Journal of Yeungnam Medical Science

Case report

Endocrinology, Diabetes, and Metabolism
Bilateral adrenal adenomas with autonomous cortisol secretion from both glands and autonomous aldosterone secretion from the left adrenal: a case report: Jung Eun Han, Soyeon Yoo, Sang Ah Lee, Gwanpyo Koh; J Yeungnam Med Sci. 2025;42:33. Published online April 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.33

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Abstract PDF: Primary aldosteronism (PA) is the most common cause of secondary hypertension and increases the morbidity and mortality associated with cardiovascular diseases. When PA coexists with autonomous cortisol secretion (ACS), the cardiovascular risk increases significantly, especially in cases of bilateral adrenal adenomas with asymmetric hormone secretion, which poses diagnostic and therapeutic challenges. A 50-year-old female presented with hypertension and hypokalemia. PA was diagnosed based on elevated aldosterone levels, suppressed plasma renin activity, and the results of various dynamic endocrine tests. Imaging revealed bilateral adrenal adenomas, and adrenal venous sampling (AVS) confirmed aldosterone hypersecretion from the left adrenal gland and cortisol hypersecretion from both adrenal glands. The patient subsequently underwent left adrenalectomy, which resolved the aldosterone hypersecretion and normalized blood pressure and potassium levels. However, the cortisol hypersecretion persisted. This case highlights the importance of AVS in identifying the sources of hormone secretion and enabling targeted surgical treatment while avoiding bilateral adrenalectomy, which can lead to lifelong adrenal insufficiency. Comprehensive endocrine evaluation, including ACS assessment, in patients with PA is essential to help reduce the cardiovascular risks associated with PA and ACS and thus improve treatment outcomes.

Review articles

Pulmonary and Respiratory Medicine
Effects of postoperative rehabilitation on functional exercise capacity, dyspnea, and quality of life after pulmonary endarterectomy: a systematic review: Massimiliano Polastri; J Yeungnam Med Sci. 2025;42:32. Published online April 10, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.32

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Chronic thromboembolic pulmonary hypertension (CTEPH) leads to increased vascular resistance and progressive right heart failure resulting from occlusion of proximal pulmonary arteries by fibrotic intravascular material. The elective surgical treatment for CTEPH is pulmonary endarterectomy (PEA), which involves removal of the chronic thromboembolic material from the entire pulmonary arterial tree. This study aimed to verify the effects of acute and subacute postoperative rehabilitation on the functional exercise capacity, dyspnea, and quality of life (QoL) of patients with CTEPH undergoing PEA. This was a systematic review of seven primary databases. At the end of the selection process, five documents were included in the final analysis. Three of these five studies were conducted in Italy, one in Korea, and one in Germany. Of 204 patients, 95 (47%) were male. This systematic review determined that in patients with CTEPH pre-PEA, the 6-minute walk distance (6MWD) ranged between 284.7 m and 371.95 m and that at 6 to 12 weeks post-PEA, after having attended postoperative rehabilitation, the 6MWD was 434.1 m to 483.6 m. The Short Form-36 Health Survey (SF-36) questionnaire was administered to evaluate QoL 3 and 22 weeks after PEA. At 22 weeks, the SF-36 physical component summary score improved from baseline (42.78±18.37 points) by 19.55±19.42 points (p=0.001), and the SF-36 mental component summary score improved from baseline (55.76±23.94 points) by 6.36±20.44 points (p=0.137).

Citations

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Transforming surgical decisions: the rise of predictive and personalized digital tools
Hebatollah E. Eitah, Mohamed Kamel, Amal Ali Alharbi, Wesam Taher Almagharbeh, Malik A. Altayar, Riham A. El-Shiekh
Expert Review of Medical Devices.2026; : 1. CrossRef

Endocrinology, Diabetes, and Metabolism
Screening and treatment of endocrine hypertension focusing on adrenal gland disorders: a narrative review: Seung Min Chung; J Yeungnam Med Sci. 2024;41(4):269-278. Published online September 19, 2024; DOI: https://doi.org/10.12701/jyms.2024.00752

