• Advances in pediatric surgery
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• 제3권1호
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• pp.71-76
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• 1997

A 3-year-old boy with a Wilms' tumor had unusually severe hypertension, polydipsia, polyuria and hypokalemia. Physical examination on admission was unremarkable except for the presence of a smooth, firm mass in the right abdomen. Computerized tomography showed a tumor occupying the upper two thirds of the right kidney. Plasma renin activity and aldosterone concentration were markedly elevated, 37.7 mg/ml/hour(normal in supine position 0.15-2.33 mg/ml/hour) and 120.1 ng/dL(normal in supine position 1 to 16 ng/dL), respectively. Hypertension varied from 150/90 mmHg to 240/180 mmHg, and was not effectively controlled by antihypertensive drugs. Right nephrectomy was performed on the sixth hospital day. At laparatomy, there was no evidence of mechenical compression of the renal artery by the tumor. The tumor, about 8 cm in diameter, was confined to the renal capsule without involvement of the renal blood vessels at the hilum. Histopathology was Wilms' tumor of favorable histology. On electron microscopy, tumor cells contained intracytoplasmic electron dense secreting graules, suggesting the possibility of renin secreting tumor cells. Shortly after nephrectomy, signs and symptoms were relieved dramatically, and plasma renin activity and aldosterone concentration were also decreased to normal.

• The Korean Journal of Physiology
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• 제30권1호
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• pp.33-41
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• 1996

The present study was aimed to investigate the role of endothelium-derived nitric oxide (NO) in the control of renin release and to examine if NO is implicated in the development of two-kidney, one clip (2K1C) hypertension. Male Sprague-Dawley rats $(150{\sim}200\; g)$ were constricted at the left renal artery. They were then supplemented with $N^{G}-nitro-L-arginine\;methyl\;ester\;(L-NAME,\; 5mg/100\;mL)$ or with L-arginine hydrochloride (400 mg/100 mL) in the drinking water. The control group was supplied with normal tap water. The sham-clipped rats were operated as in 2K1C rats except for that no clip was made. The kidneys were taken to examine in vitro release of renin at days 7 and 14 following clipping the renal artery. Northern blot analysis was also done to assess the expression of renin gene in the kidney. In sham-clipped rats, L-NAME caused a sustained increase of the blood pressure, whereas L-arginine was without effect. Neither L-NAME nor L-arginine-supplementation significantly affected the development of hypertension in 2K1C rats. Plasma renin concentration (PRC) measured on day 28 did not significantly differ among the L-NAME, L-arginine and control groups either in 2K1C or in sham-clipped rats. Renin contents (RRC) in the clipped kidney were increased, while those in the contralateral kidney were decreased. The release of renin in vitro from cortical slices was also enhanced in the clipped kidney, whereas it was attenuated in the contralateral. Comparing the RRC and in vitro release, the latter was more rapidly decreased than the former in the contralateral kidney. The renin mRNA levels in the contralateral kidney were almost at their nadir at days 7 and 14 in 2K1C rats. It is suggested that NO does not affect the development of 2K1C hypertension in which the renin-angiotensin system has been activated. The data also confirm that RRC and renin gene expression are increased in the clipped kidney and suppressed in the contralateral kidney in 2K1C rats.

• Journal of Nutrition and Health
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• 제34권4호
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• pp.409-416
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• 2001

In order to evaluate the effect of habitual Na and Ca intake on blood pressure regulation, we measured the habitual dietary intakes of Na and Ca, urinary excretion of Ca, Na and K, and plasma level of renin activity, aldosterone, and indices of Ca metabolism in 27 untreated hypertensive women and 30 age-matched normal women on a free diet. Hypertensive and total subjects were divided into four groups according to habitual dietary intakes of Na and Ca as low Na-low Ca(LNLC), low Na-high Ca(LNHC), high Na-low Ca(HNLC), and high Na-high Ca(HNHC). HNLC hypertensive group showed the lowest level of plasma renin activity, 25-(OH) Vit D$_3$, calcitonin and serum total Ca, and presented the highest level of PTH and urinary excretions of Na/K and Ca/Cr. There were no significant difference in plasma level of aldosterone and urinary excretion of Na and K among four hypertensive groups. When all subjects were divided into four groups according to the same method, HNLC group showed the highest level of blood pressure with no statistical significance and the lowest level of calcitonin and total serum Ca. The above results indicated that renin-aldosterone system and Ca regulating hormone has a mutual relationship in hypertension. Na and Ca may interact each other, rather than affecting independently blood pressure control. As a result, considering the fact that daily balance of Na and Ca intakes affects Na and Ca regulating hormones and urinary excretion of Na and Ca, it may be involved in blood pressure control. These results suggest that maintaining an adequate intake of Ca with less intake of Na may prevent from the risk of hypertension. (Korean J Nutrition 34(4) : 409~416, 2001)

