• 제목/요약/키워드: Post plasma

검색결과 445건 처리시간 0.028초

폐경 후 여성의 골다공증 및 심혈관계질환 위험도에 따른 영양소 및 식품섭취상태: 제5기 국민건강영양조사(2010-2011) 자료를 이용하여 (Food and Nutrient Intake Level by the Risk of Osteoporosis and Cardiovascular Disease in Postmenopausal Women: The use of the 5th Korean National Health and Nutrition Examination Surveys (2010-2011))

  • 김효빈;김혜숙;권오란;박희정
    • 대한지역사회영양학회지
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    • 제24권2호
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    • pp.152-162
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    • 2019
  • Objectives: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. Methods: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. Results: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin $B_2$ levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin $B_2$ was inadequately consumed by all groups. Conclusions: These results suggest that it is necessary to increase the intake of vitamin $B_2$ and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

광산 이직근로자의 만성폐쇄성폐질환 기류제한 중증도와 염증 및 산화스트레스 (Inflammation and Oxidative Stress as related to Airflow Limitation Severity in Retired Miners with Chronic Obstructive Pulmonary Disease)

  • 이종성;신재훈;백진이;정지영;최병순
    • 한국산업보건학회지
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    • 제29권2호
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    • pp.251-258
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    • 2019
  • Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Inflammation and oxidative stress are associated with COPD. The aim of this study was to evaluate the relationship among inflammation, oxidative stress, and airflow limitation severity in retired miners with COPD. Methods: The levels of serum high-sensitivity C-reactive protein(hsCRP) as a biomarker for inflammation, degree of reactive oxygen metabolites(dROMs) and biological antioxidants potential(BAP) in plasma as biomarkers for oxidative stress were measured in 211 male subjects with COPD. Degree of airflow limitation severity as determined by spirometry was divided into three grades grouped according to the classification of the Global Initiatives for Obstructive Lung Disease(GOLD)(1, mild; 2, moderate; $3{\leq}$, severe or more) using a fixed ratio, post- bronchodilator $FEV_1/FVC$ < 0.7. Results: Mean levels of dROMs significantly increased in relation to airflow limitation severity(GOLD 1, 317.8 U.CARR vs. GOLD 2, 320.3 U.CARR vs. GOLD $3{\leq}$, 350.9 U.CARR, p=0.047) and dROMs levels were correlated with serum hsCRP levels(r=0.514, p<0.001). Mean levels of hsCRP were higher in current smokers(non-smoker, 1.47 mg/L vs. smoker, 2.34 mg/L, p=0.006), and tended to increase with degree of airflow limitation severity(p=0.071). Mean levels of BAP were lower in current smokers(non-smoker, $1873{\mu}mol/L$ vs. smoker, $1754{\mu}mol/L$, p=0.006). Conclusions: These results suggest that inflammation and oxidative stress are related to airflow limitation severity in retired miners with COPD, and there was a correlation between inflammation and oxidative stress.

Improvement of Reproductive Efficiency of Artificial Insemination Following Estrus Induction in Dog II. Semen Freezing and Artificial Insemination in Dog

