• Title/Summary/Keyword: pharmacologic stress

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Emodin Isolated from Polygoni cuspidati Radix Inhibits TNF-α and IL-6 Release by Blockading NF-κB and MAP Kinase Pathways in Mast Cells Stimulated with PMA Plus A23187

  • Lu, Yue;Jeong, Yong-Tae;Li, Xian;Kim, Mi Jin;Park, Pil-Hoon;Hwang, Seung-Lark;Son, Jong Keun;Chang, Hyeun Wook
    • Biomolecules & Therapeutics
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    • v.21 no.6
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    • pp.435-441
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    • 2013
  • Emodin, a naturally occurring anthraquinone derivative isolated from Polygoni cuspidati radix, has several beneficial pharmacologic effects, which include anti-cancer, anti-diabetic, and anti-inflammatory activities. In this study, the authors examined the effect of emodin on the production of proinflammatory cytokines, such as, tumor necrosis factor (TNF)-${\alpha}$ and interleukin (IL)-6, in mouse bone marrow-derived mast cells (BMMCs) stimulated with phorbol 12-myristate 13-acetate (PMA) plus the calcium ionophore A23187. To investigate the mechanism responsible for the regulation of pro-inflammatory cytokine production by emodin, the authors assessed its effects on the activations of transcriptional factor nuclear factor-${\kappa}B$ (NF-${\kappa}B$) and mitogen-activated protein kinases (MAPKs). Emodin attenuated the nuclear translocation of (NF)-${\kappa}B$ p65 and its DNA-binding activity by reducing the phosphorylation and degradation of $I{\kappa}B{\alpha}$ and the phosphorylation of $I{\kappa}B$ kinase B (IKK). Furthermore, emodin dose-dependently attenuated the phosphorylations of MAPKs, such as, extracellular signal-regulated kinase 1/2 (ERK1/2), p38 MAP kinase, and the stress-activated protein kinases (SAPK)/c-Jun-N-terminal kinase (JNK). Taken together, the findings of this study suggest that the anti-inflammatory effects of emodin on PMA plus A23187-stimulated BMMCs are mediated via the inhibition of NF-${\kappa}B$ activation and of the MAPK pathway.

Magnetocardiogram difference between pharmacologic and exercise stress test (운동과 약물에 의한 심장 부하의 심자도 양상 비교)

  • Lim, Hyun-Kyoon;Kim, Ki-Woong;Kwon, Hyuk-Chan;Lee, Yong-Ho;Kim, Jin-Mok;Yu, Kwon-Kyu;Kim, In-Seon;Kim, Wuon-Shik;Lim, Cheong-Moo;Lee, Sang-Il;Chung, Nam-Sik;Ko, Young-Guk
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 2009.05a
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    • pp.105-108
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    • 2009
  • 심장의 박동수 자율신경계에 있어서 매우 중요한 감성 지표가 되어 왔다. 정상인 심장박동수의 개인간 차이는 유의하게 다르지 않다. 그러나 심장병 환자는 건강한 사람들과 유의한 차이를 보이게 된다. 특히 허혈 초기에는 증상이 잘 나타나지 않기 때문에 일부러 심장에 부하를 주어서 허혈 유무를 판정하기도 한다. 부하를 주는 방법은 운동에 의한 운동부하검사, 약물에 의한 약물부하검사로 나뉜다. 신체조건 및 안정상 운동부하 검사가 불가능한 경우에는 약물을 이용한다. 심전도를 이용한 심장부하 연구는 많이 수행되어 왔으나 심자도 연구는 초기단계이다. 본 연구에서는 20 대 정상인 20 명과 협심증 환자들 27명에게 약물 부하를 유도하여 나타난 심박수, 심자도의 차이를 비교하였다. 또한 8 명의 정상인을 대상으로 가혹한 운동부하를 일으켜 최대 부하상태에선 안정 상태까지 이르는 과정을 심자도로 관찰하였다. 결과로서 운동부하 검사에서 야기되는 스트레스의 정도는 약물로 얻어지는 부하에 비해 유의하게 큼을 알 수 있었다. 또한 약물 스트레스는 정상인의 심장 전기생리학적 변화는 미미하지만 일부 허혈 환자들에게서는 유의한 차이를 보였다. 미약한 약물 스트레스에 대해 변화되는 정도가 심자도에 관찰되어 허혈 검사에 사용 가능성을 보였다.

