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고혈압 환자에서 24 시간 활동 혈압과 좌심실비대와의 상관관계에 대한 연구
김상욱(Sang Wook Kim),유재격(Jae Kyuk Rhoo),김현대(Hyun Dae Kim),이은우(Eun Woo Lee),이성윤(Sung Yun Lee),박승호(Seung Ho Park),류왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1993 대한내과학회지 Vol.45 No.1
N/A Background: 24-hour noninvasive ambulatory blood pressure monitoring (ABPM) has been shown to be superior to casual BP in predicting target organ involvement in patients with hypertension and assessing anti-hypertensive therapy. This study was done to examine the relation of BP decline from day to night to the echocardiographic parameters of left ventricular anatomy in unselected hypertensive patients and normotensive subjects undergoing 24-hour noninvasive ABPM. Methods: The effect of variation of blood pressure on the echocardiographic parameters of left ventricular hypertrophy were investigated in 71 consecutive subjects. (47 patients with essential hypertension and 24 healthy normotensive subjects). 24-hour noninvasive ambulatory blood pressure monitoring and cross-sectional and M-mode echocardiography were done to examine the relation between ABPM and echocardiographic LVH. Results: 24-hour ambulatory blood pressure was lower than casual blood pressure, and weak relation was noted particularly in patients with mild-to-moderate hypertension. The continuous monitoring of BP throughout day shows characteristic circadian pattern. The highest BP was recorded at 10 am and lowest value was at 2 am-4 am. Ambulatory daytime blood pressure (6 am-8pm) was higher 15% than night-time blood pressure (8 pm-6 am), The correlation coefficient of daytime systolic blood pressure was r=0.42 (p<0.01), twenty-four hours systolic BP was r=0.41 (p<0.05). The daytime and 24 hours systolic BP seems to be more closely related to LVH than night-time BP, but the correlation was not high enough in our study. Conclusion: 24-hour ambulatory blood pressure monitoring is more useful than casual BP in patients with hypertension, and LVH in echocardiography is more closely related to daytime and 24 hours systolic BP than night-time BP.
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난소절제후 Estrogen을 투여한 흰쥐 대동맥에서 Protein Kinase C-α와 Fas 발현의 변화
이왕수,이상엽,안지현,송영빈,김학진,이광재,유재격,김상욱,김태호,김치정,류왕성 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3
Estrogen is believed to decrease coronary artery disease. Protein kinase C-α(PKCα)appear to be important in signal conduction pathways. Estrogen treatment increases catalytic activity of PKCα,and activation of PKCαcan modulate estrogen receptor levels and responsiveness. And it was reported that activation of PKC can protect cells from apoptosis induced by Fas ligation. But the beneficial effect of estrogen on PKCαwas not clearly demonstrated. The objective of this study was to evaluate the role of PKCαafter ovariectomy and estrogen therapy in rat aorta. The results were summarized as below: 1. The significant pathological changes were not observed in the rat aorta irrelevant to ovariectomy and estrogen therapy. 2. The expression of Fas was decreased in the aorta of estrogen-treated rats than that of ovariectomized rats without estrogen therapy. 3. Increased expression of PKCαwas more marked in the aprta of estrogen-treated rats than that of ovariectomized rat without estrogen therapy. In conclusion,PKCαmay be important in signal conduation pathway on the effect of estrogen. Activation of PKCαby estrogen reduced Fas expression, suggesting that PKCαactivation may play a role in protection against atherasclerosis. Further studies are needed to elucidate the role of PKCαafter estrogen therapy.
