• 제목/요약/키워드: Renal blood flow

검색결과 108건 처리시간 0.022초

Ethanol 급성투여(急性投與)가 흰쥐의 혈압(血壓)과 신기능(腎機能)에 미치는 영향(影響) (Acute Effects of Ethanol on Blood Pressure and Renal Function in Rat)

  • 배귀숙;박재식;이원정
    • The Korean Journal of Physiology
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    • 제15권2호
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    • pp.103-109
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    • 1981
  • Ethanol 투여(投與) 용량(容量)에 따른 혈압(血壓)과 신기능(腎機能)의 변화(變化)를 알아보고자 흰쥐의 복부대동맥(腹部大動脈)에 catheter 를 삽입(揷入)하고 그 다른 끝을 목뒤로 끌어낸 후(後) 1주일(週日)이상 수술(手術)에서 회복(恢復)시킨 다음 실험(實驗)에 사용(使用)하였다. 실험직전(實驗直前)에 방광(膀胱)을 비운 뒤 metabolism cage에 넣어 안정(安靜)시킨 후(後) 60분(分)에 복부대동맥(腹部大動脈)의 catheter를 통(通)하여 평균동맥혈압(平均動脈血壓)(MAP)을 직접(直接) 측정(測定)하고 동맥혈액(動脈血液)과 뇨(尿)를 채취(採取)하였다. 곧 이어 ethanol 은 10 g% (저농도(低濃度)), 또는 30 g% (고농도(高濃度)) 용액(溶液)을, 대조실험(對照實驗)으로는 물을, 체중(體重) 100 g 당(當) 1 ml 씩 각각(各各) 경구(經口) 투여(投與)하였다. 용액투여후(溶液投與後) 3시간(時間)동안 MAP를 측정(測定)하고, 혈액(血液)은 매(每) 시간(時間)마다, 뇨(尿)는 90분(分) 간격(間隔)으로 채취(採取)하여 다음의 결과(結果)를 얻었다. 혈중(血中) ethanol 농도(濃度)는 ethanol 투여후(投與後) 1시간(時間)에 최고치(最高値)를 나타내고 (저농도(低濃度); $105.0{\pm}7.5,$ 고농도(高濃度); $214.7{\pm}20.2\;mg%$), 그후 직선적(直線的)으로 감소(減少)하였다. MAP는 물투여군(投與群)에서는 변화(變化)가 없었으나 ethanol 투여군(投與群)에서는 15분(分)부터 감소(減少)하기 시작(始作)하여 3시간(時間)동안 계속유의(繼續有意)하게 감소(減少)된 상웅(狀熊)를 나타내었다. 뇨량(尿量)은 ethanol 투여군(投與群)에서는 90분(分)동안에 유의(有意)한 증가(增加)를 보여주었고 (저농도(低濃度); $0.88{\pm}0.20{\rightarrow}1.04{\pm}0.22,$ 고농도(高濃度); $0.56{\pm}0.11{\rightarrow}1.35{\pm}0.18\;ml/1.5\;hr$), 180분(分)동안에는 뇨량(尿量)이 ethanol 투여전(投與前)보다 더 낮았다(저농도(低濃度); $0.25{\pm}0.06$, 고농도(高濃度); $0.22{\pm}0.06\;ml/1.5\;hr$). 물투여군(投與群)에서는 뇨량(尿量)이 계속(繼續) 감소(減少)하였다$(0.88{\pm}0.10{\rightarrow}0.59{\pm}0.09{\rightarrow}0.45{\pm}0.09\;ml/1.5\;hr)$. 이상(以上)의 결과(結果)는 ethanol의 혈중농도(血中濃度)가 높을수록 더 심(甚)한 혈압강하작용(血壓降下作用)을 나타내며, ethanol 로 인(因)한 이뇨작용(利尿作用)도 ethanol 량(量)이 증가(增加)함에 따라 뇨량(尿量)도 증가(增加)함을 보여 주었다.

