• 대한약리학회지
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• 제5권1호
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• pp.35-38
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• 1969

1.On isolated atrial preparation of frog, effects of sympathomimetic amines were investigated. 2. Isoproterenol, epinephrine, norepinephrine, and phenylephrine produced positive chronotropic and inotropic effects. The relative potencies for the effects of these agents were: isoproterenol > epinephrine> norepinephrine> phenylephrine. Methoxamine had no effects or depressed the atria. 3. Pronethalol antagonized the positive effects of these adrenergic agents competitively. 4. Regitine did not affect the effects of these agents. 5. These data indicate that the adrenergic agents activate the atrial tissue of the frog via stimulation of adrenergic beta-receptor.

• Journal of Chest Surgery
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• 제18권2호
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• pp.193-204
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• 1985

During the period from February to March, 1984, we employed a partial left heart bypass [left atrium to ascending aorta] in 2 patients who could not weaned from cardiopulmonary bypass with inotropic agents and cardiac pacing after coronary bypass surgery. These two patients showed significant improvement in ventricular function 18 to 47 hours after inserting the left heart bypass and were able to wean from the left heart bypass under using inotropic agents. Two patients died of multiple organ failures 11 days and 15 days postoperatively. These results indicate that early institution of left heart bypass in ventricular failure patients after open heart surgery can provide satisfactory long-term result.

• Archives of Pharmacal Research
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• 제12권4호
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• pp.276-281
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• 1989

Selective inhibition of seven new PDE inhibitors on cyclic nucleotide PDE isozymes was investigated. Three PDE isozymes (PDE I, II and III) of guinea pig left ventricular muscles were used. All tested agents inhibited cyclic AMP hydrolysis by PDE III IN A concentration-dependent manner. Some agents represented more potent and selective inhibitory effect on PDE III than that of imazodan.

• 대한약리학회지
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• 제19권2호
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• pp.9-16
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• 1983

현재 사용되고 있는 강심제로는 디지탈리스 배당체가 유일한 약물이지란 그 안전역이 대단히 좁아서 보다 안전한 강심제의 개발이 요구되고 있다. 최근 강심작용이 현저할 뿐 아니라 안전역이 비교적 넓을 것으로 인정되는 higenamine이 개발되어 그 작용기전을 밝히려는 시도가 많이 있었다. 본 연구에서는 higenamine의 강심작용 기전을 규명하기 위한 연구의 일환으로 수축빈도-수축력 상관관계(interval-strength relationship)에 있어서 1) Rested-state수축력 2) Positive inotropic effect of activation(PIEA) 3) Negative inotropic effect of activation(NIEA)에 대한 higenamine의 영향을 $Ca^{++}$및 epinephrine과 비교 분석하였다. 실험결과 칼슘은 PIEA를 증가시키기 보다는 오히려 NIEA의 소멸을 촉진함으로써 강심작용을 나타내며 epinephrine 및 higenamine은 PIEA를 증가시키고 NIEA에는 거의 영향을 미치지 않았다.

• Clinical and Experimental Pediatrics
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• 제50권11호
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• pp.1041-1048
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• 2007

Not a few patients in children and adolescents are suffering from right ventricular (RV) dysfunction resulting from various conditions such as chronic lung disease, left ventricular dysfunction, pulmonary hypertension, or congenital heart defect. The RV is different from the left ventricle in terms of ventricular morphology, myocardial contractile pattern and special vulnerability to the pressure overload. Right ventricular failure (RVF) can be evaluated in terms of decreased RV contractility, RV volume overload, and/or RV pressure overload. The management for RVF starts from clear understanding of the pathophysiology of RVF. In addition to correction of the underlying disease, management of RVF per se is very important. Meticulous control of volume status, inotropic agents, vasopressors, and pulmonary selective vasodilators are the main tools in the management of RVF. The relative importance of each tool depends on the individual clinical status. Medical assist device and surgery can be considered selectively in case of refractory RVF to optimal medical treatment.

