• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.151-155
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• 2023

Licorice is a perennial herb belonging to the legume family that mainly grows in northeastern China, Mongolia, Siberia, and other regions. It is used in traditional medicine in the form of dried roots in the East and the West. The main active component of licorice, glycyrrhizin, is known to produce mineralocorticoid effects when consumed chronically, which can lead to apparent mineralocorticoid excess syndrome. Herein, we present the case of a 72-year-old woman who was admitted to the emergency room with severe generalized weakness and difficulty keeping her neck upright, which had developed after daily consumption of licorice-infused water for the past 2 months. Blood tests revealed metabolic alkalosis and severe hypokalemia, and an electrocardiogram showed ventricular bigeminy. The patient was treated with daily potassium and spironolactone supplements, leading to a significant improvement in muscle strength after a week. One week later, the patient was discharged, showing rare ventricular premature contractions on electrocardiography, but with no specific complaints. Chronic licorice ingestion leading to hypokalemia and muscle weakness can be life-threatening, necessitating the discontinuation of the causative agent, close monitoring, and cautious supplementation of potassium and spironolactone as treatment.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.153-156
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• 2020

A 14-year-old intact female Cocker Spaniel dog, weighing 6.8 kg, presented with chief complaints of severe cough, dyspnea, anorexia, and exercise intolerance. It had the characteristics of a blood clot, the evidence of mitral regurgitation, a high left atrial/aortic root ratio, and pericardial effusion with a left atrial rupture due to myxomatous mitral valve degeneration (MMVD) was strongly suspected. Traditional therapy (pimobendan, furosemide, enalapril, and spironolactone) for heart failure with MMVD was provided twice a day orally, and partial pericardiectomy was performed for pericardial effusion. The medical prescriptions for MMVD were continued, and the patient's heart disease was well-controlled. However, it suddenly died 3 months after the operation.

• The Korean Journal of Pharmacology
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• v.5 no.1
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• pp.57-64
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• 1969

Acetylsalicylic acid, administered intravenously in a dose of 120 mg+250 mg/h, markedly decreased the urinary excretion of sodium and chloride, and slightly depressed potassium excretion, so that the ratio of urinary concentrations of potassium to sodium increased after ASA. Osmolar and free water clearances also diminished during water diuresis, and free water reabsorption $(T^cH_2O)$ decreased after ASA during mannitol diuresis. Glomerular filtration rate and urine flow rate changed little. When infused directly into a renal artery, ASA exhibited identical action on both kidneys, indicating that the renotropic action is mediated by some endogenous humoral agents or by some metabolites of ASA. A dose of 100 mg i.v. of spironolactone, a aldosterone antagonist, slightly reversed the renal reflect when given during maximum action of ASA. Ethacrynic acid could display its full diuretic action unhindered during maximum ASA action. Above observations lead to the suggestion that acetylsalicylic acid might release aldosterone and the action on electrolyte excretion may be mediated by the mineralocorticoid.

• Journal of Veterinary Clinics
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• v.41 no.2
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• pp.95-100
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• 2024

A 6-year-old neutered male Poodle with a body weight of 2.7 kg was diagnosed with a congenital extrahepatic portoazygos shunt presented with progressive hepatic encephalopathy. Five days after surgical attenuation, the patient showed post-attenuation neurological signs (PANS) such as generalized tonic-clonic seizure, dull mentation, and tremor. PANS were successfully managed with antiepileptic drugs, but third-space fluid accumulation (ascites and peripheral edema) and phlebectasia were newly identified, suggesting marked portal hypertension (PHT). Telmisartan, spironolactone, carvedilol, and prednisolone were sequentially administered. Three months after surgery, both abnormal clinicopathological values such as anemia and hypoalbuminemia, and clinical signs completely resolved. Herein, we report successful management strategies for PANS and PHT in a dog following surgical attenuation of a congenital portoazygos shunt.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.313-318
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• 1986