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혈액투석을 위한 자가 동정맥루 수술에 있어서 조기개존율에 영향을 미치는 요인 (Factors Influencing on Early Patency Rate of Autogenous Arteriovenous Fistula for Hemodialysis)

  • 민선경;한재진;원태희;안재호
    • Journal of Chest Surgery
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    • 제37권4호
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    • pp.342-348
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    • 2004
  • 말기 신부전 환자의 생명 유지를 위한 혈액투석 치료에 있어서 지속적으로 개존상태가 유지되고 충분한 혈액이 관류되는 투석 경로의 확보는 매우 중요하다. 동정맥루 조성술 시행 후 조기 폐쇄로 인해 투석을 시행하지 못하는 경우, 환자는 경정맥 또는 대퇴정맥 등의 중심 정맥 삽관을 반복적으로 시행 받아 혈액투석을 유지해야 하며 경제적, 시간적 손실을 감수해야 하는 어려움을 겪게 된다. 대상 및 방법: 자가 혈관을 이용한 동정맥루 조성술에 있어 조기개존율에 영향을 미치는 요인을 파악하고, 이를 향상시키기 위해서 2002년 6월부터 2003년 5월까지 1년 간 말기 신부전 환자에게 시행한 총 85예의 동정맥루 수술 중 두부정맥(cephalic vein)과 요골동맥(radial artery)의 단측문합(end-to-side anastomisis)을 시행한 49예를 대상으로 임상분석을 하였다. 걸과: 연구대상 49예에서 조기개존율은 79.6%였다. 환자의 나이나 성별, 고혈압과 당뇨병 유무에 따른 개존율의 차이는 없었으며 환자의 체질량지수 및 고혈압과 당뇨의 유병기간, 술 전 듀플렉스 검사로 측정한 요골동맥의 직경에 따른 조기개존율의 차이는 통계적으로 유의하지 않았다. 수술 전 듀플렉스 검사로 측정한 두부정맥의 직경과 수술 시 측정한 동정맥루의 혈류량이 조기개존율과 유의한 양의 상관관계를 나타내었고, 특히 혈관직경 2.7mm가 초과되는 군에서는 조기 폐쇄 없이 개존율이 100%로 유지되었으며 동정맥루의 혈류량이 100mL/min 이하인 군에서는 조기개존율 33.3%로 100 mL/min초과인 군의 82.2%와 비교할때 유의하게 조기개존율이 낮았다. 결론: 동정맥루에 사용되는 정맥의 직경은 개존율과 밀접한 관련이 있어 가능한 한 직경이 큰 정맥을 선택해야 하며 연구에 따라 다양한 기준이 보고되어 왔으나 보다 정확한 예후 판단을 위해서는 정맥의 직경뿐 아니라 혈관 유출로의 혈류와 협착상태 등에 대한 파악이 필요할 것으로 생각된다. 본 연구에서 측정한 수술 시 동정맥루의 혈류량을 기준으로 판단할때, 100 mL/min 이하의 혈류량을 나타내는 radiocephalic fistula에서는 혈류량 감소의 원인을 찾아 교정술을 시행하고 그 이후에도 혈류량이 증가하지 않을 경우 다른 부위의 혈관 또는 인조혈관의 사용을 고려하여야만 할 것이다.

진무탕이 배양 인체 메산지움 세포증식과 기질 침착에 미치는 영향 (The Effects of Jinmu-tang on Mesangial Cell Proliferation, Fibronectin Synthesis and Expression of ICAM-1, $\beta$ 1-Integrin, MHC-Class II)

