• Journal of Genetic Medicine
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• v.10 no.2
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• pp.81-87
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• 2013

Pseudohypoaldosteronism (PHA), a rare syndrome of systemic or renal mineralocorticoid resistance, is clinically characterized by hyperkalemia, metabolic acidosis, and elevated plasma aldosterone levels with either renal salt wasting or hypertension. PHA is a heterogeneous disorder both clinically and genetically and can be divided into three subgroups; PHA type 1 (PHA1), type 2 (PHA2) and type 3 (PHA3). PHA1 and PHA2 are genetic disorders, and PHA3 is a secondary disease of transient mineralocorticoid resistance mostly associated with urinary tract infections and obstructive uropathies. PHA1 includes two different forms with different severity of the disease and phenotype: a systemic type of disease with autosomal recessive inheritance (caused by mutations of the amiloride-sensitive epithelial sodium channel, ENaC) and a renal form with autosomal dominant inheritance (caused by mutations of the mineralocorticoid receptor, MR). In the kidneys, the distal nephron takes charge of the fine regulation of water absorption and ion handling under the control of aldosterone. Two major intracellular actors necessary for the action of aldosterone are the MR and the ENaC. Impairment of the intracellular aldosterone signal transduction pathway results in resistance to the action of mineralocorticoids, which leads to PHA. Herein, ion handling the distal nephron and the clinico-genetic findings of PHA are reviewed with special emphasis on PHA type 1.

• Journal of Biomedical and Translational Research
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• v.19 no.4
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• pp.86-91
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• 2018

Angiotensin receptor blockers, such as telmisartan, are considered effective in the treatment of hypertension and proteinuria due to chronic kidney disease (CKD) in cats. It selectively blocks the $AT_1$ receptor and does not affect the $AT_2$ receptor, thus effectively blocking the activity of the renin angiotensin aldosterone system. This study aims to compare over time the changes in various indicators, including systemic hypertension and proteinuria, before and after the administration of telmisartan in cats with CKD. Decrease in blood pressure (BP) (p<0.001) and urine protein to creatinine (UP/C) ratio (p<0.001) were found to be statistically significant over time after the administration of telmisartan. BP and the UP/C ratio were $160{\pm} 22.2$ and $0.50{\pm}0.647$ before telmisartan administration (Day 0), $150{\pm}21.0$ and $0.27{\pm}0.487$ on the 30th day (Day 30), $150{\pm}17.0$ and $0.25{\pm}0.376$ on the 60th day (Day 60), and $140{\pm}17.8$ and $0.15{\pm}0.233$ on the 90th day (Day 90) after administration, respectively. BP and UP/C were statistically significantly lower in cats with CKD over time at each time point from Day 0 to Day 90 at 30 day intervals. Especially after 90 days of telmisartan administration, the improvement of BP and UP/C were estimated to be about 20 mmHg and 0.35, respectively. In conclusion, the oral administration of telmisartan to cats with CKD is effective in improving BP and proteinuria, which has a positive effect on long-term survival in cats with CKD.

• Tuberculosis and Respiratory Diseases
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• v.64 no.2
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• pp.125-132
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• 2008

Background: In chronic obstructive pulmonary disease (COPD) patients, the serum levels of C-reactive protein (CRP) are elevated and an increase of CRP is more exaggerated in the acute exacerbation form of COPD (AECOPD) than in stable COPD. Pulmonary arterial hypertension is a common complication of COPD. An increased level of CRP is known to be associated with the risk of systemic cardio-vascular disorders. However, few findings are available on the potential role of CRP in pulmonary arterial hypertension due to COPD. Methods: This study was performed prospectively and the study population was composed of 72 patients that were hospitalized due to AECOPD. After receiving acute management for AECOPD, serum CRP levels were evaluated, arterial oxygen pressure ($PaO_2$), was measured, and the existence of pulmonary arterial hypertension under room air inhalation was determined in the patients. Results: The number of patients with pulmonary arterial hypertension was 47 (65.3%)., There was an increased prevalence of pulmonary arterial hypertension and an increase of serum CRP levels in patients with the higher stages of COPD (e.g., patients with stage 3 and stage 4 disease; P<0.05). The mean serum CRP levels of patients with pulmonary arterial hypertension and without pulmonary arterial hypertension were $37.6{\pm}7.4mg/L$ and $19.9{\pm}6.6mg/L$, respectively (P<0.05). However, there was no significant difference of the mean values of $PaO_2$ between patients with pulmonary arterial hypertension and without pulmonary arterial hypertension statistically ($77.8{\pm}3.6mmHg$ versus $87.2{\pm}6.0mmHg). Conclusion: We conclude that higher serum levels of CRP can be a sign for pulmonary arterial hypertension in AECOPD patients.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.682-687
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• 2021

Systemic-to-pulmonary artery fistulas are rare. This condition may be congenital, post-traumatic, or post-inflammatory and can cause infection, hemorrhage, or pulmonary hypertension. Here, we report a case of an intercostal-to-pulmonary artery fistula, incidentally detected during the evaluation of dyspnea in a 67-year-old female. Retrograde transcatheter coil embolization in a dilated draining pulmonary artery was initially attempted. However, another draining pulmonary artery developed after 5 months. The intercostal arteries or systemic feeders were successfully embolized through a transarterial access. At the 10-month follow-up, the abnormally dilated vessels had regressed, and dyspnea had improved. Sequential or simultaneous retro- and antegrade transcatheter embolization may successfully treat pleural arterio-arterial fistulas.

