• Title/Summary/Keyword: Converting enzyme inhibitor

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Effects of Dietary Protein on the Progression of Early Chronic Renal Failure in Subtotally Nephrectomizid Rats (저단백식이의 투여가 만성신부전증의 진행에 미치는 영향에 관한 실험적 연구)

  • Kim, Kyo-Sun;Kim, Kee-Hyuk;Kim, Sang-Yun;Kang, Yong-Joo;Maeng, Won-Jae
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.64-71
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    • 1999
  • Purpose : The protective effects of dietary protein on the progression of renal failure were studied in subtotally nephrectomized rats. Methods : Treatment groups were as follows; 5/6 nephrectomy and a normal protein ($18.5\%$) diet (NP); 5/6 nephrectomy and a low protein ($6\%$) diet (LP): 5/6 nephrectomy, a normal protein diet and converting enzyme inhibitor, enalapril (NPE): 5/6 nephrectomy, a low protein diet and enalapril (LPE). Both diets were isocaloric and had the same phosphorus content. Proteinuria, remnant kidney weight, mesangial matrix expansion score and glomerular volume were assessed at 4, 12 and 16 weeks after renal ablation. Results : LP and NP developed progressive hypertension. Eight weeks after surgery, LPE and NPE controlled hypertension. LP, LPE, and NPE had significantly less proteinuria than NP at 16 weeks (P<0.05). Kidney weight in LP were markedly less enlarged than NP (P<0.05). There was no difference in kidney weight between LPE and NPE. At 12 and 16 weeks the mesangial matrix expansion score was significantly less in LP, LPE, and NPE compared to NP (P<0.05). At 12 and 16 weeks mean glomerular volume was significantly less in LP compared to NP (P<0.05). At 12 and 16 weeks mean glomerular volume in LPE was significantly less compared to NPE. Conclusion : Dietary protein restriction afforded considerable protection from renal injury in the rat remnant kidney model. During the enalapril treatment, there was no additional protective effect of dietary protein restriction against the development of renal lesions.

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An Analysis of 94 Percutaneous Renal Biopsies (경피적 신생검 94례에 대한 분석)

  • Kang, Ho-Jung;Lim, Sang-Woo;Do, Joo-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.84-95
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    • 1995
  • A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2. The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%), mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), TypeI membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.

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Primary Dilated Cardiomyopathy in a Miniature Pinscher Dog (미니어쳐 핀셔견에서 발생한 확장성 심근질환)

  • Kim, Jung-Hyun;Park, Chul;Ko, Ki-Jin;Kang, Byeong-Teck;Jung, Dong-In;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Lee, So-Young;Cho, Sue-Kyung;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.349-354
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    • 2006
  • A 9-month-old, female Miniature Pinscher(MP) dog weighing 1.97kg was presented because of periodic syncopal episode for 5 months. This case was diagnosed as primary dilated cardiomyopathy based on respiratory distress history, weak femoral pulse, generalized cardiomegaly, pulmonary edema, marked dilation of left atrium(LA) and left ventricle(LV), decreased wall thickness of LV and interventricular septum(IVS), increased EPSS in echocardiography, and young age of onset in the absence of other cardiovascular disorders. The patient was stabilized by application of diuretics(Furosemide, 2 mg/kg, SC, q 1 hr) and venodilator(Nitroglycerine patch, 0.5 mg/kg, q 12 hrs). Clinical signs were improved with medical management of positive inotropic vasodilator(Pimobendan, 0.2 mg/kg, PO, q 12 hrs) and angiotensin-converting enzyme(ACE) inhibitor(benazepril, 0.5 mg/kg, PO, q 12 hrs), potassium gluconate gel(2 mEq/dog, PO, q 12 hrs) and, L-carnitine(50 mg/kg, PO, q 12 hrs). The dog still maintains stable clinical status 10 months after the first visit. We report the rare case of DCM in small breed dog, which corresponds to the diagnosis and treatment of typical DCM in large breed dog.

