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Atenolol 과 Hydrochlorothiazide 가 고혈압 쥐의 대동맥 중막에 미치는 영향에 관한 실험적 연구
이방헌(Bang Hun Lee),김경수(Kyung Soo Kim),김정현(Jeong Hyun Kim),임헌길(Heon Kil Lim),이정균(Chung Kyun Lee),김순길(Soon Kil Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.1
N/A Background: In experimental studies, reduction in blood pressures could regress the some cellular abnormalities caused by hypertension but increases in connective tissue are difficult to be modified. The current study was undertaken to define whether atenolol and hydrochlorothiazide (HCTZ) can modify or reverse the morphologic changes of aortic media observed in spontaneously hypertensive rats (SHR). Methods: SHR were administered orally atenolol (2.5mg/kg) and HCTZ (5mg/kg) for 2weeks and morphological changes of aortic media were observed with electronmicroscopy. Results: Some irregularly arranged collagenous fiber and elastic lamina distributed among the smooth muscle cells in aorta are regularly distributed particularly in atenolol-treated SHR, Changes in nucleus, nuclear membrane and organelles in cytoplasm caused by hypertension are favorably modified more in atenolol-treated group rather than HCTZ-treated SHR. In HCTZ-treated SHR, periodical bands of collagen fibril are not apparent and some of fibrils are fragmented, and also various sized vacuoles are still present. Conclusion: It is suggested that atenolol can regress the microvascular changes of aortic media of SHR following reversal of hypertension but HCTZ may partially modify the aortic media.
이방헌(Bang Hun Lee),김경수(Kyung Soo Kim),김정현(Jeong Hyun Kim),임헌길(Heon Kil Lim),이정균(Chung Kyun Lee),김기순(Kee Soon Kim),김진혁(Jin Hyuk Kim),김찬(Chan Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.6
N/A Objectives: Hyperinsulinemia has been reported as a risk factor for coronary artery disease in western society. However, Koreans have shown about half of western people in fasting insulin and insulin secretion levels during oral glucose tolerance test (OGTT). The purpose of this study was to determine the relationship of serum insulin levels to various cardiovascular risk factors in healthy middleaged Koreans. Methods: We studied 143 subjects including 97 women and 46 men. Subjects had not received any medication for diabetes, hypertension or hyperlipidemia and had normal liver and kidney function. Anthropometric parameters and abdominal fat areas by computed tomography at the umbilical level were measured. Blood pressure, nutrient intake, total energy expenditure, serum levels of lipids and the levels of glucose, C-peptide, insulin and free fatty acid during OGTT were determined. Hyperinsulinemia was defined as both fasting and 2-hour serum insulin levels above the 80th percentile of respective serum insulin distributon in study subjects after an oral glucose load. Characteristics of hyperinsulinemic subjects were compared to normoinsulinemic subjects matehed for age, sex, and body mass index. Results: In subjects with normal glucose tolerance, hypertriglyceridemic subjects showed significantly higher serum insulin levels at 30, 60, 120 minutes during OGTT than normotriglyceridemic subjects. Similar results were observed in hypertension and low HDL cholesterolemia. A less significant difference was shown in the insulin pattern during OGTT between subjects with high LDL cholesterol and subjects with normal LDL cholesterol. Hyperinsulinemic subjects had significantly higher levels of systolic blood pressure, serum triglycerides, total cholesterol and glucose than normoinsulinernic subject. HDL cholesterol level was significantly lower in hyperinsulinemic subjects than in normoinsulinrnic subjects. No significant difference in the serum LDL cholesterol was found between two groups. Hyperinsulinernic subjects showed an