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.516-530
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• 1991

일상생활을 통한 연섭취로 인한 고혈압 발생 가능성 및 이때 연이 혈압에 영향을 미칠 수 있는 기전을 밝히기 위한 연구의 일환으로 환자 대조군 연구를 실시하였다. 대상자로서 울산 및 그 인근지역의 직업적 연폭로 과거력이 없는 남자 근로자 중 고혈압 환자 72명, 대조군 69명을 선택하였다. 혈중 연과 혈장레닌활성도(Plasma renin activity, PRA)를 측정하였으며 동시에 흡연유무, 음주유무, 고혈압 가족력 유무를 확인하고 body mass index(BMI), 혈청 소디움, 포타시움, 이온화 칼슘, 크레아티닌 및 총 콜레스테롤을 측정하였다. 고혈압군의 혈중 연농도는 $19.8{\pm}5.5{\mu}g/dl$로서 대조군의 $12.5{\pm}4.7{\mu}g/dl$에 비해 유의하게 높았고(p<0.01) 또한 혈중 연의 고혈압발생에 대한 교차비(odds ratio)가 1.38로서 역시 유의하였다(p<0.01). PRA나 In(PRA)가 고혈압군과 대조군 사이에 유의한 차이가 없었으나 고혈압군에서 혈중 연농도가 증가함에 따라 PRA도 어느정도 증가하는 양상을 보였고(p<0.1), In(PHA)를 종속변수로 하는 중회귀분석을 실시하였을 때 혈중 연농도(회귀계수 ; 0.037)가 10% 수준에서 유의하였다. 본 연구를 통해 볼 때, 지금까지 알려진 정상치 범위 이내의 혈중 연과 고혈압 발생간의 인과 관계에 대해 계속 연구해 볼 필요성을 느끼며 이때 PRA의 변화가 작용 기전의 일부에 관여할 가능성이 있을 것으로 추측된다.

• 대한약리학회지
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• 제30권1호
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• pp.75-86
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• 1994

선천성 고혈압 흰쥐(SHR)와 정상혈압 흰쥐에서 교감신경성 신경전달에 미치는 부신수질 및 renin-angiotensin계의 역할을 알아보기 위해, 부신수질을 제거하거나 angiotensin 변환 효소 억제제를 장기간 처치한 뒤 중추신경계가 파괴된 상태에서 절전신경을 자극했을 때 나타나는 승압반응과 대동맥의 catecholamine농도 및 angiotensin 변환 효소 활성도의 변화를 비교 검토하였다. 부신수질을 제거하더라도 중추신경계를 파괴하기 전후의 혈압에는 영향을 주지 못했으며, 절전 신경 자극에 의한 승압반응은, 자극 주파수에 의존적으로 증가하였으며 prazosin 전처치로서 거의 완전히 억제되었다. 정상혈압 흰쥐에서와는 달리, 선천성 고혈압 흰쥐에서는 부신수질을 제거했을 때는 절전신경 자극에 의한 승압반응이 부신수질을 제거하지 않는 군(이하 대조군)에 비하여 유의하게 약화되었다. SHR에서 부신수질 제거로 부신 catecholamine 함량은 현저히 감소되었고, 혈청의 angiotensin 변환 효소 활성도는 감소되는 경향을 나타내었다. 그러나 혈장 및 대동맥 절편의 catecholamine 함량, 대동맥 절편의 angiotensin 변환 효소의 활성도는 대조군과 유의한 차이가 없었다. 그러나 WKY에서는 부신수질이 제거된 군에서 대동맥 절편의 angiotensin 변환 효소의 활성도와 catecholamine함량이 대조군에 비해 유의하게 증가되어 있었다. Enalapril처치에 의해서 선천성 고혈압 흰쥐 평균 혈압은, 부신 catecholamine 함량 및 대동맥 절편의 angiotensin 변화 효소의 활성도와 함께 현저히 저하되어 정상혈압 흰쥐와 유사하였다. 그리고 선천성 고혈압 흰쥐에서 부신수질의 제거로 절전신경 자극에 의한 승압반응이 대조군에 비하여 약화되는 현상은 enalapril을 처치하였을 때는 관찰되지 않았다. 이상의 결과로 미루어보아 교감신경성 신경전달을 항진시키는 부신수질의 작용은 renin-angiotensin계의 활성화에 의존적이었으며, 부신수질의 제거로 정상혈압 흰쥐에서는 renin-angiotensin계가 보상적인 조절이 일어났으나, 선천성 고혈압 흰쥐에서는 보상적인 조절이 일어나지 않았다.

