• 제목/요약/키워드: pharmacologic stress

검색결과 17건 처리시간 0.028초

약물부하 검사법의 현재와 미래 (Current Trends and Future Development in Pharmacologic Stress Testing)

  • 배진호;이재태
    • 대한핵의학회지
    • /
    • 제39권2호
    • /
    • pp.107-113
    • /
    • 2005
  • Pharmacologic stress testing for myocardial perfusion imaging is a widely used noninvasive method for the evaluation of known or suspected coronary artery disease. The use of exercise for cardiac stress has been practiced for over 60 years and clinicians are familial with its using. However, there are inevitabe situations in which exorcise stress is inappropriate. A large number of patients with cardiac problems are unable to exercise to their full potential due to comorbidity such as osteoarthritis, vascular disease and pulmonary disease and a standard exercise stress test for myocardial perfusion imaging is suboptimal means for assessment of coronary artery disease. This problem has led to the development of the pharmacologic stress test and to a great increase in its popularity. All of the currently used pharmacologic agents have well-documented diagnostic value. This review deals the physiological actions, clinical protocols, safety, nuclear imaging applications of currently available stress agents and future development of new vasodilating agents.

Pharmacologic Considerations for Youth with Posttraumatic Stress Disorder

  • Keeshin, Brooks;Strawn, Jeffrey R.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • 제28권1호
    • /
    • pp.14-19
    • /
    • 2017
  • Children exposed to potentially traumatic events are at risk of developing posttraumatic stress disorder (PTSD). However, the subsequent developmental course of posttraumatic stress symptoms appears to vary considerably. In this regard, some PTSD symptoms resolve without significant interventions, while for many children and adolescents, they persist until the patient receives appropriate treatment specifically designed to address PTSD and other trauma related symptoms. Evidence-based psychotherapies represent the standard of care for children with PTSD and, while psychopharmacologic interventions are utilized for many youth with posttraumatic stress symptoms and PTSD, there is little data available to guide the use of these medications in this population. However, given the structural challenges involved in disseminating and delivering evidence-based psychotherapies in all settings, prescribing clinicians should be aware of the medications whose use in children with pediatric PTSD has been studied. Herein, we review the PTSD assessment modalities, as well as the use of pharmacologic interventions in PTSD, including antiadrenergic agents, selective serotonin reuptake inhibitors and other medications.

심근관류영상을 위한 심근부하 방법 및 검사 프로토콜 (Stress Testing and Imaging Protocols for Myocardial Perfusion Studies)

  • 김성민
    • Nuclear Medicine and Molecular Imaging
    • /
    • 제43권3호
    • /
    • pp.179-195
    • /
    • 2009
  • Scince $^{201}$TI was introduced as a myocardial perfusion imaging agent in the early 1970s, scintigraphic evaluation of myocardial perfusion for the diagnosis of coronary artery disease is a valuable noninvasive diagnostic imaging modality. Stress radionuclide myocardial perfusion imaging is widely accepted to have high diagnostic and prognostic use in the assessment of patients with known or suspected coronary artery disease. With wise use of this nonivasive imaging technique, more patients are referred for stress perfusion imaging. Until now various protocols for stress testing and myocardial imaging were developed and used in worldwide. This article presented various protocols of stress testing and myocardial imaging for clinical use.

Proteome Profiling Unfurl Differential Expressed Proteins from Various Explants in Platycodon Grandiflorum

