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Endothelin-1이 흰쥐의 기관평활근 수축에 미치는 영향에 관한 연구
인광호 ( In Gwang Ho ),강경호 ( Kang Gyeong Ho ),유세화 ( Yu Se Hwa ) 대한내과학회 1992 대한내과학회지 Vol.42 No.5
연구배경 : Endothelin-1은 돼지의 혈관 내피세포의 배양액에서 발견된 강력한 혈관수축제로 심혈관 질환의 중요 요인으로 생각되어 많은 연구가 되고있다. 이 물질은 혈관수축 이외에 기관지 수축작용이 강력하며, 최근에는 호흡상피세포에도 존재하는 것으로 밝혀졌다. Endothelin-1의 작용은 세포의 칼슘이온에 의존하고, 칼슘이온 차단제에 의해 혈관평활근 수축이 억제된다고 알려져, endothelin-1의 작용은 dihydropyridine 유도체로 길항되는 전위 의존성 칼슘이온 통로를 통하여 나타날 것으로 생각되어 왔으나, 다른 연구자들의 보고에 의하면 칼슘이온 차단제가 endothelin-1의 혈관수축에 영향을 주지 않는다고 하여 논란이 되고 있다. 지금까지 endothelin-1의 혈관 평활근에 미치는 영향에 대하여는 많은 연구가 되어왔으나, 기관지 평활근에 미치는 영향에 대한 연구는 많지 않은 편이다. 이에 endothelin-1이 기관지 평활근에 미치는 영향과 작용기전을 알아보기 위하여 본 실험을 시행하였다. 방법 : 흰쥐의 기관을 박리하여 기관절편을 만든 후 Krebs solution이 채워져 이TSms Magnus관에 근육 고정기로 고정한 다음 physiograph에 부착된 isometric transducer에 의하여 등장성 수축 곡선을 그리도록 장치하였다. 결과 : Endothelin-1에 의한 기관수축은 농도에 비례해서 발생하였고, 반응속도는느리며(5분~10분), 작용시간은 길었다(약 60분). Endothelin-1 및 histamine, acetylcholine에 의한 기관의 최대수축은 각각 0.83±0.03g, 0.67±0.03g, 1.29±0.05g 이었으며, EC50(-logM)의 의한 약물의 강도는 enothelin-1이 가장 강했다. Ca_^(2+)-free Krebs 용액에서의 10^(-6)M endothelin-1에 의한 기관수축은 정상 Krebs 용액에서의 반응과 비교하며 의미있게 감소하였다. Endothelin-1의 기관수축은 verapamil(10^(-5)M) 및 atropine(10^(-5)M)에 의해 영향을 받지 않았다. Endotheline-1에 이한 기관수축은 isoproterenol의 농도(10^(-5)-10^(-4)M)에 비례해서 이완되었으며, 10^(-4)M때 92±3%까지 이완되었다. 결론 : Endothelin-1에 의한 흰쥐의 기관수축은 강력하고 오래 지속되며, 작용은 세포의 칼슘 이온에 의존하고, 세포내 칼슘 이온의 유입은 dihydropyridine-sensi-tive 칼슘이온은 통로 이외의 다른 통로를 통하여 이루어 질 것으로 사료된다. Background: Endothelin is a recently discovered potent vasoconstrictor peptide isolated from porcine cultured endothelial cells. Respiratory epithelial cells also contain endothelin. The peptide has been found to exert a wide range of actions including bronchoconstriction and growth promotion in addition to vasoconstriction. The action of endothelin on isolated vasculature has been shown to be dependent on extracellular Ca^(2+), and to be attenuated by dihydropyridine-sensitive calcium channel blockers, which lead to the hypothesis that this compound might be an endogenous agonist for dihydropyridine-sensitive, voltage-dependent Ca^(2+) channels. But this hypothesis is controversial, and the studies about the effect of endothelin on airway smooth muscle are rare. Its role in the regulation of airway smooth muscle needs to be clarified. Method: Experiments were carried out on rat trachea superfused with oxygenated (95% O₂-5% CO₂) and warmed (37℃) Krebs solution in 50 ml organ baths. Cumulative concentration-response curves to endothelin-1 were obtained by isometric transducer Connected to physiograph. Results: Endothelin-1 (10^(-9) M~ 10^(-6) M) produced a concentration-dependent, slow-developing and long-lasting contraction of rat tracheal muscle. Endothelin-1 was a more potent contractile agent than histamine, and acetylcholine. Contractions of the tissue to 10^(-6)M endothelin-1 were attenuated significantly in Ca^(2+)-free Krebs solution containing 0.1 mM EGTA but unaffected by verapamil (10-5M). The contractile response to endothelin-1 was completely reversed by isoproterenol, but unaffected by atropine. Conclusion: Endothelin-1 is a potent, slow-developing and long-lasting constrictor of the rat tracheal smooth muscle, and its action is dependent on extracellular calcium ion, but calcium influx is not dependent on dihydropyridine-sensitive calcium channel.
