• Endocrinology and Metabolism
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• 제33권4호
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• pp.485-492
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• 2018

Background: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Therefore, we investigated the impact of altered calcium homeostasis caused by excessive aldosterone on cardiovascular parameters in patients with PA. Methods: Forty-two patients (mean age $48.8{\pm}10.9$ years; 1:1, male:female) whose plasma aldosterone concentration/plasma renin activity ratio was more than 30 were selected among those who had visited Severance Hospital from 2010 to 2014. All patients underwent adrenal venous sampling with complete access to both adrenal veins. Results: The prevalence of unilateral adrenal adenoma (54.8%) was similar to that of bilateral adrenal hyperplasia. Mean serum corrected calcium level was $8.9{\pm}0.3mg/dL$ (range, 8.3 to 9.9). The corrected calcium level had a negative linear correlation with left ventricular end-diastolic diameter (LVEDD, ${\rho}=-0.424$, P=0.031). Moreover, multivariable regression analysis showed that the corrected calcium level was marginally associated with the LVEDD and corrected QT (QTc) interval (${\beta}=-0.366$, P=0.068 and ${\beta}=-0.252$, P=0.070, respectively). Conclusion: Aldosterone-mediated hypercalciuria and subsequent hypocalcemia may be partly involved in the development of cardiac remodeling as well as a prolonged QTc interval, in subjects with PA, thereby triggering deleterious effects on target organs additively.

• Journal of Radiation Protection and Research
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• 제12권2호
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• pp.9-18
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• 1987

천연 우라늄의 주독성이 중금속독성인지 혹은 방사성장해독성인지를 알기 위하여 질산납과 질산우라늄을 투여하여 변동되는 혈중 BUN, Creatinine, C-AMP 및 $PGE_2$의 활성도를 측정 비교하였다. 질산우라늄 투여시 비호소계인 질산대사의 임상적 지표인 BUN 및 Creatinine값은 질산납 투여군에 비교하여 예민한 반응을 나타났으나 C-AMP의 활성도에는 의의있는 변화가 없었다. 한편 질산 우라늄의 농도 변화에 따른 $PGE_2$ 활성도의 변동은 질산납 투여와 달리 현저하게 증가 되는 것을 관찰하였다. 이 결과는 천연우라늄의 저준위 방출 방사선이 세포막에 반응하여 $PGE_2$농도에 변화를 주는 것으로 사료된다. 질산 우라늄의 투여로 증가된 혈중 $PGE_2$의 농도를 감퇴시킴에 있어 Glucagon, Aldosterone 및 Furosemide를 사용하였다.

• 동의생리병리학회지
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• 제20권6호
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• pp.1485-1496
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• 2006

Various kinds of related parameters on hypertension such as anti-oxygen effect, ACE, weight of body, hwart and kidney, blood pressure, heartbeat rates, contents of aldosterone, catecholamine, change rates, of plasma constituents, uric acid, BUN, creatinine were determined to verify the effects on hypertension by Kamisamul-tang (KSMT). And the results are concluded as follows. KSMT did not show any cytotoxicity at the range of concentration (1-250 ${\mu}g/m{\ell}$) on the human fibroblast cell (hFCs). KSMT decreased the production of reactive oxygen species (ROS) and DPPH generation depending on the concentration. KSMT significantly inhibited angiotensin converting enzyme(ACE) activity depending on the concentration compared with control. KSMT maintained body weight of body, heat and kidney nearly normal group in hypertensive rat induced by DOCA-salt. KSMT significantly blood pressure and heart beat rate compared with control in hypertensive rat induced by DOCA-salt. KSMT significantly decreased aldosterone, dopamine, norepineph- rine, epinephrine compared with control in hypertensive rat induced by DOCA-salt. KSMT significantly decreased the level of potassium and cloride compared with control wheareas increased that of calcium significantly in hypertensive rat induced by DOCA-salt. KSMT significantly decreased the level of uric acid and BUN compared with control in hypertensive rat induced by DOCA-salt. It is verified experimentally tat Kamisamultang(KMST) which has been used broadly as a clinical therapeutics in oriental medicine is effective for anti-hypertension mechanism. And it could be applied to develope the reliable prescriptions for anti-hypertension in the future.

