• Childhood Kidney Diseases
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• 제8권1호
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• pp.68-73
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• 2004

Gitelman 증후군과 Bartter 증후군은 모두 상염색체 열성으로 유전되는 신 세뇨관 질환으로 낮은 혈중 포타시움 농도, 대사성 알칼리혈증, 염분 소실, 정상 또는 낮은 혈압을 특징으로 한다. Gitelman 증후군은 thiazide-sensitive Na-Cl cotransporter(NCCT)의 유전자 돌연변이로 발생하며, 저마그네슘혈증과 저칼슘뇨증이 있는 것으로 Bartter 증후군과 구별된다. 환자들은 대개 증상이 없으며, 일정 기간 동안 근 약화, 테타니 등을 보이지만, 대부분의 경우 성인이 되어서 진단된다. 저자들은 11세된 여아에서 간질 발작의 악화로 내원하였다가 우연히 발견된 Gitelman 증후군 1례를 경험하였기에 보고하는 바이다. Gitelman 증후군의 진단은 대사성 알칼리혈증, 저칼륨혈증, 저마그네슘혈증, 저칼슘뇨증에 의해 근거하였다. 저자들은 또한 환자의 SLC12A3 유전자에서 이종접합체성 $^{642}$Arg(CGC)>Cys(TGC)변이와 동종접합체성 가성엑손을 확인하였다.

• Journal of Chest Surgery
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• 제16권2호
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• pp.213-220
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• 1983

Pulmonary function is the determinant of blood gas tension. However, Acid-Base disturbances can also alter partial pressures of oxygen and carbon dioxide in arterial blood. During respiratory acidosis $PO_2$ will be lowered and reverse changes will be produced during respiratory alkalosis. On the other hand, in metabolic acidosis $PO_2$ will be elevated and $PCO_2$ will be lowered by the respiratory compensation, and reverse response will be induced in metabolic alkalosis. Urinary gas tension has many influencing factors than arterial blood and difficult to estimate the tendency of its alterations. Urinary $PO_2$ and $PCO_2$ are not always identical level as venous blood. It is to be altered by blood gas tension, flow rate of urine, metabolic rate of kidney, and Acid-Base status of blood. Particularly countercurrent exchange of oxygen and carbon dioxide in the renal medulla will make larger alteration of gas tension than venous blood. After induction of Acid-Base disturbances [disturbances] arterial and urinary $PCO_2$, $PO_2$, urinary volume, and osmolarity were determined in dogs, and the relationships between arterial and urinary $PCO_2$ , $PO_2$ Acid-Base disturbances, urinary volume, and osmolarity were investigated. 1. During the acute Metabolic and Respiratory disturbances urinary pH did not respond on respiratory origin. However, there were immediate urinary response in pH on metabolic origin. 2. Urinary $PO_2$, $PCO_2$, did not always follow arterial or venous gas tension and Acid-Base disturbance. Urinary $PCO_2$, correlate well with the urinary volume. The larger the urinary volume, $PCO_2$ lowered to the venous level. The smaller the urinary volume, urinary $PCO_2$ tends to be higher. However urinary $PO_2$ did not have any particular correlation with urinary volume. 3. Correlation between urinary $PCO_2$ and $PO_2$ were inversely proportional to arterial blood. Differences of $PCO_2$ between arterial blood and urine also did not have any particular correlation with urinary volume. This may suggest that changes on blood gas tensions can influence on urinary $PCO_2$. 4. There were eminent clear inverse correlation between urinary $PCO_2$ and osmolar concentrations of urine. Above results strongly suggest that partial pressure of gas in urine primarily depend upon counter-current exchanges in renal medullary tissues.

• 대한장애인치과학회지
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• 제15권1호
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• pp.45-49
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• 2019

Bartter 증후군은 심각한 헨레고리 비후 상행각(TAL)에서의 일차적인 염류(NaCl) 수송 장애로 인하여 심각한 저칼륨혈증을 특징으로 하는 질환이다. 만성 구토로 인한 치아의 부식, 교모, 마모의 구강 내 소견을 보여 구토와 관련된 적절한 칫솔질 및 식이 습관 등에 대한 정기적인 교육과 관찰이 권장되며 교합고경의 회복을 위해 전장관 수복이 추천된다. 치과 치료 시의 스트레스로 인하여 전해질 수치의 불균형이 초래될 가능성이 있어 전신마취 하 치료가 유리할 수 있으며, 전신마취 시 과환기되어 저칼륨혈증이 심화되지 않도록 지속적인 감시를 해야하고 술 후에도 전해질 불균형이 초래되지 않도록 지속적인 감시가 필요하다.

• 대한장애인치과학회지
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• 제10권2호
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• pp.106-113
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• 2014

저자 등은 개원 치과의원에서 하악 매복지치 발치중 유발된 불안장애와 과환기증 및 발치 창상 주위 출혈과 동통을 보였던 57세 여환을 신속한 정신안정법 적용하에 수액 약물요법과 외과적 처치(잔존 치근 남긴채 창상 지혈, 봉합, 배액술 등)로 관리하여 양호한 경과를 치험하면서, 평소 진료시 정신과적 장애문제에 큰 관심을 가져야 하며, 특히 수술시 스트레스 감소법에 더욱 유념하게 되었다.

