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Pharmacological Action Mechanism(s) of Vasodilator Effect of Calcitonin Gene-related Peptide in Rat Basilar Arteries (흰쥐의 뇌 기저동맥에서 CGRP에 의한 혈관 이완반응의 기전에 대한 연구)

  • Rhim, Byung-Yong;Hong, Sun-Hwa;Kim, Chi-Dae;Lee, Won-Suk;Kim, Dong-Heon;Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.32 no.1
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    • pp.39-49
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    • 1996
  • In the present study, we observed change in intracellular $Ca^{2+}$$([Ca^{2+}]_i)$ as measured with the fluorescent $Ca^{2+}-indicator$ fura-2 in association with force development of the rat basilar arteries during activation by$K^+$ depolarizing solution and U46619, a thromboxane analogue, in the absence and the presence of calcitonin-gent related peptide (CGRP). CGRP (30 and 100 nM) caused a concentration-dependent inhibition of U46619-induced contraction with decrease in $[Ca^{2+}]_i$, whereas it did not exert any effect on the $K^+$ (90 mM)-induced contraction and increase in $[Ca^{2+}]_i$, Further, $[Ca^{2+}]_i-force$ relationships were determined by plotting the ratio of $F_{340}/F_{380}$ $([Ca^{2+}]_i)$ as a function of the force induced by U46619, and the results were compared with those obtained in the presence of CGRP. The curves obtained in the presence of CGRP (30 and 100 nM) were significantly moved to downward without right shift of the curves suggesting that CGRP inhibited the U46619-induced contraction only by mediation of reduction in $[Ca^{2+}]_i$ with out any change in the sensitivity of contractile apparatus to $Ca^{2+}$. The CGRP-induced attenuation of $[Ca^{2+}]_i$ and force development was significantly inhibited under pretreatment with CGRP $(8{\sim}37)$ fragment (100 nM), a CGRP1 receptor antagonist. Both the reduced contraction and reduction in $[Ca^{2+}]_i$ caused by CGRP were fully reversed by pretreatment with charybdotoxin (100 nM) and iberiotoxin (100 nM), large conductance $Ca^{2+}-activated$ $K^+$ channel blockers, but not by apamin (300 nM), a small conductance $Ca^{2+}-activated$ $K^+$ channel blocker, and glibenclamide ( 1 ${\mu}M$), an ATP-sensitive $K^+$ channel blocker. In conclusion, it is suggested that the CGRP1 receptor, upon activation by CGRP, are coupled to opening of $Ca^{2+}-activated$ $K^+$ channel and cause to decrease in $[Ca^{2+}]_i$, thereby leading to vasodilation of the rat basilar artery. However, it is not defined that the mechanism underlying vasodilation whether the $K^+$ channel blockers, charybdotoxin and iberiotoxin directly block the CGRP receptors and that CGRP-evoked relaxation is dependent on the cyclic AMP or $K^+$ channel opening or both actions.

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Multiple Binding Affinities for Muscarinic Acetylcholine Receptors in Rat Brain (흰쥐 뇌내(腦內)의 무수카린성 콜린 수용체의 이질성(異質性))

  • Lee, Jong-Hwa;El-Fakahany, Esam E.
    • The Korean Journal of Pharmacology
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    • v.23 no.2
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    • pp.101-111
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    • 1987
  • We investigated the binding properties of $(^3H)$ QNB and $(^3H)$ NMS to mAchR to elucidate the characterstics of mAchR in rat brain by using two different preparations (homogemates & intact brain cell aggregates). The binding properties of both ligands demonstrated high affinity and saturability in both experiments, however $(^3H)$ QNB showed a significantly higher maximal binding capacity than tha ot $(^3H)$ NMS 1. In rat brain homogenates; Displacement of both lignands with several mAchR antagonists resulted in competition curves in accoradnce with the law of massaction for QNB, atropine & scopolamine in thie preparation, also a similar profile was found for the quaternary ammonium analogs of atropine & scopolamine (methyl atropine & methylscopolamine) when $(^3H)$ NMS was used to label the receptors in rat brain. But when these hydrophillic antagonists were used to displace $(^3H)$ QNB, they showed interaction with high- and low-affinity binding sites in brain homogenates. Pirenzepine, the nonclassical mAchR antagonist, was able to displace both ligands from binding sites in this preparation. 2. In intact rat brain cell aggregates; Intact bain cell aggregates were used to elucidate the binding characteristics of $(^3H)$ NMS to mAchR in rat. The magnitude of binding of this ligand was related linearly to the amount of cell protein in the binding assay with a high ratio of total to nonspecific binding. mAchR antagonists displaced specific $(^3H)$ NMS binding according to the law of mass-action, while it was possible to resolve displacement curves using mAchR agonist into high-& low-affinity component. 3. Our results indicate that more hydrophilic receptor ligand $(^3H)$ QNB, displacement experiments in both tissues demonstrated that the lipid solubility of a particulr mAchR ligand might play an important role in determining its profile of binding to the mAchR, and the concentrations of mAchR in rat brain are both on the cell surface (membrane-bound receptor) and in the intracelluar membrane (intermembrane-bound receptor). 4. The results are discussed in terms of the usefulness of dissociated intact rat brain cells in studying mAchR in central nervous system.