  • Lee, Y. R.;S. Y. Choe
    • 한국수정란이식학회:학술대회논문집
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    • 한국수정란이식학회 2002년도 국제심포지엄
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    • pp.92-92
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    • 2002
  • Considerable attention has been focused on the cryopreservation of semen and estrus induction in dog, as consequence of poor productivity caused by long anestrus period, in order to enhance the productivity of youngs and to preserve the breeds. The objectives of this study were to evaluate semen quality after cryopreservation and to evaluate the Pregnancy rate after insemination (AI). Fifty infertilie dogs (age 2∼3 years) were selected for the study and divided into three different estrus induction treatment groups. Group 1: dogs (n=15) were given clomifene (0.1 mg/kg) orally for five days at 12 hr intervals. Group 2: dogs (n=15) were given bromocriptine (50 $\mu\textrm{g}$/kg) orally for five days at 12 hr intervals, followed by single injection intravenously of 500 IU GnRH (Group 3, n=20) when pro-estrus occurred. The rates of pregnancy in estrus inducted dogs mated naturally compared to those inseminated artificially with ejaculated fresh semen and frozen-thawed semen. Estrus detection was performed using the method of vaginal smear and confirmed by the plasma progesterone assay. The ejaculated semen to freeze was exposed to a mixture of Tris extender with cryoprotectant (Trisma, 81 mM: TES, 209 mM: citric acid, 6 mM; glucose, 5 mM; glycerol, 8%) and cryopreserved gradually by slow-cooling at 17 cm above the surface of liquid nitrogen (LN$_2$) for 23 min. The motility of frozen-thawed spermatozoa was assessed by phase-contrast microscopy. To assess their viability and acrosome content, spermatozoa were stained with a vital stain and Fluorescence conjugated lectin Pisum Savitum Agglutinin (FITC/PAS), respectively. Pregnancy was confirmed by ultrasonograpy on day 25, 35 and 55 post insemination. The use of fresh semen, the pregnancy rates were observed 66.6, 66.6, 75.0 and 83.3% in natural estrus, clomifene induced, bromocriptine induced and a combination of GnRH and bromocriptine, respectively. The use of frozen-thawed semen, the pregnancy rates were observed 66.6, 33.3, 50.0 and 60.0% in natural estrus, clomifene induced, bromocriptine induced and a combination of GnRH and bromocriptine, respectively. No difference was observed in the number of offspring produced among natural estrus and treated groups inseminated with fresh or frozen-thawed semen. In conclusion, the pregnancy rate of dogs treated with a combination of GnRH and bromocriptine was more effective than use of clomifene or bromocriptine only. In addition, frozen-thawed semen can be used successfully far artificial insemination in dog.

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Insulin-like growth factor가 소장 점막 세포 증식에 미치는 영향