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Abstract PDF

Most cases of high blood pressure have no identifiable cause, termed essential hypertension; however, in approximately 15% of cases, hypertension occurs due to secondary causes. Primary aldosteronism (PA) and pheochromocytoma and paraganglioma (PPGL) are representative endocrine hypertensive diseases. The differentiation of endocrine hypertension provides an opportunity to cure and prevent target organ damage. PA is the most common cause of secondary hypertension, which significantly increases the risk of cardiovascular disease compared to essential hypertension; thus, patients with clinical manifestations suggestive of secondary hypertension should be screened for PA. PPGL are rare but can be fatal when misdiagnosed. PPGL are the most common hereditary endocrine tumors; therefore, genetic testing using next-generation sequencing panels is recommended. Herein, we aimed to summarize the characteristic clinical symptoms of PA and PPGL and when and how diagnostic tests and treatment strategies should be performed.

Citations

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Mechanisms linking hypertension to cardiovascular and cerebrovascular diseases and their clinical implications: A comprehensive review
Guangya Li, Jing Jing Zhang, Xiaojie Mou, Xin Zhuo, Weikai Li, Shenghao Zhang, Shuang Qi, Xiubin Li
Clinical and Experimental Hypertension.2026;[Epub] CrossRef
PHEOCHROMOCYTOMA AND PARAGANGLIOMA: CLINICAL PICTURE, DIAGNOSIS, TREATMENT, FOLLOW-UP AND PROGNOSIS - A LITERATURE REVIEW
Dominika Żyła, Kornelia Rojek, Andrzej Zuzak, Katarzyna Zych, Sylwia Koziej, Adam Jakubas, Mateusz Korga, Milena Krawczyk
International Journal of Innovative Technologies in Social Science.2025;[Epub] CrossRef

Psychiatry and Mental Health
Hypertension and cognitive dysfunction: a narrative review: Eun-Jin Cheon; J Yeungnam Med Sci. 2023;40(3):225-232. Published online November 29, 2022; DOI: https://doi.org/10.12701/jyms.2022.00605

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Abstract PDF

Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

Citations

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Association of serum 25-hydroxyvitamin D and homocysteine “double-risk” status with executive dysfunction in older adults with hypertension
Lili Tan, Linya Zhao, Hongyan Li, Yamin Zhao, Yinyin Chen
Frontiers in Nutrition.2026;[Epub] CrossRef
Hypertension as a Major Risk Factor in Alzheimer’s Disease: Mechanisms, Interactions and Therapeutic Perspectives
Enshe Jiang, Sami Ullah, Irum Waheed, Jinqian Han, Xiaoguang Zhang
Clinical Interventions in Aging.2026; Volume 21: 1. CrossRef
The study of cognitive functions using the P300 event-related potential in women aged 60-74 years living in the European North of Russia, depending on the degree of hypertension control
O. V. Krivonogova, E. V. Krivonogova, L. V. Poskotinova
Acta Biomedica Scientifica.2026; 11(1): 146. CrossRef
Biomarkers for the prediction of the development of neurocognitive disorders in young people with arterial hypertension
A.V. Fysenko, V.M. Mishchenko
Psychiatry Neurology and Medical Psychology.2026; : 34. CrossRef
Electroacupuncture treatment can improve cognitive impairment in spontaneously hypertensive rats: a preliminary DTI study
Ji-peng Liu, Bing-xuan Han, Yu Liu, Bin-bin Nie, Tao Bian, Chuan Liu, Tian-qi Xia, Yu Gong, Long-teng Tu, Jing Zhang, Bing-hui Wang, Yi Yang, Song-Li Li, Lin-ding He, Qing-guo Liu, Meng Xu
Frontiers in Neuroscience.2025;[Epub] CrossRef
Clinical outcomes of antihypertensive medication use in people with dementia: a systematic review and meta-analysis
Firehiwot Amare, Corinne Mirkazemi, Gregory M Peterson, Woldesellassie M Bezabhe
GeroScience.2025;[Epub] CrossRef
Impact of Hypertension on Cognitive Function in Middle Age in the European North of Russia: P300 Event-Related Potential Study
Elena V. Krivonogova, Olga V. Krivonogova, Liliya V. Poskotinova
Ekologiya cheloveka (Human Ecology).2025; 32(7): 469. CrossRef
A study of cognitive functions in elderly men from the Arctic region of the Russian Federation with arterial hypertension using the auditory event-related potentials P300
Olga V. Krivonogova, Elena V. Krivonogova, Lilia V. Poskotinova
Ekologiya cheloveka (Human Ecology).2024; 31(2): 162. CrossRef
Chronic Neuroinflammation and Cognitive Decline in Patients with Cardiac Disease: Evidence, Relevance, and Therapeutic Implications
Jan Traub, Anna Frey, Stefan Störk
Life.2023; 13(2): 329. CrossRef
The A-to-Z factors associated with cognitive impairment. Results of the DeCo study
María Gil-Peinado, Mónica Alacreu, Hernán Ramos, José Sendra-Lillo, Cristina García, Gemma García-Lluch, Teresa Lopez de Coca, Marta Sala, Lucrecia Moreno
Frontiers in Psychology.2023;[Epub] CrossRef