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Influence of Intracerebroventricular Yohimbine on the Renal Function of the Rabbit (가토 신장기능에 미치는 측뇌실내 Yohimbine의 영향)

  • Kook, Young-Johng;Kim, Kyung-Keun;Kim, Sei-Jong
    • The Korean Journal of Pharmacology
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    • v.21 no.2
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    • pp.119-127
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    • 1985
  • The renal function is under regulatory influence of the central nervous system, mainly through activation of sympathetic nerve to the kidney, and it was recently reported that clonidine, an agonist to ${\alpha}_2$-adrenoceptors, induces diuresis and natriuresis when injected directly into a lateral ventricle of the rabbit brain (i.c.v.). This study was undertaken, therefore, to obtain further information as to the role of the central ${\alpha}_2$-adrenoceptors in regulating renal function, by observing the effects of i.c.v. yohimbine, a specific antagonist of adrenoceptors of ${\alpha}_2$-type, on the rabbit renal function, and to elucidate the mechanism involved in it. With 10 ${\mu}g/kg$ i.c.v. of yohimbine sodium excretion transiently increased along with increasing tendency of urine flow, renal plasma flow and glomerular filtration rate. These responses decreased with increasing doses. With 100 and 300 ${\mu}g/kg$ i.c.v. marked antidiuresis and antinatriuresis as well as profound decreases of renal perfusion and glomerular filtration were noted. Systemic blood pressure transiently increased. In reserpinized rabbits, 100 ${\mu}g/kg$ yohimbine i.c.v. did not produce any significant changes in urine flow, sodium excretion as well as in renal hemodynamics. The pressor response was also abolished. In preparations in which one kidney was denervated and the other left intact as control, i.c.v. yohimbine elicited typical antidiuretic antinatriuretic response in the innervated control kidney, whereas the denervated experimental kidney responded with marked diuresis and increases in excretory rates of sodium and potassium and in osmolar clearance in spite of absence of increased filtration and perfusion . Systemic blood pressure responded as in the normal rabbits. These observations indicate that i.c.v. yohimbine affects renal function in dual ways in opposite directions, the first being the antidiuretic antinatriuretic effects which results from decreased renal perfusion and glomerular filtration due to sympathetic activation and which is predominantly expressed in the normal rabbits, and the second less apparent effect being the diuretic and natriuretic action which is not mediated by nerve pathway but brought about by some humoral mechanism and which is effected by decreased sodium reabsorption in the tubules, possibly of the proximal portion.

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Herbicidal Response and Control of Scirpus juncoides Roxb. Resistant to Sulfonylurea Herbicides (Sulfonyurea계 제초제 저항성 올챙이고랭이(Scirpus juncoides Roxb.)의 제초제 반응과 방제)