  • 윤정한
    • 한국영양학회:학술대회논문집
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    • 한국영양학회 1995년도 추계학술대회 초록
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    • pp.11-34
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    • 1995
  • Growth hormone (GH) plays a key role in regulating postnatal growth and can stimulate growth of animals by acting directly on specific receptors on the plasma membrane of tissues or indirectly through stimulating insulin-like growth factor (IGF)-I synthesis and secretion by the liver and other tissues. IGF-I and IGF-Ⅱ are polypeptides with structural similarity with proinsulin that stimulate cell proliferation by endocrine, paracrine and autocrine mechanisms. The initial event in the metabolic action of IGFs on target cells appears to be their binding to specific receptors on the plasma membrane. Current evidence indicates that the mitogenic actions of both IGFs are mediated primarily by binding to the type I IGF receptors, and that IGF action is also mediated by interactions with IGF-binding proteins (IGFBPs). Six distinct IGFBPs have been identified that are characterized by cell-specific interaction, transcriptional and post-translational regulation by many different effectors, and the ability to either potentiate or inhibit IGF actions. Nutritional deficiencies can have their devastating consequence during growth. Although IGF-I is the major mediator of GH's action on somatic growth, nutritional status of an organism is a critical regulator of IGF-I and IGFBPs. Various nutrient deficiencies result in decreased serum IGF-I levels and altered IGFBP levels, but the blood levels of GH are generally unchanged or elevated in malnutrition. Effects of protein, energy, vitamin C and D, and zinc on serum IGF and IGFBP levels and tissue mRNA levels were reviewed in the text. Multiple factors are involved in the regulation of intestinal epithelial cell growth and differentiation. Among these factors the nutritional status of individuals is the most important. The intestinal epithelium is an important site for mitogenic action of the IGFs in vivo, with exogenous IGF-I stimulating mucosal hyperplasia. Therefore, the IGF system appears to provide and important mechanism linking nutrition and the proliferation of intestinal epithelial cells. In order to study the detailed mechanisms by which intestinal mucosa is regulated, we have utilized IEC-6 cells, an intestinal epithelial cell line and Caco-2 cells, a human colon adenocarcinoma cell line. Like intestinal crypt cells analyzed in vivo or freshly isolated intestinal epithelial cells, IEC-6 cells and Caco-2 cells possess abundant quatities of both type Ⅰ and type Ⅱ IGF receptors. Exogenous IGFs stimulate, whereas addition of IGFBP-2 inhibits IEC-6 cell proliferation. To investigate whether endogenously secreted IGFBP-2 inhibit proliferation, IEC-6 cells were transfected with a full-length rat IGFBP-2 cDNA anti-sense expression construct. IEC-6 cells transfected with anti-sense IGFBP-2 protein in medium. These cells grew at a rate faster than the control cells indicating that endogenous IGFBP-2 inhibits proliferation of IEC-6 cells, probably by sequestering IGFs. IEC-6 cells express many characteristics of enterocyte, but do not undergo differentiation. On the other hand, Caco-2 cells undergo a spontaneous enterocyte differentiation. On the other hand, Caco-2 cells undergo a spontaneous enterocyte differentiation after reaching confluency. We have demonstrated that Caco-2 cells produce IGF-Ⅱ, IGFBP-2, IGFBP-3, and an as yet unidentified 31,000 Mr IGFBP, and that both mRNA and peptide secretion of IGFBP-2 and IGFBP-3 increased, but IGFBP-4 mRNA and protein secretion decreased after the cells reached confluency. These changes occurred in parallel to and were coincident with differentiation of the cells, as measured by expression of sucrase-isomaltase. In addition, Caco-2 cell clones forced to overexpress IGFBP-4 by transfection with a rat IGFBP-4 cDNA construct exhibited a significantly slower growth rate under serum-free conditions and had increased expression of sucrase-isomaltase compared with vector control cells. These results indicate that IGFBP-4 inhibits proliferation and stimulates differentiation of Caco-2 cells, probably by inhibiting the mitogenic actions of IGFs.

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콜레스테롤이 동결-해동 후 인간정자의 생존과 기능보존에 미치는 영향 (Effect of Cholesterol Supplementation in Freezing Medium on the Survival and Integrity of Human Sperm after Cryopreservation)

  • 임정진;성수예;김계성;송승훈;이우식;윤태기;이동률
    • Clinical and Experimental Reproductive Medicine
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    • 제35권3호
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    • pp.203-212
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    • 2008
  • 목 적: 정자의 동결 과정에서 생길 수 있는 급격한 온도 차에 의한 동결 충격이나 동결 상해등에 의한 세포막의 손상, 세포의 기능 장애 등은 정자의 수정능에 영향을 미칠 수 있다. 본 연구에서는 인간 정자를 동결 보존하는 과정에서 콜레스테롤 전처리가 정자의 운동성 및 기능보존에 미치는 영향을 알아보고자 하였다. 연구방법: 본원을 내원한 14명 남성의 정자를 대상으로 콜레스테롤을 첨가하지 않은 대조군 (control)과 여러 농도의 콜레스테롤을 동결보존액에 첨가한 실험군에서 정자의 동결-융해 후 상태를 다음 3가지 방법으로 비교, 분석하였다. 1) 정자 분석, 2) calcium ionophore로 유도된 첨체 반응 검사, 3) 정자 염색질 구조 분석 (sperm chromatin structure assay). 결 과: 첫째로 인간 정자의 운동성은 $0.5{\mu}g$ 농도의 콜레스테롤을 첨가한 동결보존액에서 동결-해동하였을 경우, 콜레스테롤을 첨가하지 않은 군에 비해 유의적 차이를 보이며 증가하는 것을 확인하였다 ($33.46{\pm}1.48%$ vs. $30.10{\pm}1.07%$, p<0.05). 다음으로 동된 정자의 첨체 반응 검사에서도 콜레스테롤을 첨가한 동결보존액에서의 첨체 반응이 일어나는 정자의 비율이 첨가하지 않은 군에 비해 유의하게 높게 관찰되었다 ($53.60{\pm}1.60%$ vs. $47.40{\pm}1.86%$, p<0.05). 마지막으로 정자 염색질 구조 분석에서는 콜레스테롤을 첨가한 군이 첨가하지 않은 군에 비해 정자의 DNA손상이 적게 나타남을 확인하였다. 결 론: 본 실험은 동결보존액을 통한 정자 원형질막 내 콜레스테롤 함유량의 증가가 동결-융해 후 정자의 운동성과 수정능(capacitation status)을 증가시키고 DNA 손상을 방지하는 역할을 한다는 결과를 보여주었다. 이러한 결과를 통해 동결보존액 내 콜레스테롤의 첨가는 인간 정자의 동결보존 동안 발생할 수 있는 동결 상해를 줄여줄 수 있는 유용한 방법으로 사료된다.