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Comparison of $^{99m}Tc-MIBI$ Myocardial Uptake at Rest with Reinjection and 24-hour after Reinjection Images of $^{201}Tl$ ($^{201}Tl$$^{99m}Tc-MIBI$에 의한 생존심근의 진단 비교 -재분포영상에 고정관류결손을 보인 환자에서 $^{201}Tl$ 재주사법 및 $^{99m}Tc-MIBI$ 휴식기스캔에 의한 심근섭취 비교-)

  • Bom, Hee-Seung;Kim, Ji-Yeul;Park, Joo-Hyung;Ahn, Young-Keun;Jeong, Myung-Ho;Cho, Jeong-Gwan;Park, Jong-Choon;Kang, Jung-Chaee
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.274-279
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    • 1992
  • Clinical role of $^{99m}Tc-MIBI$ myocardial scintigraphy in the diagnosis of coronary artery disease (CAD) is now well accepted, however, the role of it in the identification of viable myocardium in patients with chronic CAD has not yet been clarified. To determine the usefulness of rest-injected $^{99m}Tc-MIBI$ scan as a marker of myocardial viability, the regional uptake of this agent at rest was compared with that of $^{201}Tl$ on reinjection and 24 hours after reinjection images. Subject patients were 13 chronic CAD patients who showed irreversible perfusion defect(s) on standard pharmacologic (dipyridamole) stress-redistribution images. Immediately after the redistribution images were obtained, 37 MBq thallium was injected at rest, and images were reacquired at 10 minutes and 24 hours after reinjection. After then 740 MBq $^{99m}Tc-MIBI$ was injected, and 1 hour later rest MIBI myocardial imaging was performed. Five sets of imagestress, redistribution, reinjection, delayed images of thallium, and rest image of MIBI) were then analyzed qualitatively and quantitatively. Left ventricle was arbitrarily divided into 9 segments (apex, basal and apical portions of anterior, septal, inferior, and lateral walls). Seven patients and 30 regions showed a fixed perfusion defect on the stress-redistribution images. Among 30 regions, 15 showed positive uptakes and 6 showed negative uptakes on both $^{201}Tl$ reinjection/delayed images and $^{99m}Tc-MIBI$ rest images. Five regions showed only thallium uptake and were regarded as viable clinically. Of four regions which showed only $^{99m}Tc-MIBI$ uptake, two were regarded as viable, while the other two were regarded as a nonviable scar tissue clinically. In conclusion, $^{201}Tl$ reinjection technique was more reliable in the identification of viable myocardium. However, the role of $^{99m}Tc-MIBI$ in identification of viable myocardium was still remained to be clarified because 2 of 9 regions showed only $^{99m}Tc-MIBI$ uptake and were regarded as viable tissues.

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Myocardial Uptake and Clearance of Thallium-201 in Normal Subjects: A Comparison Between Pharmacologic Stress with Intravenous Adenosine, Dipyridamole and Dobutamine, and Exercise Stress Testing (정상인 심근의 Thallium-201 섭취 및 제거 : Adenosine, Dipyridamole Dobutamine 정맥주사와 운동부하시의 비교)

