• Clinical and Experimental Pediatrics
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• 제46권10호
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• pp.983-988
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• 2003

목 적 : 실신은 소아에서 가장 흔한 증상이지만 기전은 잘 알려져 있지 않다. 증가된 미주신경의 활동과 감소된 교감신경의 자극이 저혈압, 서맥을 일으키고 마침내는 의식 소실을 초래한다. 이 연구의 목적은 혈관미주 신경성 실신으로 진단된 소아에서 기립경사 검사를 하는 동안 뇌 도플러 초음파를 실시하여 실신 전후의 뇌혈류 속도와 혈압, 심박동수 변화를 측정하고자 하였다. 방 법 : 실신의 과거력을 갖고 있는 64명의 소아를 대상으로 혈압을 10분간 안정 후와 15분 동안 기립 후에 측정하였고, 기립 경사 검사는 $80^{\circ}$에서 45분간 시행하였다. $80^{\circ}$ 각도의 경사 테이블에서 소아를 5분 간격으로 45분 동안 혈압, 심박동수, 산소 포화도를 측정하였다. 기립경사 검사를 하는 동안 실신이나 실신 전 증상이 나타난 소아에서는 검사를 중단하였다. 12-유도 심전도, 뇌파 검사, 심장 초음파를 시행하였다. 기립경사 검사에서 양성으로 나온 10명의 소아에서 Acouson 128XP/10 model 초음파 기기를 이용하여 중 대뇌동맥 혈류 속도, pulsatility 지수, time velocity integral, 혈압, 심박동수, 산소포화도 등을 측정하였다. 결 과 : 기립경사 검사에서 31.3%(20/64)의 양성률을 보였다. 검사 동안에 혈압과 맥박은 감소되지 않았고 뇌혈류 속도와 integral은 유의하게 감소되었다. 결 론: 뇌혈류 속도는 혈압이나 심박동수가 감소하기 전에 미리 감소하므로 실신 전 증상을 미리 예측할 수 있다. 뇌혈류의 자율 조절의 장애가 혈관미주 신경성 실신의 병인론에 중요한 역할을 하리라 생각된다.

• 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.