Ad libitum Pasture Feeding in Late Pregnancy Does Not Improve the Performance of Twin-bearing Ewes and Their Lambs

  • Corner-Thomas, R.A.;Back, P.J.;Kenyon, P.R.;Hickson, R.E.;Ridler, A.L.;Stafford, K.J.;Morris, S.T.
    • Asian-Australasian Journal of Animal Sciences
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    • 제28권3호
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    • pp.360-368
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    • 2015
  • The present study evaluated the effect of controlled ryegrass-white clover herbage availability from day 128 until day 142 of pregnancy in comparison to unrestricted availability, on the performance of twin-bearing ewes of varying body condition score (BCS; 2.0, 2.5, or 3.0) and their lambs. It was hypothesised that under conditions of controlled herbage availability, the performance of lambs born to ewes with a greater BCS would be greater than those born to ewes with a lower BCS. During the period that the nutritional regimens were imposed, the pre- and post-grazing herbage masses of the Control regimen ($1,070{\pm}69$ and $801{\pm}30$ kg dry matter [DM]/ha) were lower than the ad libitum regimen ($1,784{\pm}69$ and $1,333{\pm}33kg\;DM/ha$; p<0.05). The average herbage masses during lactation were $1,410{\pm}31kg\;DM/ha$. Nutritional regimen had no effect on ewe live weight, BCS and back fat depth or on lamb live weight, indices of colostrum uptake, maximal heat production, total litter weight weaned or survival to weaning (p>0.05). The difference in ewe BCSs and back fats observed among body condition groups was maintained throughout pregnancy (p<0.05). At weaning, ewes from the BCS2.0 group had lower BCS and live weight ($2.4{\pm}0.2$, $74.3{\pm}2.6kg$) than both the BCS2.5 ($2.6{\pm}0.2$, $78.6{\pm}2.4kg$) and BCS3.0 ewes ($2.7{\pm}0.2$, $79.0{\pm}2.6kg$; p<0.05), which did not differ (p>0.05). Ewe BCS group had no effect on lamb live weight at birth or weaning or on maximal heat production (p>0.05). Serum gamma glutamyl transferase concentrations of lambs born to BCS3.0 ewes were higher within 36 hours of birth than lambs born to BCS2.0 ewes and BCS2.5 ewes ($51.8{\pm}1.9$ vs $46.5{\pm}1.9$ and $45.6{\pm}1.9IU/mL$, respectively [p<0.05]). There was, however, no effect of ewe body condition on lamb plasma glucose concentration (p>0.05). Lamb survival was the only lamb parameter that showed an interaction between ewe nutritional regimen and ewe BCS whereby survival of lambs born to BCS2.5 and BCS3.0 ewes differed but only within the Control nutritional regimen ewes (p<0.05). These results indicate farmers can provide twin-bearing ewes with pre- and post-grazing ryegrass-white clover herbage covers of approximately 1,100 and 800 kg DM/ha in late pregnancy, provided that herbage covers are 1400 in lactation, without affecting lamb performance to weaning. The present results also indicate that under these grazing conditions, there is little difference in ewe performance within the BCS range of 2.0 to 3.0 and therefore they do not need to be managed separately.