Primary aldosteronism is a disease that the stimulus for the excessive aldosterone production resides within the adrenal gland. It was first described by conn in 1955. And many cases were reported by physicians at present in the world. But it is relatively rare in Korea, probably due to lack of attension and medical facilities. Only about 13 cases have been reported at present. The clinical, biochemical features in 1 case of primary aldosteranism caused by adrenal hyperplasia that was diagnosed at Yeungnam University Hospital was observed and the following result were obtained. 1. Clinical feature: The present case was 27-year-old woman who was admitted due to general weakness and easy fatigability. The above mensioned chief complaints occurred 8 months prior to admission when she delivered of second baby by cesarian section. Symptoms such as above chief complaints, intermittent muscle paralysis and cramping were noticed. Trousseau's sign was also present. The average blood pressure ranged from 170/90 to 200/120. 2. Biochemical abnormalities: Severe hypokalemia lower than 2.5 mEq/L was presented and 24 hours urine potassium showed markedly increased urinary loss.(228 mEq/day). Plasma renin activity was decreased under normal range with furosemide administration.(Basal renin; 0.01ng/ml/hr, stimulated renin 0.12ng/ml/hr). Saline suppression test revealed markedly elevated levels of aldosterone higher than normal range. (Basal aldosterone; 320.68pg/ml stimulated aldosterone; 451.86pg/ml). And posture test showed decreased plasma renin activity and increased plasma aldosterone level. - PRA(ng/ml/hr)=Bsal: 0.05(0.15~2.33), Stimulated: 0.22(1.31~3.95) - Aldosterone(pg/ml)=Bsal: 242.77(10~160), Stimulated: 432.09(40~310) 3. Adrenal CT scan revealed no abnormal findings. 4. Treatment and course: Spironolactone was given at OPD with regular follow-up. Her blood pressure ranged from 150/90 to 160/100 and symptoms were improved. The effect of treatment was satisfactory and further follow up would be performed.

• Journal of Medicine and Life Science
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• v.17 no.2
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• pp.60-63
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• 2020

Primary aldosteronism has been found more often among patients with hypertension. Primary aldosteronism can be caused by an aldosterone-producing adenoma, bilateral adrenal hyperplasia, or rarely by an adrenal carcinoma. An initial diagnostic test for aldosteronism is a measurement of the plasma renin activity and aldosterone concentration. For example, up to 20% of patients with hypertension showed increased plasma aldosterone concentration/renin activity ratio. If surgery is planned, an adrenal vein sampling is necessary for exact localization. Spironolactone, an aldosterone antagonist, is the drug of choice for patients with an aldosterone-producing adenoma or hyperplasia. It can control elevated blood pressure in most primary aldosteronism patients. However, unilateral laparoscopic adrenalectomy is the best treatment for aldosterone-producing adenoma or asymmetrical aldosterone production in patients with uncontrolled hypertension. Here we report a patient with primary aldosteronism caused by unilateral adrenal hyperplasia and a contralateral adrenal adenoma who required as many as five different kinds of antihypertensive medications for controlling elevated blood pressure. The adrenal adenoma was successfully removed by unilateral adrenalectomy and the blood pressure had been controlled well after the surgery.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.468-472
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• 2013

A 12-year-old intact female mixed dog (weighing 6.2 kg) was referred with primary complaints of severe abdominal distension, persistent coughing and exercise intolerance. Diagnostic studies found ascites, jugular distension, loud left and right apical systolic (grade 4/6) murmur, generalized cardiomegaly with caudal vena cava distension and left atrial dilation. Echocardiographic findings were consistent with degenerative mitral and tricuspid valve endocardiosis and bi-ventricular congestive heart failure. There was also a left to right shunting patent foramen ovale. The LV systolic function is depressed relative to the degree of volume overload. Based on diagnostic findings, this case was diagnosed as PFO complicated with mitral and tricuspid valve endocardiosis with ISACHC IIIa heart failure. The dog was treated with furosemide (2 mg/kg, q12hr, PO), sildenafil (1 mg/kg, q8hr, PO), pimobendan (0.3 mg/kg, q12hr, PO), enalapril (0.5 mg/kg, q12hr, PO) and spironolactone (1 mg/kg, q12hr). The clinical signs were gradually improved after medical therapy.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.112-116
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• 2014