• 한국임상수의학회지
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• 제28권4호
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• pp.352-356
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• 2011

Abstract: This study was aimed to diagnose acid-base disorders of dogs with canine parvoviral enteritis (CPE) and data to establish a rational fluid therapy regimen for patients with CPE. A total of 43 dogs which had clinical signs of CPE and had detected canine parvovirus by polymerase chain reaction, were bled anaerobically from jugular vein at the time of admission. Blood chemical test, determination of electrolytes and blood gas analysis were conducted, and calculated values were obtained from each measured items. The values of blood chemical and electrolytes of dogs with CPE were various depending on the degree of clinical signs, and these tests were not specific to diagnose for CPE. Hypochloremia (20.9%), hyperchloremia (11.6%), hypokalemia (7.0%), hyperkalemia (11.6%), hyponatremia (9.3%) and hypernatremia (18.6%) were diagnosed as abnormalities of electrolytes from 43 dogs with CPE. The 29 out of 43 dogs (67.4%) were metabolic acidosis and 3 dogs (7.0%) were metabolic alkalosis. The acid-base status of 11 dogs out of 43 dogs (25.6%) was normal.

• Childhood Kidney Diseases
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• 제20권2호
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• pp.83-87
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• 2016

Congenital chloride diarrhea (CLD) is a rare autosomal recessive disease that is difficult to diagnose. CLD requires early treatment to correct electrolyte imbalance and alkalosis and to prevent severe dehydration. Renal injury is clearly associated with defective electrolyte balance induced by CLD, particularly during the first months or years of life. A 7-year-old boy was diagnosed with CLD following detection of a homozygous mutation (c.2063-1G>T) in SLC26A3 at 6 months of age. During treatment with electrolyte supplements, mild proteinuria was detected at 8 months of age, and is still present. Renal biopsy showed the presence of focal renal dysplasia, with metaplastic cartilage and mononuclear cell infiltration, calcification, and fibrosis in the interstitium. Up to two-thirds of the glomeruli exhibited global obsolescence, mostly aggregated in the dysplastic area. In nondysplastic areas, the glomeruli were markedly increased in size and severely hypercellular, with increased mesangial matrix, and displayed segmental sclerosis. The marked glomerular hypertrophy with focal segmental glomerulosclerosis suggested a compensatory reaction to the severe nephron loss or glomerular obsolescence associated with renal dysplasia, with superimposed by CLD aggravating the tubulointerstitial damage.

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.101-105
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• 2017

Gitelman syndrome is a condition caused by a mutation of the thiazide sensitive Na-Cl cotransporter gene on the distal convoluted tubule. It results in a variety of clinical features, including hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. It is often diagnosed in asymptomatic adults presented with unexplained hypokalemia; however, it is sometimes associated with muscular cramps, numbness, fatigue, weakness, or paralysis. We experienced a case of rheumatoid arthritis accompanied by Gitelman syndrome, presented with hand tremor. We diagnosed her using renal clearance study and genetic analysis. Here, we report our experiences regarding this case along with a literature review.

• Asian-Australasian Journal of Animal Sciences
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• 제20권5호
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• pp.742-747
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• 2007

In order to investigate the mechanism of adaptation to long-term heat stress, six female buffalo calves of about 7 to 8 months age, were exposed to the cool-comfort environment (THI 65) for 21 days to obtain normal values of blood acid-base. An adaptive response of acid-base regulation was determined to long term (21 days) exposure of buffalo calves to hot-dry (THI 80) and hot-humid (THI 84) conditions. Higher rectal temperature and respiratory rate was recorded under hot-humid exposure compared to hot-dry. Significant reduction in the rectal temperature and respiratory rate on day 21 of hot-dry exposure indicated early thermal adaptation compared to hot-humid. Decreasing rectal temperature and respiratory rate from day 1 to 21 was associated with concurrent decrease in blood pH and pCO2. Increased plasma chloride concentration with low base excess in blood and in extracellular fluid suggested compensatory response to respiratory alkalosis. Reduced fractional excretion of sodium with increased fractional excretion of potassium and urine flow rate indicated renal adaptive response to heat stress.

• Childhood Kidney Diseases
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• 제6권2호
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• pp.259-265
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• 2002

저자들은 본원 소아과에 입원한 9년 3개월된 남아에서 만성병색소견, 심한 근무력증, 왜소증, 저칼륨성 대사성 알칼리혈증 및 신석회증과 좌측 요관의 확장을 보이는 영아기 이후 발병한 Bartter 증후군 1례를 경험하였기에 치료반응 및 임상경과를 문헌 고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제31권1호
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• pp.21-24
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• 2014

Clinical presentation of Bartter syndrome is similar to surrepitious vomiting or use of diuretics. Therefore, precise differential diagnosis of Bartter syndrome is crucial. We report a case of medullary nephrocalcinosis (MNC) induced by furosemide mimicking Bartter syndrome. A 55-year-old female patient visited our hospital with renal dysfunction on basis of hypokalemia and metabolic alkalosis. She had no history of hypertension or drug use except allopurinol and atorvastatin. She did not complain of nausea or vomiting on presentation and the serum magnesium level was normal. We performed ultrasonography, that showed MNC. For these reasons, we suspected Bartter syndrome and corrected the electrolyte imbalance. During outpatient follow up, we found that the patient had been taking 400 mg of furosemide daily for 30 years. We could diagnose furosemide induced MNC, and recommended to her to reduce the amount of furosemide.