• Journal of Chest Surgery
• /
• v.20 no.1
• /
• pp.171-176
• /
• 1987

Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and its major branches. Symptoms and signs of the disease are various depending on the involved area. We experienced a surgical case of Takayasu`s arteritis mainly involving both renal arteries with renovascular hypertension in a 13 year old girl. Hypertension was not controlled by medical treatment including diuretics and captopril [160/140 mmHg]. Aortogram showed severely stenosed right renal artery, nearly obstructed left renal artery and not visulalized superior mesenteric artery. Angioplasty was performed for the right renal artery but aorta-renal bypass graft with greater saphenous vein was inevitable for the left renal artery. Blood pressure was controlled sufficiently with some adjunct of captopril postoperatively [130/90 mmHg]. While the patient was discharged with much improvement, she was lost follow up and died of not identified definitive cause 3 months later.

• Journal of Chest Surgery
• /
• v.25 no.2
• /
• pp.200-204
• /
• 1992

A 63 year old male had suffered from hypertension and angina pectoris for 4 years, On physical examination, blood pressure was 150/110 mmHg with medication of antihypertensive drugs. Aortogram showed the stenosis of the left renal artery, the complete occlusion of the right renal artery, and atherosclerotic change of abdominal aorta. Blood urea nitrogen was 25 mg/dl, serum creatinine was 1.2 mg/dl, and renin activity in peripheral blood was 8.7 ng /ml /hour, The stenosis of left renal artery and the complete occlusion of right renal artery should have produced the renovascular hypertension Bilateral aorto-renal bypasses with saphenous grafts were done for treatment of ren-ovascular hypertension Postoperatively, blood pressure was normalized with only small dosage of antihypertensive drugs.

• Journal of Chest Surgery
• /
• v.14 no.2
• /
• pp.175-178
• /
• 1981

Since the first report by Freeman of renal artery repair for renovascular hypertension in 1954, there has been a gradual improvement in the results of renovascular reconstruction. This is case report of renovascular hypertension due to diffuse primary arteritis, which was performed aorto-bllateral renal bypass graft with using of Y -woven dacron graft. This 33 y-o male has complained intermittent headache, facial edema & malignent hypertension symptoms for 1.5 years. He had the history of Rt. B-K amputation due to unhealed wound after trauma of the Rt. great toe about 7 years ago. The abdominal aortography revealed nearly not visualized the Rt. renal artery & severe narrowing of the Lt. renal arterly. During postop. course, Blood pressure was well controlled. At postop. 3rd week, systolic pressure was down to 130-140mmHg But, diastolic pressure was remained to 100-110mmHg. At postop. 30th day, exploration was done due to intestinal obstruction signs. But severe ischemic enteritis was occured due to fibrotic obstruction of the superior mesenteric artery. The next day, he was dead. in spite of Rt. common iliac artery-sup. mesenteric artery bypass graft.

• Childhood Kidney Diseases
• /
• v.18 no.1
• /
• pp.51-55
• /
• 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.

• The Korean Journal of Physiology
• /
• v.23 no.1
• /
• pp.67-78
• /
• 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.

• Korean Journal of Pharmacognosy
• /
• v.15 no.4
• /
• pp.179-187
• /
• 1984

To investigate the recorded efficacy in Oriental medical references and effects in clinics, experimental studies were undertaken to estimate 'Palmiwhan' to the diuretic effect in normal rats, rabbits and rats with $HgCl_2-induced$ acute renal failure and hypotensive effects on the nephrogenous hypertension in rabbits with $HgCl_2-induced$ acute renal failure. The results of this study were summarized as follows; Increase in urinary volume, urinary $Na^+\;and\;Cl^-$ excretions were significantly recognized in normal rats and rabbits. Increase in urinary volume, urinary $Na^+\;and\;Cl^-$ excretions were significantly shown in rats with 2mg/kg $HgCl_2-induced$ acute renal failure. Although plasma electrolyte and creatinine levels were little affected, plasma urea nitrogen levels were significantly elevated in normal rats and 2mg/kg $HgCl_2-induced$ acute renal failure of rats. Although the blood pressure was not affected in normal rabbits and cats, hypotensive actions due to the diuretic effect were recognized in rabbits $HgCl_2-induced$ acute renal failure.

