• The Korean Journal of Physiology and Pharmacology
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• 제20권6호
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• pp.605-611
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• 2016

Ketamine is an anesthetic with hypertensive effects, which make it useful for patients at risk of shock. However, previous ex vivo studies reported vasodilatory actions of ketamine in isolated arteries. In this study, we reexamined the effects of ketamine on arterial tones in the presence and absence of physiological concentrations of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) by measuring the isometric tension of endothelium-denuded rat mesenteric arterial rings. Ketamine little affected the resting tone of control mesenteric arterial rings, but, in the presence of 5-HT (100~200 nM), ketamine ($10{\sim}100{\mu}M$) markedly contracted the arterial rings. Ketamine did not contract arterial rings in the presence of NE (10 nM), indicating that the vasoconstrictive action of ketamine is 5-HT-dependent. The concentration-response curves (CRCs) of 5-HT were clearly shifted to the left in the presence of ketamine ($30{\mu}M$), whereas the CRCs of NE were little affected by ketamine. The left shift of the 5-HT CRCs caused by ketamine was reversed with ketanserin, a competitive 5-$HT_{2A}$ receptor inhibitor, indicating that ketamine facilitated the activation of 5-$HT_{2A}$ receptors. Anpirtoline and BW723C86, selective agonists of 5-$HT_{1B}$ and 5-$HT_{2B}$ receptors, respectively, did not contract arterial rings in the absence or presence of ketamine. These results indicate that ketamine specifically enhances 5-$HT_{2A}$ receptor-mediated vasoconstriction and that it is vasoconstrictive in a clinical setting. The facilitative action of ketamine on 5-$HT_{2A}$ receptors should be considered in ketamine-induced hypertension as well as in the pathogenesis of diseases such as schizophrenia, wherein experimental animal models are frequently generated using ketamine.

• Journal of Chest Surgery
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• 제32권2호
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• pp.138-143
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• 1999

배경: 혈관 내피층에서 분비되어 평활근층 이완을 일으키는 물질의 본체는 산화질소(nitric oxide, NO)이며 NO synthase(NOS)에는 뇌형(brain NOS, bNOS), 내피세포형(endothelial constitutive NOS, ecNOS) 및 유도형 (inducible NOS, iNOS) 등 세 가지 동위효소가 있음이 알려져 있다. 고혈압은 혈관 내피층 기능 이상을 보임이 알려져 있으나 NOS 동위 효소의 변화를 포함한 세포내 기전은 아직 확실치 않다. 저자들은 고혈압 기전을 구명하기 위한 일환으로 고혈압 혈관에서 NOS 동위효소가 어떻게 변화되는가 조사하고자 하였다. 대상 및 방법: 흰쥐에서 two-kidney, one clip (2K1C) 고혈압과 deoxycorticosterone acetate(DOCA)-salt 고혈압을 일으켰다. 4주 뒤 고혈압이 일어난 것을 확인하고 적출 흉부 대동맥 표본에서 Western blot 분석에 의한 NOS 동위효소 발현 조사 및 비색법에 의한 조직내 산화질소 정량을 하였다. 결과: 2K1C 및 DOCA-salt 흰쥐에서 실험군은 각각의 대조군에 비해 유의하게 높은 혈압을 보였다. 두 고혈압군에서 모두 적출 대동맥 표본의 bNOS 및 ecNOS 단백 발현이 감소되었다. iNOS 단백은 DOCA-salt 고혈압에서 변화를 보이지 않으나 2K1C 고혈압에서는 역시 감소를 보였다. 혈관조직내 산화질소 함량은 두 고혈압에서 모두 유의하게 감소되었다. 결론: 2K1C 및 DOCA-salt 고혈압에서 혈관의 NOS 발현과 산화질소 함량이 감소되어 있으며 이는 고혈압의 유지 기전에 공헌하리라 추측되었다.

• Journal of Chest Surgery
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• 제25권6호
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• pp.650-660
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• 1992