Case reports

Anesthesiology and Pain Medicine
Intra-abdominal hypertension during hip arthroscopy: a case report: Saeyoung Kim, Hyun-Su Ri, Ji Hyun Kim, Jiyong Yeom; J Yeungnam Med Sci. 2023;40(1):102-105. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00430

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Abstract PDF

Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.

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Massive peritoneal effusion following hip arthroscopy: a case report and review of the literature
Ze Wang, Lingchuan Gu, Ying Zhang, Tiao Su, Jiangming Luo, Ran Xiong, Chengjun Huang, Xin Chen, Guangxing Chen
Journal of Medical Case Reports.2025;[Epub] CrossRef
Heated Irrigation Fluids Did Not Reduce the Prevalence of Rectally Measured Hypothermia During Hip Arthroscopic Surgery Compared With Room-Temperature Fluids: A Prospective Randomized Trial
Ahmet Fırat, Enejd Veizi, İlknur Kalaycı, Başak Sinem Sezgin, Yasin Erdoğan, Safa Gürsoy, Bruno Capurro-Soler, Christos Koutserimpas
Orthopaedic Journal of Sports Medicine.2025;[Epub] CrossRef

Cardiology and Cardiovascular Medicine
Fatal progressive right heart failure in a pancreatic cancer patient: Jeong Tae Byoun, Jae Young Cho; Yeungnam Univ J Med. 2020;37(2):122-127. Published online September 19, 2019; DOI: https://doi.org/10.12701/yujm.2019.00332

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Abstract PDF

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal complication of cancer and causes pulmonary hypertension and acute/subacute right heart failure. PTTM is most commonly associated with gastric cancer and more rarely associated with pancreatic cancer. We report a case of progressive right heart failure associated with clinically diagnosed pancreatic cancer, suggesting PTTM.

Citations

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A rare, life-threatening debut of pancreatic adenocarcinoma: Pulmonary tumor thrombotic microangiopathy
Pablo Jiménez-Labaig, Soledad Fernández Solé, Susana Gómez Varela, Jorge García Calvo, Sergio Carrera Revilla, Alberto Muñoz Llarena
Current Problems in Cancer: Case Reports.2023; 10: 100238. CrossRef
Evidence of sex differences in cancer‐related cardiac complications in mouse models of pancreatic and liver cancer
Anna Gams, Alejandro Nevarez, Stephanie Perkail, Aileen Venegas, Sharon A. George, Tatiana Efimova, Igor R. Efimov
Physiological Reports.2023;[Epub] CrossRef
Prospective of Pancreatic Cancer Diagnosis Using Cardiac Sensing
Mansunderbir Singh, Priyanka Anvekar, Bhavana Baraskar, Namratha Pallipamu, Srikanth Gadam, Akhila Sai Sree Cherukuri, Devanshi N. Damani, Kanchan Kulkarni, Shivaram P. Arunachalam
Journal of Imaging.2023; 9(8): 149. CrossRef
Fatal pulmonary tumour thrombotic microangiopathy in patient with ovarian adenocarcinoma: review and a case report
Gintare Neverauskaite-Piliponiene, Kristijonas Cesas, Darius Pranys, Skaidrius Miliauskas, Lina Padervinskiene, Jolanta Laukaitiene, Giedre Baksyte, Gintare Sakalyte, Egle Ereminiene
BMC Cardiovascular Disorders.2022;[Epub] CrossRef

