• 제목/요약/키워드: Water-electrolyte imbalance

검색결과 10건 처리시간 0.025초

A Case of Hepatotoxicity by Salvia Plebeia R. Br.

  • Son, Chang-gue
    • 대한한방내과학회지
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    • 제40권6호
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    • pp.1219-1224
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    • 2019
  • Objective: To investigate the possibility of hepatotoxicity by supplemental foods or folk herbs such as Salvia Plebeia R. Br. Methods: A hospitalized male patient with alcoholic liver disease and electrolyte imbalance had recovered, and then followed by rapid hepatic serum enzymes after taking S. Plebeia. This study monitored the clinical outcome and biochemical parameters. Result: A 58-year male had drunk frequently, which led to alcoholic steatohepatitis and hospitalization. Two weeks after his discharge from hospital, he felt nausea, dizziness, and mild difficulties in speech and walking, resulting in re-hospitalization at the Korean Medical Hospital. The symptoms disappeared on correction of the electrolyte imbalance suspected to have been caused by severe sweating while working in the outdoors, and the patient was discharged. During treatment and monitoring of his health as an outpatient, the serum hepatic enzyme rapidly elevated approximately 10-fold in hepatic enzymes; the enzyme levels fluctuated according to whether or not he was taking the boiled water of S. Plebeia. The RUCAM score was 12, which met the criteria for toxic hepatitis by S. Plebeia. His general condition and abnormal hepatic enzymes recovered with cessation of S. Plebeia and administration of Chungganplus syrup (CGX). Conclusion: This study reports the hepatotoxic risk of Salvia Plebeia, which is commonly used as a folk remedy in Korea.

The Clinical Characteristics of Electrolyte Disturbance in Patients with Moderate and Severe Traumatic Brain Injury Who Underwent Craniotomy and Its Influence on Prognosis

  • Geng Huan Wang;Yu Yan;He Ping Shen;Zhengmin Chu
    • Journal of Korean Neurosurgical Society
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    • 제66권3호
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    • pp.332-339
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    • 2023
  • Objective : The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. Methods : A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. Results : A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). Conclusion : The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

수분 섭취 및 배설량의 측정방법에 관한 연구 (A Study on Fluid Intake and Output Measurements)

  • 최스미;양영희;정연
    • 대한간호학회지
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    • 제25권1호
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    • pp.88-98
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    • 1995
  • The Fluid and electrolytes balance in the body is of critical importance in maintaining good health. When the fluid and electrolyte imbalance is present, patients are in great danger. They must be assessed immediately by a nurse so that appropriate treatment can be started as soon as possible. Patients' fluid intake and output records contain highly important information for the diagnosis and treatment of fluid imbalance, but, these records are often inaccurate and the method of recording the fluid intake is not universal for every hospital. Be-cause they are few quantitative measurements of a patient's hydration, the need to improve the accuracy of fluid intake records is very important. However, very few studies have been done to investigate the accuracy of measurements of patients' fluid intake and output. The purpose of this study was to investigate the methods used for calculation of fluid intake which is most similar to fluid output in normal adults and hospitalized patients. This study focused on three different calculation methods for fluid intake and compared these to fluid output and developed suggestions as to the ideal way to record fluid in-take. Data for 43 hospitalized patients and 37 normal adults were analyzed. The findings of this study are as follows ; 1) In normal adults, the daily intake of water which enteres by the oral route was 2415m1 (the first method of calculation). The daily intake of water in the form of pure water or some other beverage was 1365m1 (the third method of calculation) The daily intake of water including fresh fruits and vegetables, rice, porridges, and Me m which have water content more than 80% were 2186m1 (the second method of calculation). 2) The urine output of the normal adults was 1350m1. This apprroximates the amount of fluid an adult takes in the form of pure water. 3) In patient group, the total intake of water was 2550m1 (the first method of calculation). The in-take of water in the form of pure water or as some other beverage and IV fluid was 1661m1 (the third method of calculation). The daily in-take of water including foods which have high water content was 2356m1 (the second method of calculation). 4) The urine output of the patient's group was 1728m1. This approximates the amount of fluid an adult takes in the form of pure water. 5) Investigation of the method of calculation of the patient fluid intake showed that among the 31 hospitals studied, only eight use the third method of calculation which reflects the most close value to urine output. From the results obtained in this study, it was indicated that the amount of fluid taken in the form of pure water reflects the most close value to urine output. Therefore, it can be suggested that the third method of calculation which includes water in-take only in the form of pure water or beverage should be used as patients' fluid intake record.

