• Title/Summary/Keyword: 신혈관성 고혈압

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Long-Term Result of Surgical Treatment for Renovascular Hypertension (신혈관성 고혈압의 외과적 치료 결과)

  • 우건화;김창호
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.393-396
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    • 1996
  • During the past eight years, we have encountered 9 patients, aged between 2 and 61 years, with renovascular hypertension. The renovascular hypertension In this series included Takayasu's disease with renal artery stenosis, arteriosclerosis of renal artery, fibromuscular dysplas a of renal artery Aortd-renal bypass was performed In 8 patients, iliac-to-renal bypass in 1 patient. 9 patients have been followed form 2 months to 5.1 years. Postoperatively, all patients'hypertension was improved. Only 2 patients need to take small dose of antihypertensive medication after discharge. These data indicated the good results of renovascular reconstruction for the patients with renovascular hypertension.

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A Case of Renovascular Hypertension Controlled by Percutaneous Transluminal Renal Angioplasty with Balloon Dilatation (경피적 신동맥 혈관 성형술로 치료한 신혈관 고혈압증 1례)

  • Park, Sung-Woo;Jeong, Su-Ho;Jeong, Young-Sun;Jun, Yong-Hoon;Hong, Young-Jin;Lee, Ji-Eun
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.105-110
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    • 2008
  • Renovascular hypertension results from a lesion that impairs blood flow to a part of or all, of one or both kidneys. Renal artery stenosis is the major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. Recently, percutaneous transluminal renal angioplasty(PTRA) with or without stent placement, has become the preferred choice for correcting symptomatic renal artery stenosis since it is less invasive than surgical reconstruction. PTRA with balloons designed for the dilatation for the dilatation of the coronary artery can be tried in small sized renal artery stenosis. We report a case of renovascular hypertension in a 13-year-old male who had small sized renal artery stenosis. Hypertension was controlled by PTRA with balloon dilatation.

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Surgical Treatment for Renovascular Hypertension and Iliac Artery Occlusion (신혈관성 고혈압 및 장골동맥 폐쇄에 대한 수술)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kang, Tae-Soo;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.582-586
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    • 2007
  • A 48-year old male patient visited our hospital with uncontrolled hypertension and pair of the left leg. CT angiography shows atherosclerotic occlusion of both renal artery orifices and the left common iliac artery. Despite of medical treatment for 2 months, the clinical condition of the patient worsened. We performed the surgical revascularization with both renal arteries and aorto-left femoral artery bypass with using an 8 mm artificial vascular graft. He lived well without hypertension with using only angiotensin receptor blocker and an anticoagulant for 10 postoperative months. Using surgical revascularization for renovascular hypertension has decreased due to the development of intervention technology and medication, but this surgery is indicated in cases of renovascular hypertension with extensive atherosclerotic lesions. We report here on a case of surgical revacularization for medically Intractable atherosclerotic renovascular hypertension together with left common iliac artery occlusion.

The Vasodilating Mechanism of Atrial Natriuretic Peptide in 2-kidney 1 Clip Renovascular Hypertensive Rats (2-kidney 1 clip 신혈관성 고혈압흰쥐에서의 심방이뇨??????타이드의 혈관이완작용의 기전)

  • Jung, Jin-Young;Ahn, Young-Chul;Kim, Hun-Sik;Koh, Gou-Young;Ahn, Hee-Yul;Kim, Myung-Suk
    • The Korean Journal of Pharmacology
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    • v.32 no.1
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    • pp.51-56
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    • 1996
  • The objectives of this study is to find out mechanism of vasodilating effects of ANP in 2K-1C renovascular hypertensive rat aorta and to compare with those of normotensive rat aorta. In 2K-1C renovascular hypertensive rat, average arterial blood pressure and plasma renin activity were higher than in normotensive rat. In 2K-1C renovascular hypertensive rat aorta, NE sensitivity was more increased and maximal contraction of aorta by NE was higher than those of normotensive rat aorta. ANP inhibited NE-induced contraction in both 2K-1C renovascular hypertensive and normotensive rat aorta, concentration-dependently. However, ANP was less effective for relaxing NE-induced contraction in 2K-1C renovascular hypertensive rat aorta than in normotensive rat aorta. ANP inhibited $^{45}Ca^{2+}$ uptake induced by NE in both 2K-1C renovascular hypertensive and normotensive rat aorta. From these results. inhibition of $Ca^{2+}$ influx may be one of the vasodilating mechanism of ANP in 2K-1C renovascular hypertensive rat aorta. Although the potency of ANP in relaxing NE-induced contractions was attenuated, the efficacy of ANP was not changed in 2K-1C renovascular hypertensive rat aorta compared with that of ANP in normotensive rat aorta. Abbreviations: ANP, Atrial natriuretic peptide; 2K-1C, 2-kidney 1 clip; NE, norepinephrine; SHR, Spontaneously hypertensive rat; DOC, Deoxycorticosterone; EDTA, Ethylenediaminetetra-acetic acid; PSS, Physiological salt solution; TRIS, tris(hydroxymethyl) aminomethane

