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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.
폐경후 여성에서 호르몬 대치요법의 투여기간이 지질과 Lipoprotein ( a ) 에 대한 효과에 미치는 영향
김치정(Chee Jeong Kim),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),이광제(Kwang Je Lee),정유석(Yoo Suk Chung),민용기(Young Ki Min),유왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1997 대한내과학회지 Vol.52 No.6
N/A Objectievs: Hormone replacement therapy(HRT) in postmenopausal women decreases lipoprotein(a) [Lp(a)]. The influences of progesterone on Lp(a) and lipids, administered with estrogen, are controversial. However, previous studies had variable duration of therapy, and there was no report evaluating the effect of the duration of medication. Methods: A total 246 postmenopausal women were divided into 4 groups: group A; 0.625mg conjugated equine estrogen(CEE)(n=90), group B; 0.625mg CEE plus 5mg medroxyprogesterone acetate(MPA)(n=35), group C; 0.625mg CEE plus 10mg MPA(n=43), and group D; 2mg estradiol valerate(E2) plus 0.5mg norgestrel(N)(n=76). Lp(a) and lipids levels were measured before, 2, 6 and 12 months after HRT. Results: In total subjects, Lp(a) was decreased with medication for 2 months by 20.7%(p<0,0001). Compared with levels at 2 months after medication, levels at 6 and 12 months revealed further reduction(p<0.001) by 5.3% and 9.0% respectively. Medication for 2 months increased HDL-C in group A, not changed in group B and C, and decreased in group D. After 12 months, HDL-C levels were increased in Group A, B, and C, and not changed in group D, In total subjects, low density lipoprotein- cholesterol(LDL-C) was decreased by 12.2% after 2 months(p<0.001). Compared with levels at 2 months after medication, LDL-C level was decreased by 3.4% after 6 months(p<0.001) and there was no further reduction after 12 months. Conclusion: The effect of hormone replacement therapy on Lp(a) and lipids were dependent upon the duration of medication. Inconsistent results in previous studies can be partially explained by the difference in this parameter.
난소절제후 Estrogen을 투여한 흰쥐 대동맥에서 Protein Kinase C-α와 Fas 발현의 변화
이왕수,이상엽,안지현,송영빈,김학진,이광재,유재격,김상욱,김태호,김치정,류왕성 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3
Estrogen is believed to decrease coronary artery disease. Protein kinase C-α(PKCα)appear to be important in signal conduction pathways. Estrogen treatment increases catalytic activity of PKCα,and activation of PKCαcan modulate estrogen receptor levels and responsiveness. And it was reported that activation of PKC can protect cells from apoptosis induced by Fas ligation. But the beneficial effect of estrogen on PKCαwas not clearly demonstrated. The objective of this study was to evaluate the role of PKCαafter ovariectomy and estrogen therapy in rat aorta. The results were summarized as below: 1. The significant pathological changes were not observed in the rat aorta irrelevant to ovariectomy and estrogen therapy. 2. The expression of Fas was decreased in the aorta of estrogen-treated rats than that of ovariectomized rats without estrogen therapy. 3. Increased expression of PKCαwas more marked in the aprta of estrogen-treated rats than that of ovariectomized rat without estrogen therapy. In conclusion,PKCαmay be important in signal conduation pathway on the effect of estrogen. Activation of PKCαby estrogen reduced Fas expression, suggesting that PKCαactivation may play a role in protection against atherasclerosis. Further studies are needed to elucidate the role of PKCαafter estrogen therapy.
김경만,김치정,유언호,곽미향,유왕성,박종택 한국지질학회 1996 韓國脂質學會誌 Vol.6 No.2
This study was conducted to evaluate the property of lipoprotein(a)[Lp(a)] as an acute phase reactant. Lp(a) consists of low density lipoprotein and apolipoprotein(a), specific glycoprotein. It is generally accepted that high concentration Lp(a) is an independent risk factor for cardiovascular disease. However, Lp(a) level cannot be lowered by nonpharmacologic and pharmacologic methods for hyperlipidemia. Although Lp(a) is thought to be an acute phase reactant, there is still controversy. A total 22 premenopausal women who underwent transabdominal hysterectomy with/without unilateral salphingoophorectomy were enrolled. Lp(a) and lipid profiles were measured before, at 1 week and at 1 month after operation. In contrast to other lipids, Lp(a) concentration was elevated by 96.7% from 18.1±2.6 ㎎/dL to 35.6±27.1 ㎎/dL at 1 week after operation. At 1 month, the concentration returned to basal level. Low density lipoprotein cholesterol was lowered only by 11.2%, and total cholesterol and high density lipoprotein cholesterol decreased after operation. In conclusion, Lp(a) is thought to be an acute phase reactant and this property might be involved in the pathogenesis of atherosclerosis.