  • Park, Tae-Seon;Kang, Dong-Kyun;Kim, Kil-Ung
    • The Korean Journal of Pesticide Science
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    • v.9 no.3
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    • pp.250-261
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    • 2005
  • This study was conducted to investigate the herbicidal response and effective control strategy of sulfonylurea(SU)-resistant Scirpus juncoides Roxb. occurred in the paddy fields of Korea. A biotype of Scirpus juncoides Roxb. resistant to SU was identified in the paddy fields treated with SU herbicide-based mixtures for seven consecutive years. The apparent SU resistance observed in Scirpus juncoides Roxb. was completely confirmed in greenhouse tests. The susceptible biotype was almost controlled at the recommended dose of all the tested, but the resistant biotype was survived 20 to 30% even at 10 times higher dose of each the recommended dose of SU herbicides. The $GR_{50}$ values of 4 SU herbicides for the resistant biotype were 53 to 88 times higher than those for the susceptible biotype. The acetolactate synthase(ALS) isolated from the resistant biotype against bensulfuron-methyl and pyrazosulfuron-ethyl was less sensitive than that of the susceptible biotype. The $I_{50}$ values of the resistant biotype against bensulfuron-methyl and pyrazosulfuron-ethyl were 498 and 126 times higher than those for the susceptible biotype. A rapid diagnosis for identifying resistance of Scirpus juncoides Roxb. was possible within at least 3 days after SU herbicides. Three herbicides having different mode of action from SU herbicide, carfentrazone-ethyl, pyrazolate and simetryne exhibited excellent controlling effects on the resistant biotype of Scirpus juncoides Roxb. till 3.5 leaf stage. Among the SU-based herbicides, pyriminobac-methyl+pyrazosulfuroil-ethyl+carfentrazone-ethyl GR and azimsulfuron+carfentrazone-ethyl+pyriminobac-methyl GR were very effective to control resistant biotype of Scirpus juncoides Roxb. without rice injury. The resistant biotype which were not controlled with SU herbicise-based herbicides survived from the fields were effectively controlled by bentazone SL.

Affecting Factors on the Safety on School -Focusing on U.S Public School Security Guard Patterns- (학교 내 안전에 영향을 미치는 요인: 미국 공립학교의 경비활동 유형을 중심으로)

  • Shin, So-Ra;Cho, Youn-Oh
    • Korean Security Journal
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    • no.37
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    • pp.137-163
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    • 2013
  • This research will incorporate cases from U.S public schools to analyze the factors which influences the security within the school and efficient security patterns to suggest an adequate suggestion to elevate domestic school security system. This study is divided into two following models: a serious criminal offense model, which considers crimes occurred on campus as subordinate variables, and a school violence model, which considers as subordinate variables after limiting an act of delinquency and an a group action that can harm the safety of students, although they are not included in the categories of crimes. First, from analyzing the factors which influences security within school, the explanation power of serious crime offense safety model and school violence safety model is measured 12% and 11.3%. In serious crime offense safety model, the safety education for students, among the safety programs provided by schools(t=2.548, p=0.011), parent participation to school management(t=10.694, p=0.000), Security activities on campus(t=3.643, p=0.000), and CPTED activity(t=6.467, p=0.000) are statistically significant, as affecting factors on the safety from serious crimes. Similarly in school violence model, the safety education for students, among the safety programs provided by schools(t=3.228, p=0.001), parent participation to school management(t=12.034, p=0.000), security activities on campus(t=2.663, p=0.000), and CPTED activity(t=3.928, p=0.000) are statistically significant, as affecting factors on the safety from school violence. Second, according to the analytic results on figuring out the optimal pattern to heighten the security activities, the serious offence model's explanatory power was 4.4% and school violence safety model rated 3.9%. With the serious offense safety model, the activity factors which showed statistically significant in influencing safety from serious offenses were cooperation with local police force (t=2112, p=0.035), school policy management (t=3.309, p=0.001), security patrolling activity (t=2.548, p=0.011). In the school violence model, security activities initiated by the school which showed statistically significant from serious offenses were cooperation with local police force (t=2.364, p=0.018) and policy management (t=4.142, p=0.000). In accordance with the result of this study, education for students rather than education for teachers is more positive in terms of the safety on campus, and parent participation, like education, is consistently needed for the safety on campus. In case of CPTED activity, reinforcing plans should be prepared by intactly accepting examples in the USA. In case of security activity, plans that can increase visibility and reinforce cooperation with local police in a smooth way will provide a positive effect to the safety on campus.

