• Childhood Kidney Diseases
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• v.6 no.2
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• pp.169-177
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• 2002

Purpose: Hypertension accelerates the progression of chronic renal disease, whether it results from, or causes, the renal disease. Therefore, the control of hypertension is one of the important factors that retard the rate of renal deterioration. We compared the effects of different antihypertensive agents on renal function and glomerular morphology In subtotal nephrectomized rats. Materials and methods: After induction of chronic renal failure with 5/6 nephrectomy, the rats were divided into three groups; control group (Group C), enalapril group (Group E), and nicardipine group (Group N). Systolic blood pressure was measured by tail cuff method every 4 weeks until 12 weeks after nephrectomy. At 12 weeks after nephrectomy, all rats were placed in metabolic cages for 24 hour urine collections to measure urinary protein and creatinine excretion. After urine collection and blood sampling for serum creatinine, all rats were sacrificed. The renal tissue was processed for morphometric study with light microscope and electron microscope. Results: 1. The blood pressure of Group C increased progressively, but both enalapril and nicardipine prevented the development of hypertension, and the two drugs were equally effective in maintaining normal blood pressure throughout the study. 2. Twenty-four hour urinary protein excretion was lower in Group E compared to Group C and Group N 3. Mesangial expansion score in both treated groups were significantly lower than the control group. Mean glomerular volume in Group E was significantly reduced compared to Group C and Group N. There was no significant difference in mean glomerular volume between Group C and Group N. 4. There was no significant difference in podocyte structural changes, estimated by filtration slit length density, among control, enalapril and nicardipine treated groups. Conclusion: Control of hypertension with enalapril or nicardipine afforded considerable protection from mesangial expansion in the rat remnant kidney model. But protein excretion and glomerular growth were significantly reduced in Group E compared to Group N. There was no significant difference in podocyte structural changes among the 3 groups.

• The Korean Journal of Pharmacology
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• v.15 no.1_2 s.25
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• pp.45-56
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• 1979

With a view to searching after a new antihypertensive or hypotensive agents in the botanical crude plants, authors intended to reevaluate several natural products caltivated in Korea. This experiment was undertaken to compare pharmacogical actions of Machilus thunbergii Siebold et Zuccarini with those of Magnolia obovata Thunberg in anesthetized rats and in normal mice. Machilus thunbergii Sieb. et Zucc., a tree belonging to the Lauraceae family, is caltivated at Ull-ung Do, and their cortecies have been used as folk medicine mingled with those of Magnolia obovata Thunberg. These two cortecies have teen also applied in chinese medicine, it was advocated that these cortecies exerted good therapeutic effects on gastritis, convulsive abdominal pain, nausea, vomiting and urinary tract disorders. Therefore, we intended to determine the pharmacological action of two palnt of different family each other, especially their effects on blood pressure and heart rate, and also their mechanism of action were observed. We studied their action with extracts of hexane(MTHE), ether(MTEE), methanol(MTME) and water(MTWE) from Machilus thunhergii Sieb. et Zucc., and also fractionations of methanol(MOME), chloroform(MOCE) and water(MOWE) from Mapolia obovata Thunberg. The results of this experiment were as follows; 1) MTME, when intravenously administered to rats, elicited the significant hypotensive responses dependent on the administered dosage. 2) MOWE was also exhibited the hypotensive effect dependent on the treated dose. 3) Depressor effect of MTME was blocked by pretreatment with hexamethonium. 4) The hypotensive response of MOWE was blocked by pretreatment with hexamethonium or hrdralazine. 5) HTME and MOWE were also observed the anticonvulsive effect and sedative effect. These results suggested that MTME may induce the hypotensive response via central sympathetic effect, but the site of action in brain are not clarified, and the hypotensive effect of MOWE may be due to dual mechanism of central sympathetic action and direct vasodilation of blood vessel.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1061-1068
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• 2009

The treatment of pediatric patients with chronic renal disease comprises management of nutritional imbalance, fluid, electrolyte, and acid-base disturbances, mineral bone disease, anemia, hypertension, and growth retardation. The treatment also includes administration of appropriate renal replacement therapy, if required. Adequate dietary intake of carbohydrates, fats, and proteins and caloric intake must be encouraged in such patients to ensure proper growth and development. In addition, fluid, electrolyte, and acid-base status must be regularly monitored and should be well maintained. Serum calcium, phosphorus, and parathyroid hormone levels must be maintained at their target range, which are determined on the basis of the glomerular filtration rate, to avoid the development of mineral bone disease. This can be achieved by using phosphorus binders and vitamin D analogues. An erythropoiesis-stimulating agent must be administered along with iron supplementation to maintain the hemoglobin level of the patients between 11-12 g/dL. Hypertension must be controlled with adequate water and sodium balance and appropriate antihypertensive agents. Administration of recombinant human growth hormone is recommended to improve the final adult heights.

