• The Korean Journal of Physiology
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• v.27 no.1
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• pp.57-66
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• 1993

Effects of a voltage dependent calcium channel antagonist, nifedipine, on the responses of blood pressure, and secretion of atrial natriuretic peptide (ANP) and aldosterone to angiotensin II (Ang II) were compared in male Wistar and spontaneously hypertensive rats (SHR). A low, control or high sodium diet (2, 10 or 25 mmol Na/100 g diet) was fed for 6 weeks from the age of 6 weeks. On the morning of the experiment catheters were inserted under ether anesthesia in the femoral artery for pressure recording and blood sampling, and in the femoral vein for drug infusion. Ang II was infused at a rate of 250 ng/kg/min for 20 min. Nifedipine mixed with Ang II was infused at a rate of $16{\mu}g/kg/min$ for 20 min. Arterial blood samples were collected before and after infusion of Ang II with or without nifedipine. The control plasma level of aldosterone was inversely related to the amount of salt intake, whereas the plasma ANP level was not different between the salt groups. SHR showed a higher basal plasma ANP but a lower aldosterone concentration than Wistar rats. Infusion of Ang II produced a significant increase in blood pressure and plasma levels of aldosterone and ANP: The % increase was not significantly different either between the salt groups or between SHR and Wistar rats. SHR showed a greater pressor response to Ang II but a remarkably smaller decrease in heart rate after Ang II infusion than Wistar rats, With increasing sodium intake, the effect of Ang II on aldosterone secretion was decreased, whereas that on ANP secretion or blood pressure was not changed. Nifedipine decreased the responses of blood pressure and heart rate to Ang II in all groups. Nifedipine caused almost a complete inhibition of Ang II induced ANP secretion, but only a partial inhibition of Ang II induced aldosterone secretion or vasoconstriction. These results indicate that calcium dependent processes were involved in Ang II induced vasoconstriction, and secretions of aldosterone and ANP. However, the calcium dependent process far ANP secretion was considerably different from that for aldosterone secretion or vasoconstriction evoked by ang II. The ang II induced increase in ANP secretion appeared to be caused primarily by activating voltage-dependent calcium channels, whereas Ang II induced aldosterone secretion and vasoconstriction was not.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.256-269
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• 1998

The purpose of this study was to evaluate the usefulness of variables which were known to be related to blood pressure for discriminating between hypertensive and normotensive groups. Variables were obesity, serum lipids, life style-related variables such as smoking, alcohol, exercise, and stress, and demographic variables such as age, economical status, and education. The data were collected from 400 male clients who visited one university hospital located in Incheon, Republic of Korea, from May 1996 to December 1996 for a regular physical examination. Variables which showed significance for discriminating systolic blood pressure in this study were age, serum lipids, education, HDL, exercise, total cholesterol, body fat percent, alcohol, stress, and smoking(in order of significance). By using the combination of these variables, the possibility of proper prediction for a high-systolic pressure group was 2%, predicting a normal-systolic pressure group was 70.3%, and total Hit Ratio was 70%. Variables which showed significance for discriminating diastolic blood pressure were exercise, triglyceride, alcohol, smoking, economical status, age, and BMI (in order of significance). By using the combination of these variables, the possibility of proper prediction for a high-diastolic pressure group was 71.2%, predicting a normal-diastolic pressure group was 71.3%, and total Hit Ratio was 71.3%. Multiple regression analysis was performed to examine the association of systolic blood pressure with life style-related variables after adjustment for obesity, serum lipids, and demographic variables. First, the effect of demographic variable alone on the systolic blood pressure was statistically significant (p=.000) and adjusted $R^2$was 0.09. Adding the variable obesity on demographic variables resulted in raising adjusted $R^2$to 0.11 (p=.000) : therefore, the contribution rate of obesity on the systolic blood pressure was 2.0%. On the next step, adding the variable serum lipids on the obesity and demographic variables resulted in raising adjusted R2 to 0.12(P=.000) : therefore, the contribution rate of serum lipid on the systolic pressure was 1.0%. Finally, adding life style-related variables on all other variables resulted in raising the adjusted $R^2$to 0.18(p=.000) ; therefore, the contribution rate of life style-related variables on the systolic blood pressure after adjustment for obesity, serum lipids, and demographic variables was 6.0%. Multiple regression analysis was also performed to examine the association of diastolic blood pressure with life style-related variables after adjustment for obesity, serum lipids, and demographic variables. First, the effect of demographic variable alone on the diastolic blood pressure was statistically significant (p=.01) and adjusted $R^2$was 0.03. Adding the variable obesity on demographic variables resulted in raising adjusted $R^2$to 0.06 (p=.000) ; therefore, the contribution rate of obesity on the diastolic blood pressure was 3.0%. On the next step, adding the variable serum lipids on the obesity and demographic variables resulted in raising the adjusted $R^2$ to 0.09(p=.000) ; therefore, the contribution rate of serum lipid on the diastolic pressure was 3.0%. Finally, adding life style-related variables on all other variables resulted in raising the adjusted $R^2$ to 0.12 (p=.000) : therefore, the contribution rate of life style-related variables on the systolic blood pressure after adjustment for obesity, serum lipids, and demographic variables was 3.0%.