A 2-month-old intact male Pitbull terrier (weighing 1.01 kg) were referred with primary complaints of severe abdominal distension, exercise intolerance, retarded growth, yellow nasal discharge and anorexia. Diagnostic imaging studies found enlarged right atrium partitioned by abnormal membrane, severe pulmonic systolic jets (5.66 m/s of peak velocity) and right-to-left blood shunt at the inter-atrial septum. Based on clinical and diagnostic findings, the case was diagnosed as cor triatriatum dexter complicated with severe pulmonic stenosis and right-to-left shunted patent foramen ovale. Either surgical or interventional therapy has not been attempted, because of unstable patient's condition. Using blood transfusion, oxygen supply and cardiac medications (i.e., sildenafil, spironolactone, enalapril), the dog was recovered.

• Journal of Veterinary Clinics
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• v.34 no.5
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• pp.353-355
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• 2017

A four month old, intact female Jindo dog presented to the Veterinary Teaching Hospital of Kangwon National University with collapse. Physical examination revealed a heart rate of more than 200 beats per minute. Blood tests showed mild anemia and mild neutrophilia, while thoracic radiography and ultrasonography revealed no remarkable findings. Electrocardiography showed ventricular premature complexes (VPCs). The dog was diagnosed with congenital ventricular tachyarrhythmia. The condition was improved by lidocaine infusion. After 10 days, the dog was discharged from the hospital with a prescription of atenolol, pimobendan, diltiazem, furosemide, spironolactone, and L-carnitine. This dog is still alive after 31 months. However, progressive cardiac remodeling was confirmed on radiography and ultrasonography. Congenital ventricular tachyarrhythmia is rare in dogs, and the prognosis of reported cases is poor. This report describes the long-term successful management of a dog with congenital ventricular tachyarrhythmia.

• The Journal of Korean Medicine
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• v.22 no.2
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• pp.94-101
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• 2001

Background and Purpose : Relationship between 17-KS.17-OHCS in 24hrs urine and Deficiency Syndrome of the Kidneys had been examined, but the study about 17-KS.17-OHCS in stroke patients was rare6'. In this study, we aimed to investigate the usefulness of 24hrs urine 17-KS.17-OHCS in stroke patients as an index for the Differentiation of Deficiency Syndrome of the Kidneys. Subjects : 66 stroke patients(male : female =2 9 : 37) were selected, they were admitted in the hospital of oriental medicine, Kyunghee university(from November 1 st, 1998 to May 30th, 2000). Their age was over 65 years. The patients who had renal malfunction, hyperthyroidism, hypothyroidism were excluded and who took chlorpromazine, spironolactone, digoxin, reserpine, hormonal agent were also excluded. Methods : After we selected the patients, we investigated the Differentiation of Syndrome by use of Diagnostic Paper and examined the level of 17-KS.17-OHCS in 24hrs urine. We compared Deficiency Syndrome with non-Deficiency Syndrome of the Kidneys using of 17-KS.17-OHCS in 24hrs urine. Results : 1. Stroke did not affect 17-KS.17-OHCS excretion in 24hrs urine. 2. In 24hrs urine, 17-KS of male stroke patients and 17-OHCS of female stroke patients were lower in patients diagnosed as a Deficiency Syndrome than non-Deficiency Syndrome of the Kidneys(p<0.05). 3. Among Deficiency Syndrome of Yin, Yang, Yang and Yin of the Kidneys group, there was no differentiation of 17-KS.17-OHCS in 24hrs urine(p>0.05).