• The Korean Journal of Physiology
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• 제23권1호
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• pp.43-49
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• 1989

Atrial natriuretic peptide (ANP)의 혈압조절에 대한 효과를 구명하기 위하여 2-kidney, 1-clip 흰쥐의 고혈압 발생에 미치는 ANP의 영향을 조사하였다. 실험군은 왼쪽 신동맥에 clip을 끼우고 경정맥내에 지속적으로 ANP를 주입한(atriopeptin III, 500 ng/h) 군으로 하였으며, 대조군은 clip을 끼웠으나 ANP를 주입하지 않은 군으로 하였다. Clip을 끼우기 전과 clip을 끼운 제 4,7,10일에 꼬리동맥으로부터 혈압을 측정한 후 단두하여 혈액을 채취하고 양측 신장을 떼어내어 renin 치를 구하였다. ANP 주입군은 대조군에 비하여 고혈압의 발생이 약화되었고 혈장 renin활성도가 유의하게 낮았으나 신피질 renin함량은 양군간에 유의한 차이가 없었다. 한편 clip을 끼우지 않은 흰쥐에서는 ANP 주입군과 비주입군간에 혈압, 혈장 renin 활성도와 신피질 renin 함량 등이 모두 서로 유의한 차이를 보이지 않았다. 이상의 실험결과는 지속적 ANP 주입이 2-K, 1-C 흰쥐의 고혈압 발생을 방지하지는 못하였으나 약화시켰음을 보여주었으며, ANP는 적어도 부분적으로는 renin-angiotensin계를 길항하므로써 장기적 혈압 조절에 관여하는 것이 시사되었다.

• 핵의학기술
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• 제25권1호
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• pp.29-33
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• 2021

PRA 검사는 치료 가능한 고혈압 질환 중 하나인 일차성 알도스테론증의 선별 진단에 이용되는 검사 중 하나이다. 혈장의 레닌은 체외에서 변형이 쉬운 물질이며 온도 변화에 민감한 것으로 알려져 있다. 본 연구에서는 검체의 보관온도와 해동온도에 차이를 두어 각각의 결과 차이를 비교 분석하고, PRA 검사의 정확한 결과 보고를 위한 치침의 마련과 재현성을 높일 수 있는 방안을 마련하고자 하였다. 본원에 의뢰된 PRA 검체 43건에 대하여 냉동보관 혈장 분리 자검체와 냉장보관 EDTA tube의 혈장을 재검사 실시하였다. 본검사를 기준으로 회귀분석과 bland-altman plot, 백분율을 비교하여 결과를 분석하였다. 또한, 해동온도에 따른 결과 비교를 위하여 PRA 검체 13건에 대하여 각각 실온해동과 냉장해동을 실시하였다. 실험을 마친 뒤, 다시 얼리고 2차 실온해동과 냉장해동을 실시하여 본검사를 기준으로 결과를 회귀분석하였다. 혈장 분리된 자검체 재검사를 시행한 결과는 y = 1.2048x + 1.046(R=0.8501, n=43)이며, 냉장보관 EDTA tube의 혈장으로 재검사한 결과는 y = 1.0594x + 0.1365 (R=0.9966, n=41)였다. Bland-altman plot에서 본실험과 차이에 대한 평균이 EDTA tube 혈장 재검사한 결과가 0.24, 냉동보관 자검체 재검사한 결과가 1.4로 냉장 보관 EDTA tube의 혈장이 높은 상관관계를 나타내었다. 해동온도에 차이를 두고 비교실험 한 결과, 1차 실온해동한 결과보다 2차 실온해동한 결과의 평균 백분율이 증가한 것으로 나타났다. 동일하게, 1차 냉장해동 결과보다 2차 냉장해동 결과의 평균 백분율이 증가하였다. 본 연구를 통해 PRA 검체의 보관 방법과 해동 온도에 따른 결과변화를 비교 분석한 결과, 냉장 보관된 원검체 EDTA tube 혈장의 재검사 결과가 더 높은 상관관계를 나타내었다. 또한, 해동 시 온도에 상관없이 혈장분리 자검체의 반복적인 얼림과 녹임이 PRA 결과에 영향을 미치는 것으로 나타났다. 따라서 PRA의 재검사 시에는 냉장 보관 중인 원검체 EDTA tube에서 혈장을 다시 채취하여 검사하는 것이 검사 결과의 오차를 줄이고 재현성을 높일 수 있을 것으로 사료된다.