STZ-당뇨쥐에서 운동부하가 골격근 및 간의 항산화효소 활성도에 미치는 영향 (Effect of Exercise on Antioxidant Enzyme Activities of Skeletal Muscle and Liver in STZ-diabetic Rats)

  • 석광호;이석강
    • Journal of Yeungnam Medical Science
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    • 제17권1호
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    • pp.21-30
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    • 2000
  • 당뇨쥐에서 운동부하가 골격근과 간의 항산화효소 활성도에 미치는 영향과 산소유리기에 의한 조직손상 여부블 관찰한 연구 결과를 요약하면 다음과 같다. Strcptozotocin으로 유도한 당뇨군의 혈당농도(mg/dL)는 $344{\pm}14.8$로서 대조군의 $117{\pm}2.7$보다 높았으며(p<0.001) 운동부하에 의해서 유의하게 감소하였다(p<0.01). 혈장 인슐린 농도(${\mu}U/mL$)는 당뇨군에서 $8.5{\pm}0.5$로서 대조군의 $20.6{\pm}1.4$보다 유의하게 낮았으며(p<0.001) 운동부하후에는 운동부하전과 비교하여 차이가 없었다. 당뇨군에서 실제 운동부하의 정도를 평가하기 위해서 측정한 운동부하후 골격 끈파 간의 당원농도(mg/100 g wet wt.)는 각각 $1.0{\pm}0.1$$7.7{\pm}0.8$로서 운동부하전과 비교시 모두 유의하게 감소하였다(p<0.001, p<0.01). 당뇨군의 골격근과 간의 항산화효소 즉 superoxide dismutase(SOD), glutathionc pcroxidase(GPX) 및 catalase(CAT)의 활성도는 운동부하에 의해서 각기 다른 반응을 보였다. 골격근의 SOD 활성도(unit/mg protein)는 대조군에서 $6.3{\pm}0.2$였으며 당뇨군에서는 $5.8{\pm}0.2$로서 대조군과의 사이에 유의한 차이를 발견할 수 없었으나 운동부하후에는 $5.0{\pm}0.1$로서 대조군과 운동부하전 당뇨군보다 유의하게 감소하였다(p<0.001, p<0.01). GPX 활성도(nmol/min/mg protein)는 당뇨군에서 운동부하전후에 각각 $2.3{\pm}0.2$$1.8{\pm}0.1$로서 대조군의 $1.6{\pm}0.0$보다 다같이 높았으나(p<0.05, p<0.05) 운동부하에 의해서 영향을 받지 않았다. CAT 활성도(pmol/min/mg protein)는 당뇨군에서 $7.6{\pm}0.7$로서 대조군의 $6.3{\pm}0.7$과 비교하여 차이가 없었으나 훈동부하후에는 $4.6{\pm}0.3$으로서 대조군보다 감소하였으며(p<0.05) 당뇨군의 운동부하전보다도 감소하였다(p<0.01). 당뇨군의 MDA 농도는 대조군과 비교하여 차이가 없었으며 당뇨군에서 운동부하에 의한 영향도 받지 않았다. 간의 SOD 활성도는 대조군에서 $11.3{\pm}0.2$였으며 운동부하전 당뇨군에서는 $9.6{\pm}0.3$으로서 유의하게 감소하였다(p<0.01). 당뇨군에서 운동부하전후 측정한 SOD 활성모는 대조군과 비교하여 다같이 감소하였으나(p<0.01, p<0.001), 운동부하에 의한 영향은 없었다. 당뇨군외 GPX와 CAT의 활성도는 대조군과 비교하여 유의한 차이가 없었으며 당뇨군에서 운동 부하에 의한 변화도 없었다. 운동부하전 당뇨군의 MDA 농도(nmol/g wet wt.)는 $38.5{\pm}1.3$으로서 대조군의 $24.8{\pm}0.9$에 비해서 유의하게 증가하였으며(p<0.001) 운동부하에 의해서는 대조군보다는 높았으나(p<0.001) 운동부하전과 비교하여서는 차이가 없었다. 이상의 결과를 종합하면 당뇨쥐에서 골격근은 운동부하로 인한 산화 스트레스에 대한 적응과정을 통해서 손상이 없었으나, 간 조직은 당뇨병 자체로 인한 산소유리기의 발생으로 손상의 위험이 있었으나 운동부하에 의한 더 이상의 손상은 없었다.

