당뇨병 환자에서 비관혈적 방법에 의한 좌심실기능 평가에 관한 연구

방준경(Joon Kyung Bang),현창훈(Chang Hun Hyun),이병직(Byung Jik Lee),류왕성(Wang Seong Ryu),권기익(Ki Ik Kwon),강창순(Chang Soon Kang),유언호(Un Ho Ryoo) 대한내과학회 1987 대한내과학회지 Vol.32 No.4

N/A Diabetes mellitus has been clearly identified as an independent risk factor in coronary heart diasase, sudden death, congestive heart failure, stroke, and peripheral vascular disease. The diabetic patient is twice as prone to develop heart disease as the general population. Recently the term Diabetic cardiomyopathy has been appeared in medical publications. This term imply the existence of a specific diabetic heart disease, a new nosological entity that has been growing out of several studies performed during the last few years by research workers in diabetes. The assessment of left ventricular function as an index of potential myocardial involvement in diabetic patients without clinical evidence of myocardial ischemia or other cardiovascular abnormalities has become increasingly important. To examine left ventricular function in diabetic patients without clinical evidence of cardiac involvement, eleetrocardiogram, phonocardiogram, carotid pulse tracing, echocardiogram, apexardiogram, and the first derivative of the apexcardiogram were performed in normal subjects and 16 diabetic patients. The results were as follows. 1) Corrected R to first peak interval was 96.1±25.9 msec in diabetic group and 66.3±14.8 msec in control group (p<0.05), height ratio was 52.9±7.4% in diabetic group and 56.5±4.0% in control group (p<0.05). S to second peak interval was not significant value. 2) Pre-ejection period was 85.9±27.2 msec in diabetic group and 40.9±12.2 msec in control group (p<0.05), left ventricular ejection time was 302.5±39.9 msec in diabetic group and 340.0±20.7 msec in control group (p<0.05). Electromechanical systole was not significant value. 3) A-MVO was 90.4±19.1 msec in diabetic group and 64.8±13.7msec in control group (p<0.05), ejection fraction was 59.5±11.2% in diabetic group and 68.5±7.5% in control group (p<0.05). Based on these findings, mechanocardiography for assessment of left ventricular function may be utilized as a good index of potential myocardial involvement in diabetic patients.

Doppler 심 초음파에 의한 폐 동맥 혈류 측정에 있어서 관찰 View 에 따른 비교

김태호(Tae Ho Kim),최신환(Sin Whan Choi),장용준(Yong Jun Jang),류호준(Ho Jun Ryoo),심상준(Sang Jun Shim),류왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1989 대한내과학회지 Vol.37 No.5

N/A The analysis of pulmonary blood flow by Doppler echocardiography is very useful in evaluating various cardiac patients with pulmonary hypertension. How- ever, determinations of pulmonary arterial blood flow can vary markedly when measured from different sites. One hundred subjects (90 normal subjects, 10 C.O.P.D. patients) underwent Doppler and two-dimensional echocardiographic examination of the pulmonary artery from multiple views to determine the variability in the magnitude of Doppler determined peak velocity, acceleration time of pulmonary arterial blood flow and pulmconary arterial diameter. The results were as follows: 1) The maximun diameter of the pulmonary artery was 2.0±0.5cm (mean±S.D) and was measured from the parasternal right ventricular outflow tract (PRVOT) view (78), the subcostal short axis (SCSAX) view (65) and the parasternal short axis (PSAX) view (51) in turn. 2) The peak. velocity of pulmonary blood flow was mostly detected from the PRVOT view (59%) and sometimes from the PSAX view (17%). 3) The highest flow velocity of the pulmonary artery was recorded from the SCSAX view in 24 patients including 8 C.O,P,D patients. 4) Our results indicate that the PRVOT view was most useful in evaluating the image and blood folw pattern of the pulmonary artery, and in some cases (such as C.O.P,D), the SCSAX view was much better than any other view.

복잡성 심실성 부정맥과 좌심실 비후의 상관관계 및 예후에 관한 연구

이광제(Kwang Je Lee),정유석(Yoo Suk Chung),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),김치정(Chee Jeong Kim),류왕성(Wang Seong Ryoo),유언호(Un Ho Yoo) 대한내과학회 1997 대한내과학회지 Vol.53 No.1