Determinants of Erythropoietin Hyporesponsiveness in Management of Anemia in Hemodialysis Patients (혈액투석 환자의 빈혈관리에서 Erythropoietin 반응에 영향을 미치는 인자)

  • Shin, Seung-Hee;Ji, Eun-Hee;Lee, Young-Sook;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.122-130
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    • 2011
  • Objective: Although recombinant human erythropoietin (rhEPO) has revolutionized the treatment of anemia in chronic kidney disease (CKD) receiving hemodialysis (HD) with no need of blood transfusion, some patients have a blunted or appear to be resistant to rhEPO. There is a controversy in the causes of rhEPO resistance in maintenance HD patients with anemia. This study is to examine current anemia treatment outcomes and the factors influencing the rhEPO responsiveness in HD patient with CKD. Methods: The clinical parameters or factors relating to erythrompoietin treatment outcomes and erythropoietin responsiveness were collected from the HD patients in two large dialysis centers for three months. The collected paramenters included serum iron, total iron biding capacity (TIBC), transferrin saturation rate, ferritin, albumin, intact PTH, C-reactive protein (CRP), nPCR and medications such as an angiotensin converting enzyme inhbitor, an angiotension II receptor blocker and an HMG-CoA reductase inhibitor (HMG-CoA RI). The data were analyzed to examine the degree of acheiveing the anemia treatment goal and factors relating to ERI. Results: Among total 111 patients, 42 (42.3%) and 47 (37.8%) patients achieved the target Hct and Hb based on the Health Insurance Review and Assessment Services (HIRA) reimbursement criteria. In the higher ERI group (upper quartile), the patients had higher CRP levels (0.5 mg/dl) (p=0.0096), and lower TIBC score (<$240{\mu}g/dl$) (p=0.0027), and less patients were taking HMG-CoA RI (p=0.0019). Male patients (p=0.0204), patients with high TIBC score ($R^2$=0.084, p=0.0021) and patients taking HMG-CoA RI (p=0.0052) required to administer less dose of rhEPO meaning higher erythropoietin responsiveness. Conclusion: Less than 50% of CKD patients were achieving the goals of anemia by erythropoietin administration in large hospitals in Korea even though the goals were lower than those of NKF-K/DOQI practice guideline. The factors influencing ERI were sex, TIBC and HMG-CoA RI administration status, and neither an ACEI nor an ARB did not influence ERI.

Prescribing Patterns of Antihypertensive Drugs by Outpatients with Hypertension in 2007 (고혈압 환자의 혈압강하제 처방양상 - 외래 처방전을 중심으로 -)

  • Sung, Ye-Na;Jang, Sun-Mee;Lim, Do-Hee;Shin, Suk-Youn;Song, Hyun-Jong;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.167-179
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    • 2009
  • Hypertension is one of the most common chronic diseases and it causes cardiovascular and cerebrovascular disease. While antihypertensive drug use increased, it took 15% of national health insurance drug expenditure. This study aimed to examine the pattern of antihypertensive drug prescription using National Health Insurance claims database and compare it with recommendations of Korea Hypertension Treatment Guidelines. Among the antihypertensive drugs, calcium channel blocker(64.4%) was most commonly prescribed class, and diuretics(44.6%), angiotensin II receptor blocker(33.3%), angiotensin converting enzyme inhibitor(11.7%) was followed. Approximately 81% of antihypertensives prescription were without cardiovascular or cerebrovascular disease, and among the comorbid conditions, diabetes(10.7%) was most common. calcium channel blocker(62.3%) was mostly prescribed class for hypertension with angina pectoris, angiotensin receptor blocker(45.3%) with myocardial infarction, diuretics(70.2%) and calcium channel blocker(49.5%) with congestive heart failure. For Hypertension with cerebrovascular disease, calcium channel blocker(68.0%) and angiotensin receptor blocker(43.3%) were prescribed mainly. When it comes to diabetes, calcium channel blocker(57.2%) was still mostly prescribed and angiotensin receptor blocker(45.9%) followed. But in hospitals and tertiary hospitals, angiotensin receptor blocker(65.7, 66.1%) was mostly prescribed for the patients with diabetes. For Hypertension with chronic renal disease, angiotensin receptor blocker(59.5%), calcium channel blocker(56.5%), diuretics(54.6%) were mainly used. Average number of classes per prescribing was $1.89{\pm}0.89$ class, average days per prescribing was $33{\pm}19$ day. Among the hypertension without comorbidity, 40.5% of prescription was monotherapy and 58.8% of polytherapy included diuretics. Among the outpatient prescriptions, calcium channel blocker was the most commonly used class, and the prescription pattern in clinic did not closely followed recommendations of Hypertension Treatment Guidelines.