• 동의생리병리학회지
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• 제22권1호
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• pp.162-170
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• 2008

Kamisungihwalhyul-tang(KSHT) has been used for many years as a therapeutic agent for cerebrovascular disease and hypertension in Oriental Medicine. But the effect of KSHT on hypertension and reactive oxygen is not well-known. This study was examined to investigate the effect of KSHT on hypertension and reactive oxygen. After administering KSHT extract to Sprague- Dawley Rat forinjected subcutaneous with deoxycorticosterone acetate(DOCA) 8 weeks, changes in blood pressure, pulse rate, 2,2-diphenyl-1-picrylhydrazyl, reactive oxygen species, angiotensin converting enzyme, aldosterone, catecholamine levels, electrolyte, uric acid, BUN, creatinine in plasma were examined, and immunohistochemical changes and scanning electron microscopic changes were observed. 2,2-diphenyl-1-picrylhydrazyl(DPPH) scavenging activity was increased, reactive oxygen species(ROS) was decreased in a KSHT concentration-dependent. Angiotensin converting enzyme(ACE) inhibitory activity was increased in a concentration-dependent by KSHT. KSHT significantly decreased the blood pressure and heart rate in DOCA-salt hypertensive rat. KSHT significantly decreased the levels of aldosterone in DOCA-salt hypertensive rat. KSHT significantly decreased the level of dopamine, norepinephrine, epinephrine in DOCA-salt hypertensive rat. $Na^+$, $K^+$ and Cl- were decreased significantly, $Ca^{2+}$ was increased significantly by KSHT. KSHT significantly decreased uric acid, BUN, creatinine.

• 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.

• Childhood Kidney Diseases
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• 제14권2호
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• pp.132-142
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• 2010

저칼륨혈증의 경우 약제 또는 백혈구 증가증 등에 의해서 칼륨이 일시적으로 세포내로 이동하는 재분포에 의해서 생기는 저칼륨혈증을 먼저 감별한다. 칼륨소실에 의한 결핍의 경우 소변 칼륨 농도 또는 TTKG를 구하고, 감소되어 있는 경우에는 칼륨의 신외성 손실, 칼륨 섭취의 부족 등을 감별한다. 증가되어 있는 경우 신장을 통한 칼륨의 소실을 생각하고, 고혈압이 동반되어 있지 않을 경우 산증과 관련된 경우, 구토에 의한 경우, 세뇨관에서의 칼륨 재흡수 장애 또는 칼륨의 분비가 증가되는 경우를 생각할 수 있다. 고혈압이 동반되어 있을 경우 혈장 레닌과 알도스테론을 측정하여 레닌이 증가되어 있을 경우, 혈장 레닌이 정상 또는 낮으면서 혈장 알도스테론만 증가한 경우, 혈장 알도스테론은 증가되어 있지 않지만 알도스테론 이외에 광물부신겉질호르몬의 작용이 증가하는 경우를 감별한다. 증상은 무기력, 경련, 근육통, 횡문근 융해증, 변비, 장폐쇄, 부정맥, 지각이상 등이 있다. 치료는 원인 질환의 치료 및 칼륨공급이다. 고칼륨혈증은 재분포에 의한 경우, 가성 고칼륨혈증, 진성 고칼륨혈증을 감별해야 한다. 진성 고칼륨혈증이면서 사구체 여과율이 감소되어 있는 경우 신부전 또는 체내 칼륨 부하가 증가하는 경우를 감별한다. 사구체 여과율이 15 mL/min/$1.73m^2$ 이상인 경우에는 혈장 레닌과 알도스테론을 검사한다. 모두 낮을 경우, 혈장 레닌은 정상이지만 알도스테론만 낮은 경우, 혈장 알도스테론의 농도는 정상이지만 알도스테론의 작용을 저해되는 경우 등을 감별해야 한다. 증상은 부정맥, 감각 이상, 허약 등이 있다. 치료는 calcium gluconate, 인슐린, 베타2작용제, 중탄산염, furosemide, resin, 투석 등이 있으며, 칼륨을 제한하고 원인 약물이 있을 경우 이를 중단해야 한다.