  • 안영민;안세영;두호경;이태원;박재경
    • 대한한의학회지
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    • 제21권3호
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    • pp.40-50
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    • 2000
  • Objectives : The progression of renal disease can be identified as a glomerulosclerosis by histological examination, and the basic mechanism of glomerulosclerosis is mesangial cell proliferation and mesangial matrix accumulation. ICAM-1, ${\beta}1-integrin$ and MHC-class II are known to attribute to the progression of glomerulosclerosis. They mediate cell-cell or cell-matrix interactions and are expressed in response to injury and inflammation. Up to now, there have been few satisfactory regimens to treat glomerular diseases except minimal change nephrotic syndrome, which can be improved by steroid therapy. Studies were performed in order to investigate whether Jinmu-tang has suppressive effects on some factors associated with the progression of glomerular disease, mesangial cell proliferation, fibronectin synthesis, ICAM-1, ${\beta}1-integrin$ and MHC-class II expression. Methods : Studies were performed with the method of surface enzyme immunoassays or flow cytometry after addition of peripheral blood mononuclear cells(PBMC) supernatants treated with Jinmu-tang, using the cultured human mesangial cells. Results : 1. The suppressive effect of Jinmu-tang on mesangial cell proliferation was higher than that of hydrocortisone. 2. Jinmu-tang has some suppressive effects on fibronectin synthesis, ICAM-1, expression, ${\beta}1-integrin$ expression and MHC-class II expression of mesangial cells, but was lower than hydrocortisone. Conclusions : Jinmu-tang generally shows some immunosuppressive effects. We carefully suggest that the above prescription may be applied to prevent the progression of renal disease or can be used as an adjuvant of or a substitute for steroid therapy.

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Screening of Natural Products for Endothelial and Renal Nitric Oxide Production

  • Kim, Hyeyoung;Han, Sang-Won
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 1997년도 춘계학술대회
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    • pp.90-90
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    • 1997
  • Natural products, which have been used for the treatment of hypertension, diuresis and nephritis in traditional oriental medicine, were selected for the screening of nitric oxide (NO) production in endothelial cells and kidney tissues in vitro as well as in vivo by measuring the conversion of [$\^$14/C]-L-arginine to [$\^$14/C]-L-citrulline, a coproduct of the enzyme reaction with NO. Confluent monolayer of endothelial cells were used for the screening of 16 natural products. Among the natural products, Zizyphus jujuba and Codonopsis pilosula stimulated endothelial NO synthase activity. Thus, both confluent monolayer of endothelial cells and kidney homogenates (glomeruli, cortical tubules, meudllae) were treated with Zizyphus jujuba and Codonopsis pilosula (final concentration 10 $\mu\textrm{g}$/$m\ell$) and NO releases were compared with those by receptor - dependent agonists, bradykinin and ADP and receptor - independent calcium ionophore A23187 in vitro. In rat experiment, NO releases in glomeruli, cortical tubules and medullae and plasma renin activity were assessed after intraperitoneal injection of Zizyphus jujuba and Codonopsis pilosula (10 mg/kg/day for 4 days). As a result, both Zizyphus jujuba and Codonopsis pilosula significantly increased NO releases in cultured endothelial cells, kidney tissues in vitro as well as in vivo. Stimulation of NO releases by Zizyphus jujuba and Codonopsis pilosula was similar to those by receptor - dependent agonists, bradykinin and ADP and receptor - independent calcium ionophore A23187 in cultured endothelial cells. However, plasma renin activity was not influenced by these two natural products. In conclusion, stimulatory effects of Zizyphus jujuba and Codonopsis pilosula on NO release in kidney may contribute their hypotensive effects and antinephritic action possibly by increasing renal blood flow.

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장기혈액투석환자의 투석중 혈압하강과 Coil내 혈액손실 방지를 위한 기초조사 (A Study on the long-term Hemodialysis patient중s hypotension and preventation from Blood loss in coil during the Hemodialysis)

  • 박순옥
    • 대한간호학회지
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    • 제11권2호
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    • pp.83-104
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    • 1981
  • Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance(P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.