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고콜레스테롤 식이가 Spontaneously Hypertensive Rat의 체내지질과 항산화성 영양소 상태에 미치는 영향
유언호 ( Yu Eon Ho ),류왕성 ( Lyu Wang Seong ),김현대 ( Kim Hyeon Dae ),유재격 ( Yu Jae Gyeog ),최영선 ( Choe Yeong Seon ),이희숙 ( Lee Hui Sug ),조성희 ( Jo Seong Hui ) 대한내과학회 1993 대한내과학회지 Vol.44 No.5
연구배경 : 고혈압과 고콜레스테롤혈증은 동맥경화와 심혈관계 질환의 대표적인 위험인자로 알려져있다. 순환기 질환과 관련된 영양은 주로 지질영양에 편중되어 왔으며 항산화기능을 영양소에 관하여 조사된 바가 적다. 동맥경화 과정에서 저밀도지단백의 산화는 지질과 산화물의 형성에 의하여 개시되고 촉진되므로 이 과정에서 과산화물 생성을 억제하는 항산화영양소들의 역할이 주목된다. 방법 : 성장기 Wistar쥐 및 자연발생고혈압쥐(SHR)를 대상으로 하여 고콜레스테롤식이를 6개월간 섭취케 함으로써 고콜레스테롤증을 유발시켰으며 고혈압과 고콜레스테롤혈증이 중복된 상황에서 체내 지질상태의 변화와 고혈압 대상의 지질대사 특이성을 조사하고 과산화지질의 형성과 항산화성 영양소들의 유지수준을 평가하였다. 결과 : Wistar쥐의 수축기혈압이 전체 실험기간 동안 102∼120㎜Hg에 머무르는데 비하여 SHR의 수축기혈압은 생후 5주째 평균 118㎜Hg에서 점차 혈압이 상승하여 식이 2개월에는 175±13㎜Hg로 고혈압이 뚜렷하여 졌으며 Wistar쥐와 SHR 모두에서 고콜레스테롤식이에 따른 혈압의 변화는 없었다. 혈청과 간의 콜레스테롤은 식이콜레스텔롤에 의하여 각각 약 2배, 10배 증가하였다. 혈청중성지방과 인지질은 SHR에서 다소 낮았고 간의 중성지방은 고콜레스테롤식이로 유의하게 증가하였다. 혈청지질 과산화물은 SHR에서 높았으나 식이콜레스테롤에 의한 영향은 적었고 간에서는 고혈아과 식이콜레스테롤 모두에 의하여 증가되었다. 혈청, 간의 비타민 E수준은 SHR에서 낮았고 고콜레스테롤식이에 의하여 혈청수준은 더 감소하였다. 비타민 A 수준도 식이콜레스테롤에 의하여 현저히 낮아졌다. 결론 : 고혈압과 고콜레스테롤혈증은 체내 지질과산화물을 증가시키고 비타민 E와 A의 소모를 가져올수 있다. Backgrounds: Hypertension and hypercholesterolemia are two of the most important risk factors for atherosclerosis and cardiovascular morbidity. The mechanism by which hypertension and hypercholesterolemia accelerates atherosclerosis is still uncertain. Methods: To investigate the effect of high cholesterol diet on lipid and antioxidant nutritent status in spontaneously hypertensive rat (SHR), SHRs and Wistar rats were fed diets with or without 2% cholesterol and 0.3% Na-taurocholate for 6 months. Results: SHRs became apparently hypertensive after 2 months of feedings, when their systolic pressure was over 180 mmHg. Heart weight-to-body weight ratios of SHRs were significantly higher than those of Wistar rats. Levels of serum total cholesterol were increased about two-folds and those of liver, ten-folds in both SHRs and Wistar rats by dietary cholesterol. Serum HDL-cholesterol of SHRs were significantly lower than those of Wistar rats and HDL·/total cholesterol. Serum TG levels were not changed, but liver levels increased by dietary cholesterol and lower in SHRs. Serum TBARS levels were higher in SHRs, but little changed by dietary cholesterol. Liver levels appeared to be higher in SHRs and cholesterol groups. Serum and liver vitamin E levels were lower in SHR. Serum vitamin A levels were little changed, but liver contents were somewhat decreased in SHRs and remarkably reduced by dietary cholesterol. Conclusions: It is concluded that hypertension and hypercholesterolemia, individually, result in accumulation of lipid peroxide as well as consumption of body tocopherol and retinol, which can be further augmented by coexistence of two abnormal conditions.
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