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"병태생리학" 교과목에 대한 전문간호사의 교육 요구도 조사 (Educational Need Assessment of Advanced Practice Nurses on the Pathophysiology)

  • 박미정;안경주;정재심;김희승;홍해숙;최명애
    • Journal of Korean Biological Nursing Science
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    • 제9권1호
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    • pp.85-102
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    • 2007
  • Purpose: Knowledge on pathophysiology is important to understand diseases and patient conditions and also in providing advanced nursing care. This study was performed to investigate the present situation, knowledge, and educational need on pathophyiology of advanced practice nurses(APN). Method: Eighty-four APN, who is practicing in hospitals nationwide, were surveyed with structured questionnaires developed by researchers. The questionnaire were composed of 109 items with 4 point scales with the contents of general characteristics, educational experience on pathophyisology, educational need, and knowledge on major and subcategories of pathophysiology. Result: The 77.1% of APN had experience of taking pathophysiology lecture and the lecturer were mainly medical doctors(39.8%) and APN(32.4%). The 61.5% of APN answered that the knowledge on pathophysiology was helpful and 97.6% of APN thought pathphysiologic education is needed in clinical practice. Seven major categories of pathophysiology showed higher scores were water imbalance, heart diseases, hemodynamic disorders, arterial vessel disorders, electrolyte imbalance, diseases of the digestive system, and diseases of the respiratory systems. Educational needs on the major and subcategories of pathphysiology were different by the field of APN and also by the clinical experiences as APN. APN also responded that there is a necessity to change the present curricular more specific to each practice field and more focus on the clinical practice. Conclusion: It was confirmed that educational and clinical need on the pathophysiology is very high and there is urgent need to change current curricular more specific to the field of APN and also clinical practice. This survey will help to identify and clarify the areas of change and to improve the education for the APN.

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소아의 만성신장질환의 치료 (Treatment of chronic kidney disease in children)

  • 이주훈
    • Clinical and Experimental Pediatrics
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    • 제52권10호
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    • pp.1061-1068
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    • 2009
  • 만성 신질환 환아들의 치료는 신대체 요법과 더불어 적절한 식이 요법, 수분, 전해질 및 산-염기의 관리, 신장 골형성 장애의 예방 및 치료, 빈혈과 고혈압, 성장 지연의 치료 등으로 이루어진다. 식이 요법은 환아들의 성장이 충분히 이루어질 수 있도록 탄수화물, 지방, 단백질 및 열량의 공급이 적절하게 이루어져야 한다. 수분, 전해질 및 산-염기의 상태를 확인하고 적절하게 관리해야 한다. 혈청 칼슘, 인, 부갑상선 호르몬 농도가 사구체 여과율에 따른 적절한 목표치 안에서 유지될 수 있도록 인 결합 제제와 비타민 D 제제를 투여하여 신장 골형성 장애를 예방하여야 한다. 적혈구 생산 촉진제와 철분 제제를 투여하여 혈색소 값을 11-12 g/dl로 유지하여야 한다. 수분 및 염분의 균형과 적절한 항고혈압제의 투여로 고혈압을 조절해야 한다. 사람 재조합 성장 호르몬을 투여하여 최종 성인 키를 호전시키도록 한다.

Severe Gastrointestinal Hemorrhage in a Child after Taking an Improper Oral Rehydration Solution

  • Chung, Chanyoung;Park, Ji Sook;Seo, Ji-Hyun;Youn, Hee Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권4호
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    • pp.405-410
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    • 2020
  • Oral rehydration solution (ORS) is safe and effective for the prevention and treatment of dehydration in children. It has been commercially available as a small packaging unit that needs to be taken with a specified amount of water. Intake of incorrectly formulated ORS results in side effects, such as electrolyte imbalance and upper gastrointestinal (GI) disturbance. We experienced a case of severe GI hemorrhage from gastric and duodenal ulcers in a previously healthy child following intake of incorrectly formulated ORS. GI hemorrhage in children is often life threatening and reaching a diagnosis may be challenging. Commercially manufactured packets of powdered oral rehydration salts have been widely used and GI hemorrhage associated with an improperly diluted ORS has been rarely reported. Caution and education for proper preparation of ORS are imperative.

Polyuria after Surgery of Ruptured Cerebral Aneurysm : with Special Reference to the Administration of Osmotic Diuretics

  • Kang, Sung-Don;Kim, Jong-Moon
    • Journal of Korean Neurosurgical Society
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    • 제38권6호
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    • pp.431-434
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    • 2005
  • Objective : Subarachnoid hemorrhage[SAH] is commonly associated with polyuria [solute diuresis or water diuresis]. The authors investigate the incidence and clinical characteristics of polyuria with special reference to the administration of osmotic diuretics. Methods : One hundred and forty eight patients with high urine output [>200ml/hr] after ruptured cerebral aneurysm operated early from Jan 1998 to Jun 2003 were selected. Water diuresis [diabetes insipidus, DI] was differentiated from solute diuresis by lower urine specific gravity [<1.005] and higher plasma osmolality. The incidence and mode of onset of polyuria were compared between two types of diuresis. Additionally, the relationships between development of polyuria and clinical features including aneurysm location, clinical grade, Fisher grade, and outcome were analyzed. Osmotic diuretics were not routinely used in patients with Hunt-Hess grade I-III since July 2001. Results : Annual incidence of polyuria decreased markedly since July 2001 : 45.2% in 1998, 34.5% in 2001, 11.9% in 2003. Postoperative DI occurred in $2.4{\sim}11.1%$. DI developed mainly from ruptured anterior communicating artery aneurysm. The mean interval between the last SAH and the onset of DI was 7.1 days [range $1{\sim}27$ days] and lasted mean 4.6 days. When compared with solute diuresis, the development of DI was significantly delayed. Other clinical features were not closely related to polyuria. Conclusion : Uncontrolled polyuria may lead to cerebral ischemia and electrolyte imbalance because SAH patients are already predisposed to hypovolemia, and will risk precipitating the opposite situation with overhydration. We can decrease the development of polyuria without routine use of osmotic diuretics, by avoiding the increased intracranial pressure such as the intraoperative ventriculostomy and gentle brain retraction in good grade patients.