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The Usability Evaluation of Application that is Developed the Dynamic Kidney Phantom System in Nuclear Medicine

  • Kim, Jae-Hyun;Lee, Juyoung;Park, Hoon-Hee
    • 대한디지털의료영상학회논문지
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    • 제16권2호
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    • pp.15-24
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    • 2014
  • Currently commercially available phantom can reproduce and evaluate only a static situation, the study is incomplete research on phantom and system which is can confirmed functional situation in the kidney by time through dynamic phantom and blood flow velocity, various difference according to the amount of radioactive. Therefore, through this study, it has produced the dynamic kidney phantom to reproduce images through the dynamic flow of the kidney, it desires to evaluate the usefulness of nuclear medicine imaging. The production of the kidney phantom was fabricated based on the normal adult kidney, in order to reproduce the dynamic situation based on the fabricated kidney phantom, in this study it was applied the volume pump that can adjust the speed of blood flow, so it can be integrated continuously radioactive isotopes in the kidney by using 99mTc-pertechnate. Used the radioactive isotope was supplied through the two pump. It was confirmed the changes according to the infusion rate, radioactive isotopes and the different injection speeds on the left and right, analysis of the acquired images was done by drawn five times ROI in order to check the reproducibility of each on the front and rear of the kidney and bladder. Depending on the speed of injection, radioisotope was a lot of integrated and emissions up when adjusting the pressure of the pump as 30 stroke, it was the least integrated and emissions up when adjusting as 40 stroke. The integration of the left & right kidney was not reached in the amount of the highest when adjusting as 10 stroke. In the changes according to the amount of the radioactive isotope, 0.6 mCi(22.2 MBq), 0.8 mCi (29.6 MBq)was showed up similar tendency but, in the result of the injection 0.8 mCi, it was showed up counts close to double of 0.6 mCi. In the result of the differently injection speed of the left & right kidney, as a result of different conditions that injection speed was 20 stroke through left kidney phantom, the injection speed was 30 stroke through right kidney phantom, it was enough difference in the resulting image can be easily distinguished with the naked eye. Through this study, the results showed that the dynamic kidney phantom system is able to similarly reproduce renogram in the actual clinical. Especially, the depicted over time for the flow to be excreted through the kidney into the bladder was adequately reproduce, it is expected to be utilized as basic data to check the quality of the dynamic images. In addition, it is considered to help in the field of functional imaging and quality control.

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비스테로이드 항염제 (Nonsteroidal Anti-inflammatory Drugs)

  • 이충기
    • Journal of Yeungnam Medical Science
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    • 제17권1호
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    • pp.1-11
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    • 2000
  • Inhibition of cyclooxygenase(COX), and thus prevention of the formation of prostaglandins, provided a unifying explanation of the therapeutic and toxic actions of nonsteroidal anti-inflammatory drugs (NSAIDs). Recently, the discovery of the two isoforms of COX was made by molecular biologists studying neoplastic transformation in chick embryo cells. The constitutive enzyme, COX-1, is obviously responsible for the production of prostaglandins involved in housekeeping functions such as maintenance of integrity of the gastric mucosa, renal blood flow and platelet aggregation. The inducible form of COX (COX-2) is responsible for the formation of prostaglandins that pathologically affects inflammation, pain and fever. Clearly, all the experimental and clinical data support the hypothesis that the beneficial effects of NSAIDs are due to inhibition of the COX-2 enzyme, whereas the gastrotoxicity is due to inhibition of COX-1. The cox-2/COX-1 ratios of the NSAIDs in common use have been measured and compared with epidemiological data on their side effects. There is little evidence to suggest that one NSAID is clearly more effective than another, But substantial individual variability is present with respect to the pharmacology and pharmacokinetics of these drugs: therefore it is essential to adjust the dosage and choose specific drug to the patient's response.

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가토 기흉에서 본 $^{86}Rb$의 분포 ($^{86}Rb$ Distribution in the Lung of the Rabbit with Pneumothorax)