• Journal of Korean Neurosurgical Society
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• v.63 no.1
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• pp.56-68
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• 2020

Objective : To analyze the incidence and treatment trends of hemorrhagic stroke (HS), according to HS subtypes, using nationwide data in Korea from January 2008 to December 2016. Methods : We used data from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and age-standardized incidence of each disease associated with HS, which included intracranial aneurysm (IA), hypertensive intracerebral hemorrhage (ICH), and arteriovenous malformation (AVM), were calculated and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and number of treatments were analyzed for each cerebrovascular disease using the Korean Classification of Diseases procedure codes. Results : In 2016, the total number of newly diagnosed adult patients with HS was 24169, showing a decrease by 7.0% since 2008; the age-standardized incidence of HS was 46.2 per 100000 person-years. The age-standardized incidence of unruptured IA (UIA) in adults was 71.4 per 100000 person-years-increased by 2.6-fold since 2008-while that of ruptured IA (RIA) was 12.6 per 100000 person-years, which had decreased at a rate of 20.3% since 2008. The number of coil embolization (CE) for UIA increased by 3.4-fold over 9 years and exceeded that of clipping since 2008. With respect to RIA, CE increased by 2.0-fold over 9 years and exceeded that of clipping from 2014. As for spontaneous ICH in adults, the age-standardized incidence was 31.3 per 100000 person-years in 2016-decreased by 34.7% since 2008-and 14.6% of patients diagnosed with ICH were treated in 2016, which was not significantly different from the proportion of patients treated since 2008. The age-standardized incidence of unruptured AVM (UAVM) was 2.0 per 100000 person-year in 2016, while that of ruptured AVM (RAVM) was 2.4 per 100000 person-years in 2016, showing a decreasing rate of 17.2% from 2008. The total number of treated patients with AVM declined since 2014. Conclusion : In Korea, age-related cerebral vascular diseases, such as RIA, ICH, and RAVM, demonstrated a declining trend in age-standardized incidence; meanwhile, UIA and UAVM demonstrated an increased trend in both crude incidence and age-standardized incidence for 9 years. The increase in the elderly population, management of hypertension, and development of diagnostic and endovascular techniques appear to have influenced this trend.

• The Korean Journal of Physiology and Pharmacology
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• v.24 no.1
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• pp.111-119
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• 2020

In vascular smooth muscle, K⁺ channels, such as voltage-gated K⁺ channels (Kv), inward-rectifier K⁺ channels (Kir), and big-conductance Ca²⁺-activated K⁺ channels (BK_Ca), establish a hyperpolarized membrane potential and counterbalance the depolarizing vasoactive stimuli. Additionally, Kir mediates endothelium-dependent hyperpolarization and the active hyperemia response in various vessels, including the coronary artery. Pulmonary arterial hypertension (PAH) induces right ventricular hypertrophy (RVH), thereby elevating the risk of ischemia and right heart failure. Here, using the whole-cell patch-clamp technique, we compared Kv and Kir current densities (I_Kv and I_Kir) in the left (LCSMCs), right (RCSMCs), and septal branches of coronary smooth muscle cells (SCSMCs) from control and monocrotaline (MCT)-induced PAH rats exhibiting RVH. In control rats, (1) I_Kv was larger in RCSMCs than that in SCSMCs and LCSMCs, (2) I_Kv inactivation occurred at more negative voltages in SCSMCs than those in RCSMCs and LCSMCs, (3) I_Kir was smaller in SCSMCs than that in RCSMCs and LCSMCs, and (4) I_BKCa did not differ between branches. Moreover, in PAH rats, I_Kir and I_Kv decreased in SCSMCs, but not in RCSMCs or LCSMCs, and I_BKCa did not change in any of the branches. These results demonstrated that SCSMC-specific decreases in I_Kv and I_Kir occur in an MCT-induced PAH model, thereby offering insights into the potential pathophysiological implications of coronary blood flow regulation in right heart disease. Furthermore, the relatively smaller I_Kir in SCSMCs suggested a less effective vasodilatory response in the septal region to the moderate increase in extracellular K⁺ concentration under increased activity of the myocardium.