기관내삽관과 기관절개술을 시행한 환자에서의 폐흡인에 관한 연구
인광호(Kwang Ho In),안태훈(Tae Hoon Ahn),유진목(Zin Moc Yu),강경호(Kyung Ho Kang),유세화(Se Hwa Yoo) 대한내과학회 1988 대한내과학회지 Vol.35 No.3
N/A Aspiration is a well recognized source of pulmonary infection. In most clinical situations, however, the actual incidence of aspiration has not been well documented, We investigated the incidence of pulmonary aspiration and the factors affecting aspiration in patients with intubation and tracheostomy. Aspiration was evaluated by applying Evans blue dye to the posterior tongue just after each formula tube feeding for 24 hours. Bluish discoloration and elevated glucose concentration of the material suctioned from the artificial airway were regarded as evidence of aspiration. The results obtained were as follows: 1) The incidence of pulmonary aspiration in patients with intubation or tracheostomy was high (69%), 2) Unconscious patients tended to aspirate frequently, but the presence or absence of ventilatory support, tracheostomy or intubation did not play a significant role in the development of aspiration. 3) There was only a weak correlation between the Evans blue dye test and the glucose oxidase reagent strip method in detecting pulnonary aspiration. In conclusion, the incidence of pulmonary aspiration in patients with intubation and tracheostomy is very high. These findings suggest that even in the case of intubation and tracheostomy, careful observation of pulmonary aspiration is necessary
천식과 호산구성 기관지염에서 CD4, CD8 림프구 침윤
이상엽 ( Lee Sang Yeob ),이승룡 ( Lee Seung Lyong ),김제형 ( Kim Je Hyeong ),신철 ( Sin Cheol ),심재정 ( Sim Jae Jeong ),강경호 ( Kang Gyeong Ho ),유세화 ( Yu Se Hwa ),인광호 ( In Gwang Ho ),이지혜 ( Lee Ji Hye ),정운용 ( Jeong U 대한결핵 및 호흡기학회 2003 Tuberculosis and Respiratory Diseases Vol.55 No.5
강경호,이상화,이진구,김광택,김형묵,심재정,유세화,조재연,인광호,박상면,오유환 대한내과학회 1996 대한내과학회지 Vol.50 No.5
Chronic thromboembolic pulmonary hypertension is the result of single or recurrent pulmonary emboli arising from sites of venous thrombosis. For reasons still unknown, the emboli in chronic thromboembolic pulmonary hypertension patients do not resolve completely. The vessels involved are the central elastic vessels such as main, lobar and/or segmental arteries. Such patients should be considered separately from acute pulmonary embolism because their thrombi are potentially removable by surgical thromboendarterectomy. The prevalence of deep vein thrombosis and pulmonory embolism seems to be lov, in Korea. But, we experienced 3 cases of chronic thromboembolic pulmonary hypertension in a year recently. They complained of progressive exertional dyspnea for a few months to years. Lung perfusion scan revealed multiple segmental perfusion defects and pulmonary angiography, spiral CT reveal multiple defects in main and lobar pulmonary arteries. One patient(case 1) died of low output cardiac failure while waiting for operation, and another patient(case 2) has been treated medically at OPD, one(case 3) was treated by right main pulmonary artery thromboendarterectomy and his pulmonary arterial pressure was sucessfully dropped from 60/39mmHg to 26/18mmHg. We reported 3 cases of chronic thromboembolic pulmonary hypertension with review of literatures.