Case Report

Rheumatology
Non-cirrhotic portal hypertension in an ankylosing spondylitis patient: Sukki Park, Ji Hyun Lee, Joon Sul Choi, Hyun Woo Kim, Beom Jin Shim, Won Kyu Choi, Sang Hyun Kim; Yeungnam Univ J Med. 2018;35(1):89-93. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.89

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Abstract PDF: Idiopathic non-cirrhotic portal hypertension (INCPH) is a disease with an uncertain etiology consisting of non-cirrhotic portal hypertension and portal pressure increase in the absence of liver cirrhosis. In INCPH, patients exhibit normal liver functions and structures. The factors associated with INCPH include the following: Umbilical/portal pyremia, bacterial diseases, prothrombic states, chronic exposure to arsenic, vinyl chloride monomers, genetic disorders, and autoimmune diseases. Approximately 70% of patients present a history of major variceal bleeding, and treatment relies on the prevention of complications related to portal hypertension. Autoimmune disorders associated with INCPH are mainly systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis. To the best of our knowledge, a case of ankylosing spondylitis (AS) associated with INCPH has not been reported thus far. Therfore, we report our experience of a patient with AS accompanied by INCPH, who showed perisplenic varices with patent spleno-portal axis and hepatic veins along with no evidence of cirrhosis on liver biopsy, and provide a brief literature review.

Original Article

Microbiology
Sulfatase 1 mediates the inhibitory effect of angiotensin II type 2 receptor inhibitor on angiotensin II-induced hypertensive mediator expression and proliferation in vascular smooth muscle cells from spontaneously hypertensive rats: Hye Young Kim, Hye Ju Cha, Hee Sun Kim; Yeungnam Univ J Med. 2017;34(1):43-54. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.43

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Abstract PDF

BACKGROUND
Extracellular sulfatases (Sulfs), sulfatase 1 (Sulf1) and sulfatase 2 (Sulf2), play a pivotal role in cell signaling by remodeling the 6-O-sulfation of heparan sulfate proteoglycans on the cell surface. The present study examined the effects of Sulfs on angiotensin II (Ang II)-induced hypertensive mediator expression and vascular smooth muscle cells (VSMCs) proliferation in spontaneously hypertensive rats (SHR). METHODS: Ang II receptors, 12-lipoxygenase (12-LO), and endothelin-1 (ET-1) messenger RNA (mRNA) expressions in SHR VSMCs were analyzed by real-time polymerase chain reaction and Western blotting. VSMCs proliferation was determined by [³ H]-thymidine incorporation. RESULTS: Basal Sulfs mRNAs expression and enzyme activity were elevated in SHR VSMCs. However, Sulfs had no effect on the basal or Ang II-induced 12-LO and ET-1 mRNA expression in SHR VSMCs. The inhibition of Ang II-induced 12-LO and ET-1 expression by blockade of the Ang II type 2 receptor (AT₂ R) pathway was not observed in Sulf1 siRNA-transfected SHR VSMCs. However, Sulf2 did not affect the action of AT₂ R inhibitor on Ang II-induced 12-LO and ET-1 expression in SHR VSMCs. The down-regulation of Sulf1 induced a reduction of AT₂ R mRNA expression in SHR VSMCs. In addition, the inhibition of Ang II-induced VSMCs proliferation by blockade of the AT₂ R pathway was mediated by Sulf1 in SHR VSMCs. CONCLUSION: These findings suggest that extracellular sulfatase Sulf1 plays a modulatory role in the AT₂ R pathway that leads to an Ang II-induced hypertensive effects in SHR VSMCs.