To elucidate a potential contribution of endotheline-1[ET-1] to the genesis of pulmonary hypertension and postoperative pulmonary hypertensive crisis in the patients with heart disease, we measured plasma levels of the ET-1 during perioperative period of open heart surgery. In addition, we examined changes of ET-1 during perioperative period and correlations between ET-1 levels and hemodynamic variables. 12 patients including 5 acquired heart disease and 7 congenital heart disease patients were selected randomly as a study group, Group A and B, respectively. 6 patients proved not having heart or hemodynamic problem were selected as a control, Group C. 110 blood samples from pulmonary artery[ET-P] and radial artery[ET-S] were taken and assayed by Sep-pak extraction and RIA. ET-1 levels of Group A were ET-P, 3.94$\pm$5.31pg /ml, ET-S, 3.10$\pm$2.90pg/ml[p>0.05], Group B were ET-P, 1.63$\pm$0.62pg/ml, ET-S, 1.99$\pm$2.45pg/ml[p>0.05], Group C were ET-P, 1.97$\pm$2.02pg/ml, ET-S, 1.72$\pm$0.77pg/ml[p>0.05]. There were no statistically significant differences of ET-1 levels among the Group A, B, C[p>0.05]. There was no correlation between pulmonary artery pressure[PAP] and ET-1 level[p>0.05], and ET-1 levels were not increased even in the cases of pulmonary hypertensive criwis or low cardiac output syndrome, whereas significant correlation between ET-S and pulmonary vascular res-istance[Rp] [r=0.36, p<0.05], and negative correlation between ET-S and OS saturation of pulmonary artery[OS-P][r= -0.49, p<0.01] were identified. Another significant finding was peak increase of ET-1 levels in the postoperative period 1 hour[p<0.05] and then gra-dualy decrease through the postoperative period. In conclusion, ET-1 has no correlation with PAP, whereas correlation with Rp, and inverse correlation with OS-P. It is suggested that ET-1 is neither the direct causative substance of pulmonary hypertension nor pulmonary vasospasm but there must be increased production of ET-1 in chronic pulmonary hypertensive state. Counter-regulatory mechanism to ET-1 is speculated during the pulmonary vasospasm.

• Nutrition Research and Practice
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• 제12권1호
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• pp.69-77
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• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권4호
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• pp.229-238
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• 2017

Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.51-55
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• 2014

소아에서 신장동맥의 동맥류는 신혈관성 고혈압 가운데 드문 질환으로 하나로 수술적인 치료법 가운데 복잡한 형태의 동맥류의 경우 신혈관 재건술과 신장 자가이식술이 현재 선호되고 있는 수술법이다. 본 저자들은 13세 소아환자에서 우연히 정기건강검진에서 발견된 고혈압에 대해 시행한 전산화 단층 혈관촬영술을 통해 발견된 일측성 신장동맥의 동맥류에 대해 보고한다. 환아는 $2.8{\times}2.1{\times}1.9$ cm의 크기의 우측 낭포성 동맥류가 발견되었으며, 분지혈관이 복잡하고 병변이 신문부에 위치하여 신혈관 재건술과 신장 자가이식을 시행하였다. 그러나 도플러 신장 초음파를 통해 신장 혈류가 매우 감소하였음을 확인 후 신장 자가이식 한지 5일째 신절제술을 시행하였다. 병리적 소견은 전반적인 신장 허혈성 변화를 보였고, 섬유근성 형성장애를 시사하는 소견은 없었다. 본 저자들은 국내에서 현재까지 보고된 바 없는 신혈관성 고혈압 및 일측성 신동맥의 동맥류로 진단된 소아를 대상으로 체외 신혈관 재건 및 신장 자가이식을 시도한 증례를 보고하였다. 추후에 신동맥의 동맥류와 관련된 신혈관성 고혈압의 치료에 대한 다양한 방법 및 장기적인 추적 관찰에 대한 보고가 추가되어야 할 것이다.

• 생명과학회지
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• 제30권4호
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• pp.352-358
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• 2020

홍국은 한국에서 오랫동안 음식과 전통의학 소재로 사용되어 왔다. Monascus sp.의 생장과 2차 대사과정을 통해 Monascus 색소, monacolins, γ-aminobutyric acid 등을 생산할 수 있다. Monascus 종의 대사산물인 monacolin K, γ-aminobutyric acid과 dimerumic acid는 특정 항산화 효과로 인해 콜레스테롤과 혈압을 낮춘다고 알려져 있다. 이 연구는 Monascus sp.로 발효된 홍국쌀 에탄올 추출물의 항염증 활성을 조사하였다. 홍국 에탄올 추출물의 총 폴리페놀 함량을 측정하였고, 항염증 효과는 LPS가 유도된 Raw 264.7 cell에서 NO 생성, iNOS 및 사이클로옥시게나아제-2(cyclooxygenase-2 (COX-2)) 단백질 활성을 측정하였다. 총 폴리페놀 함량은 발효되지 않은 일반쌀보다 높은 함량을 나타내었다. NO 생성 저해활성 평가는 400 ㎍/ml 농도에서 LPS를 처리하지 않은 음성대조군의 NO 생성량과 유사한 결과를 나타내었다. iNOS 및 COX-2 단백질 발현 저해활성은 400 및 800 ㎍/ml에서 iNOS의 발현을 상당부분 억제하였다. 홍국 에탄올 추출물은 높은 항염증 효과를 확인하였으며, 기능성화장품 및 항염증소재로서 활용 가능할 것으로 사료된다.