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Mammary Performance of First Lactation Bali Cows (Bibos banteng) Fed Grass-Legume Based Diets in Relation to the Role of Glucose

  • Sukarini, I.A.M.;Sastradipradja, Djokowoerjo;Nusada, N.;Mahardika, I.G.;Kiranadi, B.
    • Asian-Australasian Journal of Animal Sciences
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    • 제14권5호
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    • pp.615-623
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    • 2001
  • A study of mammary function in relation to glucose metabolism of first lactation Bali cows on grass-legume diets was carried out using 12 primiparous cows (initial BW $263.79{\pm}21.66kg$) for 16 weeks starting immediately post calving. The animals were randomly allocated into 4 dietary treatment groups R1, R2, R3 and R4, receiving from the last 2 months of pregnancy onwards, rations based on a mixture of locally available grass and legume feed ad libitum. On a DM basis R1 contained 70% elephant grass (PP, Penicetum purpureum) plus 30% Gliricidia sepia leaves (GS), R2 was 30% PP plus 25% GS supplemented with 55% Hibiscus tilliacius leaves (HT, defaunating effect), R3 and R4 were 22.5% PP+41.25% GS+11.25% HT+25% concentrate, with R4 supplemented with zinc-diacetate. TDN, CP and zinc contents of the diets were 58.2%, 12.05% and 18.3 mg/kg respectively for R1, 65.05%, 16.9% and 25.6 mg/kg respectively for R2, 66.03%, 16.71% and 29.02 mg/kg respectively for R3 and 66.03%, 16.71% and 60.47 mg/kg respectively for R4. Milk production and body weights were monitored, an energy and protein balance trial conducted, overall glucose kinetics parameters assessed, mammary blood flow (MBF) and metabolite arteriovenous differences (${\Delta}AVs$) measured to get uptake data and mammary performance relationships. Parameters of glucose kinetics at peak lactation or during dry condition were not affected by ration quality. Glucose pool size, space of distribution and flux increased by 61.77, 62.26 and 82.08%, respectively, during lactation compared to the dry period. Mean glucose flux of lactating Bali cows was $5.52mg/min.kgBW^{0.807}$ which resembles the range of values of temperate dairy cows. Calculation showed that glucose requirements for maintenance, milk lactose and fat-glycerol synthesis, and the formation of NADPH reached 461.69 g for a yield of 1 kg/d or equal to 320.62 mg/min, which was less than the average glucose flux of lactating Bali cows of 481.35 mg/min. Mammary blood flow (MBF) values ranged from 56 to 83 l/h for the different treatments and the ratio MBF per kg milk produced improved from av. 1540 l/kg for R1 to av. 967 l/kg for R4 treated cows. Mammary glucose uptake ranged from 6.27 to 12.03 g/h or 120 to 140 g/kg milk. Glucose uptake was mass-wise 2 to 4 times the amount secreted as lactose, which indicated values less than the calculated mammary glucose needs and that little lactose was synthesized. The excess glucose taken-up was used for other metabolic processes. Linear relationships between metabolite ${\Delta}AVs$ and arterial blood plasma concentration [A] showed that in Bali cows triglycerides (TG), phenylalanine (Phe) and tyrosine (Tyr) have high coefficients of determination, i.e. 0.77, 0.81 and 0.69, respectively. For glucose, the relationship is quadratic with an $R^2$ value of 0.49. It was concluded that lactose synthesis was inadequate, which led to a speculation that milk yield could be improved by increased lactose synthesis.