  • Kim, Hye-Rim;Kwon, Soo-Jeong;Roy, Swapan Kumar;Cho, Seong-Woo;Kim, Hag-Hyun;Cho, Kab-Yeon;Boo, Hee-Ock;Woo, Sun-Hee
    • 한국작물학회지
    • /
    • 제60권1호
    • /
    • pp.97-106
    • /
    • 2015
  • Platycodon grandiflorum, commonly known as Doraji in Korea, has a wide range of pharmacologic properties, such as reducing adiposity and hyperlipidemia, and antiatherosclerotic effects. However, the mechanisms underlying these effects remain unclear. In order to profile proteins from the nodal segment, callus, root and shoot, high throughput proteome approach was executed in the present study. Two dimensional gels stained with CBB, a total of 84 differential expressed proteins were confirmed out of 839 protein spots using image analysis by Progenesis SameSpot software. Out of total differential expressed spots, 58 differential expressed protein spots (${\geq}$ 2-fold) were analyzed using MASCOT search engine according to the similarity of sequences with previously characterized proteins along with the UniProt database. Out of 58 differential expressed protein, 32 protein spots were up-regulated such as ribulose-1,5-bisphosphate carboxylase, endoplasmic oxidoreductin-1, heat stress transcription factor A3, RNA pseudourine synthase 4, cysteine proteinase, GntR family transcriptional regulator, E3 xyloglucan 6-xylosyltransferase, while 26 differential protein spots were down-regulated such as L-ascorbate oxidase precursor, late embryogenesis abundant protein D-34, putative SCO1 protein, oxygen-evolving enhancer protein 3. However, frequency distribution of identified proteins using iProClass databases, and assignment by function based on gene ontology revealed that the identified proteins from the explants were mainly associated with the nucleic acid binding (17%), transferase activity (14%) and ion binding (12%). In that way, the exclusive protein profile may provide insight clues for better understanding the characteristics of proteins and metabolic activity in various explants of the economically important medicinal plant Platycodon grandiflorum.

심장관류SPECT 검사 프로토콜 (Protocols of Myocardial Perfusion SPECT)

  • 김성민
    • 대한핵의학회지
    • /
    • 제39권2호
    • /
    • pp.82-86
    • /
    • 2005
  • In myocardial perfusion scintigraphy, the results of this evalution now confront the practitioner of nuclear medicing with methodologic options. Most nuclear cardiologic studies are performed using thallium-201, Tc-99m sestamibi and Tc-99m tetrofosmin. Some part of these studies use some form of pharmacologic stress test. While tailoring each test to the individual is ideal, this may be impractical for a busy department. Accordingly, established protocols to be used for patients with similar clinical presentations will be helpful. The following review presents methodology of various imaging protocols mainly according to the guidelines of nuclear cardiology procedures in American Society of Nuclear Cardiology.

The Protein Kinase 2 Inhibitor CX-4945 Induces Autophagy in Human Cancer Cell Lines

  • Kim, Jiyeon;Park, Mikyung;Ryu, Byung Jun;Kim, Seong Hwan
    • Bulletin of the Korean Chemical Society
    • /
    • 제35권10호
    • /
    • pp.2985-2989
    • /
    • 2014
  • Autophagy is a self-digestion process in which intracellular structures are degraded in response to stress. Notably, prolonged autophagy leads to cell death. In this study, we investigated whether CX-4945, an orally available protein kinase 2 (CK2) inhibitor, induces autophagic cell death in human cervical cancer-derived HeLa cells and in human prostate cancer-derived LNCaP cells. CX-4945 treatment of both cell lines resulted in the formation of autophagosomes, in the conversion of microtubule-associated protein 1 light chain 3 (LC3), and in down-regulation of the Akt-mammalian target of rapamycin (mTOR)-p70 ribosomal protein S6 kinase (S6K) signaling cascade. Thus, pharmacologic inhibition of CK2 by CX-4945 induced autophagic cell death in human cancer cells by down-regulating Akt-mTOR-S6K. These results suggest that autophagy-inducing agents have potential as anti-cancer drugs.