increase in visceral fat area and percent calorie intake per total energy expenditure, compared with normoinsulinemic subjects. Conclusion: Our results showed that insulin levels in middle-aged Koreans are closely related to serum triglycerides and HDL cholesterol levels. In addition, healthy Koreans with normal glucose tolerance and hyperinsulinemia have an increase in risk factors for coronary artery disease such as hypertension, hypertriglyceridemia and low HDL cholesterol levels as compared with healthy subjects with normal insulin level. Therefore, it is recommended that insulin resistance subjects increase insulin sensitivity and decrease serum insulin level through lifestyle modification to prevent coronary artery disease,
확장성 심근증에 있어서 기능적 영상에 의한 심실벽 운동의 평가
이방헌(Bang Hun Lee),이오영(Oh Young Lee),김정현(Jeong Hyun Kim),임헌길(Heon Kil Lim),이정균(Chung Kyun Lee),조석신(Suhk Shin Cho),김주형(Ju Hyung Kim),강영희(Yeong Hee Kang),홍선미(Sun Mee Hong) 대한내과학회 1991 대한내과학회지 Vol.40 No.2
N/A To evaluate the regional wall motion of left and right ventricles in dilated cardiomyopathy (DCM), the authors carried out functional studies (phase image histogram, and ejection fraction image) by computer-assisted application of radionuclide ventriculography (RVG) and compared functional images with regional ejection fraction by RVG in 17 patients with DCM and 20 normal controls. The results are as follows: 1) Compared with normal controls, regional ejection fraction of left ventricle and ejection fraction of right ventricle were significantly reduced in DCM (all p<0.001). 2) The standard deviation of phase angle in histogram of left ventricle in DCM was significantly greater than normal group. 3) In DCM there was agreement between phase image and regional ejection fraction of left and right ventricle by RVG as to the presence of asyergy in 84.3%, and 94.1% respectively. 4) In DCM, asynergy was noted in all three regions of left ventricle and there was agreement between ejection fraction image and regional ejection fraction as to the presence and localization of asynergy in 94.1% and 98.0% respectively. These results suggest that the advantage of phase image is to quantify the degree of abnormal wall motion and ejection fraction image is superior to phase image in the differentiation between normal and abnormal wall motion and in the localization of asynergy in dilated cardiomyopathy.
이상(Sahng Lee),김정현(Jeong Hyun Kim),이방헌(Bang Hun Lee) 대한내과학회 1995 대한내과학회지 Vol.49 No.5
N/A Objectives: Defective cardiac innervation and abnormalities in the heart rate pattern and blood pressure control have been demonstrated in diabetic patients with autonomic neuropathy. Although disabilities due to cardiovascular autonomic neuropathy are associated with poor prognosis and sudden death, the earliest symptoms are usually vague and non-specific, and it is difficult to make a clinical diagnosis. Methods: In this study, the author diagnosed autonomic neuropathy easily and rapidly by using the electrocardiogram analyser and determined circardian variations is blood pressure in diabetic patients by ambulatory blood pressure monitoring, Results: 1) The daytime-nighttime systolic blood pressure difference in patients with and without autonomic neuropathy showed significant differences(6.5±1.4mmHg versus 15.463mmHg, p<0.05) 2) The daytime-nighttime diastolic blood pressure difference in patients with and without autonomic neuropathy showed significant differences(5.3±6.4mmHg versus 10.7+4.6mmHg, p<0.05) 3) The daytime-nighttime blood pressure difference was significantly associated with a decrease in CVRR and a increase in HbAlc. Conclusion: Therefore ambulatory blood pressure monitoring may be useful in evaluating diabetic autanomic neuropathy as a tool of screening tests as well as evaluating hypertension.