• The Korean Journal of Physiology and Pharmacology
• /
• v.3 no.3
• /
• pp.351-356
• /
• 1999

The present study was aimed at investigating whether the calcium current in the vascular smooth muscle (VSM) cells is altered in renal hypertension. Two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension were made in Sprague-Dawley rats. Rats without clipping the renal artery or implanting DOCA were used as control for 2K1C and DOCA-salt hypertension, respectively. Four weeks after clipping, systolic blood pressure was significantly higher in 2K1C rats than in control $(192{\pm}24\;and\;119{\pm}4$ mmHg, respectively, n=16 each). DOCA-salt rats also showed a higher blood pressure $(180{\pm}15$ mmHg, n=18) compared with control $(121{\pm}6$ mmHg, n=14). VSM cells were enzymatically and mechanically isolated from basilar arteries. Single relaxed VSM cells measured $5{\sim}10\;{\mu}m$ in width and $70{\sim}150\;{\mu}m$ in length were obtained. VSM cells could not be differentiated in size and shape between hypertensive and normotensive rats under light microscopy. High-threshold (L-type) calcium currents were recorded using whole-cell patch clamp technique. The amplitude of the current recorded from VSM cells was larger in 2K1C hypertension than in control. Neither the voltage-dependence of the calcium current nor the cell capacitance was significantly affected by 2K1C hypertension. By contrast, the amplitude of the calcium current was not altered in DOCA-salt hypertension. These results suggest that high-threshold calcium current of the VSM cells is altered in 2K1C hypertension, and that calcium channel may not be involved in calcium recruitment of VSM in DOCA-salt hypertension.

• The Korean Journal of Physiology and Pharmacology
• /
• v.2 no.4
• /
• pp.455-460
• /
• 1998

The present study was aimed at investigating whether the development of hypertension is related with an altered expression of nitric oxide synthases (NOS) in the kidney. By Western blot analysis, the expression of bNOS and ecNOS isoforms was determined in the kidney of deoxycorticosterone acetate (DOCA)-salt and two-kidney, one clip (2K1C) rats. In DOCA-salt hypertension, the expression of both bNOS and ecNOS was decreased, along with tissue contents of nitrites. In 2K1C hypertension, the nitrite content of the clipped kidney was decreased along with ecNOS levels, whereas neither the nitrite content nor the expression of NOS isoforms was significantly altered in the contralateral non-clipped kidney. These results suggest that the development of hypertension is associated with an altered renal expression of NOS and nitric oxide generation in DOCA-salt and 2K1C rats.

• Childhood Kidney Diseases
• /
• v.14 no.2
• /
• pp.223-229
• /
• 2010

Percutaneous transluminal renal angioplasty (PTRA) is the current treatment of choice for renal artery revascularization, but renal autotransplantation has been an alternative treatment for complex cases. Here we report a 14-year-old boy with severe hypertension successfully treated with PTRA and renal autotransplantation. Doppler ultrasonography and computed tomography (CT) angiography revealed slight narrowing in the right renal artery ostium and complete obstruction in the left renal artery ostium with multiple collaterals. PTRA with stent insertion was performed for the treatment of the right renal artery, but it was impossible for the left renal artery due to the total obstruction. Therefore, left nephrectomy for autotransplantation was done with the peritoneal approach and the left kidney was autotransplanted to the ipsilateral iliac fossa. Postoperatively, Doppler ultrasonography and mercapto-acetyl-triglycine (MAG-3) renogram were performed, which showed normal renal artery blood flow and kidney function. Blood pressure was normalized and anti-hypertensive drugs were gradually tapered. Fibromuscular dysplasia was suspected to be responsible for the renal artery stenosis based on clinical aspects. In conclusion, renal autotransplantation is also a good treatment option for children with severe renovascular hypertension when endovascular treatment has failed or is not possible.

• Korean Journal of Acupuncture
• /
• v.19 no.1
• /
• pp.47-56
• /
• 2002

The frequency of the hypertension is increasing as the life level is improved and an average span of the life is extended since we approached modern stage. The hypertension is also dangerous disease which raises fatal complication for example with the bleeding aproplexy and the ischemic attack. The medicinal treatment about the hypertension is required patients to take continually. The acupuncture have been introduced because a medicine-chemical treatment hasn't good influence on the human body. It recently has been processed that studies acupuncture effect for blood pressure and have been found out that blood pressure go down. The object of this study observe the effect of LR3 acupuncture on hypertension in Renal Hypertension RAT induced by 2K1C. The 2K1C model was based on renin-angiotensin system. We put the silver clip in renal artery to induce renal hypertension. We try to observe that LR3 acupuncture influence on the blood pressure and c-fos expression in CVLM, NTS, RVLM. In results, the blood pressure was decreased during acupuncture than before acupuncture, after acupuncture. The heart rate was also decreased during acupuncture than before acupuncture, after acupuncture. The LR3 acupuncture significantly effects on blood pressure and heart rate (P<0.05). The increased expression of c-fos was shown in CVLM, NTS, but not in RVLM. In conclusion, LR3 was relived the action of control upon the hypertension and related with medulla, particularly CVLM, NTS. It needs to be closely examined pharmacological mechanism and studied combination with other acupoints.