시상하부-뇌하수체-부신계 조절에 대한 Monoamine 신경전달물질의 역할에 관한 연구(III)-뇌 5-hydroxytyptamine(Serotonin)이 Stress 시 Corticosteroid 변동에 미치는 영향 (Roles of Monoamine Neurotransmitters in Regulation of Hypothalamic PITUITITARY-ADRENAL AXIS(HPA) (III) - Role of 5-hydroxytryptamine in Controlling the Stress-Induced Elevation of Corticosterone in Rat -)

  • 서유헌;임정규;박찬웅
    • 대한약리학회지
    • /
    • 제19권2호
    • /
    • pp.45-55
    • /
    • 1983
  • 뇌내 여러 신경전달물질계가 시상하부-뇌하수체-부신계(HPA)를 복잡하게 조절하고 있다는 증거가 많이 나오고 있다. 그 중에서도 5-HT(Serotonin)계의 stress시의 역할에 대해서는 많은 연구가 있어왔으나 아직 논란이 많이 제기되고 있다. 따라서 저자는 5-HT가 stress시 HPA axis를 조절하는데 필수적인 역할을 하는가를 말아보기 위해서 1) Stress전후에 5-HT의 steady state농도와 5-HT의 교체율(turnover rate) 및 합성율(synthesis rate)을 측정해 보았으며 2) 비교적 5-HT계에 특이하게 작용하는 여러 약물들을 주사한 후에 stress 반응을 측정해 보았다. 1) 1분간 ether stress 가한 직후에 시상하부와 다른 뇌부위에서의 5-HT와 5-HIAA농도는 즉각적으로 의미있게 상승하였으나 혈장 corticosterone농도는 즉각상승을 보이지 않다가 2분후에 상승을 보였다. 2) Stress(30분 immobilization & 1분 ether stress)가한 백서에서는 시상하부와 다른 뇌부위에서 5-HT합성을 혹은 교체율이 2배-4배까지 상승하였다. 3) 5-HT합성 전구물질(L-tryptophan)과 수용체 자극제 (5-MeODMT)를 투여하였을 때는 투여용량에 비례해서 혈장 corticosterone함량이 상승하였다. 4) L-tryptophan과 MAO억제제 (pargyline) 혹은 L-tryptophan과 5-MeODMT의 병합 투여로 stress시 혈장 corticosterone의 상승이 더 높게 나타났다. 5) 5-HT 합성억제제(PCPA), 5-HT 신경독약(5,7-DHT)을 투여하고 stress를 가하였을 때는 시상하부와 다른 뇌 부위에서 5-HT의 하강이 별로 나타나지 않았으며, 동시에 혈장 corticosterone의 하강도 의미있게 나타나지 않았다. 그러나 midline raphe핵을 파괴하였을 때는 5-HT와 corticosterone의 하강이 나타났다. 6) 비교적 특이하게 serotonin제에 작용하는 여러 약물들을 투여한 후에 나타나는 5-T와 혈장 corticosterone함량 사이에는 상당히 높은 양의 상관관계계가 있었다(r>0.81). 이상의 결과를 종합해 볼때 serotonin(5-HT)은 시상하부-뇌하수체-부신계의 스트레스반응조절에 중요한 자극적 역할을 하리라고 생각된다.

  • PDF

허혈성 심장 질환의 One-stop Evaluation Protocol: Myocardial Fusion PET Study (One-stop Evaluation Protocol of Ischemic Heart Disease: Myocardial Fusion PET Study)