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Renal Artery Aneurysm in a 13-year-old Child (13세 남아에서 발견된 신동맥의 동맥류 증례 보고)

  • Yeh, Hye Ryun;Kim, Min Jee;Kang, Eun Gu;Han, Jee Yeon;Lee, Joo Hoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.51-55
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    • 2014
  • Primary renal artery aneurysm has been estimated to account for an incidence of 0.015-1% with associated morbidities including renovascular hypertension and rupture. Renovascular hypertension associated renal artery aneurysms in children is not a common disease. In patients with complicated renal vascular disease, renal autotransplantation has been used as an alternative to percutaneous transluminal angioplasty, which may be hazardous in these situations. We report a case of a renal artery aneurysm in a 13-year-old Korean child presenting hypertension detected during school health examination. Preoperative workup demonstrated a $2.8{\times}2.1{\times}1.9$ cm saccular aneurysm in the right renal hilum that was not amendable to endovascular repair. A surgical strategy including extracorporeal renal artery reconstruction with autotransplantation was applied in order to restore renal artery anatomy and to treat renovascular hypertension. Immediately he complained of severe right flank pain and postoperative doppler sonography revealed lack of perfusion. On the 5th day after autotransplantation, the patient underwent a transplant nephrectomy. He was well postoperatively and was found to have a normal kidney function and stable blood pressure control without antihypertensive medication. This is the first pediatric case of renal artery aneurysm in Korea who underwent extracorporeal repair followed by autotransplantation failure. More pediatric cases with renal artery aneurysm should be reported to identify therapeutic outcome and long term prognosis.

Renovascular Hypertension in Children (소아의 신혈관성 고혈압)

  • Kang Byoung-Chul;Ha Il-Soo;Kim In-One;Cheong Hae-Il;Choi Yong;Ko Kwang-Wook
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.101-108
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    • 1997
  • Purpose : The clinical characteristics of renovascular hypertension (RVHT) in children were analyzed. Methods : Medical records of 16 children diagnosed as RVHT on the basis of angiography during Jan. '86 to Jun. 94 in our hospital were reviewed retrospectively. Results : The mean age at the onset was 8.5 yrs and the sex ratio(M:F) was 7:9. The causes of RVHT were Takayasu arteritis in 6, Moyamoya disease in 5, and fibromuscular dysplasia in 3 patients. Abdominal bruit was noted in 6 patients (38%). Peripheral renin activity was raised in all tested patients. Bilateral renal arterial involvemnent was found in 9 patients (56%). Captopril renal scans showed good correlation with angiographic findings. Five patients were treated with antihypertensives only, and blood pressure was controlled completely in 2 and incompletely in 3. Percutaneous transluminal angioplasty was performed in 10 patients with 50% of success rate. However, hypertension was recurred due to restenosis or accompaning aortic stenosis in 3 patients. Surgical treatment was performed in 4 patients, and the blood pressure was controlled partially in 1 and poorly in the remaining 3. Conclusions : Takayasu arteritis, Moyamoya disease and fibromuscular dysplasia are the major causes of childhood RVHT in our country. The diagnosis of RVHT in children should be based on a set of tests individually selected for case by case. For the low curability of the current treatment modalities available, RVHT in children should not be regarded as 'curable' so far. We expect, however, that the outcome will be improved by more extensive application of the newly developed surgical technique.

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