  • Lee, Jae-Tae;Chung, Byung-Chun;Choi, Jung-Il;Kwak, Dong-Suk;Lee, Kyu-Bo;Chae, Shung-Chull;Chung, Chin-Hong
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.35-50
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    • 1993
  • 심근관류 스캔에서 약제부하 검사에 많이 이용되는 것으로는 adenosine, dipyridamole, dobutamine등이 있다. 이 약제들이 혈역학 및 thallium의 약동학에 미치는 효과를 검사하기 위하여 저자들은 15명의 건강인을 대상으로 이들 약제를 정맥주사한 후에와 그리고 운동부하를 시행한 후에 thallium-201 신근관류 스캔을 시행하여 thallium의 약동학에 미치는 영향에 대하여 서로 비교하였다. 부작용은 adenosine (87%), dipyridamole(80%), dobutamine (73%)을 정맥주사할 시에 흔히 나타났으나 경미하였다. 1예에서는 dobutamine을 주사할때의 부작용으로 인하여 최대용량을 투여하지는 못한바 있었다. 대상들은 dipyridamole (13%)이나 dobutamine (27%)보다 adenosine (60%)을 선호하였다 (P<0.05). Thallium의 절대 적인 심근섭취는 운동부하 검사보다 adenosine (1.3배), dipyridamole(1.2배), dobutamine(1.4배) 부하시에 더 많았고, 이들 약제 사이에는 유의한 차이는 없었다. Thallium의 심근제거율(%/hr)는 운동부하 검사보다 약제부하한 후에가 더 늦었다. 폐, 간, 비장, 및 내장지역에서 thallium의 섭취 및 제거는 운동부하 검사보다 약제부하시에 더 많았으나, 이들 약제 사이에는 유의한 차이가 없었다. Dobutamine 투여시의 thallium의 섭취 및 제거는 adenosine 또는 dipyridamole을 투여시의 결과와 상응하였다. 저자들은 adenosine, dipyridamole 및 dobutamine을 이용한 약제부하 thallium-201 심근관류 검사를 시행하는데 코든 대상들에서 어려움 없이 쉽게 시행할 수 있었다. Thallium의 심근내 섭취 및 제거는 각 약제부하에 따라서 다를 수가 있으므로 심근관류 스캔의 정량적인 분석을 시행할 때는 각각 약제에 대한 특별한 진단기준이 마련되어야 할 것으로 생각된다.

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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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The Value of Calcium-scoring CT for Ischemic Cardiovascular Disease Screening (허혈성 심혈관 질환 선별을 위한 Calcium-scoring CT의 유용성)

  • Oh, Jung-Hoan;An, Sung-Min
    • Journal of radiological science and technology
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    • v.32 no.1
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    • pp.69-78
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    • 2009
  • The cardiovascular disease has been known as a common cause of death for a long time in the west. The eating habits of Asia, including Korea, have changed recently, so that this disease is also a problem in Asia now. Annual Report on the Cause of Death Statistics from 1996 to 2006 reported that the cardiovascular disease would become the number one cause of death in the next $5{\sim}10$ years. Therefore we realize that more accurate examination is required. The aim of this study was to investigate the accuracy of Calcium-scoring CT and the relationship between risk factor and quantitative scores of Calcium-scoring CT. Through this study we expect that the national public health will be improved. Seventy patients with chest pain were chosen at random. The patients were undergone both coronary CT antigraphy and Calcium - scoring CT at G hospital in Incheon from February 1 to June 30, 2008. The result of the Calcium-scoring CT showed its usefulness for Ischemic cardiovascular disease, with an accuracy similar to that of exercise/pharmacologic stress or ECG when it is difficult for a patient to exercise due to joint problems, aging or for other reasons.

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Safety and Feasibility of Thallium-201 Myocardial SPECT with Intravenous Infusion of Disodium Adenosine Triphosphate (ATP) in the Diagnosis of Coronary Artery disease (관상동맥 질환 진단에서 ATP부하 T1-201 심근 관류 SPECT의 안전성과 유용성)

  • Pai, Moon-Sun;Park, Chan-H.;Yoon, Seok-Nam;Kim, Won;Kim, Han-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.250-258
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    • 1998
  • Purpose: ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet been sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-201 myocardial SPECT using an intra-venous ATP infusion in patients with suspected coronary artery disease. Materials and Methods: Thallium-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/kg/min for 6 min). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Results: Although 76.5% of the patients had some adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Conclusion: Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.

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