• 동국한의학연구소논문집
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• 제1권
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• pp.55-80
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• 1992

In order to examine that the effect of Sam Hwa San, circulating the vital energy of Sam Cho and controlling body fluid metabolism, gives any influence on renal function, changes in the urine flow, eletrolytes excretion, plasma aldosterone concentration and renin activity were observed after intravenous infusion of the Sam Hwa San extract in rabbit. Also in vitro effect of the herb extract on oxygen consumption in renal cortical slices and ATPase activity in kidney microsomes was measured. The following results were obtained : 1. The urine flow was markedly increased at 10 min after intravenous infusion of the Sam Hwa San extract($0.134{\pm}0.015$ vs. $0.433{\pm}0.046ml/min.kg$), but return ed to normal value after 40 min of infusion. 2. The glomerular filtration rate was significantly increased at 10 min after in travenous infusion of the Sam Hwa San extract, and the renal plasma flow at 10 and 20 min after infusion of the Sam Hwa San extract, following return to normal value. 3. $Na^+$ excretion was significantly increased during 10-40 min after intravenous infusion of the Sam Hwa San extract, although showed the maximal rate at 10-20 min. The fractional $Na^+$ excretion was also increased during 10-40 min. $K^+$ excretion was rapidly increased at 10 min after the intravenous Infusion of the Sam Hwa San extract and then gradually decreased to normal level at 40 min. The fractional $K^+$ excretion was significantly increased during 10-40 min after the intravenous infusion of the Sam Hwa San extract. 4. The plasma aldosterone concentration and renin activity were not altered by the infusion of the Sam Hwa San extract. 5. The ouabain-sensitive oxygen consumption of renal cortical slices was significantly reduced by the Sam Hwa San extract(0.5 and 1.0 vol.%). 6. The Na-K-ATPase activity of renal microsomes was strongly inhibited by the Sam Hwa San extract(0.5 and 1.0 vol.%). These results suggest that the Sam Hwa San causes a strong diuretic effect which results from reduction of Na reabsorption in renal tubule by a direct inhibition of Na-pump and, in part, from all increase in renal blood flow. In clinic, it is considered to obtain the therapeutic effect in body fluid metabolism disharmony to cause the circular disorder of vital energy.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.187-193
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• 2009

목 적 : Adiponectin은 대사 증후군에서 중요한 역할을 하는 물질이며, 비만, 2형 당뇨, 관동맥 질환 등에서 그 수치가 감소하는 것으로 알려져 있다. 고혈압과 혈청 adiponectin치의 관계는 여러 저자에 의하여 발표되었으나 아직 논란의 여지가 남아있는 상태이다. 우리는 낮은 adiponectin치가 청소년 고혈압과 어떤 관계가 있는지, 또 영향을 끼치는 기전이 유전적인지 혹은 생물학적인 것인지 알고자 유전자 다형성 분석을 하였다. 방 법 : 16에서 17세 사이의 40명의 고혈압 청소년과 20명의 대조군 청소년을 대상으로 각 군의 혈청 adiponectin, insulin, renin, aldosterone, ACE를 측정하여 비교하였다. cIMT와 PWV도 측정하였다. PCR법으로 adiponectin I164T 유전자 다형성을 조사하였다. 결 과 : 고혈압 청소년군에서 cIMT와 PWV가 의미있게 높았다. 혈청 insulin, renin, aldosterone치도 고혈압군에서 의미있게 높았다. 두 군간에 adiponectin치는 의미있는 차이를 보이지 않았다. 본 연구에 참여한 청소년에서는 TC genotype은 발견되지 않았고 모두 TT genotype을 보였다. 결 론 : 결론적으로 adiponectin치는 고혈압 청소년 군에서나 정상군에서나 차이가 없었다. 두 군에서 유전적인 다형성도 보이지 않았다. 더 큰 규모의 연구가 필요할 것으로 생각된다.