한국형 이동식 심폐소생기 개발 보고 II. 응급소생술을 위한 이동식 심폐소생기의 동물 실험 연구 (Report for Development of Korean Portable Cardiopulmonary Bypass II. Experimental Study of Portable Cardiopulmonary Bypass for Emergency Cardiopulmonary Resuscitation after Cardiac Arrest in Normal Dogs)

  • 김형묵;이인성;백만종;선경;김광택;이혜원;이규백;장준근;김종원;김학제
    • Journal of Chest Surgery
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    • 제31권12호
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    • pp.1147-1158
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    • 1998
  • 배경:이동식 인공심폐기는 심정지 기간 동안 안정한 혈역학 상태를 유지하여 생존율을 향상시킬 수 있기 때문에 강력하고 효과적인 심폐소생법의 하나로 그의 사용이 증가하고 있다. 본 연구진은 초기모델의 한국형 이동식 심폐소생기를 이용한 심폐소생술과 기존의 개흉식 심폐소생술을 비교하여 혈역학 유지와 소생 여부 및 신체장기들에 미치는 효과를 알아보고자 하였다. 대상 및 방법: 한국산 잡견 8마리(30∼51kg)를 대상으로 개흉식 심폐소생술군과 심폐소생기를 이용한 심폐소생술군으로 각각 4마리 씩 나누었다. 4분 간의 심실세동형 심정지 기간이 지난 후 15분 간의 기본 심폐소생술(basic life support; BLS)을 실시하고 30분 간의 고급 심폐소생술(advanced life support; ALS)을 실시하여 자발순환회복, 혈역학 상태, 혈구성분에 미치는 효과, 혈액 가스 검사, 생화학 검사 및 생존율 등을 알아보았다. 심장압박과 폐환기는 두 군 모두 동일한 조건으로 유지하였으며, 고급 심폐소생술 시작과 동시에 제세동을 하고 에피네프린 및 탄산수소나트륨을 투여하여 자발순환회복을 유도하였다. 측정한 관찰값은 심정지전 관찰값으로부터의 변화율(%)로 환산하여 평균±표준편차로 표시하였다. 결과: 고급 심폐소생술 초기에 평균 체동맥압은 심폐소생기군에서 개흉식 심폐소생술군 보다 높게 유지되었고 (90±19% vs. 71±32%, p<.05), 평균 폐동맥압은 심폐소생기군이 개흉식 심폐소생술군 보다 낮게 유지되었다 (105±24% vs. 146±6%, p<.05). 자발순환회복은 모든 실험견에서 나타났다. 자발순환회복 후 심폐소생기군에서 혈중 헤마토크리트치, 적혈구와 혈소판 수가 유의하게 감소하였고 혈중 유리헤모글로빈치는 유의하게 증가하였다(p<.05). 혈액가스검사와 lactate 및 CK-MB치는 두 군간에 차이가 없었다. 실험 후 조기사망은 심폐소생기군에서 2마리, 개흉식 심폐소생술군에서 3마리에서 있었다(생존기간 228±153 vs. 31±36 시간, p=ns). 나머지는 모두 장기 생존율을 보였다. 결론: 본 연구결과 이동식 심폐소생기를 이용한 심폐소생술은 심정지 기간 동안 안정한 혈역학 상태를 유지하여 자발순환회복 및 장단기 생존율을 향상시킬 수 있다. 추후 이동식 심폐소생기 개선과 임상적용을 위해 초기모델을 수정 보완하는 실험연구가 더 필요하리라 본다.

