3040 90 2 Vol. 21 No. 81999
21 60 Vol. 21 No. 81999 3
4444444444444444444444444444444444444444444444444444444 1830 10 12 1010 18 80 32 4 Vol. 21 No. 81999
Vol. 21 No. 81999 5
6 Vol. 21 No. 81999
Vol. 21 No. 81999 7
10 49, 10431046,1997. 51, 609-611,1999. 514 34-35 1998. 51, 447-4491999. 2139421999. 8 Vol. 21 No. 81999
30 50 70 2010 70 gout mg 26 41 7 22 349 694 464 490 75mg 200mg 16 p.189.1989 Vol. 21 No. 81999 11
12 Vol. 21 No. 81999 guttadrop mgdl 10 purinepure+urine 2040 RA 40 60 30 40 mgdl 2060 7
13 Vol. 21 No. 81999 nucleotide AMP: adenosine monophosphate IMP: inosine monophosphate GMP: guanosine monophosphate nucleoside adenosineinosine guanosine(base adeninehypoxanthine guanine uricase 700mg 1200mg 3.87.5 mgdl2.45.8mgdl ph7.437 6.4mgdl 7.0 mgdl 7.0mgdl 7.0mgdl 7.0mgdl 1 2
360 500 39.830.4529 55.651.0 4 5 1 2 1!! 5.12 6.86 4.35 0.12 0.38 0.03 1.21 0.39 2.37 3.15 2.01 0.05 0.16 0.01 0.48 0.15 (10) 14 Vol. 21 No. 81999
15 Vol. 21 No. 81999 25 30kcal 0.5kgkg 152020 305060 2!! 1520 100g 75mg 85100mg 1501,000mg 1987
3!! 4!! 10g 39p 5 ATP NAD R R R R R R R R R R R R R 100p 160kcal 113kcal 140p 180p158kcal 250kcal 60p 760p1900kcal 20 113kcal 140p 25 141kcal 110p 35 201kcal 80p 45kcal 360p 180p 81kcal CAN 56kcal 290p 180p140kcal 39kcal 400p 350p134kcal 29kcal 500p 350p102kcal 15kcal 1060p 250p 38kcal 73kcal 200p 334p224kcal 75kcal 200p 720p540kcal 66kcal 240p 190p125kcal 139kcal 110p 160p222kcal 180kcal 90p 1 20p36kcal 16 Vol. 21 No. 81999
17 Vol. 21 No. 81999 20 g VLDL HDL n-6
18 Vol. 21 No. 81999 EPAn-3 70g100g R
90 8 20 40 30 15 45 0.1 0.01 30 20 10 10 10 1 0.01 250 165 50 3 0.1 100 100 10 3 30 30 10 40 23 30 40 2 0.3 1 165 30 30 10 30 10 10 15 30 5 100 100 5 0.1 6 10 3 40 20 5 0.1 15 15 50 70 1 / 490kcal 16g 6.3g 3.6g 442kcal 22.6g 39.3g 2g 601kcal 25.2g 13.3g 4.2g 1,659kcal 64g 67.6g 9.8g Vol. 21 No. 81999 19
1996.4.6 1998, 5, 1998, VOL92 p5064 p3841 1998.9.20 p42436 vol.89 no.4 1996 p475476 p5 p4245 1992.10.20 p85108 10 1995.12.22 p14 20 Vol. 21 No. 81999
23 Vol. 21 No. 81999 ddddddddddddddddddddddddddddddddddddddddddddd ddddddddddddddddddddddddddddddddddddddddddddd
24 Vol. 21 No. 81999
Vol. 21 No. 81999 25
26 Vol. 21 No. 81999
BT Vol. 21 No. 81999 27
cyto-kineto-cytokine 28 Vol. 21 No. 81999
29 Vol. 21 No. 81999 TDM MIC AUC TDM GOTGPTALP VK VB
g/ml 12 2 35 10 35 10 12 2 35 10 12 2 12 2 12 2 12 2 GFR ScrBUN ACE NSAIDs 30 Vol. 21 No. 81999
45cm Vol. 21 No. 81999 33
1951 1020 3-10-11 181590 18 111606 34 Vol. 21 No. 81999
10 1020 19 1930 1951 918934 Cassia gasta obtusifolia Cassia obtusifolia L. 17161735 1.5m cm cm 1.3cm 1518cm 2050 mmmm Vol. 21 No. 81999 35
Foeted cassia, Oriental senna C. tora. L. m 10mm1323mm mmmm2.5mm mm coffee senna, stinking weed C. occidentalis L.C. torosa Cav. 0.5m cm 1013cm 3045 10 chrysophanol physcionobtusifolin obtusinchryso-obtusin aurantio-obtusin gluco-obtusin gluco-aurantio-obtusin cassiasido emodin aloe-emodinrhein 1- chrysophanic acid 1-genti-obioside rubrofusarin 9-chrysophanol 9-anthrone bianthraquinone funiculosin 7-jaceidin 7-rhamnoside casiollin 1.5 36 Vol. 21 No. 81999
13 15g Vol. 21 No. 81999 37
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr QA IVHTPNHPN IVH: Intravenous HyperalimentationTPN: Total Parenteral NutritionHPN: Home Parenteral Nutrition HPN HPN HPN HPN Vol. 21 No. 81999 39
40 Vol. 21 No. 81999 HPN N Q11 HPN HPN HPN HPN 100 10010,000 IX C
Vol. 21 No. 81999 41