• The Korean Journal of Pharmacology
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• v.24 no.2
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• pp.153-164
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• 1988

The potential role of endogenous opioid peptides (EOPS) in cardiovascular regulation has only recently been entertained. EOPS have been localized in brain, spinal cord, autonomic ganglia, particularly the adrenal gland, and many other peripheral tissues. There are at least five major types of opioid receptors; namely ${\mu},\;{\delta},\;k,\;{\sigma},\;and\;{\varepsilon}$ and Experimental evidence indicates that cardiovascular actions of the peptide are mediated primarily by ${\mu},\;{\delta}$ and k receptors, and that these receptor types may be allosterically coupled. In anesthetized rabbits met-enkephalin decreased blood pressure and heart rate, which closely paralleled a reduction in sympathetic discharge. Naloxone, but not naloxone methobromide, antagonized these effects, which suggests a central site of action of met-enkephalin. A number of autonomic agents, particularly adrenergic ${\alpha}$-and, ${\beta}-agonists$ and antagonists modify the cardiovascular actions of met-enkephalin. Experiments in reserpine-treated and adrenalectomized rats provide no evidence of sympathetic nervous system involvement in the pressor responses to intravenous injection of opioid peptides, but rather suggest a direct peripheral action. Finally, activation of a beta-endorphinergic pathway projecting from the arcuate nucleus to the nucleus tractos solitarii in rats can cause naloxone reversible hypotension and bradycardia. There is evidence to implicate this pathway in antihypertensive drug action and in the modulation of baroreflex activity.

• Korean Journal of Adult Nursing
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• v.24 no.4
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• pp.406-416
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• 2012

Purpose: The purposes of this secondary data analysis study were first to identify the number of Korean adults achieving goals set by the American Diabetes Association for hemoglobin A1c (HbA1c), blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C), and secondly to identify the characteristics associated with lack of goals attainment. Methods: The sample was 413 Koreans with diagnosed diabetes aged thirty years or older who participated in the Fourth Korea National Health and Nutrition Examination Survey. Goals attainment for HbA1c, BP, and LDL-C were presented in percentages. Logistic regressions were used to examine associations between participants' characteristics and lack of goals attainment. Results: About 48% had HbA1c<7%, 48.2% had BP<130/80mmHg, and 34.1% had LDL-C<100mg/dL. Only 8.7% of the sample achieved all three parameters. In multivariate analysis, younger age, longer diabetes duration, insulin use, and abdominal obesity were associated with not meeting HbAlC goal. Smoking and use of antihypertensive medication were associated with BP${\geq}$130/80 mmHg. No use of lipid lowering agents was associated with LDL-C${\geq}$100 mg/dL. Conclusion: Many Koreans with diabetes were not at goals for HbA1c, BP, and LDL-C. For optimal control, appropriateness of therapy and poor lifestyle habits should be assessed periodically and managed accordingly.

• Korean Journal of Pharmacognosy
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• v.10 no.3
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• pp.125-135
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• 1979

This study was undertaken to search for a new antihypertensive or hypotensive agents in natural crude products in Korea. Betula schmidtii Regel, a tree belonging to the Betulaceae family, is cultivated for the most part of our country, and their cortecies or tree milk has been used as folk remedy, which exerted good antiinflammatory effect on rheumatic fever, arthritis or rheumatism. The rats were treated with several extracts from Betula schmidtii Regel, that is, extracts of water, methanol from inner cortecies, extracts of ether, methanol, hexane, chloroform or butanol from outer and total cortecies. In this experiment, we measured the blood pressure and heart rate in anesthetized rats, and atropine, diphenhydramine, phentolamine, propranolol, epinephrine, hexamethonium and hydralazine were pretreated prior to Betula extracts to clarify the mechanism of the hypotensive action. The results of the experiment were as follows; 1. BOIE(Betula outer cortex water-insoluble extract) and BICE(Betula inner cortex chloroform extract) elevated the blood pressure and heart rate. 2. BIME(Betula inner cortex methanol extract), BIBE(Betula inner cortex butanol extract) and BIWE (Betula inner cortex water extract) significantly lowered the blood pressure and heart rate. 3. With the pretreatment of hydralazine, the hypotensive effect of Betula schmidtii Regel was significantly blocked. From the above results, it is suggested that the hypotensive effect of Betula schmidtii Regel is due to the direct vasodilation of blood vessel.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.1131-1141
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• 2021