  • 김경목;이병욱;이동욱;김정수;장영도;방찬석;백종훈;이인수
    • 핵의학기술
    • /
    • 제14권2호
    • /
    • pp.33-37
    • /
    • 2010
  • 관상동맥질환의 진단 및 평가에 있어서 myocardial perfusion SPECT검사와 FDG를 이용한 myocardial PET검사 그리고 PET/CT에 장착된 64-slice CT를 이용한 coronary CT angiography를 동시에 실행함으로 검사의 신뢰도와 편의성을 한층 더 높이고자 한다. 먼저 약물부하 myocardial perfusion SPECT검사를 먼저 시행한다. 환자의 피폭경감을 위해서 $^{99m}Tc$-MIBI 10 mCi 로 주사하며 myocardial PET검사를 위해서 지방식을 먹지 않고 ursodeoxcholic acid 100 mg을 생수와 함께 복용하게 하여 1시간 후에 SPECT 영상을 얻는다. 이어서 myocardial FDG PET검사를 시행한다. 혈중의 지방산 농도를 낮추고 심장의 FDG섭취율을 증가시키기 위해 혈중 포도당 농도치에 따라 insulin과 Acipimox를 함께 사용하는 독창적인 경구 당 부하법을 사용하였으며, 환자의 피폭 경감을 위해서 $^{18}F$-FDG 5 mCi를 주사하고 1시간 후에 10분간 gated 영상을 얻으며 필요시 delay 영상을 얻는다. PET검사가 끝남과 동시에 환자는 동일한 position을 하고 연속해서 coronary CTA를 시행한다. 이 검사에서 가장 중요한 것은 심박동수 조절과 환자의 호흡협조이다. 심박동수를 65회 이하로 낮추기 위해 beta blocker 50 mg~200 mg을 의사와 상의하여 복용케 하고 호흡법을 충분히 연습을 시키다. 검사 직전에 isosorbide dinitrate를 3~5회 분무하여 혈관벽의 긴장을 낮추고 혈관을 확장시켜서 coronary artery의 해부학적 형태를 더욱 잘 나타낼 수 있게 한다. 촬영 시 CT 조영제를 4.0~5.0 mL/sec의 압력으로 주입하며 촬영을 한다. Coronary CTA를 이용하면 coronary artery stenosis가 잘 보이며, 약물부하 myocardial perfusion SPECT로 coronary CTA에서 보인 stenosis와 perfusion저하의 상관관계를 검토(culprit vessel 확인)할 수 있으며, FDG PET으로 hibernating myocardium 또는 infarction site의 viability를 확인할 수 있다. 한 가지 검사로 lesion site와 severity 및 치료에 대한 반응 예측이 가능함으로 약물치료, PCI, CABG 등 치료방향을 설정할 수 있다. 또한 모든 검사 과정들이 연속적으로 동시에 이루어지기 때문에 짧은 시간(3시간) 내에 one-stop으로 검사를 종료할 수 있는 큰 장점을 가지게 된다. 그러므로 이 검사법은 ischemic heart disease의 one-stop evaluation에 있어서 유용한 protocol로 보여진다.

  • PDF

Profiling of differential expressed proteins from various explants in Platycodon grandiflorum

  • Kim, Hye-Rim;Kwon, Soo Jeong;Roy, Swapan Kumar;Kamal, Abu Hena Mostafa;Cho, Seong-Woo;Kim, Hag Hyun;Boo, Hee Ock;Cho, Kab Yeon;Woo, Sun-Hee
    • 한국작물학회:학술대회논문집
    • /
    • 한국작물학회 2017년도 9th Asian Crop Science Association conference
    • /
    • pp.131-131
    • /
    • 2017
  • Though the Platycodon grandiflorum, has a broad range of pharmacologic properties, but the mechanisms underlying these effects remain unclear. In order to profile proteins from the nodal segment, callus, root and shoot, high throughput proteome approach was executed in the present study. Two-dimensional gels stained with CBB, a total of 84 differential expressed proteins were confirmed out of 839 protein spots using image analysis by Progenesis SameSpot software. Out of total differential expressed spots, 58 differential expressed protein spots (${\geq}2-fold$) were analyzed using MASCOT search engine according to the similarity of sequences with previously characterized proteins along with the UniProt database. Out of 58 differential expressed protein, 32 protein spots were up-regulated such as ribulose-1,5-bisphosphate carboxylase, endoplasmic oxidoreductin-1, heat stress transcription factor A3, RNA pseudourine synthase 4, cysteine proteinase, GntR family transcriptional regulator, E3 xyloglucan 6-xylosyltransferase, while 26 differential protein spots were down-regulated such as L-ascorbate oxidase precursor, late embryogenesis abundant protein D-34, putative SCO1 protein, oxygen-evolving enhancer protein 3. However, the frequency distribution of identified proteins using iProClass databases, and assignment by function based on gene ontology revealed that the identified proteins from the explants were mainly associated with the nucleic acid binding (17%), transferase activity (14%) and ion binding (12%). Taken together, the protein profile may provide insight clues for better understanding the characteristics of proteins and its metabolic activities in various explants of this essential medicinal plant P. grandiflorum.

  • PDF