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토양 및 지하수 Investigation 과 Remediation에 대한 현장적용

  • Wallner, Heinz
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2000.11a
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    • pp.44-63
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    • 2000
  • Situated close to Heathrow Airport, and adjacent to the M4 and M25 Motorways, the site at Axis Park is considered a prime location for business in the UK. In consequnce two of the UK's major property development companies, MEPC and Redrew Homes sought the expertise of Intergeo to remediate the contaminated former industrial site prior to its development. Industrial use of the twenty-six hectare site, started in 1936, when Hawker Aircraft commence aircraft manufacture. In 1963 the Firestone Tyre and Rubber Company purchased part of the site. Ford commenced vehicle production at the site in the mid-1970's and production was continued by Iveco Ford from 1986 to the plant's decommissioning in 1997. Geologically the site is underlain by sand and gravel, deposited in prehistory by the River Thames, with London Clay at around 6m depth. The level of groundwater fluctuates seasonally at around 2.5m depth, moving slowly southwest towards local streams and watercourses. A phased investigation of the site was undertaken, which culminated in the extensive site investigation undertaken by Intergeo in 1998. In total 50 boreholes, 90 probeholes and 60 trial pits were used to investigate the site and around 4000 solid and 1300 liquid samples were tested in the laboratory for chemical substances. The investigations identified total petroleum hydrocarbons in the soil up to 25, 000mg/kg. Diesel oil, with some lubricating oil were the main components. Volatile organic compounds were identified in the groundwater in excess of 10mg/l. Specific substances included trichloromethane, trichloromethane and tetrachloroethene. Both the oil and volatile compounds were widely spread across the site, The specific substances identified could be traced back to industrial processes used at one or other dates in the sites history Slightly elevated levels of toxic metals and polycyclic aromatic hydrocarbons were also identified locally. Prior to remediation of the site and throughout its progress, extensive liaison with the regulatory authorities and the client's professional representatives was required. In addition to meetings, numerous technical documents detailing methods and health and safety issues were required in order to comply with UK environmental and safety legislation. After initially considering a range of options to undertake remediation, the following three main techniques were selected: ex-situ bioremediation of hydrocarbon contaminated soils, skimming of free floating hydrocarbon product from the water surface at wells and excavations and air stripping of volatile organic compounds from groundwater recovered from wells. The achievements were as follows: 1) 350, 000m3 of soil was excavated and 112, 000m3 of sand and gravel was processed to remove gravel and cobble sized particles; 2) 53, 000m3 of hydrocarbon contaminated soil was bioremediated in windrows ; 3) 7000m3 of groundwater was processed by skimming to remove free floating Product; 4) 196, 000m3 of groundwater was Processed by air stripping to remove volatile organic compounds. Only 1000m3 of soil left the site for disposal in licensed waste facilities Given the costs of disposal in the UK, the selected methods represented a considerable cost saving to the Clients. All other soil was engineered back into the ground to a precise geotechnical specification. The following objective levels were achieved across the site 1) By a Risk Based Corrective Action (RBCA) methodology it was demonstrated that soil with less that 1000mg/kg total petroleum hydrocarbons did not pose a hazard to health or water resources and therefore, could remain insitu; 2) Soils destined for the residential areas of the site were remediated to 250mg/kg total petroleum hydrocarbons; in the industrial areas 500mg/kg was proven acceptable. 3) Hydrocarbons in groundwater were remediated to below the Dutch Intervegtion Level of 0.6mg/1; 4) Volatile organic compounds/BTEX group substances were reduced to below the Dutch Intervention Levels; 5) Polycyclic aromatic hydrocarbons and metals were below Inter-departmental Committee for the Redevelopment of Contaminated Land guideline levels for intended enduse. In order to verify the qualify of the work 1500 chemical test results were submitted for the purpose of validation. Quality assurance checks were undertaken by independent consultants and at an independent laboratory selected by Intergeo. Long term monitoring of water quality was undertaken for a period of one year after remediation work had been completed. Both the regulatory authorities and Clients representatives endorsed the quality of remediation now completed at the site. Subsequent to completion of the remediation work Redrew Homes constructed a prestige housing development. The properties at "Belvedere Place" retailed at premium prices. On the MEPC site the Post Office, amongst others, has located a major sorting office for the London area. Exceptionally high standards of remediation, control and documentation were a requirement for the work undertaken here.aken here.