Objective: This study examined the case of a 63-year-old man with a history of hypertension and gout who had developed an intracerebral hemorrhage (ICH) of the right basal ganglia of the corona radiata. Methods: The patient was treated with herbal medicine (Boyanghwanoh-tang and powdered Oryeong-san extract), Western medicine (Anticonvulsants, antihypertensive drugs, psychotropic agents, and others), acupuncture, moxibustion, cupping, and rehabilitative therapy. Their effects were evaluated using the Manual Muscle Test (MMT), Korean version of the modified Barthel Index (K-MBI), National Institute of Health's Stroke Scale (NIHSS), and Modified Rankin Scale (mRS). Results: After treatment, the MMT grade improved from 3/3+ to 4+/4+. Additionally, the K-MBI score improved from 62 to 77. Conclusion: The results suggest that combined traditional Korean and Western medicine can effectively treat patients with ICH.

• The Journal of Internal Korean Medicine
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• v.43 no.3
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• pp.436-443
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• 2022

Objectives: This study examined the case of a 69-year-old man with a history of stroke and Alzheimer's disease who had been diagnosed with probable-rapid eye movement sleep behavior disorder (probable-RBD). Methods: The patient was treated with herbal medicine (Ukgan-san, Ukgansangayonggolmoryeo-tang, and powdered Gamisoyo-san extract), Western medicine (clonazepam, antiplatelet, psychotropic agents, antihypertensive drugs, and others), and acupuncture. Their effects were evaluated by the frequency and severity of sleep-related behavioral symptoms. Results: After treatment, the observed frequency and severity of sleep-related behavior decreased. Conclusion: The results suggest that using traditional Korean medicine with clonazepam can be effective in the treatment of patients with probable-RBD.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.330-339
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• 2012

Background : Hypertension is treated with both lifestyle modification and pharmacotherapy. The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7), published in 2003, provides a streamlined management approach to hypertension for the primary care physician. The JNC-7 is the gold standard also in Korea. According to the JNC-7, special therapeutic considerations are recommended for high-risk individuals with compelling indications. The presence of compelling indications in any given patient should be considered when selecting specific pharmacotherapy to treat hypertension. However, in patients with compelling indications, it is unknown that hepatotoxicity is caused by Calcium Channel Blocker (CCB), one of 1st anti-hypertensive drugs. Now, the CCB is the most used 1st anti-hypertensive drug in Korea Therefore, we evaluated the changes in blood liver function parameters (ALT, AST, Total bilirubin, serum albumin) for the study group. Methods : We randomly collected and retrospectively analyzed Electronic Medical Record data (n=28,788) of patients, and who took calcium channel blockers(non-dihydropyridines; diltiazem, verapamil, dihydropyridines; amlodipine, barnidipine, benidipine, clinidipine, efonidipine, felodipine, isradipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine), with having liver function tests (LFTs) from July 1st 2009 to June 30th 2010 at the Seoul National University Hospital in Korea. Control groups are two antihypertensive agents: RAS blockade (ARB; candesartan, irbesartan, losartan, olmesartan, telmisartan, valsartan, ACE-I; cilazapril, enalapril, fosinopril, imidapril, perindopril, ramipril) and, Diuretics (loop; furosemide, torsemide, thiazide; hydrochlorothiazide[HCTZ], indapamide). Patients not having LFT results at these three standard points of time(baseline, during, medication, and after finishing medication) were excluded. The collected data were analyzed by using the SPSS (Version12.0) and Microsoft Excel (Version2007). Results : 711 patients who were treated CCB (297), RAS blockade (232) or Diuretics (182) monotherapy were selected for the study. In selected patients, liver damage degree(changes of each LFTs value) was higher in diuretics group than other groups, followed by RAS blockade and CCB. In diuretics group's was loop-diuretics group was higher than thiazide-diuretics group. In CCB group, Nondihydropyridine-CCB's damage degree was higher than Dihydropyrine-CCB's that. Conclusions : Despite the limitations due to the retrospective study, among patients with abnormal LFTs, the use of CCBs led to a less liver damage than other 1st anti-hypertensive agents. It can be recommended CCBs as one of the initial treatments of hypertension in patients with liver disease.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.45-53
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• 2018

Background: Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA. Methods: Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay. Results: There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group ($13.3{\pm}4.6days$ in the GA group vs. $8.5{\pm}2.4days$ in the RA group, p<0.001). Conclusion: In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.