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Diagnosis of Systemic Lupus Erythematosus During Medical Follow-up After Urinary Screening (학교 집단 요 검사 이상으로 추적검사 중 전신 홍반 루푸스로 진단된 1예)

  • Yoon, So-Jin;Song, Ji-Eun;Shin, Jae-Il;Jeong, Il-Cheon;Lee, Jae-Seung;Shim, Hyo-Sup;Jeong, Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.227-232
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    • 2008
  • A 16-year-old girl presented with proteinuria and microscopic hematuria detected through mass urinary screening and was diagnosed as having suspected postinfectious glomerulonephritis by renal biopsy. However, heavy proteinuria did not respond to angiotensin converting enzyme inhibitor therapy. After 6 months, cervical lymphadenitis developed and a neck node biopsy showed subacute necrotizing lymphadenitis. After an additional 2 months, she developed facial erythema and thrombocytopenia. A repeat renal biopsy demonstrated lupus nephritis class IV. She was treated with pulse methylprednisolone(500 mg/day intravenously for 3 consecutive days) followed by oral deflazacort and monthly intravenous cyclophosphamide pulse(1 g/$m^2$) for 6 months. We report a case diagnosed as systemic lupus erythematosus(SLE) during medical follow-up after urinary screening.

Characteristics and Physiological Functionalities of Unrecorded Yeasts from Wild Flowers of Seonyudo in Jeollabuk-do, Korea (전라북도 선유도일대 야생화에서 분리한 국내 미기록 효모들의 특성 및 생리기능성)

  • Hyun, Se-Hee;Han, Sang-Min;Lee, Jong-Soo
    • Microbiology and Biotechnology Letters
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    • v.42 no.4
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    • pp.402-406
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    • 2014
  • Six kinds of newly recorded yeasts such as Rhodosporidium diobovatum SY4-2, Cryptococcus bestiolae SY7-1, Kazachstania unispora SY14-1, Kazachstania servazzii SY14-3, Pichia holstii SY20-2 and Cryptococcus tephrensis SY26-1 were screened from sixty one yeasts derived from wild flowers found in Seonyudo, Gogunsanyeoldo, Jeollabuk-do, Korea. All of them grew in 50% glucose-containing yeast extract-peptone-dextrose (YPD) broth and Pichia holstii SY20-2 was also halophile, growing in 20% NaCl-containing YPD broth. All of them, except Cryptococcus tephrensis SY26-1, were assimilated to glucose. Cell-free extract from Kazachstania servazzii SY14-3 showed the highest 98.6% of ${\alpha}$-glucosidase inhibitory activity and maximal production of the ${\alpha}$-glucosidase inhibitor was obtained with 24h incubation at $30^{\circ}C$. The antihypertensive angiotensin I-converting enzyme inhibitory activity of the unrecorded yeasts were showed 58.6-80.4% in their supernatants.

Physiological Effects of Casein-derived Bioactive Peptides (카제인 유래 생리활성 Peptide의 체내 효과)

  • Jung, Ho-Jung;Min, Bock-Ki;Kwak, Hae-Soo
    • Food Science of Animal Resources
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    • v.29 no.6
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    • pp.659-667
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    • 2009
  • Casein is considered to be the main source of protein in milk; therefore, many studies have been conducted to identify casein-derived bioactive peptides and their physiological effects. Casein is inactive within the parent protein but can be liberated by various proteases and enzymatic hydrolysis during microbial fermentation and gastrointestinal digestion. Once absorbed, casein exhibits different bioavailabilities in the body. Specifically, casein-derived peptides function as angiotensin converting enzyme (ACE) inhibitor in the cardiovascular system; thus, they are expected to reduce and prevent hypertension. Additionally, casein-derived peptides behave as opioid-like peptides in the nervous system, which impacts relaxation. These peptides are also expected to modulate various aspects of immune functions. Finally, caseinophosphopeptide (CPP) and glycomacropeptide (GMP) may exhibit a number of nutritional effects such as the absorption of calcium, iron or zinc. Many studies have been conducted to evaluate casein-derived peptides due to their multifunctional properties and the results of these studies have contributed to the development of a wide variety of functional dairy products. The purpose of this paper was to review the generation of bioactive peptides, their absorption and metabolism, and their specific bioactive effects.