  • 허갑도
    • 대한핵의학회지
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    • 제6권1호
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    • pp.51-59
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    • 1972
  • $^{86}Rb$ uptake of some organs and tissues, ego both lungs, both renal cortices. small intestine, liver and skeletal muscle were studied in the control and the rabbit subjected to pneumothorax. $^{86}Rb$ in the form of chloride mixed with physiological saline was intravenously. injected. The doses were $100{\mu}c$ for a rabbit. The rabbits were sacrificed at intervals of 10, 20, 40, and 60 seconds after the injection of $^{86}Rb$, by the injection of saturated KCI solution. After sacrification, the organ and tissue sample were quickly removed. $^{86}Rb$ uptake in gm of the organs and tissues were measured. On the basis of uptake value, administered doses and body weight, % dose/gm tissues per 200 gm body weight was calculated. Followings were the results; 1. Pneumothorax resulted in a marked elevation in $^{86}Rb$ uptake value of collapsed lung and returned to normal level lately. 2. Contralateral lung of pnemothorax also showed marked elevation in $^{86}Rb$ uptake value and recovered to normal level. 3. Initial $^{86}Rb$ uptake value of liver, small intestine of the rabbit with pneumothorax showed some elevation as compared to control, but that of late stage were similar with control. 4. Local blood flow determination by means of $^{86}Rb$ uptake were inadequate in the collapsed lung of pneumothorax. 5. It was suggested that the mechanism for the initial elevation of $^{86}Rb$ uptake value in each organs and tissue were different from each other.

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소금 섭취량을 달리한 정상 및 고혈압쥐에서 Atrial Natriuretic Peptide가 혈압, Renin-Aldosterone 및 신배설에 미치는 영향 (Effect of Sodium Intake on Responses of Blood Pressure, Renin-Aldosterone and Renal Excretions to Atrial Natriuretic Peptide in Spontaneously Hypertensive Rats)

  • 전제량;이원정;박재식;주영은
    • The Korean Journal of Physiology
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    • 제24권2호
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    • pp.319-329
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    • 1990
  • 장기적으로 소금 섭취량을 달리 한 정상 및 고혈압쥐에서 atrial natriurectic peptide (ANP) 가 혈압, renin-aldosterone 및 신배설에 미치는 효과를 비교하였다. 생후 6주된 spontaneously hyper-tensive rate (SHR)와 Wistar 숫쥐를 각각 저염, 정상염 및 고염 (2, 10, 25 mmol NaCl/100g diet) 군으로 나누어 실험 식이를 6주동안 먹었다. 실험 당일 아침에 쥐를 ether로 마취시킨 상태에서 대퇴 동맥과 정맥 및 방광에 catheter를 삽입한 다음에 쥐를 restraining cage에 넣어 고정시켰다. 마취가 깨고 혈압이 안정된 후에 정맥관으로 0.9% saline을 0.02ml/min의 속도로 80분간 주입하고 안정시 뇨와 혈액을 채취하였다. 그후 ANP를 380 ng/kg/min의 속도로 20분간 주입하였으며 그동안 10분 간격으로 요를 채취한 다음 채혈하였다. 혈장 aldosterone 농도와 renin 활성도 (PRA)를 방사면역법으로 측정하였다. ANP를 주입하기 전에 SHR 고염군의 평균동맥압은 정사염이나 저염군보다 유의하게 높았으나, Wistar의 혈압은 소금군 사이에서 차이가 없었다. ANP 주입전의 혈장 aldosterone 농도는 소금 섭취량이 많을수록 유의하게 낮았으며, Wistal 군이 SHR 보다 높은 값을 보였다. 혈장 renin 활성도는 소금군 간에 차이가 없었으며, Wistar와 SHR 간에도 차이가 없었다. 요량이나 Na, K 배설률은 소금군 간에 유의한 차이가 없었으나, SHR이 Wistar 보다 높은 경향을 보였다. Hematocrit 값도 소금군 간에 차이가 없었으나, SHR의 값이 Wistar 보다 유의하게 높았다. ANP를 주입하는 동안 혈압이 점진적으로 감소하여 20분후에는 $20{\sim}30\;mmHg$ 정도 감소하였으나, 각 소금군사이에 차이가 없었다. 그러나, ANP에 의한 혈압 강하 정도는 SHR이 Wistar 보다 유의하게 높았다. ANP 주입 후에는 모든 군에서 aldosterone과 혈장 renin 활성도가 유의하게 감소하였는데, aldosterone의 감소 정도는 저염군에서 가장 크게 나타났다. ANP의 이뇨 및 Na 배설 항진효과는 Wistar에서는 소금군 간에 차이가 없었으나, SHR 에서는 고염군의 Na 배설률이 저염군보다 유의하게 높았다. ANP의 혈압강하 효과나 Na 배설 항진효과가 SHR에서 Wistar 보다 유의하게 높게 나타났으나, 이뇨반응, renin 및 hematocrit의 변화에는 차이가 없었다. 이상의 결과에서, 장기적으로 소금 섭취량이 다름에 따라 ANP의 효과 중에서 특히 aldosterone 분비나 SHR의 Na 배설에 차이가 나타났는데 그 작용 기전은 확실치 않다.