N/A Objectives: Echocardiographically determined left ventricular hypertrophy is associated with increased risk for sudden cardiae death and for complex ventricular arrhythmias in 24-hour ambulatory electrocardiographic monitoring. In subjects with left ventricular hypertrophy, the presence of asymptomatic complex ventricular arrhythmias is associated with higher incidence of sudden cardiac death and higher cardiovascular mortality. However, their accurate relationship and prognostic significances have been remained to be established. The purpose of this study was to evaluate the relationship between complex ventricular arrhythmias, left ventricular hypertrophy, and sudden cardiac death in Korean patients. Methods: Twenty four hour ambulatory electrocardiographic monitoring, echocardiographic data and medical records were reviewed in 360 subjects from 1991 to 1994. We evaluated the relationship between complex ventricular arrhythmias and left ventricular mass index, and the prognostic values of them. Of the 360 subjects, 187 could be followed up for one to four years. The mean follow-up period was 2.8 years. Results: The incidence of complex ventricular arrhythmias was significantly correlated with left ventricular mass index and ejection fraction in all subjects. During the follow-up periods, seven of 187 subjects died from sudden cardiac death. Six of them had complex ventricular arrhythmias with left ventricular hypertrophy. Conclusion - The incidence of complex ventricular arrhythmias was significantly correlated with echocardiographically determined left ventricular hypertrophy and it is suggested that subjects with complex ventricular arrhythmias combined with left ventricular hypertrophy have higher risk for sudden cardiac death.

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.

확장성심근중 환자에서 Enalapril 치료가 좌심실내경의 순간변화율에 미치는 영향

김철우(Cheol Woo Kim),정유석(Yoo Suk Jung),이광제(Kwang Je Lee),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),김태호(Tae Ho Kim),김치정(Chee Jeong Kim),류왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1997 대한내과학회지 Vol.52 No.5

N/A Objective: Angiotensin-converting enzyme inhibitors have been shown to improve survival in patients with congestive heart failure. To evaluate the efficacy of enalapril in patients with dilated cardiomyopathy during concurrent treatment with digoxin and diuretics, the peak rates of left ventricular movement were assessed after 6 months of follow-up by digitized echocardiography. Methods: Using a high quality digitizer, continuous measurement of left ventricular dimension and its rate of change (dD/dt) were obtained throughout the cardiac cycle. Normalized rates of wall movement (dD/dt/D) were used for comparison. Results: 1) Compared with control subjects, patients with dilated cardiomyopathy showed much lower Peak(-) dD/dt and Peak(-) dD/dt/D. 2) Peak(+) dD/dt and Peak(+) dD/dt/D were also depressed in patients. 3) Peak dD/dt improved significantly (p<0.05) in the enalapril group (n=16), but did not change in the conventional treatment group (n=20) after 6 months. Peak dD/dt/D improved approximately (p<0.005) in the enalapril group. 5) There were no deaths in 2 treatment groups during initial 6 months, but 3 patients in the conventional treatment group died suddenly during 1 year of follow-up. Conclusion: The present study has shown that left ventrieular Peak dD/dt and Peak dD/dt/D are significantly depressed in patients with dilated cardiomyopathy. Enalapril appears to provide well-tolerated and effective long-term therapy by improving peak rates of left ventricular movement in patients with dilated cardiomyopathy.

자연발생 고혈압 흰쥐 심근의 미세구조 변화에 대한 연구

김명식,류왕성,유언호,송계용 중앙대학교 의과대학 의과학연구소 1991 中央醫大誌 Vol.16 No.4

Left ventricular hypertrophy is a common sequence as the process of adaptive structural changes in arterial hypertension. Considerable attention has been devoted in recent years to the hemodynamic and nonhemodynamic factors such as sympathetic nervous system, intracellular renin-angiotensin system and genetic influence with intracelluar signals to hypertrophy. The spontaneously hypertensive rat(SHR) is generally held to be a reliable model and experimental counterpart for the essential hypertension in man. In this particular strain of rat, severe and sustained systemic hypertension invariably occurs, accompanied by marked cardiac hypertrophy and interstitial proliferation. The blood pressure of SHR rised gradually from the 5th week after birth and reached nearly 190 mmHg at the 16th week. Hypertension(systolic BP>140mmHg) developed in 20% of SHR at the age of 7 weeks, in 72% of SHR at the age of 10 weeks and in 100% of SHR at the age of 16 weeks. The ratio of heart weight to body weight was significantly higher in SHR than Wistar rats. The significant increase in myofibril/mitochondria volume ratio in SHR suggests a decreased ratio of energy-producing volume to energy-consuming volume and also indicates a disproportionate synthesis of these organelles during hypertrophy. There were marked changes in the intercalated discs associated with numerous immaature sarcomeres. Intercalated discs were increased in number as well as height of undulations in the myocardium of SHR. Focal accumulation of mitochondria in the subsarcolemmal region was also commonly noted in SHR.