• Journal of Oral Medicine and Pain
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• v.9 no.1
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• pp.43-49
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• 1984

The need for a brief questionaire, written in language that the patient can readily understand, to provide the dentist with an adequate current medical history of his patient has been estabished. So this study with brief medical questionaire for routine use in dental practice is discussed in relation to the findings from its use among a survey group of 513 patients. The results are that : 1. In 58.3% percent of the patients surveyed, at least one question was answered posi tively. 2. The frequency of positive responses in the various group was: medical treatment within recent 2 years, 27.5%; hospitalization, 27.1%;drug history within recent year, 25.9%. 3. The important systemic diseases being considerd in dental practice are: anemia, 4.9%; hypertension, 4.1%; tuberculosis, 3.9%.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.67-71
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• 2016

Eisenmenger syndrome (ES) is characterized by pulmonary arterial hypertension and right-to-left shunting. The signs and symptoms of ES include cyanosis, shortness of breath, fatigue, hemoptysis, and sudden death. In patients with ES, it is important that the systemic and pulmonary circulations be properly distributed and maintained. General dental treatment is not known to be particularly dangerous. To control pain and anxiety, local anesthetics without epinephrine are usually recommended. However, in cases of difficulty of cooperation, general anesthesia for dental treatment makes the condition worse. In the present case, intravenous deep sedation with propofol and remifentanil was administered for behavioral management during dental treatment successfully.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.1
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• pp.12-14
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• 2004

Anaphylaxis is a systemic allergic reaction which can bring fatal results. The common symptoms are erythema, angioedema, urticaria, hypertension and dyspnea. However, in very few cases, ST segment changes in the electrocardiogram can be seen. This is a case of a 51 year old female with normal heart function who showed reversible ST segment depression during anaphylaxis caused by a $H_2$-blocker agent. The cause of ST segment changes during anaphylaxis is thought to be the result of coronary vasospasm mediated by various factors.

• Journal of Oral Medicine and Pain
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• v.49 no.2
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• pp.40-42
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• 2024

Hyperparathyroidism (HPT) is a significant condition marked by the overproduction of parathyroid hormones, affecting both systemic health and orofacial regions. Predominantly, secondary HPT associated with chronic kidney disease (CKD) is critical because of its link to widespread conditions such as diabetes and hypertension. This short article highlights the vital role of dental professionals in identifying HPT through panoramic radiography, which can reveal critical orofacial signs such as brown tumors, altered dental development, and specific bone changes. With the CKD prevalence expected to increase alongside an aging population, the importance of early detection of HPT and its manifestations in dental settings cannot be overstated. Dental practitioners play a crucial role in the early detection of HPT, emphasizing the importance of being knowledgeable about its orofacial manifestations.

• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.66-71
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• 2004

Primary pulmonary hypertension (PPH) is a rare, progressive and incurable disease, which is characterized by an increase in the pulmonary artery pressure without a demonstrable cause. The most common presenting symptom is dyspnea on exertion, with other symptoms comprising of chest pain, syncope and hemoptysis. The diagnosis is one of exclusion of any of the known causes of pulmonary hypertension. When associated with pregnancy, the maternal mortality ranges from 30 to 50%. Because pregnancy and labor are very serious problems for patients with PPH, the available evidence suggests that pregnancy when afflicted with PPH should be avoided. In account the case of a 33-year old patient, reporting with massive hemoptysis, and diagnosed with PPH during her twenty seventh week of gestation, is presented. She was treated with conservative management, including oxygen and a vasodilator, and underwent a pregnancy termination. However, due to aggravation of right heart failure, she presented with severe systemic hypotension and hypoxemia, and eventually died. This case is reported, with brief review of the literature.

• Journal of Veterinary Clinics
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• v.33 no.4
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• pp.234-236
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• 2016

A 14 kg, 9-year-old, spayed female, Cocker Spaniel was presented to the Veterinary Medical Teaching Hospital of Seoul National University with a history of head tilt and circling. Otitis externa and media were diagnosed by computerized tomography, and total ear canal ablation was performed. In preanesthetic evaluation, systemic hypertension and second-degree atrioventricular block were observed, but there was no regurgitation through the heart valves. Systemic hypertension was managed with amlodipine (0.1 mg/kg, PO, BID) for the anesthesia. The dog was premedicated with cefazolin (22 mg/kg, IV) and midazolam (0.2 mg/kg, IV). Anesthesia was induced with alfaxalone (2 mg/kg, IV) and maintained with isoflurane and 100% oxygen following intubation. During surgery, vital signs (heart rate, respiratory rate, blood pressure, end tidal carbon dioxide partial pressure and body temperature) were maintained within normal ranges, but bradycardia was observed and corrected with glycopyrrolate (5 ug/kg IV, twice). During subcuticular suture, electrohemostasis was applied at the incision line, which was close to the trigeminal nerve. In no time at all, heart rate dramatically decreased from 110 to 60 beats per minute. No additional treatment was done because mean blood pressure was maintained above 70 mmHg. The heart rate recovered according to the decrease of end tidal isoflurane concentration and there were no complications associated with the anesthesia and surgery. Sudden bradycardia after electrical stimulation around the trigeminal nerve was considered as trigeminocardiac reflex (TCR). It is recommended to be careful of bradycardia from TCR when electrocautery is used in the craniofacial area during surgery.