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        한국인 폐확산능 정상예측식의 임상적 유용성과 정확성

        나승원 ( Seung Won Ra ),박태선 ( Tai Sun Park ),홍윤기 ( Yoon Ki Hong ),홍상범 ( Sang Bum Hong ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2

        연구배경: 폐확산능을 해석하는 데 필요한 정상예측식으로는 한국인을 대상으로 하여 박 등이 개발한 식(박 식)이 있으나 아직 외국 정상예측식을 많이 사용하고 있다. 이에 국내에서 많이 사용하는 외국 정상예측식인 Burrows 식과 박 식의 임상적 유용성과 정확성을 비교하고자 하였다. 방법: 1. 임상적 유용성 연구; 2006년 7월부터 12월까지 6개월간 폐확산능검사를 시행한 환자 중 두 식을 각각 정상예측식으로 적용하였을 때 폐확산능 해석이 다른 276명(대상군 A)을 대상으로 하였다. 대상군 A에게 두 식을 각각 적용하였을 때 폐확산능 해석과 임상적 판단과의 일치도를 비교하여 임상적 유용성을 평가하였다. 2. 간질성폐질환 진단의 정확성 비교; 2001년부터 2006년까지 폐조직검사를 시행하여 확진된 간질성폐질환군과 서울아산병원에서 모집한 정상군을 대상으로 하여 정상예측식으로 두 식을 각각 적용하였을 때 폐확산능 해석의 정확도를 비교하였고, 두 식이 차이가 나는지 맥니머의 카이스퀘어 검정을 하였다. 결과: 1. 임상적 판단과의 일치도 비교; 276명을 임상정보를 토대로 폐확산능을 예측하여 분류한 결과 정상 54명, 감소 220명, 불분명이 2명이었다. 예측식으로 박 식과 Burrows 식을 적용하였을 때 임상적 판단과 일치하는 환자는 각각 78%와 22%이었다(p<0.001). 2. 간질성폐질환 진단의 정확성 비교; 박 식은 민감도 90.1%, 특이도 100%이었고 Burrows 식은 민감도 64.2%, 특이도 100%로 민감도가 통계학적으로 유의하게 박 식이 높았다(p<0.001). 결론: 우리나라 정상예측식인 박 식이 외국 정상예측식인 Burrows 식을 정상예측식으로 적용하는 것보다 임상적 유용성이나 간질성폐질환 진단의 민감도에서 더 우월하였다. 향후 폐확산능검사의 정상예측식으로 박 식을 사용해야 할 것으로 사료된다. Background: Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park`s equation) with that of the foreign equation (Burrows` equation) that is commonly used in Korea. Methods: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (DLCO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of DLCO in trials employing Burrows` equation and Park`s equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows` equation and Park`s equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows` equation and Park`s equation) for DLCO. Results: Agreement between clinical assessment and interpretation of DLCO was 22% for the use of Burrows` equation and 78% for the use of Park`s equation. The sensitivity and specificity of the Burrows` equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park`s equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park`s equation for diagnosing ILD was significantly higher than that of Burrows` equation (p<0.001). Conclusion: The Korean reference equation (Park`s equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows` equation). (Tuberc Respir Dis 2008;64:80-86)

      • 구속스트레스를 가한 흰쥐에서 Cholate류의 항스트레스작용에 관한 연구

        박인,김양일,이선미,조태순 성균관대학교 약학연구소 1996 成均藥硏論文集 Vol.8 No.1

        This study was done to investigate whether cholic acid derivatives have anti-stress activity and what is a cause of this anti-stress effect. Seven cholic acid derivatives (cholic acid, taurocholic acid, ursodeoxycholic acid, tauroursodeoxychoic acid, chenodeoxy cholic acid, dehydrocholic acid, hyodeoxycholic acid) were used, silymarin and valproic acid were used as positive controls. Stress was induced by restraint immobilization technique plus water immersion (24hrs) and adrenal weight, spleen weight, adrenal ascorbic acid, serum cholesterol, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), adrenal cholesterol, glucose and corticosterone levels were measured as stress indicators. Most cholic acid derivatives markedly decreased the adrenal weight, and TUDCA and DHCA increased the spleen weight. The restraint stress induced increments in serum LDH, ALP and cholesterol were attenuated by most cholic acid derivatives. Cholic acid, taurocholic acid and tauroursodeoxycholic acid only increased the content of adrenal ascorbate. While valproic acid showed an inhibitory effect against stress, silymarin did not. Our findings suggest that most cholic acid derivatives have anti-stress effect and that their anti-stress effect is, in part, related to choleretic activity.