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Effect of Moutan Cortex Radicis on gene expression profile of differentiated PC12 rat cells oxidative-stressed with hydrogen peroxide (모단피의 PC12 cell 산화억제 효과 및 neuronal 유전자 발현 profile 분석에 대한 연구)

  • Kim Hyun Hee;Rho Sam Woong;Na Youn Gin;Bae Hyun Su;Shin Min Kyu;Kim Chung Suk;Hong Moo Chang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.2
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    • pp.529-541
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    • 2003
  • Yukmijihwang-tang has been widely used as an and-aging herbal medicine for hundred years in Asian countries. Numerous studies show that Yukmijihwangtang has anti-oxidative effect both in vivo and in vitro. It has been reported that Moutan Cortex Radicis extract (MCR) was the most effective herb in Yukmijihwang-tang on undifferentiated PC12 cells upon oxidative-stressed with hydrogen peroxide. The purpose of this study is to; 1) evaluate the recovery of neuronal damage by assessing the anti-oxidant effect of MCR on PC12 cells differentiated with nerve growth factor (NGF), 2) identify candidate genes responsible for anti-oxidative effect on differentiated PC12 cells by oligonucleotide chip microarray. PC12 cells, which were differentiated by treating with NGF, were treated without or with hydrogen peroxide in the presence or absence of various concentration of MCR. Cell survival was determined by using MTS assay. Measurement of intracellular reactive oxygen species (ROS) generation was determined using the H2DCFDA assay The viability of cells treated with MCR was significantly recovered from stressed PC12 cell. In addition, wide rage of concentrations of MCR shows dose-dependent inhibitory effect on ROS production in oxidative-stressed cells. Total RNAs of cells without treatment(Control group), only treated with H₂O₂ (stressed group) and treated with both H₂O₂ and of MCR (MCR group) were isolated, and cDNAs was synthesized using oligoT7(dT) primer. The fragmented cRNAs, synthesized from cDNAs, were applied to Affymetrix GeneChip Rat Neurobiology U34 Array. mRNA of Calcium/calmodulin-dependent protein kinase II delta subunit(CaMKII), neuron glucose transporter (GLUT3) and myelin/oligodendrocyte glycoprotein(MOG) were downregulated in Stressed group comparing to Control group. P2X2-5 receptor (P2X2R-5), P2X2-4 receptor (P2X2R-4), c-fos, 25 kDa synaptosomal attachment protein(SNAP-25a) and GLUT3 were downregulated, whereas A2 adenosine receptor (A2AR), cathechol-O-methyltransferase(COMT), glucose transporter 1 (GLUT1), EST223333, heme oxygenase (HO), VGF, UI-R-CO-ja-a-07-0-Ul.s1 and macrophage migration inhibitory factor (MIF) were upregulated in MCA group comparing to Control group. Expression of Putative potassium channel subunit protein (ACK4), P2X2A-5, P2X2A-4, Interferon-gamma inducing factor isoform alpha precursor (IL-18α), EST199031, P2XR, P2X2 purinoceptor isoform e (P2X2R-e), Precursor interleukin 18 (IL-18) were downregulated, whereas MOO, EST223333, GLUT-1, MIF, Neuronatin alpha, UI-R-C0-ja-a-07-0-Ul.s1, A2. adenosine receptor, COMT, neuron-specific enolase (NSE), HO, VGF, A rat novel protein which is expressed with nerve injury (E12625) were upregulated in MCR group comparing to Stressed group. The results suggest that decreased viability and AOS production of PC12 cell by H₂O₂ may be, at lease, mediated by impaired glucose transporter expression. It is implicated that the MCR treatment protect PC12 cell from oxidative stress via following mechanisms; improving glucose transport into the cell, enhancing expression of anti-oxidative genes and protecting from dopamine cytotoxicity by increment of COMT and MIF expression. The list of differentially expressed genes may implicate further insight on the action and mechanism behind the anti-oxidative effects of herbal extract Moutan Cortex Radicis.

Herbicidal Properties of 5,8-dihydroxy-1,4-naphthoquinone and Their Possible Mode of Action (천연물 유래 5,8-dihydroxy-1,4-naphthoquinone의 살초특성과 작용기구)

