimensionless basis, acceleration-based models appear tohave a statistically significant greater sensitivity to changesin LV contractility. Furthermore, by combining simultaneousarterial blood pressure measurements with EDM-based flow information, the components of afterload and their effects onLV contractility could be estimated. Conclusions Future research is warranted to determine theapplicability and limitations of the EDM in continuousassessment of LV contractility and related hemodynamicparameters.