      • KCI등재
      • 신원방우황청심원의 뇌허혈 및 중추신경계에 미치는 영향

        조태순,이선미,이은방,조성익,김용기,신대희,박대규 성균관대학교 약학연구소 1999 成均藥硏論文集 Vol.11 No.-

        Abstract-In order to investigate pharmacological properties of New Wonbang Woohwangchungsimwon Pill(NSCH) and Wonbang Woohwangchungsimwon Pill (SCH), the effects of NSCH and SCH on cerebral ischemia and central nervous system were compared. Cerebral ischemia insult was performed using unilateral carotid artery occlusion in mongolian gerbils. The histological observations showed preventive effects of NSCH and SCH treatments with ischemia-induced brain damage. The ATP in brain tissue was decreased in vehicle-treated ischemic gerbils. This decrease was prevented by SCH treatment. In contrast to what was seen with ATP, lipid peroxide were elevated in vehicle-treated ischemic gerbils. This elevation was inhibited by NSCH and SCH treatments. While NSCH and SCH had no effects on the hexobarbital-induced sleeping time, they prevented the seizures induced by eletric shock and strychnine. NSCH and SCH showed sedative effect in rotarod and spontaneous activity test. Furthermore, NSCH and SCH showed anti-stress effect. Our findings suggest that the pharmacological profiles of NSCH on cerebral ischemia and central nervous system are similar to those of SCH.

      • 신원방우황청심원액의 심혈관계에 관한 약효

        조태순,이선미,김낙두,허인회,안형수,권광일,박석기,심상호,신대희,박대규 성균관대학교 약학연구소 1999 成均藥硏論文集 Vol.11 No.-

        Abstract-In order to investigate the pharmacological properties of New Wonbang Woohwangchungsimwon Liquid (NSCL), effects of Wonbang Woohwangchungsimwon Liquid (SCL) and NSCL were compared. In isolated rat aorta, NSCL and SCL showed the relaxation of blood vessels in maximum contractile response to phenylephrine (10^-6 M) regardless to intact endothelium or denuded rings of the rat aorta. Furthermore, the presences of the inhibitor of NO synthase and guanylate cyclase did not affect the relaxing effect of NSCL and SCL. NSCL and SCL inhibited the vascular contractions induced by acetylcholine, prostaglandin endoperoxide or peroxide in a dose-dependent manner. In conscious spontaneously hypertensive rats (SHRs), NSCL and SCL significantly decreased heart rate. NSCL and SCL, at high doses, had a negative inotropic effect that was a decrease of left ventricular developed pressure and (-dp/dt)/(+dp/dt) in the isolated perfused rat hearts, and also decreased the contractile force and heart rate in the isolated rat right atria. In excised guinea-pig papillary muscle, NSCL and SCL had no effects on parameters of action potential such as resting membrane potential, action potential amplitude, APD_90 and V_max at low doses, whereas inhibited the cardiac contractility at high doses. These results suggested that NSCL and SCL have weak cardiovascular effects with relaxation of blood vessels and decrease of heart rate, and that this effect is no significant differences between cardiovascular effects of two preparations.

      • 신원방우황청심원액의 뇌허혈 및 중추신경계에 대한 약효

        조태순,이선미,이은방,조성익,김용기,신대희,박대규 성균관대학교 약학연구소 1999 成均藥硏論文集 Vol.11 No.-

        Abstract-In order to investigate pharmacological properties of New Wonbang Woohwangchungsimwon Liquid(NSCL) and Wonbang Woohwangchungsimwon Liquid(SCL), the effects of NSCL and SCL on cerebral ischemia and central nervous system were compared. Cerebral ischemia insult was performed using unilateral carotid artery occlusion in mongolian gerbils. The histological observations showed a preventive effect of NSCL and SCL treatments with ischemia-induced brain damage. The ATP in brain tissue was decreased in vehicle-treated ischemic gerbils. This decrease was prevented by NSCL and SCL treatment. In contrast to what was seen with ATP, lipid peroxide were elevated in vehicle-treated ischemic gerbils. This elevation was inhibited by NSCL and SCL treatments. While NSCL and SCL had no effects on the hexobarbital-induced sleeping time, they showed sedative effect in rotarod and spontaneous activity test. NSCL and SCL prevented the seizures induced by electric shock and strychnine, but the effect of NSCL was less than that of SCL. Furthermore, NSCL and SCL showed anti-stress effect. Our findings suggest that the phamacological profiles of NSCL on cerebral ischemia and central nervous system are similar to those of SCL.