백서 심근의 β아드레날린 수용체 결합에 대한 연구

임상재,류왕성,유언호 중앙대학교 의과대학 의과학연구소 1991 中央醫大誌 Vol.16 No.3

The catecholamines are key regulators of many physiologic events in human beings. These catecholamine initiate target-cell response by binding to specific recognition sites, the adrenergic receptors. Super-and subsensitivity of the myocardial receptors and their functional status during myocardial failure have important clinical and pharmacological implications. The development of radioligand binding technique using radioactively labeled hormones or drugs, either agonists or antagonists, opened the new era of receptor investagarion. 〔^3H〕 Dihydroalprenolol was used to identify the veta-adrenergic receptors of rat cardiac membranes in this study. The concentration dependence of 〔^3H〕Dihydroalprenolol binding was studied with labeled compounds of various concentrations ranging from 5x 10^-11 M to 1.5x_-8M. Specific 〔^3H〕Dihydroalprenolol binding was a saturable process and Scatchard analysis of the data showed a single class of binding sites characterized by an equilibrium dissociation constant Kd of 5.2x 10^-9M and a calculated Bmax of about 68.8 fmol/mg protein. The specific binding occurred as rapidly and reversibly as the response to the unlabeled ligand and it increased as a linear function of increasing tissue concentration. Levo epinephrine was more potent than levo norepinephrine in inhibiting 〔^3H〕Dihydroalprenolol binding. The use of 〔^3H〕Dihydroalprenolol to identify beta-adrenergic receptors will make possible the study of alterations in number and affinity of cardiac beta-receptors in many clinical states of altered sensitivity to catecholamines.

자연발생 고혈압흰쥐에서 관성소동맥 미세구조의 변화 및 고콜레스테롤 식이의 영향에 관한 연구

김용기,류왕성,유언호,송계용,조성희 중앙대학교 의과대학 의과학연구소 1993 中央醫大誌 Vol.18 No.1

Vaseular lesions develop during the course of hypertension and are the major cause of morbidity and mortality from this disease. Some of these are protective in nature and are associated with a remodeling of the artery to better withstand the increase in wall tension resulting from the elevated intravascular pressure. Other responses to vascular injury caused by hypertension, however, can predispose the artery to further adverse consequences. The spontaneously hypertensive rat(SHR) is generally held to be a reliable model and experimental counterpart for the essential hypertension in man. The present study was undertaken to evaluate the changes of coronary arterioles in SHR which had taken 2% cholesterol diet and normal diet for 8 months. The blood pressure of SHR rised gradually from the 5th week after birth and reached nearly 190 mmHg at the 15th week. Raised blood cholesterol levels were observed in the rats fed high cholesterol diet. The mena percent lumen of the coronary arterioles was significantly reduced in SHR compared with that in Wistar rats. The mean ratio of HDL cholesterol to total cholesterol concentrations was 63% in Wistar rats, 56% in SHR fed normal diet and 45% in SHR fed 2% cholesterol diet. Vascular pathology involved both intima and media in SHR and medial thickening was associated with decreased luminal diameters. There was marked proliferation of smooth muscle cells. The endothelial cells were larger and cytoplasm was rich in organelles and pinocytotic vesicles. The internal elastic lamina was very wide and irregular. The smooth muscle cells were more increased in the number and separated by more abundant connective tissue matrix in SHR fed high cholesterol diet.

실신을 주소로한 설인성 신경통 2예

방준경,강응택,손덕재,류왕성,권기익,유언호 중앙대부설한국의과학연구소 1988 한국의과학 Vol.20 No.4

고콜레스테롤식이 ( 食餌 ) 에 의한 SHR 고혈압쥐의 체내 지질과산화 ( 脂質過酸化 ) 와 비타민 E 수준의 기간별 변화

최영선,이희숙,조성희,류왕성,유언호 한국지질학회 1993 韓國脂質學會誌 Vol.3 No.2

To investigate the effect of hypertension and high cholesterol diet on serum and liver levels of lipid peroxide and vitamin E, spontaneously hypertensive rats (SHRs) and Wistar rata were fed diets with or without 2% (wt/wt) cholesterol for 2, 4, 6 and 8 months. After 2 months of feeding, SHRs became apparently hypertensive and at 4th month, their systolic pressure was over 180 mmHg which was maintained until 8th month. Body weight gains almost ceased in SHRs after 4 months of feeding, but continuously increased in Wistar rats until the end of feeding. Dietary cholesterol had no effect on growth and blood pressure of either SHRs or Wistars. Serum lipid peroxide levels measured as thiobarbituric acid reacting substances (TBARS) were higher in SHRs than in Wistar rats after 6 months. Liver levels appeared to be higher in SHR. Dietary cholesterol did not change TBARS levels in serum and liver of Wistar rats, but tended to increase the TBARS levels in SHRs. Compared with Wistar rats, serum vitamin E in SHRs were maintained at consistently low levels during 8 months, which were further reduced by dietary cholesterol after 4 months. Liver vitamin E contents were lower in SHRs than in Wistar rats at 6 th and 8 th month, but were not affected by dietary cholesterol. In liver triglyceride, content of C_(18:2)n-6 and fatty acid was higher in SHRS, while in liver phospholipid, contents of C_(18:1), and C_(18:1) fatty acids were increased by dietary cholesterol. It is therefore concluded that the requirement for vitamin E is higher to maintain an appropriate status of vitamin E status and reduce the enhanced lipid peroxidation in hypertensive subjects.