• The Korean Journal of Physiology
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• 제23권1호
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• pp.67-78
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• 1989

Since the atrial receptor was suggested to be involved in the control of extracellular fluid volume, it has been shown that the granularity of atrial cardiocytes can be changed by water and salt depletion, and that an extract of atrial tissue, when injected intravenously into anesthetized rats, causes a large and rapid increase in renal excretions of sodium and water. The immunoreactive atrial natriuretic peptide (ANP) has been found in the plasma of patients suffering from various cardiovascular diseases. A high level of ANP in the plasma has been reported in essential hypertension. Several studies on the effects of ANP on renal function and arterial blood pressure have presented contradictory results showing attenuated or accentuated responses. Thus, involvement of the ANP in the development of hypertension remains unresolved. Present study was undertaken to investigate whether the ANP is involved in the development of hypertension in two-kidney one-clip Goldblatt hypertensive rats. The plasma concentration of immunoreactive ANP appeared to be significantly elevated in hypertensive rats as compared with normotensive Goldblatt operated and sham-operated rats. Plasma renin concentration was higher in hypertensive rats than in normotensive rats, as observed in earlier experiments. Intravenous infusions of ANP resulted in increases of urine flow and urinary excretions of sodium and potassium in both hypertensive and normotensive rats. The renal response to ANP was markedly accentuated in Goldblatt hypertensive rats. The plasma concentration of ANP showed a linear relationship with the arterial blood pressure. Infusions of ANP reduced blood pressure both in hypertensive and normotensive rats. These results suggest that in Goldblatt hypertensive rats an elevation of ANP level in the plasma may not be a cause, but instead a consequence of hypertension, and that the renal responsiveness to the ANP is accentuated by some unknown mechanisms.

• 한방안이비인후피부과학회지
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• 제12권2호
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• pp.53-66
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• 1999

This study has been carried out to investigate the effects of Dojuksan on the renal functions and internal secretion system, as water balance, urine volume, urinary excretion of sodium and potassium, free water clearance, urinary excretion of creatinine, plasma levels of artrial natriuretic peptide (ANP), plasma levels of aldosterone and plasma renin activity, comparing experimental group which Dojuksan water extract were administrated with control group. Sprague-Dawley rats, about 200-250 g, were used for this experiment. The results of this study were as follows: 1. Water balance decreased significantly after the administration of Dojuksan water extract. 2. Urine volume increased significantly after the administration of $100{\mu}l$ Dojuksan water extract per 100g rat. 3. Urinary excretion of sodium increased significantly but urinary excretion of potassium did not change after the administration of Dojuksan water extract. 4. Free water clearance decreased significantly after the administration of Dojuksan water extract 5. Urinary excretion of creatinine increased significantly after the administration of Dojuksan water extract 6. Plasma renin activity did not change after the administration of Dojuksan water extract 7. Plasma levels of artrial natriuretic peptide (ANP) did not change after the administration of Dojuksan water extract 8. Plasma levels of aldosterone decreased significantly after the administration of 200 ${\mu}Dojuksan water extract per l00g rat The results suggest that Dojuksan increase the urinary excretion of sodium. and thus reduce the water balance, which resulted from suppression of sodium reabsorption into renal tubule by increasing glomerular filtration rate and decreasing aldosterone.

• The Korean Journal of Physiology and Pharmacology
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• 제1권2호
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• pp.151-159
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• 1997

In an attempt to investigate whether hemorrhage affects the gene expression of the renin-angioteusin system (RAS) components in the brain and peripheral angiotensin-generating tissues, changes in mRNA levels of the RAS components in response to hemorrhage were measured in conscious unrestrained rats. Wistar rats were bled at a rate of 3 ml/kg/min for 5 min, and then decapitated 7 h after hemorrhage. Levels of mRNA for renin, angiotensinogen and angiotensin $II-AT_1$ receptor subtypes ($AT_{1A}$ and $AT_{1B}$) were determined with the methods of northern blot and reverse transcriptase-polymerase chain reaction (RT-PCR). Hemorrhage produced a profound hypotension with tachycardia, but blood pressure and heart rate recovered close to the basal level at 7 h. Plasma and renal renin levels were significantly increased at 7 h. Hemorrhage induced rapid upregulation of gene expression of both $AT_{1A}$ and $AT_{1B}$ receptor subtypes in the brainstem and hypothalamus, downregulation of them in the adrenal gland and liver. However, renin mRNA level increased in the brainstem, decreased in the liver, but was not changed in the hypothalamus, kidney and adrenals after hemorrhage. Angiotensinogen mRNA level was not significantly changed in any of the tissue except a slight increase in the liver. The kidney and liver did not show any significant change in gene expression of the RAS components. These results suggest that gene expression of the RAS in central and peripheral tissues are, at least in part, under independent control and the local RAS in each organ plays specific physiologic role.