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도문홍 사단법인 한국당뇨협회 2000 당뇨 Vol.132 No.-
당이 있으면 신장사용료를 지급해야 한다. 즉, 무언가 대가를 치러야한다는 뜻이다. 미국에서는 말기 신부전증의 원인질환으로 당뇨병성 신장질환이 36$\%$로서 가장 높은 것으로 보고되었으며, 한국에서는 만성 사구제신염 다음으로 가장 많은 원인 질환으로 되어 있지만 그 비율이 증가하는 추세이다.
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혈관 손상에 동반되는 혈관 내막 평활근의 중식에 미치는 Ramipril 의 효과
도문홍(Moon Hong Doh),신원호(Won Ho Shin),함종렬(Jong Yeol Ham),최동주(Dong Ju Choi),고경혁(Gyung Hyuck Ko),서봉관(Bong Kwan Seo),정순일(Sun Il Jung),최진학(Jin Hak Choi) 대한내과학회 1994 대한내과학회지 Vol.46 No.5
Objective: Advanced atherosclerotic lesion consists mainly of intimal smooth muscle cell proliferation. Many factors are considered to be implicated in this process. The role of locally produced angiotensin II as a potent growth stimulus had been investigated. To evaluate the effect of ramipril, a new converting enzyme inhibitor, on the smooth muscle proliferative process this animal study was performed, Ramirpil was selected because of its unique physicochemical properties. Methods: Forty nine male New Zealand White or Chinchilla rabbits were randomly assigned to four groups: Group I (N=5), normal control; Group II (N=12), 2% cholesterol diet feeding without vascular injury; Group III (N =16), 2% cholesterol diet feeding after vascular injury; Group IV (N=16), ramipril treated group. Bilateral femoral atherosclerosis was induced by endothelial damage using desiccated nitrogen gas followed by a 4-week high cholesterol diet (2%-cholesterol & 6%-peanut oil). Ramipril, dose of 1 mg/kg/day, was given from 7 days before injury. Results: No definite atherosclerotic lesion was found in group II rabbits, But atherosclerotic lesion with intimal enlargement was induced in all group III & IV rabbits. The lesions were made of abundant cellular components, collagen fibers, & elastic fibers. The presence of intimal smooth muscle cells was confirmed by the immunohistochemical staining with muscle-specific monoclonal antibody HHF-35. Occasionally the foam cell lesions were scattered in the media as well as in the intima. There was frequent disruption of internal elastic lamina. Luminal area, neointimal area, media area, & ratio of intima to media were examined from the histologic sections of the femoral artery. There was no significant difference in all parameters between group I & group II rabbits. But between group I & group III rabbits was there significant difference in all 4 parameters. The same relationship was also found between group II & group III. So it was apparent that the hypercholesterolemic diet for 4 weeks alone could not induce atherosclerotic lesion in this animal model. The luminal area was not significantly different between group III & group IV. (0.10±0.08mm2 vs. 0.11±0.08mm2; p>0.05). The neointimal area of ramipril treated group was significantly smaller than that of group III rabbits (0.56±0.36mm2 vs. 0.17±0.12mm2; p<0.01). The media area was also smaller in ramipril treated group (0.34±0.17 mm2 vs. 0.22±0.06 mm2, p<0.05). The radio of neointima area to media area was higher in group III (1.67±0.80 vs. 0.76±0.44; p<0.01). Conclusion: This rabbit-desiccation injury-cholesterol diet model proved to be useful for the study of atherogenesis. Ramipril was considered to inhibit the intimal smooth muscle cell proliferation in this animal model.
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