Imaging Diagnosis of Dilated Cardiomyopathy in a Maltese Dog

  • An, Soyon;Park, Junghyun;Mok, Jinsu;Kim, Areum;Han, Changhee;Song, Joong Hyun;Yu, Dohyeon;Hwang, Tae Sung;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.38 no.3
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    • pp.163-168
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    • 2021
  • A 6-year-old, spayed female, Maltese dog with tachypnea and dry cough was presented to Gyeongsang National University Veterinary Medical Teaching hospital. On physical examination, its respiration rate was 132 per minute. Decreased partial pressure of oxygen, partial pressure of carbon dioxide, and hyperlactatemia were found on arterial blood gas analysis. Its diastolic blood pressure was 80 mmHg. Auscultation revealed arrhythmia. Electrocardiogram revealed P pulmonale, P mitrale, and ventricular premature complexes. Thoracic radiographs revealed mild enlargement of both atrium and moderate enlargement of the left ventricular. There was also a moderate alveolar pattern in the right and caudal part of the left cranial lung lobe. Two-dimensional echocardiography showed enlargement of generalized four chambers without remarkable findings of valvular degeneration. M-mode echocardiography showed decreased left ventricular fractional shortening and enlarged left ventricular internal diameter at both end-systolic and end-diastolic. Color-flow Doppler imaging revealed eccentric turbulent flow starting below the left ventricular outflow tract and extending into the left atrium during systole. Spectral Doppler recordings revealed a high velocity flow through the mitral, tricuspid, aorta, and pulmonic regurgitation. Restrictive transmitral flow revealed high E-wave velocity, short E-wave deceleration time, and reduced A-wave velocity. There was also low ejection velocity thorough left ventricular out tract flow. Based on echocardiographic examination, dilated cardiomyopathy was the tentative diagnosis. The dog was medicated with inotropes, angiotensin converting enzyme inhibitor, and diuretics. At the 10-day following-up, the dog died suddenly. This report describes echocardiographic diagnosis and prognosis of dilated cardiomyopathy rarely reported in small breed dogs.

The Korean Cough Guideline: Recommendation and Summary Statement

  • Rhee, Chin Kook;Jung, Ji Ye;Lee, Sei Won;Kim, Joo-Hee;Park, So Young;Yoo, Kwang Ha;Park, Dong Ah;Koo, Hyeon-Kyoung;Kim, Yee Hyung;Jeong, Ina;Kim, Je Hyeong;Kim, Deog Kyeom;Kim, Sung-Kyoung;Kim, Yong Hyun;Park, Jinkyeong;Choi, Eun Young;Jung, Ki-Suck;Kim, Hui Jung
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.14-21
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    • 2016
  • Cough is one of the most common symptom of many respiratory diseases. The Korean Academy of Tuberculosis and Respiratory Diseases organized cough guideline committee and cough guideline was developed by this committee. The purpose of this guideline is to help clinicians to diagnose correctly and treat efficiently patients with cough. In this article, we have stated recommendation and summary of Korean cough guideline. We also provided algorithm for acute, subacute, and chronic cough. For chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered. If UACS is suspicious, first generation anti-histamine and nasal decongestant can be used empirically. In CVA, inhaled corticosteroid is recommended in order to improve cough. In GERD, proton pump inhibitor is recommended in order to improve cough. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, angiotensin converting enzyme inhibitor, habit, psychogenic cough, interstitial lung disease, environmental and occupational factor, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and idiopathic cough can be also considered as cause of chronic cough. Level of evidence for treatment is mostly low. Thus, in this guideline, many recommendations are based on expert opinion. Further study regarding treatment for cough is mandatory.