IVH() IVH ft 3 0.5µm 100 1003.5l 10,000 10,000350l 100,000 100,0003,500l 1,300,000 400,000 200,000 1,900,000 CF-N101 DD 42 Vol. 21 No. 81999
43 Vol. 21 No. 81999 HPN 10cm HPN HPN HPN 1519ml60 ml ml
44 Vol. 21 No. 81999 HPN24 10 HPN
M V I MV A IU 10,000 3,000 3,300 D IU 1,000 400 200 E mg 5 15 10 K mg 2 2 B1 mg 50 3.0 3.0 B2 mg 10 5.0 3.6 B6 mg 15 4.0 4.0 B12 mg 10 5.0 C mg 500 100 100 mg 100 40 40 mg 25 14 15 g 400 400 g 100 60 30 14 HPN HPN HPN HPN HPN HPN HPN Vol. 21 No. 81999 45
HPN 98 11 IVH 1990 1996 1991 1996 Vol.38, No.13, 1996 46 Vol. 21 No. 81999
48 Vol. 21 No. 81999 11153 16 3011 12 40 20 10
49 Vol. 21 No. 81999 10 1124 1122 1120 101126 101025 1017 1023 CR 1018
50 Vol. 21 No. 81999 1770 401772 16 21 1802
51 Vol. 21 No. 81999 1804 1815 1824 1827 301863 1812
199923 A Nitric OxideNO phosphodiesterasepde 19983 9EU 19981999 2523 25mg50mg 100mg 25mg50mg 65 Ccr30ml/min 25mg 24 P450CYP3A4 50mg ph 8013 0.001 Vol. 21 No. 81999 53
25mg50mg phosphodiesterase type 5PDE 5 non-adrenergic noncholinergicnanc NO c-gmp c-gmpc- GMPPDE5 c-gmp PDE5 PDE5 PDE PDE5 54 Vol. 21 No. 81999
Vol. 21 No. 81999 55
PDE PDE 550 IC503.5nmol/L PDEIC 50PDE11/80PDE2 PDE3PDE41/2000PDE6 1/10PDE5 PDE5 PDE5 cgmp NO NO Boolell4812 36633.4 102550mg 302 Goldstein24 12 32 53225mg50mg100mg 50mg 329 69 22p 0.001 5.91.5 p0.001 FDA 2550 100mg 50mg706 343 322322 337 10 10 10 10 10 56 Vol. 21 No. 81999
Least Squares mean Dunnettp0.001 p0.001 50mg 36317 52 90 50mg136 132 5610 100mg 244243 Vol. 21 No. 81999 57
Morales 25100mg n734 n725 2550mg n157 n62 16 4 13 3 10 1 11 3 7 2 1 0 4 2 0 0 3 2 0 0 3 0 2 0 2 1 0.6 0 2 1 0.6 0 2 1 0 0 15.0 2550100mg 50mg 58.372.472.3 25mg 50mg1574025.48 20 12.741610.193 1.91157 3119.75CPK PDE6 PDE5 1/10PDE6 PDE6 25mg3127122.76 50mg51119037.18823 26131.71 10913.2 12515.2283.4 182.2 Morales28 2,722 0.04 10 ;; ; 58 Vol. 21 No. 81999
2.52.3 190 11 NO mmhg 50mg200mg 12 25mg 500g15 25mmHg 12 1215 12 Vol. 21 No. 81999 59
24 13 10mg 16 100mg 12 60 Vol. 21 No. 81999
450CYP3A4 11 HIV CYP3A4 CYP3A4 R c-gmp 199827FDA 900 450 199959 1415161718 Vol. 21 No. 81999 61
Anderson K.E.Pharmacol. Rev. 45: 253, 1993 Holmquist F. et. al., J.Urol. 150: 1310, 1993 Beltman J. et. al., J.Pharmacol. Exp. Ther. 47: 330, 1995 Ballard S.A. et al. J Urol 159: 6, 2164, 1998 Wallis R.M. et. al., Am J Cardiol 83: 3C, 1999. Turko I.V. et.al., J Biol Chem 273: 11, 6460, 1996 Boolell M. et al. Int J Impotence Res 8: 47, 1996 Goldstein I. et al. N Engl J Med 338: 1397, 1998, 90: 2, 225, 1999 10Morales A. et al. Int J Impotence Res 10: 69, 1998 11Zusman R.M. et.al., Am J Cardiol 83: 35C, 1999. 12David J.W. et.al., Am J Cardiol 83: 21C, 1999. 13ACC/AHA Expert Consensus Document. J Am Coll Cardiol 33: 273, 1999 14NIH Consensus Development Panel on Impotence: JAMA. 270: 83, 1993 15Feldman, H.A. et al.: J Urol 151: 54, 1994 16, No.149: 7-13 17FDA, 19981124) 18 76: 5, 9, 1999 62 Vol. 21 No. 81999
10 16 18 18 19 20 23 1128 3F 1045 10 10 10 11 11 10 JR 101-0036 18 103-3526-4700 FAX03-3526-4701 Vol. 21 No. 81999 63
64 Vol. 21 No. 81999 10 17 0700080002 81 10 11 12 13 11 10 11 12 1650 17 18 19 20 22 24 267655 29
65 Vol. 21 No. 81999 1410 15 16 1711 18PI999 19 107,909 11NHK 6/1623307/7 11:00 11 11 24 No.1 28 15 11 Vol.22 No.1 32 111314 10 10 11 31 1111 12 13 14 15 DRUG SAFETY UPDATE 16 11 11 11 11632 A5 4,160 500 600 A4 9,6000
A 2,000 3-9-10 1618 8/128/20 8/138/18 :103-3294-8840 21383 300 101-0054 1 21 132940271 66 Vol. 21 No. 81999