• The Korean Journal of Physiology and Pharmacology
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• v.8 no.2
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• pp.89-94
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• 2004

The arterial pressure is regulated by the nervous and humoral mechanisms. The neuronal regulation is mostly carried out by the autonomic nervous system through the rostral ventrolateral medulla (RVLM), a key area for the cardiovascular regulation, and the humoral regulation is mediated by a number of substances, including the angiotensin (Ang) II and vasopressin. Recent studies suggest that central interleukin-1 (IL-1) activates the sympathetic nervous system and produces hypertension. The present study was undertaken to elucidate whether IL-1 and Ang II interact in the regulation of cardiovascular responses to the stress of hemorrhage. Thus, Sprague-Dawley rats were anesthetized and both femoral arteries were cannulated for direct measurement of arterial pressure and heart rate (HR) and for inducing hemorrhage. A guide cannula was placed into the lateral ventricle for injection of IL-1 $(0.1,\;1,\;10,\;20\;ng/2\;{\mu}l)$ or Ang II $(600\;ng/10\;{\mu}l)$. A glass microelectrode was inserted into the RVLM to record the single unit spike potential. Barosensitive neurons were identified by an increased number of single unit spikes in RVLM following intravenous injection of nitroprusside. I.c.v. $IL-1\;{\beta}$ increased mean arterial pressure (MAP) in a dose-dependent fashion, but HR in a dose-independent pattern. The baroreceptor reflex sensitivity was not affected by i.c.v. $IL-1\;{\beta}$. Both i.c.v. $IL-1\;{\alpha}\;and\;{\beta}$ produced similar increase in MAP and HR. When hemorrhage was induced after i.c.v. injection of $IL-1\;{\beta}$, the magnitude of MAP fall was not different from the control. The $IL-1\;{\beta}$ group showed a smaller decrease in HR and a lower spike potential count in RVLM than the control. MAP fall in response to hemorrhage after i.c.v. injection of Ang II was not different from the control. When both IL-1 and Ang II were simultaneously injected i.c.v., however, MAP fall was significantly smaller than the control, and HR was increased rather than decreased. These data suggest that IL-1, a defense immune mediator, manifests a hypertensive action in the central nervous system and attenuates the hypotensive response to hemorrhage by interaction with Ang II.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.4
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• pp.1055-1060
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• 2004

Apoptosis is the ability of cells to self-destruct by the activation of an intrinsic cellular suicide program when the cells are no longer needed or when they are seriously damaged. Morphologically, apoptosis is characterized by the appearance of membrane blebbing, cell shrinkage, chromatin condensation, DNA cleavage, and the fragmentation of the cell membrane-bound apoptotic bodies. Siegesbeckia glabrescens Makino (Siegesbeckiae Herba, SG) has been widely used as treatments for arthritis, and fever, as well as detoxification properties. The present studies were undertaken to evaluate if SG has an anti-apoptotic property. Cell viability was measured by XTT and tryphan blue stain. Morphological characteristic of human aortic smooth muscle cells(HASMC) were visualized with a phase-contrast microscope. SG significantly reduced HASMC, but not human umbilical vein endothelial cell(HUVEC), viability in a dose-dependent manner. Confluent untreated cells at 24hrs showed normal morphology, flat with a uniform polygonal shape. SG-treated cells (0.5㎎/㎖) at 24hrs showed apoptotic morphology. Cells became irregular with elongated lamellipodia, and exhibited condensed chromatin in nuclei with occasional endoucleation. There was an increase in the number of apoptotic cells rounding-up and being detached from the substrate. TUNEL staining of SG-treated cells showed dark-brown stains in nuclei and cytosol. Caspases are central components of the machinery responsible for apoptosis and are generally divided into two categories; the initiator caspases, which include caspases-2,-8,-9, and -10, and the effector caspases, which include caspases-3,-6, and -7. SG decreased anti-caspase-3 protein expression, which means activation of caspases-3 activity. It has been reported that there is a link between NO formation and apoptosis. NO production was accelerated by SG treatment in HASMC. L-NNA, NOS inhibitor, inhibited SG-induced apoptosis. These results, therefore, indicated that both caspases-3 and NO production are involved in apoptosis in smooth muscle cells. According to these results, SG may have a potential effect in the treatment of hypertensive atherosclerosis.

• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.435-442
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• 1999

Objectives: The purpose of this study was to examine the twelve-year incidence of hypertension, and to find risk factors for the incidence in adult population in Kangwha County, Korea. Methods: In 1986, 413 males(mean age 37 years) and 434 females(mean age 33 years) were examined in the Kangwha Study, Among 764 non-hypertensive participants, 164 males and 214 females were reexamined in 1998. Blood pressure(BP) was measured with standard mercury sphygmomanometers. Multiple logistic regression analysis was used to estimate the relative risk of risk factors on the incidence of hypertension. Results: During the 12-year period, 68 of 164 males and 53 of 2f4 females developed hypertension. In a multiple logistic model adjusted for age and pulse rate, baseline BP, baseline body mass index(BMI) and BMI change during the follow-up period were significantly related to the incidence of hyperiension. Adjusted relative risk(RR)s of baseline high-normal BP were 3.90(95% CI: 1.81-7.84) in males, and 12.72(95% CI: 3.70-30.73) in females. Compared with lower baseline BMI group, adjusted RRs of middle baseline BMI group were 2.66(95% CI: 1.19-5.70) in males, and 2.33(95% CI: 0.95-5.55) in females. Adjusted RRs of upper baseline BMI group were 3.52(95% CI: 1.53-7.67) in males and 3.63(95% CI: 1.50-8.43) in females. Increase of BMI was positively related to the incidence in males(adjusted RR=2.71, 95% CI: 1.00-6.71) and females(adjusted RR=3.05, 95% CI: 1.29-6.88). Conclusions: The twelve-year incidence of hypertension was 41.5% in males, and 25.8% in females. Baseline BP, baseline BMI, and BMI change were strongly related to the incidence of hypertension.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.5
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• pp.700-705
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• 2003

Oriental pear was used as treatment of asthma, control of blood pressure tonic medicine vasoactio, diabetes in oriental medicine. In this study, it was investigated that pear pectin effects on cardiovascular system as blood pressure and renin and atrial natriuretic peptide (ANP) in plasma, cardiac hypertrophy. The experiments were performed on Sprague-Dawley rats, 2K1C hypertension model was prepared by constricting the left renal artery with a sliver clip. Animals were then divided into four groups, 5 mg/kg, 10 mg/kg, 15 mg/kg and the control, pear pectin and apple pectin solutions were supplied with them. The blood pressure was more decreased in pear pectin 10 mg/kg than in apple pectin. The plasma ANP was decreased in pear pectin 10 mg/kg, and renin was increased in same concentration of drug. Cardiac hypertrophy had a tendency to decrease in pear pectin 15 mg/kg, but was not statistically significant compared to control group.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.77-84
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• 2005

Objectives: Chunghyul-dan is a combinatorial herbal medicine, and previous studies reported it had therapeutic effects for microangiopathy, which is a major part. in the progression of stroke, as well as having anti-hypertensive, anti-hyperlipidemic, anti-apoptotic, anti-oxidative, and anti-inflammatory activities, Therefore, we examined the inhibitory effect of Chunghyul-dan on stroke occurrence in patients with silent brain infarction. Methods: We prescribed Chunghyul-dan at 600 mg a day to patients with silent brain infarction confirmed by brain MRI, and monitored stroke occurrence, drug compliances, and adverse effects for 1 year, We then performed follow-up brain MRI to detect new vascular lesions after 1 year of Chunghyul-dan medication. As for the subjects lost to follow-up, we assessed their prognosis after 1 year by telephone. Results: There were twenty-one subjects who were treated with Chunghyul-dan for more than 1 year, None of them experienced new clinical syndromes characterized by rapidly developing clinical symptoms and signs of focal and at times global loss of brain function, which could be accompanied with evidence of stroke occurrence, or any adverse effects during the Chunghyul-dan medication period. These results might be explained by various biochemical effects of Chunghyul-dan on microangiopathy, which is closely related with cell cycle progression, hypertension, hyperlipidemia, vascular inflammation, and oxidative damage. Of the 10 subjects lost to follow-up, six were reached; two of them had stroke occurrence. Conclusions: We suggest Chunghyul-dan could be useful for prevention of stroke occurrence in patients with silent brain infarction by preventing the progression of microangiopathy. Further study with a randomized controlled trial is needed to confirm this suggestion.