      • 人蔘 Total Saponin, Protopanaxadiol 및 Protopanaxatriol의 消炎作用에 關한 硏究

        조태순,이선미,정국현,이범구,이석용,박종대 성균관대학교 약학연구소 1999 成均藥硏論文集 Vol.11 No.-

        Abstract-In an attempt to elucidate the anti-inflammatory action of ginseng total saponin, protopanaxadiol and protopanaxatriol, the anti-inflammatory activity of three compounds was investigated under various acute and chronic inflammatory models. The blood vessel permeability was slightly inhibited by total saponin and protopanaxatriol treatments. Granuloma formation induced by 2% carrageenan was inhibited by total saponin and protopanaxatriol. The cotton-pellet granuloma formation was significantly inhibited by intraperitoneal injection of total saponin. Total saponin and protopanaxadiol inhibited leukocyte emigration and protein exudation in CMC-induced pouch but protopanaxatriol increased leukocyte emigration. The swelling of rat hind paw induced by 1% carrageenan was significantly inhibited by total saponin, protopanaxadiol and protopanaxatriol both single and 2 weeks treatments. Total saponin, protopanaxadiol and protopanaxatriol decreased the anti-inflammatory activity in adrenalectomized rat. Our results suggest that total saponin, protopanaxadiol and protopanaxatriol have potent anti-inflammatory activity, this may be mediated in part through stimulation of adrenal glands.

      • KCI등재
      • 신우황청심원액의 심혈관계에 관한 약효연구

        조태순,이선미,김낙두,허인회,안형수,권광일,박석기,심상호,신대희,박대규 충남대학교 약학대학 의약품개발연구소 1997 藥學論文集 Vol.13 No.-

        In order to investigate the pharmacological properties of New Woohwangchungsimwon Liquid (NCL), efects of Woohwangchungsimwon Liquid (CL) and NCL were compared. In isolated rat aorta, NCL and CL showed the relaxation of blood vessels in maximum contractile response to phenylephrine (10^6M) without regard to intact endothelium or denuded rings of the rat aorta. Furthemore, the presences of the inhibitor of NO synthase and guanylate cyclase did not affect the relaxation of NCL and CL. NCL and CL inhibited the vascular contractions induced by acetylcholine, prostaglandin endoperoxide or peroxide in a dosedependent manner. In conscious spontaneously hypertensive rats (SHRs), NCL and CL significantly decreased heart rate. NCL and CL, at high doses, had a negative inotropic effect that was a decrease of LVDP and (-dp/dt)/(+dp/dt) in the isolated perfused rat hearts, and also decreased the contractile force and heart rate in the isolated rat right atria. In excised guinea-pig papillary muscle, NCL and CL had no efects on parameters of action potential at low doses, whereas inhibited the cardiac contractility at high doses. These results suggested that NCL and CL have weak cardiovascular effects with relaxation of blood vessels and decrease of heart rate, and that this effect is no significant differences between two preparations.

      • 신원방우황청심원액의 심혈관계에 관한 약효

        조태순,이선미,김낙두,허인회,안형수,권광일,박석기,심상호,신대희,박대규 충남대학교 약학대학 의약품개발연구소 1999 藥學論文集 Vol.15 No.-

        In order to investigate the pharmacological properties of New Wonbang Woohwangchungsimwon Liquid (NSCL), effects of Wonbang Woohwangchungsimwon Liquid (SCL) and NSCL were compared. In isolated rat aorta, NSCL and SCL showed the relaxation of blood vessels in maximum contractile response to phenylephrine (10^-6M) regardless to intact endothelium or denuded rings of the rat aorta. Furthermore, the presences of the inhibitor of NO synthase and guanylate cyclase did not affect the relaxing effect of NSCL and SCL. NSCL and SCL inhibited the vascular contractions induced by acetylcholine, prostaglandin endoperoxide or peroxide in a dose-dependent manner. In conscious spontaneously hypertensive rats (SHRs), NSCL and SCL significantly decreased heart rate. NSCL and SCL, at high doses, had a negative inotropic effect that was a decrease of left ventricular developed pressure and (-dp/dt)/(+dp/dt) in the isolated perfused rat hearts, and also decreased the contractile force and heart rate in the isolated rat right atria. In excised guinea-pig papillary muscle, NSCL and SCL had no effects on parameters of action potential such as resting membrane potential, action potential amplitude, APD_90 and V_max at low doses, whereas inhibited the cardiac contractility at high doses. These results suggested that NSCL and SCL have weak cardiovascular effects with relaxation of blood vessels and decrease of heart rate, and that this effect is no significant differences between cardiovascular effects of two preparations.

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