Adenosine 수용체 촉진제 및 KATP 통로 개구제가 Adriamycin 심근독성에 미치는 영향
이상(Sahng Lee),조원길(Wan-Gil Cho),백두진(Doo-Jin Paik),이방헌(Bang-Hun Lee),백태경(Tai-Kyoung Baik),김원규(Won-Kyu Kim),정호삼(Ho-Sam Chung) 대한체질인류학회 2001 해부·생물인류학 (Anat Biol Anthropol) Vol.14 No.1
간추림 본 연구는 adriamycin 투여 후 나타나는 심장독성과 항산화제를 병용투여 하거나 심장에서 항산화 기 능을 활성화 시키는 것으로 알려진 adenosine A₁ 수용체 혹은 KATP 통호를 개구시키는 약제를 병용투여한 후 나 타나는 심장독성을 비교 관찰하기 위해 본 실험을 시도하였다. 실험 동물은 체중 30-40 g 의 건강한 SPF(specific pathogen free)ICR 계 숫 생쥐를 사용하였으며, 대조문, Adriamycin (15 mg/kg) 투여군, SOD (superoxide dismutase, 2,000 U/kg) 전처치군, DMTU (dimethyl thiourea, 500 mg/kg) 전처치군 ,NAC(N-acetykysteine, 400 mg/kg) 전처치군, RPIA (R(-)N6-(2-Phenylisopropropyl)- adenosine, 150 μg/kg) 전처치군, 8-CPDPX (8-Cyclopentyl-l, 3-dipropyl-xanthine, 1 mg/kg) 천처치군, Pinacidil (1 mg/kg) 전처치군과 Glibenclamide (0.5 mg/kg) 전처치군으로 나누었으며 모든 실험군은 다시 l 일 경과군과 4 일 경과군으로 세분하여 관찰하였다. 심장세포에서의 apoptosis 를 확인하기 위한 방법으로 TUNEL assay 의 원리를 이용하였고, 혈중 creatine kinase 의 활성은 CK -10 kit (sigma diagnostics, USA) 를 사용하여 측정하였으며, Bcl-2 의 발현은 연역조직화학적인 방법으로 관찰하였다. 그리고 항암효과 변동 여부를 관찰하기 위해 96 well plate 에 2.5×103/well 의 293T 세포를 분주하고 24 시간 경과한 다음, adriamycin 단독 혹은 adriamycin과 SOD, DMTU, NAC, RPIA, 8-CPDPX, pinacidil과 glibenclamide 를 병용투여하고 18 시간 경과 후 well 에서 293T 세포의 증식 정도를 MTT 시약으로 측정하여 다음과 같은 결과를 얻었다. 1. RPIA 를 병용투여한 군에서는 adriamycin 만 투여한 군에 비해서 apoptosis 양성 세포가 다소 감소하는 양상을 보였고, g-CPDPX 룰 병용투여한 군에서는 apoptosis 양성 세포가 거의 같거내 다소 증가하는 양상을 보 였다. 2. Pinacidil 을 병용투여한 군에서 약물 투여 l 일 경과 군과 4 일 경과군 모두에서 apoptosis 양성세포가 많이 감소하는 양상을 보였으며, glibe nclamide를 병용투여한 군에서는 손상이 매우 증가하는 것을 관찰할 수 있 었다. 3.Bc1-2 면역염색반웅은 심장조직에서 손상이 심해지는 것에 비례해서 증가하는 것으로 관찰되였다. 4. MTI assay 결과 병용투여한 모든 약제들은 adriamycin 의 항암 작용에 유의한 영향을 끼치지 않았다. 이상의 결과를 종항해 보면 adriamycin 에 의한 심장독성이 자유산소기의 발생과 밀접한 연관이 있으며, SOD와 DMTU 의 방어효과는 약물 투여 l 일 경과군에서 SOD 가, 약물 투여 4 일 경과문에서 DMTU 가 더 효과적인 것으로 나타났다. 특히, KATP 통로의 개구제인 pinacidil 이 효과적으로 adriamycin 에 의한 심장독성을 감소시키는 것으로 결온 지을 수 있었다.
Holter 심전도 모니터를 이용한 만성 폐쇄성 폐질환 환자에 있어서의 부정맥에 대한 연구 - 만성 폐쇄성 폐질환에 있어서의 부정맥에 대한 연구
이정균 ( Chung Kyun Lee ),이정희 ( Chung Hee Lee ),박성수 ( Sung Soo Park ),이방헌 ( Bang Hun Lee ),주상언 ( Sang Aun Joo ),김순길 ( Soon Gill Kim ),신승호 ( Seung Ho Shin ),황흥곤 ( Hweung Kon Hwang ),정효철 ( Hyo Chul Chung ) 대한내과학회 1984 대한내과학회지 Vol.27 No.11