• The Korean Journal of Physiology
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• 제23권2호
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• pp.313-328
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• 1989

The electrophysiological properties of the inward current contributing to the late plateau phase of the action potential were investigated using the whole cell clamp technique and intracellular dialysis in single atrial cells isolated from the rabbit heart. The inward current was activated by various repolarizing pulses after a brief depolarizing pulse to +40 mV for 2 ms and its time course was similar to that of the late plateau of the action potential. The current was fully activated above the potential of -40 mV and abolished by intracellular EGTA. Ryanodine of $1{\mu}M$ also abolished the late plateau and the inward current. Reduced $Na_o\;to\;30%\;and\;20\;mM\;Na_1$ diminished the late plateau together with the inward current. Diltiazem blocked the activation of the current and Ni in the concentration of $40{\sim}200\;{\mu}M$ decreased the development of the late plateau and the inward current. Fully activated current-voltage relation of the inward current showed exponential voltage dependency which was steeper in more hyperplarizing range. The above findings suggest that the inward current was activated by intracellular calcium and contribute the late plateau phase of the action potential. It could be concluded that the inward current would be the inward component of Na-Ca exchange.

• 대한의용생체공학회:의공학회지
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• 제43권5호
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• pp.331-340
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• 2022

Early afterdepolarization (EAD), a significant cause of fatal ventricular arrhythmias including Torsade de Pointes (TdP) in long QT syndromes, is a depolarizing afterpotential at the plateau or repolarization phase in action potential (AP) profile early before completing one pace. AP duration prolongation is related to EAD but is not necessarily accounted for EAD. Several computational studies suggested EAD can form from an abnormality in the late plateau and/or repolarization phase of AP shape. In this sense, we hypothesized the slope during repolarization has the characteristics to predict TdP risk, mainly focusing on the maximum slope during repolarization (dVm/dt_{max_repol}). This study aimed to predict the sensitivity of dVm/dt_{max_repol} to ion channel conductances as a TdP risk metric through a population simulation considering multiple effects of simultaneous reduction in six ion channel conductances of g_NaL, g_Kr, g_Ks, g_to, g_K1, and g_CaL. Additionally, we verified the availability of dVm/dt_{max_repol} for TdP risk prediction through the correlation analysis with qNet, the representative TdP metric. We performed the population simulations based on the methodology of Gemmel et al. using the human ventricular myocyte model of Dutta et al. Among the sixion channel conductances, dVm/dt_{max_repol} and qNet responded most sensitively to the change in g_Kr, followed by g_NaL. Furthermore, dVm/dt_{max_repol} showed a statistically significant high negative correlation with qNet. The dVm/dt_{max_repol} values were significantly different according to three TdP risk levels of high, intermediate, and low by qNet (p<0.001). In conclusion, we suggested dVm/dt_{max_repol} as a new biomarker metric for TdP risk assessment.

• The Korean Journal of Physiology
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• 제24권2호
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• pp.377-388
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• 1990

Ca movements during the late plateau phase in rabbit atrium implicate Na-Ca exchange. In single atrial cells isolated from the rabbit the properties of the inward current of Na-Ca exchange were investigated using the whole cell voltage clamp technique. The inward currents were recorded during repolarization following brief 2 ms depolarizing pulse to +40 mV from a holding potential of -70 mV. Followings are the results obtained: 1) When stimulated every 30 sec, the inward currents were activated and reached peak values $6{\sim}12\;ms$ after the beginning of depolarizing pulse. The mean current amplitude was 342 pA/cell. 2) The current decayed spontaneously from the peak activation and the timecourse of the relaxation showed two different phases: fast and slow phase. 3) The recovery of the inward current was tested by paired pulse of various interval. The peak current recovered exponentialy with a time course similar to that of Ca current recovery. 4) Relaxation timecourse was also affected by pulse interval and time constant was reduced almost linearly according to the decrease of pulse interval between 30 sec and 1 sec. 5) The peak inward current was increased by long prepulse stimulation, Bay K, isoprenaline or c-AMP. 6) The relaxation time constant of the inward current was prolonged by Bay K or c-AMP, and shortened by isoprenaline. From the above results, it could be concluded that increase of the calcium current potentiates and prolongs intracellular calcium transients, while shortening of the timecourse by isoprenaline or short interval stimulations might be due to the facilitation of Ca uptake by SR.

• 정신신체의학
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• 제7권1호
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• pp.10-25
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• 1999

2세이상의 어린이는 성적 흥분을 느낄 수 있기에 만지거나 자위행위 등의 성적인 즐거움을 찾기 시작 한다. 60년대 후반부터 70년대 초반사이 산부인과 의사 Masters와 사회사업가 Johnson은 인간의 성반응 단계를 흥분기, 고원기, 오르가슴기, 반응소실기의 4단계로 나눠 설명하였고, 여성에게는 무반응기가 없어 여러번의 오르가슴이 가능함을 밝혔다. 그들의 성치료원칙은 행동치료에 입각하여 감각초점법과 부부치료, 성교육등으로 구성되어있다. Masters와 Johnson이후 정신과 의사이자 정신분석가인 Kaplan이 1970년대 초반에 정신분석적 정신치료와 행동치료를 결합한 '새로운 성치료'를 제안했다. 그리고, 성기능 장애를 3가지 카테고리로 재분류했다. 1980년대 이후는 남성의 발기부전의 치료를 중심으로 의학적 치료방법론이 대세를 이루고 있는데, 음경 보속물, 국소주사치료, 경구약제등이 발달하였다. 최근 Sildenafil(Viagra)이 등장해 남성 발기부전 치료의 최선의 선택으로 받아들여지고 있다.