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동적신장팬텀시스템 개발에 따른 장비별 사구체여과율의 비교 (Comparison for Glomerular Filtration Rate in Gamma Camera Systems Using Dynamic Renal Phantom System)

  • 강천구;박훈희;오신현;이한울;김정열;오주영;이주영;김재삼;이창호
    • 핵의학기술
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    • 제17권2호
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    • pp.3-9
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    • 2013
  • 핵의학 검사 중 동적 신장검사는 신장기능을 평가하는 가장 대표적인 검사법으로 방사성동위원소를 이용하여 시간에 따른 신장의 기능을 평가하고 소변이 배설에 이르기까지의 질환 평가에 유용하다. 이러한 검사영상의 질 평가 및 정량 분석에서 현재 상용화 된 팬텀은 정적 상황만 재현하고 평가할 수 있기 때문에 동적 팬텀을 통한 시간에 따른 신장의 기능적 상황과 혈류속도, 방사성동위원소의 주입량에 따른 다양한 차이 등을 확인할 수 있는 연구가 미비한 상황이다. 그러므로 본 연구를 통해 동적 신장팬텀 시스템을 제작하여 신장의 동적 흐름을 통한 영상을 재현함으로써 핵의학에서 영상학적으로 유용성을 평가하고자 한다. 신장팬텀은 정상 성인 신장을 기준으로 제작하였고, 동적 상황을 재현하기 위하여 혈류의 속도를 조절할 수 있는 정량 펌프를 적용하였으며, $^{99m}Tc-pertechnate$를 신장팬텀에 방사성의약품이 집적되고 방광으로 배설되도록 제작하였다. 사용된 방사성의약품은 각 신장팬텀에 각각 주입되도록 하였으며, 주입속도, 방사성의약품, 좌우 신장팬텀에 다른 주입속도에 따른 변화를 확인하였다. 획득한 영상의 분석은 전면상과 후면상 각각의 신장과 방광에 관심영역을 그려 분석하였으며, 재현성을 확인하기 위하여 각 10회씩 반복하여 분석하였다. 동일한 조건하에 주입속도 40 mL/min로 고정하여 펌프의 압력을 조절하였을 때 방사성의약품이 2-3분 사이에 신장팬텀에 가장 많이 집적되었다가 방광으로 배출되었다. 각 장비별 사구체 여과율은 각각 SYMBIA 1,091 mL/min, FORTE 1,232 mL/min, ARGUS 1,264 mL/min, INFINIA 1,302 mL/min로 통계적으로 유의한 차이가 있는 것으로 나타났으며, Tmax 값 그리고 T1/2 값 모두에서 장비별 통계적으로 유의한 차이가 있는 것으로 나타났다. 변동계수인 CV 값은 5% 이하로 재현성이 있는 것으로 나타났으며, 그 중에서 SYMBIA가 2.67%로 가장 낮게 나타났고, INFINIA가 4.86%으로 가장 높게 나타났다. 본 연구를 통하여 동적신장팬텀시스템이 실제 임상의 신장동적검사를 유사하게 재현이 가능한 것을 확인할 수 있었다. 특히 신장을 통해 방광으로 배설되는 흐름에 대해 시간에 따른 묘사가 충분하게 재현되었으며, 동적 영상의 질을 확인하는데 기초 자료로 활용이 가능하리라 사료된다. 또한 추후 기능적 영상 분야에 연구 및 정도관리 분야에도 도움이 되리라 여겨진다.

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