Citations

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Sulfatase 1 mediates IL-10-induced dimethylarginine dimethylaminohydrolase-1 expression and antiproliferative effects in vascular smooth muscle cells of spontaneously hypertensive rats
Hye Young Kim, Hee Sun Kim
Cytokine.2021; 137: 155344. CrossRef
Sulfatase 2 mediates, partially, the expression of endothelin-1 and the additive effect of Ang II-induced endothelin-1 expression by CXCL8 in vascular smooth muscle cells from spontaneously hypertensive rats
Hye Young Kim, Dae Won Jeong, Hee Sun Kim
Cytokine.2019; 114: 98. CrossRef

Case Reports

Nephrology
Page kidney after botulinum toxin injection during chiropractic care.: Han Min Park, Chung Jo Choi, Jin Hee Kim, Ja Kyung Kim, Bum Jun Kim, Jae Yong Seo, Yong Seol Jeong, Jwa Kyung Kim, Sung Gyun Kim; Yeungnam Univ J Med. 2015;32(2):143-145. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.143

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Abstract PDF: Page kidney refers to the phenomenon of hypertension secondary to long-standing compression of renal parenchyma caused by renal subcapsular collection. The most common cause of renal subcapsular collection is a hematoma which usually occurs after a history of blunt trauma. A 42-year-old female patient who received botulinum toxin injection in her back during chiropractic care was admitted to the emergency room with sudden bilateral flank pain and hypertension. The computed tomography (CT) images demonstrated the presence of bilateral subcapsular renal hematoma. The patient was treated conservatively and recovered well. The follow up CT images showed markedly resolved bilateral hematoma.

Cardiology and Cardiovascular Medicine
Cardiovascular beriberi: rare cause of reversible pulmonary hypertension.: Joon Hyuk Song, Sang Soo Cheon, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2014;31(1):38-42. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.38

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Abstract PDF

Cardiovascular beriberi is caused by thiamine deficiency and usually presents as high cardiac output failure associated with predominantly right-sided heart failure and rapid recovery after treatment with thiamine. Because of its rarity in developed countries, the diagnosis can often be delayed and missed. We recently experienced a case of cardiovascular beriberi with pulmonary hypertension which successfully treated with thiamine infusion. A 50-year-old man with chronic heavy alcoholics was refered to our department for dyspnea with mental change. Echocardiography showed marked right ventricular (RV) dilatation and flattening of the interventricular septum with a D-shaped deformation of the left ventricle. Moderate tricuspid valve regurgitation was found and estimated RV systolic pressure was 52 mm Hg. Because of his confused mentality and history of chronic alcohol intake, neurological disorder due to thiamine deficiency was suspected and intravenous thiamine was administered and he continuously received a daily dose of 100 mg of thiamine. Follow up echocardiography showed marked reduction of RV dilatation and improvement of a D-shaped deformation of the left ventricle. He finally diagnosed as cardiovascular beriberi on the basis of dramatic response to intravenous thiamine. Thiamine deficiency can cause reversible pulmonary hypertension, and can still be encountered in the clinical setting. Thus high index of suspicion is critically needed for diagnosis.

Citations

Citations to this article as recorded by

Beriberi: A Reversible Cause of Acute Severe Pulmonary Hypertension
Mei L Tan, Christopher G Willis
Cureus.2022;[Epub] CrossRef
Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure
Jeong Ho Eom, Myung Goo Lee, Chang Youl Lee, Kyong Min Kwak, Won Jae Shin, Jung Wook Lee, Seong Hoon Kim, Sang Hyeon Choi, So Young Park
Yeungnam University Journal of Medicine.2015; 32(2): 106. CrossRef

Review Article

Pediatrics, Perinatology, and Child Health
Obesity and Insulin Resistance in Childhood.: Kwang Hae Choi; Yeungnam Univ J Med. 2012;29(2):73-76. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.73

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Abstract PDF: More and more children are becoming obese and overweight due to several factors that include a high energy density in the diet (a high fat intake) and low energy expenditure. Consequently childhood obesity is becoming a significant health problem. Fat tissue releases many cytokines such as resistin, tumor necrosis factor-alpha, leptin, interleukin-6. These adipocytokines induce obesity-related insulin resistance. Insulin resistance is a key component of obesity-related metabolic problems such as hypertension, type 2 diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, acanthosis nigricans and polycystic ovarian syndrome. This review article focused on insulin resistance and its related metabolic diseases.

