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RISS 인기검색어
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- 저자 : 김융(Yoong Kim) (검색결과 13 건)
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Study on Mechanical Responses Induced by Hypoxia in Porcine Isolated Cerebral Artery
김융,Kim, Yoong The Korean Society of Pharmacology 1993 대한약리학잡지 Vol.29 No.2
돼지의 적출뇌동맥에서 저산소 유발 수축반응을 관찰하고 그 기전을 구명하며 저산소가 혈관수축제의 수축반응과 acetylcholine (ACh)의 내피세포 의존성 이완반응에 미치는 영향을 검토코자하여 본 실험을 시행하였다. 내피세포가 존재하는 표본에서는 저산소는 일과성 혈관수축을 일으켰고 산소 재공급시에 일과성 이완 후 수축이 나타나는 이상성 (biphasic) 반응이 관찰되었다. KCI 및 $PGF_{2\alpha}$전처치로 수축된 표본에서 저산소 유발은 추가적 수축반응을 일으켰고, 산소재공급으로 이완반응이 관찰되었다. 내피세포 제거 후 및 nimodipine 또는 indomethacin처리 후 저산소와 산소 재공급에 의한 수축반응은 현저히 감약되었다. 저산소하에서 KCl의 수축반응은 영향받지 않았으나, $PGF_{2\alpha}$와 endothelin (ET)의 수축반응은 현저히 억제되었고 ET수축반응이 저산소에 가장 예민하였다. $PGF_{2\alpha}$와 ET로 수축된 내피세포 존재표본에서 ACh은 용량의존성 이완반응을 일으켰고 이 이완반응은 저산소 하에서 소실되었으며 내피세포 제거표본에서는 ACh의 이완반응이 관찰되지 않았다. $PGF_{2\alpha}$로 처리한 내피세포 존재표본에서 ACh은 cyclic GMP농도를 증가시켰고 이 증가는 저산소하에서 소실되었다. 이상의 성적으로 저산소와 산소 재공급 수축반응은 내피세포 및 calcium의존성이고, prostaglandin계 물질의 유리에 기인한다고 추론하였다. This study was designed to observe hypoxia-induced mechanical responses of porcine cerebral artery and to clarify their possible mechanisms. Hypoxia produced a transient vasoconstriction, recovering to the basal tension within 10 min and subsequent reoxygenation produced a biphasic (relaxalion-contraction) response in rings with endothelium under resting tension. Hypoxia produced a further contraction in rings precontracted with KCl or $PGF_{2{\alpha}}$, and following reoxygenation caused only sustained relaxation. Removal of the endothelium and pretreatment with nimodipine or indomethacin markedly attenuated the hypoxia- and reoxygenation-induced contractions. The KCl-induced contraction was not affected in hypoxic state, but contractions induced by $PGF_{2{\alpha}}$ or endothelin (ET) were inhibited in the hypoxia, the latter being more sensitive to the hypoxia. Upon reoxygenation, the attenuated contraction rapidly recovered to the original tension. Both hypoxia and reoxygenation significantly increased cyclic GMP content in the intact preparations, but not in the endothelium-removed ones. Acetylcholine (ACh) produced concentration-dependent relaxations in the intact endothelial rings precontracted with $PGF_{2{\alpha}}$ or endothelin, and the ACh-induced relaxation was inhibited by removal of endothelium and by hypoxia. ACh also increased cyclic GMP content in tissues pretreated with $PGF_{2{\alpha}}$ and the increase of cyclic GMP was abolished in hypoxic state. These results suggest that hypoxia- and reoxygenation-induced contractions are dependent on endothelium and extracellular calcium, and related to the release of prostaglandin-like substance(s).
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의료기관의 의료시혜 확대 및 사회복지 서어비스 제공에 관한 모형연구
김성이,김융일 聖心女子大學校 1981 論文集 Vol.12 No.1
The purpose of this study is to establish a model for enlargement of medical services as well as social services in rural areas by community medical centers. In rural areas the level of medical services is very low in terms of quality and quantity because of the concentration of medical personnel and facilities in urban areas which has resulted from the low level of financial ability of rural residents, the high cost of medical care, and the prepayment system for medical services. However, it has been recently pointed out that the lower level of medical personnel and facilities is not fully utilized because of mismanagement. Furthermore, the medical delivery system is not integrated into other social agencies and services. Therefore, the major purpose of this study is to suggest a basic practical and theoretical concept for a medical delivery system. To achieve this end, two research methods were used. One is a Field study examining the current situations and system of four leading community medical service centers such as the Korean Community Medical Cooperation's Sabook Medical Center, the Asan Social Welfare Program Foundation's Inje Medical Center, the Korean Health Development Institute's Hong Chun Medical Center, and Yeonsei University's Kang Hwa Medical Program Center. The other is a survey of all the households in Wontong 7th Ri and Hange 2nd Ri areas which are covered by the Asan Social Welfare Program Foundation's Inje Medical program in order to develop a model and to examine the effectiveness of this medical program. These collected data were analyzed by association analysis such as Kendall's Tau as well as the descriptive analysis such as a frequency test and cross tabsulation methods. The delivery system's theoretical framework is based on the primary health care concept. The primary health care concept is to integrate medical services into social services in order to improve living conditions. Therefore, the primary health care program consists of a family health care program, human development services, and a community development program. These three major parts are closely interrelated. Therefore, the three parts should be brought under one system to increase effectiveness. Thus the community medical center should give these three kind of services for residents as well as for the agency itself. In order to carry out the above basic concept, the service centers should perform the following roles: First, the center should try to gather the material and non-material resources from the communitie agencys and the residents. Second, the center should gather the medicalresources through rational management of the center's medical manpower and facilities. Third, the center should use the community's combined resources for purposeful development of the community. Last, the center should use the combined resources from the center itself for enlargement and maintenance of the center. The four reles of the center seem to be the successfully carried out in a county unit, in other words, in county medical centers or hospitals in county areas. Furthermore the county medical center should be integrated into private hospitals in terms of function (which may be called the community medical center). In order to perform the four functions the community medical center should manage and control the organization which is composed of the residents, the community agencies and the government branches. For example, committees for sponsoring community affairs, administrative cooperation committees and medical insurance organizations should be controlled by the community medical center. The next important thing to be considered is the principle of closing the gap between the community medical center and the residents. This role is taken over by primary care centers and village health workers. The primary care centers should be located in areas where the residents have difficulty reaching medical care for lack of transportation. The village health worker has the function as innovator of changing the residents' health awareness and behavior as well as being a first aid helper. Therefore, the village health worker is selected from people who are respected and are active participants in village affairs. In summary, the whole medical delivery system can be classified into two parts: one is the main office's system and the other is the connections system the main office system and the residents. The main office system is composed of the community service department. The connection system is composed of the primary health center and the village health worker. The primary care center does the functions which are delegated from by the main office in those areas where the main office directly serves the residents. The village health worker's major role is to influence the opinion of residents on health. The suggested conceptual model was checked partly by other researchers and authors of this study. The results of this research show the positive effects of this system. Therefore, if the suggested model is used over a given period of time, the community medical services would be expanded and achieve their purposes.
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