• 대한약리학회지
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• 제2권1호
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• pp.21-29
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• 1966

Dichloroisoproterenol(DCI) i; one of the well known ${\beta}$-adrenergic receptor blocking agents. According to Moran and Perkins, DCI has sympathomimetic like action in relatively low concentrations. Fleming and Hawkins confirmed that DCI acts upon the receptors concerned with positive chronotropic and inotropic actions in the heart. Vogins reported that DCI, in concentration of $5{\times}10^{-8}$ to $5{\times}10^{-6}g/ml$, had properties of sympathomimetic amine causing positive inotropic and chronotropic actions in normal rat atria. And James and Nadeau found that DCI had not only adrenergic blocking effect in moderate and higher concentrations, but it also blocked the effect on the sinus node by vagal stimulation and of directly administered acetylcholine in higher concentrations. As stated above by many authors, DCI has complicated actions according to its concentrations. Our aim at the present experiments was to study the effects of DCI to the action of ouabain and acetylcholine upon the excised rabbit atria, as well as to the action of barium chloride and acetylcholine upon the excised rabbit intestine. In addition, Pan ax Ginseng is widely used as tonics in oriental nations, its pharmacological action, however, has not been clearly established. So we atempted to investigate the effects of the water extract of Panax Ginseng to the action of ouabain and DCI upon both atria and intestine. The results obtained were as follows. 1) DCI has a negative inotropic effect on the excised rabbit atria at concentration of $10^{-5}$ and a positive inotropic effect at concentration of $10^{-6}$. 2) DCI (at concentration of $10^{-6}$) potentiates the positive inotropic effect of ouabain upon the excised rabbit atria. 3) DCI antagonizes the action of acetylcholine upon the excised rabbit atria. 4) The water extract of Panax Ginseng, at concentration of $10^{-3}$, decreases the contractile force of rabbit atria, and tends to slightly increase that of rabbit atria at $10^{-4}$. 5) The water extract of Panax Ginseng exhibits a synergistic action with ouabain on the contractile force of rabbit atria. 6) DCI, in concentrations of $10^{-7}{\sim}10^{-6}$, depresses the tone and amplitude of contraction of the excised rabbit intestine. The depression of the intestinal tone markedly appears in pretreatment with reserpine 2mg/kg 24 hours. 7) DCI antagonizes the contractile effect of barium chloride on the excised rabbit atria. 8) DCI has no significant influence on the action of acetylcholine upon the excised rabbit intestine. 9) The series of those evidences indicates that DCI has a sympathomimetic-like action and more over a relaxing action directly on the excised rabbit intestine. 10) The water extract of Panax Ginseng in concentrations of $10^{-4}{\sim}10^{-3}$, has transient depression of the intestinal tone, but later gradually recovers its normal motility: 11) The water extract of Panax Ginseng has a synergistic action with ouabain on the intestinal contractility.

• 대한약리학회지
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• 제12권1호
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• pp.45-55
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• 1976

The effect of positive inotropic agents on the contractile properties of myocardial muscle were studied in the cat papillary muscle preparation. For the purpose, the effects of ouabain $(1{\times}10^{-6}g/ml)$, norepinephrine (0.05r/m1) and Aconiti tuber butanol fraction (AF(5), $1{\times}10^{-4}$, $5{\times}10^{-4}$, $1{\times}10^{-3}$, $2{\times}10^{-3}g/ml$) on the contractile dynamics of the papillary muscle preparation isolated from right ventricle of cat were observed in terms of the characteristics of isometric twitch and the lengh-tension relation, the force-velocity relation and the load-extension relation of the series elastic component of contractile model of A.V. Hill. All the studied inotropic drugs similary increased the rate and the intensity of the developed isometric tension, while shortened the time from onset of contraction to peak tension and the total duration of contraction. In the afterloaded simultaneous isotonic and isometric contraction, they also similary increased the maximal velocity of shortening accompanied with the increasing the maximum developed force. In the load-extension relation all the drugs, however, had no appreciable influence on the properties of the series elastic component. Increasing the concentration, Aconiti tuber butanol fraction produced more pronounced effect on all the studied parameters of isometric and isotonic contraction of cat papillary muscle preparation. From the aspect of contractile dynamics, it seemed that the positive inotropic effect of ouabain, norepinephrine and Aconiti tuber butanol fraction are similary achieved through an influence on the behavior of the contractile component only.