  • Choi, Jung-Sup;Kim, Ji-Yeon;Seo, Bo-Ram;Ko, Young-Kwan;Cha, Mi-Ran;Kim, Young-Sup;Ryu, Shi-Yong;Hwang, In-Taek
    • Korean Journal of Weed Science
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    • v.31 no.3
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    • pp.250-259
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    • 2011
  • This study was conducted to assess the possibility of 5,8-dihydroxy-1,4-naphthoquinone (DHNQ) as a environmental friendly herbicide candidate. Foliar application of DHNQ showed excellent herbicidal effect to the 3 grasses and 5 broad-leaved weeds. Among them, Digitaria sanguinalis and Solanum nigrum were completely controlled by $250{\mu}g\;mL^{-1}$ of DHNQ with main symptoms of desiccation or burndown within 24 hours. Aeschynomene indica was also sensitive to DHNQ treatment. All of the eight weed species were controlled by 90~100% at a concentration of $1000{\mu}g\;mL^{-1}$. However, soil application of DHNQ to Digitaria sanguinalis did not show any herbicidal symptoms. DHNQ strongly inhibited KAPAS activities in vitro and the $IC_{50}$ was $4.4{\mu}M$. Cellular leakage from cucumber leaf squares treated with DHNQ increased depending on the concentrations increased from 6.25 to $100{\mu}M$ after 24 hours incubation with or without light. However, chlorophyll loss in cucumber leaf squares was negligible. Biotin supplements significantly rescued the inhibition of germination rate of Arabidopsis thaliana seeds previously inhibited by the DHNQ. According to above results, DHNQ is a good natural herbicide candidate having a new target KAPAS, which is involved in biotin biosynthesis pathway, with environmental friendly.

Response of the Resistant Biotype of Echinochloa oryzoides to ACCase and ALS inhibitors, and Effect of Alternative Herbicides (ACCase 및 ALS 저해 제초제들에 대한 저항성 강피의 반응과 대체약제들의 효과)

  • Park, Tae-Seon;Ku, Bon-Il;Kang, Sin-Koo;Choi, Min-Kyu;Park, Hong-Kyu;Lee, Kyong-Bo;Ko, Jae-Kwon
    • Korean Journal of Weed Science
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    • v.30 no.3
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    • pp.291-299
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    • 2010
  • Cyhalofop-butyl and penoxsulam, known for respective acetyl CoA carboxylase (ACCase) and acetolactate synthase (ALS) inhibitor, have been widely using as a post-emergence foliar application for many years in wet-seeded rice field in Korea. Since 2009, control of Echinochloa oryzoides with cyhalofop-butyl and penoxsulam was no longer satisfactory. Greenhouse and experiment in rice field were conducted to confirm E. oryzoides resistance to ACCase and ALS inhibitors and to compare herbicide treatments for control of the resistant E. oryzoides to ACCase and ALS inhibitors. Three resistant E. oryzoides to ACCase and ALS inhibitors accessions were tested for levels of resistance to cyhalofop-butyl and penoxsulam, base on survival rate. Iksan and Kimje accessions were not any affected to the survival by treatment with recommended doses of two herbicides tested. Buan accession displayed an intermediate response of 62 and 72% survival at recommended doses of cyhalofop-butyl and penoxsulam, respectively. Survival rates to herbicides mixed with ACCase and ALS inhibitors at 3.5 leaf stage of E. oryzoides was over 80%. Benzobicyclon+fentrazamide+bensulfuron SC, benzobicyclon+mefenacet+bensulfuron SC, benzobicyclone +cafenstrole+pyrazosulfuron-ethyl GR controlled effectively by 2 leaf stage of resistant E. oryzoides to ACCase and ALS inhibitors. In the field experiment, single treatment of benzobicyclon+ fentrazamide+bensulfuron SC and benzobicyclon+mefenacet+bensulfuron SC failed to control E. oryzoides, but squential treatment of benzobicyclon+thiobencarb SE and benzobicyclon+ mefenacet+ bensulfuron SC controlled effectively it in rice infant seedling culture with machine. Our results suggest that resistant E. oryzoides to ACCase and ALS inhibitors had not developed multiple resistance to herbicides with different modes of action. In particular, cafenstrole, fentrazamide, mefenacet were effective control measures.

Relationship Between Adenosine-Induced ST Segment Depression During $^{99m}Tc$-MIBI Scintigraphy and The Severity of Coronary Artery Disease (Adenosine 부하 $^{99m}Tc$-MIBI 심근 관류스캔도중 나타나는 ST절 하강과 관상동맥 질환의 중증도와의 관계)

  • Cho, Jung-Ah;Choi, Chung-Il;Kwak, Dong-Suk;Kim, Jeong-Gyun;Bae, Sun-Kun;Chung, Byung-Cheon;Lee, Jae-Tae;Lee, Kyu-Bo;Kang, Seung-Wan;Woo, Eon-Jo;Kim, Sin-Woo;Sohn, Sang-Kyun;Chae, Shung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.177-185
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    • 1994
  • Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.

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