• 동의생리병리학회지
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• 제22권5호
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• pp.1223-1235
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• 2008

This experiment was performed to investigate the effects of Hyeonsamdansameum(HDE) on hypertension. For the study of HDE, we had divided Sprague-Dawley rats to three groups-normal, control, HDE. The control group was injected subcutaneous with monocrotaline(50 mg/kg). The treatment group was injected subcutaneous with monocrotaline(50 mg/kg) and orally administered with HDE extract for 4 weeks(once a day, 208 mg/kg). Then we measured blood pressure, heart rate, on the plasma aldosterone, catecholamine, electrolyte, uric acid, BUN, creatinine, and observed the lung, cardiac muscle. liver. etc. The results of these were as follows: 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity and superoxide dismutase(SOD) - like activity were increased. reactive oxygen species (ROS) was decreased. Angiotensin converting enzyme(ACE) inhibitory activity was increased in a concentration-dependent by HDE. HDE significantly increased body weight in monocrotaline hypertensive rat, so supported nearly normal group. HDE significantly decreased blood pressure and heart rate in monocrotaline hypertensive rat. HOE significantly decreased aldosterone in adrenocortical hormones. HDE significantly decreased dopamine. norepinephrine, epinephrine. Na+. Cl- were intended to decrease. K+ was decreased significantly by HDE. Uric acid. BUN were significantly decreased and creatinine was intended to decrease by HDE. HDE inhibited lung, liver and heart injury connected with hypertension. These results suggest that HDE is usefully applied in treatment and prevention of hypertension.

• 한국축산식품학회지
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• 제24권3호
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• pp.283-292
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• 2004

본 연구는 흰쥐(S.D, ♂)에 각 처리에 따라 기초사료로 시판사료(T$_1$)를 무제한 급여하면서 시험사료로 한약 증탕액 (T$_2$), 오골계 증탕액(T$_3$), 오골계 교잡종 육에 Flavourzyme을 0.1%첨가하여 가수 분해시킨 후 한약제와 혼합하여 증탕시킨 증탕액(T$_4$)을 35일간 경구 투여한 후 흰쥐의 혈청에 대한 glucose및 hormones과 면역학적 변화에 미치는 영향을 조사 한 결과는 다음과 같았다. 비만하였을 때나 과도한 스트레스를 받았을 때 insulin 함량이 증가한다고 하였으나 효소 처리 오골계 교잡종 증탕액을 급여한 처리구에서 체중 증가가 일반사료를 급여한 처리구에 비해 유의적으로(p<0.05) 증가하였어도 insulin 함량이 일반사료 급여구보다 증가하지 않은 것으로 나타나 바람직한 생리현상을 나타냈다. Aldosterone은 스테로이드 계통의 호르몬으로 물의 생리적 밸런스와 혈압조절에 관여하는데 일반사료 급여구에 비해 한약 증탕액, 오골계 증탕액,효소 처리 오골계 증탕액 급여 구에서 낮은 함량을 나타내 고농도 단백 식이의 급여에도 불구하고 aldosterone수치의 저하로 혈압 저하의 효과를 나타 낸 것은 한약을 첨가시켜 고압으로 처리시킨 증탕액의 효과와 가수분해 효소에 의한 소화가 용이하도록 처리한 결과로 사료된다 Cortisol은 스트레스 측정에 감도가 높은 호르몬으로 알려져 있는데 일반사료급여구가 0.67 nmol/L인 반면 증탕액을 급여한 구에서는 0.40∼0.49 nmol/L으로 cortisol 농도가 감소하는 경향을 나타냈는데 이는 aldosterone에서와 같이 한약제와 동물성 단백질을 섭취함에 따른 효과로 사료된다. 흰쥐에 증탕액 급여가 면역반응에 미치는 영향에서 IL-4, IFN-v 및 anti-BSA IgG의 역가는 일반사료를 급여한 처리구에 비해 오골계 증탕액 및 효소 처리 오골계 교잡종 증탕액 급여구에서 spleen과 serum두에서 증가하는 경향을 나타내었는데 앞에서 언급했던 바와 같이 한약(십전대보탕)의 효과와 소화시키기 쉬운 고농도의 단백질 가수분해 물질의 다량 섭취에 의해 면역 활성이 증가되었을 것으로 사료된다.