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두개강내 병소와 동반되는 급성 고혈압의 치료 : 이상적인 항고혈압 치료제의 선택을 중심으로 Focus on Selecting Ideal Antibypertensive Agents
박정율,이자규,이일옥,공명훈,송우혁,정흥섭,이기찬,이훈갑 고려대학교 의과대학 1997 고려대 의대 잡지 Vol.34 No.2
Patients with acute hypertension associated with intracranial pathology often require prompt reduction of elevated blood pressure. But the principal goal here is to ameliorate systemic hypertension while maintaining adequate cerebral perfusion pressure to provide required cerebral blood flow and thereby preventing secondary ischemic brain damage. Although many new antihypertensive agents are now available, the ideal agent along with optimal guidelines for blood pressure reduction still remain controversial in acute hypertensive patients with different types of intracranial pathologies. Object of this study was to first review briefly the cerebrovascular pathophysiology of hypertension in conjunction with management of these patients. Pertinent literature is searched, indexed, and referenced from MEDLINE for this purpose. From this information, along with clinical experiences, authors tried to provide some of basic guidelines for managing these patients in various clinical situations, focusing mainly on selecting ideal antihypertensive agents available at present time. From the present standpoint it is generally agreed that 1- or 1-adrenergic receptor antagonists provide arterial pressure reduction with little or no adverse effect on intracranial pressure within regulatory range. Although many promising calcium-channel blocking agents are now available, their use are often limited by their action to cause cerebral vasodilation and thus increased intracranial pressure. Angiotensin converting enzyme inhibitors can be used for moderate hypertension but have potential to further increase intracranial pressure in patients who already have intracranial hypertension. It has long been known that barbiturates can be adjuvant method in case of resistant or malignant hypertension with intractablly increased intracranial pressure since it decreases both the blood pressure and cerebral blood flow with reduction of oxygen metabolism. The proper management of acute hypertension in the patients with intracranial pathology should be based on sufficient understanding of the pathophysiology of hypertension and cerebral perfusion pressure. Ideal agents would be individually based on their ability to promptly and reliably ameliorate the hypertension and at the same time maintain adequate cerebral blood flow and intracranial pressure.
乾燥 BCG-Vaccin에 依한 Lepromin 反應의 影響에 對해서
崔在圭,金重明,李相準,河桂子,卞東吉,崔炳吉,徐舜鳳 慶北大學校 醫科大學 1958 慶北醫大誌 Vol.1 No.1
Since 1939, Fernandez had reported on the tuberculin and lepromin test, prophylaxy of leprosy by inocculating with BCG was also suggssted by him, and Azulay, Rosenberg, Neyra, Ramirez, Convit, Bundiansky and others were agreable by their furthermore invstigation, but some othsrs discussed. Recently in Japan, Mayama showed that a fraction of serum protein induced from human and rat leprosy has been an inhibitory growing factor of tubercle bacilli. On the other hand Gawaguch said that the haemoagglutination test was to be stronger positive not only with tuberculous patient's serum, cut with serums of human and rat leprosy. From Feb. to Sept. in 1957, we inocculated with dry BCG Vaccine to 116 cases of untainned children of leprosy at Sam Hyuck Preventorium in Taegu city, and observed the influences of lepromin reaction by vaccination of dry BCG, and dividing A.B. and C group of all cases according to its given conditions observed results are as follow;. In the A group (53 casss), 13 cases of the lepromin negative 3 cases of them were turned to be lepromin positive by firs vaccination of BCG. After 2 months later, and lepromin positives increased to 2 cases by second inocculation, after 5 months later. And there were 15 cases of the leptomin negative in the B group, (52 casss) 4 cases of them covnerted to be lepromin positive by vaccination of BCG after 5 months later. In the C group (11 case) 3 cases were negative, one case of them turned to be positive. Of the total cases, there were some cases which a lepromin positive reactor inverted to be negative and which a lepromin negative fixed parmanentely for the negative nevertheless. Generally, the lepromin negative reactors were 31 cases in total (116 casss), 10 cases of them (31 cases) converted to be lepromin positive. As above, Vaccination of BCG enables the lepromin negative to convert to be lepromin positive. Especially, it is most important things to in occulats with BCG to the untainned children for prevention of leprosy and tuberculosis.