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유소아 경증 지속성 천식에서 저용량 서방형 테오필린 건조시럽과 캡슐 제형의 치료 효과 비교 (Therapeutic comparison between low-dose sustained-release theophylline dry syrup and capsule in children with mild persistent asthma)

  • 이현승;이혜경;권희정;김정희;나영호;김진택;김영호;이혜란;편복양
    • Clinical and Experimental Pediatrics
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    • 제50권3호
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    • pp.284-291
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    • 2007
  • 목 적 : 테오필린은 천식의 치료제로서 부작용을 개선하기 위하여 서방형 제제가 개발 되었고 캡슐 제형과 더불어 유소아에 대한 임상적용의 편의를 위한 건조시럽 제형이 개발 되어 사용되고 있다. 저자들은 두 가지 테오필린 제형들의 효과를 비교하기 위하여 경증의 천식 환자들에게 테오필린 캡슐 제형과 건조시럽 제형을 저용량으로 투여한 후 제형에 따른 효능을 비교 분석하였다. 방 법 : 2005년 10월 1일부터 2006년 3월 31일까지 가톨릭대학교 의정부성모병원, 경희대학교 경희의료원, 인하대학교 병원, 순천향대학교 병원, 한림대학교 강동성심병원 등의 국내 5개 대학병원 소아 알레르기클리닉에 내원하여 경증 천식으로 진단받은 2-6세 사이 환자 90명을 대상으로 12주 동안 서방형 테오필린을 건조시럽 제형 투여군(n=44)과 캡슐 제형 투여군(n=46)으로 나누어 1일 2회, 4 mg/kg/회의 용량으로 경구 투여하였다. 연구자가 임상 시험 시작(0주)과 매 4주째마다 주간 및 야간 천식 증상 개선도를 평가 하였으며, 매 4주째마다 복약 순응도, 약물 복용감, 그리고 종합적인 평가로서 약제의 유용도를 평가하였다. 이중 약제의 유용도는 환자 보호자에게도 스스로 평가할 수 있게 하였다. 4주와 12주째 혈액내 테오필린 농도와 0주와 12주째 혈액내 ECP농도를 측정하였다. 결 과 : 두 군 모두에서 4주와 12주의 혈액내 테오필린 평균 농도는 $5-10{\mu}g/mL$의 치료 농도를 보였으며 4주째부터 임상시험 시작에 비해 천식 증상의 유의한 호전을 보였다. 두 군간 비교에서는 건조시럽 투여군이 캡슐 투여군보다 주간 천식 증상 점수는 4주째부터 야간 천식 증상 점수는 8주째부터 유의하게 낮은 결과를 보였다. 연구자에 의한 약제의 유용도 평가에 있어서도 건조시럽 투여군이 캡슐 투여군보다 유의하게 높은 결과를 보였으며 평가에 있어서 주관성이 강한 환자 보호자에 의한 평가는 연구자에 의한 평가 보다 4주 먼저 건조시럽 투여군이 캡슐 투여군 보다 유의하게 높게 나타났다. 건조시럽 투여군이 캡슐 투여군 보다 약물 복용감과 복약 순응도가 유의하게 높게 나타났으며 호산구에 의한 기도 염증반응 정도를 반영하는 혈액내 ECP농도는 건조시럽 투여군에서만 12주 동안 테오필린 투약 후가 투약전보다 유의하게 감소하였다. 결 론 : 저용량의 서방형 테오필린은 항염증 작용이 있는 안전하고 유용한 천식 치료제로 생각되며 건조 시럽 제형은 캡슐 제형에 비해 장기간 복약 순응도가 높아서 특히 유소아 천식환자들의 임상적용에 많은 장점이 있는 것으로 사료된다.