• Korean Circulation Journal
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• 제52권3호
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• pp.173-197
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• 2022

Treatment options for patients with heart failure (HF) with reduced ejection fraction (HFrEF) have expanded considerably over the past few decades. Whereas neurohormonal modulation remains central to the management of patients with HFrEF, other pathways have been targeted with drugs that have novel mechanisms of action. The angiotensin receptor-neprilysin inhibitors (ARNIs) which enhance levels of compensatory molecules such as the natriuretic peptides while simultaneously providing angiotensin receptor blockade have emerged as the preferred strategy for inhibiting the renin angiotensin system. Sodium glucose cotransporter 2 (SGLT2) inhibitors which were developed as hypoglycemic agents have been shown to improve outcomes in patients with HF regardless of their diabetic status. These agents along with beta blockers and mineralocorticoid receptor antagonists are the core medical therapies for patients with HFrEF. Additional approaches using ivabradine to slow heart rate in patients with sinus rhythm, the hydralazine/isosorbide dinitrate combination to unload the heart, digoxin to provide inotropic support and vericiguat to augment cyclic guanosine monophosphate production have been shown in well-designed trials to have beneficial effects in the HFrEF population and are used as adjuncts to the core therapies in selected patients. This review provides an overview of the medical management of patients with HFrEF with focus on the major developments that have taken place in the field. It offers prospective of how these drugs should be employed in clinical practice and also a glimpse into some strategies that may prove to be useful in the future.

• 한국임상수의학회지
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• 제29권3호
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• pp.203-206
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• 2012

심부전의 치료는 심방의 용적 과부하를 줄이기 위한 이뇨제, 심실 압력 과부하를 줄이기 위한 혈관확장제, 심근의 수축력을 향상시키기 위한 강심제 치료로 이루어진다. 이 중 이뇨제가 개의 심부전 조절에서 가장 중요하다. 하지만 장기간의 이뇨제 사용으로 급성 신부전이나 전해질 이상과 같은 부작용이 발생할 수 있다. 따라서 이 연구는 개에서 부작용이 적으면서 더 나은 이뇨효과를 가지는 생약성분의 이뇨제를 찾기 위해 설계되었다. 5마리의 건강한 개를 대상으로 한 예비실험에서 목통(Akebia quinata Decaisne) 추출물은 경도에서 중등도의 이뇨효과(furosemide 2 mg/kg 용량 효과의 0.3-0.5배의 효력)를 보였으며 혈청화학 수치와 전해질 변동은 거의 없었다. 실험 개체 수가 적고 기간이 충분하지 않지만 이 실험을 통해 심부전 환자에서 furosemide의 사용량을 줄이거나 대체할 수 있는 생약성분의 이뇨제 성분을 발굴하였다.

• Journal of Chest Surgery
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• 제26권10호
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• pp.804-807
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• 1993

We experienced a case of cardiac rhabdomyoma,which is incidentally found at perinatally checked sonography.The cardiac rhabdomyoma is the most common cardiac tumor of infants & children, and second most common cardiac tumor of all age groups, which is usually multiple in the case of 90%, invariably involves the ventricles affecting the left & right side equally. In more than fifty percents, the size of cardiac rhabdomyoma is enough large to threatening the life of newborn within 24hrs of birth. Cardiac rabdomyoma is actually a myocardial harmatoma rather than a true neoplasm,because of the finding of complete lack of mitotic activities. Recently,more advanved instruments such as ultrasonography or echocardiography allows to us early detection & surgical intervention of this tumor. In our case, the tumor was found at both ventricles, which occupied nearly total chambers of both ventricles. The patient was operated on 3 day after birth. The operation was removal of the tumor through left ventriculotomy and right ventriculotomy respectively. He expired in the immediate postoperative period due to low cardiac output syndrome, despite of massive inotropic agents.