• Journal of Ginseng Research
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• 제41권4호
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• pp.572-577
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• 2017

Background: Panax ginseng Meyer is cultivated because of its medicinal effects on the immune system, blood pressure, and cancer. Major ginsenosides in fresh ginseng are converted to minor ginsenosides by structural changes such as hydrolysis and dehydration. The transformed ginsenosides are generally more bioavailable and bioactive than the primary ginsenosides. Therefore, in this study, hydrothermal processing was applied to ginseng preparation to increase the yields of the transformed ginsenosides, such as 20(S)-Rg3, Rk1, and Rg5, and enhance antioxidant activities in an effective way. Methods: Ginseng extract was hydrothermally processed using batch reactors at $100-160^{\circ}C$ with differing reaction times. Quantitative analysis of the ginsenoside yields was performed using HPLC, and the antioxidant activity was qualitatively analyzed by evaluating 2,2'-azino-bis radical cation scavenging, 2,2-diphenyl-1-picrylhydrazyl radical scavenging, and phenolic antioxidants. Red ginseng and sun ginseng were prepared by conventional steaming as the control group. Results: Unlike steaming, the hydrothermal process was performed under homogeneous conditions. Chemical reaction, heat transfer, and mass transfer are generally more efficient in homogeneous reactions. Therefore, maximum yields for the hydrothermal process were 2.5-25 times higher than those for steaming, and the antioxidant activities showed 1.6-4-fold increases for the hydrothermal process. Moreover, the reaction time was decreased from 3 h to 15-35 min using hydrothermal processing. Conclusion: Therefore, hydrothermal processing offers significant improvements over the conventional steaming process. In particular, at temperatures over $140^{\circ}C$, high yields of the transformed ginsenosides and increased antioxidant activities were obtained in tens of minutes.

• Genomics & Informatics
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• 제6권3호
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• pp.99-109
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• 2008

Protein phosphorylation at tyrosine residues is a key regulatory event that modulates insulin signal transduction. We studied the PTPN1 gene with regard to susceptibility to Korean type 2 diabetes mellitus (T2DM) and its related quantitative traits. A total of seven SNPs [g.36171G>A (rs941798), g.58166G>A (rs3787343), g.58208A>G (rs2909270), g.64840C>T (rs754118), g.69560C>G (rs6020612), g.69866G>A (rs718050), and g.69934T>G (rs3787343)] were selected based on frequency (>0.05), linkage disequilibrium (LD) status, and haplotype tagging status. We studied the seven SNPs in 483 unrelated patients with type 2 diabetes (age: $64{\pm}2.8$ years, onset age: $56{\pm}8.1$ years; 206 men, 277 women) and 1138 nondiabetic control subjects (age: $64{\pm}2.9$; 516 men, 622 women). The SNP rs941798 had protective effects against T2DM with an odds ratio of 0.726 (C.I. $0.541{\sim}0.975$) and p-value=0.034, but none of the remaining six SNPs was associated with T2DM. Also, rs941798 was associated with blood pressure, HDL cholesterol, insulin sensitivity. rs941798 also has been associated with T2DM in previous reports of Caucasian-American and Hispanic-American populations. This is the first report that shows an association between PTPN1 and T2DM in the Korean as well as Asian population.

• 과학기술학연구
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• 제14권2호
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• pp.165-198
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• 2014

이 연구는 비만(obesity)이 어떻게 독립적인 질병지위(status of disease)를 획득하게 되었는지 살펴봄으로써 질병 탄생의 메커니즘을 찾아보고자 하였다. 세계보건기구(WHO)는 1996년과 1997년에 "비만은 분명히 치료가 필요한 병"이라고 경고하였다. 그러나 그 이전까지 비만은 비(非)표준 비(非)정상의 신체 상태로 분류되었고 질병의 범주에 속하지 않았다. 이 논문은 비만이라는 질병의 탄생 메커니즘을 알아보기 위해 비만의 역사적 질병 담론 형성 과정과 병리학적 역학적 실재성을 고찰하였다. 연구 결과, 의료계가 BMI(Body Mass Index: 체질량지수)를 조정하고 정상 신체 범주를 좁히는 한편, 치수차별주의(sizism)를 제도화하였음을 확인하였다. 특히, 의료계가 비만의 신체 상태를 고혈압, 당뇨병 등 의료비 지출이 큰 만성적 고위험 질병과 결부(結付)짓는 비만공포증(fatphobia)을 유포함으로써 비만에 독립적인 질병지위를 부여하는 강력한 의료적 통제관리 메커니즘을 형성한 것으로 확인되었다. 이 논문은 이러한 고찰을 통해 비만과 같은 비(非)감염성 질병은, 실재의 병리학적 요인보다 문화적 사회경제적인 비(非)의료적 요인이 더 강력하게 개입하여 탄생할 수 있다는 함의를 발견하였다.