Case Reports

Pulmonary and Respiratory Medicine
Chronic Obstructive Pulmonary Disease with Severe Pulmonary Hypertension: A Case Report.: Chan Soh Park, Hyun Jung Chin, Seok Min Kim, Chang Woo Son, Sung Ken Yu, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2008;25(1):50-57. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.50

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Abstract PDF: Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.

Neurology
Neuro-Behcet's Disease Presented with Cerebral Venous Sinus Thrombosis: A Case Report.: Yun Kyung Lee, Mee Young Park, Seung Hyun Lee, Sung Gyun Joo, Yong Kook Cho; Yeungnam Univ J Med. 2004;21(1):96-100. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.96

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Abstract PDF: Behcet's disease is a chronic, relapsing multisystem disorder, that may develop into variable neurological manifestations. They include vascular and parenchymal involvement. Vascular involvement is dominated by cerebral venous sinus thrombosis marked by benign intracranial hypertension. Cerebral venous sinus thrombosis can present with all the classical criteria for idiopathic intracranial hypertension, including normal brain CT findings with normal CSF content. But brain MRI is a useful diagnostic method in this situation to confirm the presence of cerebral venous sinus thrombosis. We experienced a case of raised intracranial pressure in a 21-year-old man, caused by cerebral venous sinus thrombosis. We disclosed his symptoms and signs thus fulfilling the diagnostic criteria for Behcet's disease.

Original Article

Gastroenterology and Hepatology
The Effects of Nitric Oxide Inhibitor on Hyperdynamic Circulation in Portal Hypertensive Rats.: Pill Young Kim, Byeong Ik Jang, Tae Nyeun Kim, Moon Kwan Chung; Yeungnam Univ J Med. 1999;16(2):181-192. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.181

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Abstract PDF: BACKGROUND
Nitric oxide, a vasodilator synthesized from L-arginine by vascular endothelial cells. accounts for the biological activity of endothelium derived relaxing factor. Previous studies demonstrated that nitric oxide inhibitor. N'-Nitro-L-Arginine(NNA)diminished the hyperdynamic splanchnic and systemic circulation in portal hypertensive rats. The present study was done to determine the role of nitric oxide in the development of hyperdynamic circulations in the prehepatic portal hypertensive rat model produced by partial portal vein ligation. METHODS: The portal hypertensive rats were divided into water ingestion group and NNA ingestion group. After partial portal vein ligation. NNA ingestion group and water ingestion group received NNA, 1mg/kg/day and plain water through the mouth for 14 days, respectively. Cardiac output, mean arterial pressure, organ blood flow and porto-systemic shunting were measured by radioisotope microsphere methods. Vascular resistances were calculated by standard equation. RESULTS: There were significant decreases in mean arterial pressure, increases in cardiac output and cardiac index, and decreases in total systemic and splanchnic vascular resistance in portal hypertensive rats compared to normal control froup(p<0.01). Compared to the water ingestion group, significantly increased mean arterial pressure wit decreased cardiac output and cardiac index were dexeloped in the NNA ingestion group. Total systemic and splanchnic vascular resistance were significantly increased in the NNA ingestion group compared to water ingestion group(p<0.05). But, there was no significant difference in portal pressure between the two groups. CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic circulation in prehepatic portal hypertensive rat model was attenuated by ingestion of NNA. Nitric oxide may play an important role in the development of hyperdynamic circulation with splanchnic vaodilation in chronic portal hypertension.

Case Report

Nephrology
Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis.: Ho Jin Jung, Won Suk Choi, Hyun Jae Kang, Byung Chun Jung, Bong Ryeol Lee, Jong Joo Lee, Jun Young Lee; Yeungnam Univ J Med. 2015;32(2):146-151.; DOI: https://doi.org/10.12701/yujm.2015.32.2.146

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Abstract PDF: Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

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