• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.84-89
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• 2018

Purpose Renin is a proteolytic enzyme synthesized and secreted from epidermal(juxtaglomerular) cells in kidney. Renin acts on the renin substrate angiotensinogen to produce angiotensin I, and then angiotensin II is produced by the action of angiotensin converting enzyme. This causes the adrenal glands to boost blood pressure (vasoconstriction) and promote aldosterone secretion. While Plasma renin activity (PRA) is to test angiotensin I, the active renin concentration (ARC) is a renin test directly. They have different test methods and their own substrates. However, these two methods are sometimes interpreted as the same as a result. The purpose of this study was to evaluate the usefulness of the ARC test by comparing the results between PRA and ARC. Materials and Methods For the diversity of the experiment, 26 samples were requested to test with PRA(TFB company) and ARC(Cisbio company) to other institution. We compared and analyzed PRA(Immunotech company) and ARC(Cisbio company) tests using 28 samples from September $15^{th}$ to October $13^{th}$ in 2017. The statistical analysis method for PRA/ARC evaluated the usefulness using Microsoft Excel program by verifying a correlation analysis of Aldosterone/PRA ratio and a correlation analysis of Aldosterone/ARC ratio and conducting T-test. Results The regression equation of the PRA(Immunotech company)/ARC(Cisbio company), which was tested in the department, was y = 0.0619x + 0.4615 and the correlation coefficient was 0.73. The regression equation of the PRA(TFB company)/ARC(Cisbio company), which was tested in the other institution, was y = 0.0888x + 0.3316 and the correlation coefficient was 0.91. In addition, The regression equation of Aldosterone / PRA ratio and Aldosterone / ARC ratio was y = 0.875x - 11.688 and the correlation coefficient was 0.87. Plus T - test showed no significant difference (P>0.05). Conclusion Both tests showed a strong positive correlation, but this only represents the strength and direction of the relationship between the two tests. Furthermore, the actual results showed somewhat differences. It is presumed that the measured value was influenced by the endogenous renin group mass in the plasma, the condition of the enzyme reaction and the kind of the inhibitor. When the active renin concentration (ARC) test is performed, it is useful to distinguish between the two tests as they are complementary.

• The Korean Journal of Physiology
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• v.8 no.1
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• pp.7-14
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• 1974

This study was carried out to investigate the acute changes in R-A-A system following lasix administration, and to evaluate the materials in plasma R-A-A system and electrolytic excretion every 30 minutes for 2 hours after lasix administration with normal high sodium Korean food, moderate sodium restriction, and severe sodium restriction, and it was concluded as followed; 1. Plasma renin activity, angiotensin II concentration, and aldosterone concentration elevated in course of time after lasix administration with high sodium Korean food, but the R-A-A system takes insignificant part because of the increasing rate was so slight. 2. Although the increasing rate of plasma renin activity reached lower levels, angiotensin II and aldosterone concentration were significantly increased after lasix administration with moderate sodium restriction. 3. It was observed that higher rise in aldosterone concentration following lasix administration during severe sodium restriction than when moderate sodium restriction. 4. Urinary sodium and potassium excretion during two hours after lasix administration showed decrease as little as the amount of sodium intake, but K/Na excretion ratio showed increase with small amount of sodium intake because of the decreasing rate of potassium was low value. 5. Sodium excretion after lasix administration reached more than 1.5 times of sodium intake, even though R-A-A reaction showed significantly. 6. As our results showed, R-A-A reaction following acute diuresis was insignificant with high sodium Intake, the increasing ratio of aldosterone concentration showed high rise compare with of plasma renin activity as little as the amount of sodium intake, and the participated rate in sodium reabsorption of R-A-A system was increased.

• 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.

• Endocrinology and Metabolism
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• v.33 no.4
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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.