비소세포폐암 환자에서 발생한 지속성 딸꾹질 1예 (A Case of Persistent Hiccup in a Patient with Non-small Cell Lung Cancer)

  • 박혜성;심윤수;임소연;조정연;권성신;노선희;김유리;천은미;이진화;류연주;송동은;문진욱
    • Tuberculosis and Respiratory Diseases
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    • 제64권1호
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    • pp.39-43
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    • 2008
  • 저자 등은 종격동 림프절 비대를 동반한 비소세포폐암환자에서 발생한 지속성 딸꾹질을 경험하였기에 이에 대한 임상적 특성과 치료에 관한 문헌 고찰과 함께 보고하는 바이다.

Regulation of Chilling Tolerance in Rice Seedlings by Plant Hormones

  • Chu, Chun;Lee, Tse-Min
    • 한국작물학회지
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    • 제37권3호
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    • pp.288-298
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    • 1992
  • Since the major important factors limiting plant growth and crop productivity are environmental stresses, of which low temperature is the most serious. It has been well known that many physiological processes are alterant in response to the environmental stress. With regard to the relationship between plant hormones and the regulation of chilling tolerance in rice seedlings, the major physiological roles of plant hormones: abscisic acid, ethylene and polyamines are evaluated and discussed in this paper. Rice seedlings were grown in culture solution to examine the effect of such plant hormones on physiological characters related to chilling tolerance and also to compare the different responses among tested cultivars. Intact seedlings about 14 day-old were chilled at conditions of 5$^{\circ}C$ and 80% relative humidity for various period. Cis-(+)-ABA content was measured by the indirect ELISA technique. Polyamine content and ethylene production in leaves were determined by means of HPLC and GC respectively. Chilling damage of seedlings was evaluated by electrolyte leakage, TTC viability assay or servival test. Our experiment results described here demonstrated the physiological functions of ABA, ethylene, and polyamines related to the regulation of chilling tolerance in rice seedlings. Levels of cis-(+)-ABA in leaves or xylem sap of rice seedlings increased rapidly in response to 5$^{\circ}C$ treatment. The tolerant cultivars had significant higher level of endogenous ABA than the sensitive ones. The ($\pm$)-ABA pretreatment for 48 h increased the chilling tolerance of the sensitive indica cultivar. One possible function of abscisic acid is the adjustment of plants to avoid chilling-induced water stress. Accumulation of proline and other compatible solutes is assumed to be another factor in the prevention of chilling injuies by abscisic acid. In addition, the expression of ABA-responsive gene is reported in some plants and may be involving in the acclimation to low temperature. Ethylene and its immediate precusor, 1-amincyclopropane-1-carboxylic acid(ACC) increased significantly after 5$^{\circ}C$ treatment. The activity of ACC synthase which converts S-adenosylmethionine (SAM) to ACC enhanced earlier than the increase of ethylene and ACC. Low temperature increased ACC synthase activity, whereas prolonged chilling treatment damaged the conversion of ACC to ethylene. It was shown that application of Ethphon was beneficial to recovering from chilling injury in rice seedlings. However, the physiological functions of chilling-induced ethylene are still unclear. Polyamines are thought to be a potential plant hormone and may be involving in the regulation of chilling response. Results indicated that chilling treatment induced a remarkable increase of polyamines, especially putrescine content in rice seedlings. The relative higher putrescine content was found in chilling-tolerant cultivar and the maximal level of enhanced putrescine in shoot of chilling cultivar(TNG. 67) was about 8 folds of controls at two days after chilling. The accumulation of polyamines may protect membrane structure or buffer ionic imbalance from chilling damage. Stress physiology is a rapidly expanding field. Plant growth regulators that improve tolerance to low temperature may affect stress protein production. The molecular or gene approaches will help us to elucidate the functions of plant hormones related to the regulation of chilling tolerance in plants in the near future.

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수화기제탕(水火旣濟湯)이 주령별 흰쥐의 혈청과 테스토스테론에 미치는 영향 (Effects of Suhwagije-tang Distillate on Serum and Testosterone in Aging Rats)

  • 이정환;구덕모;안택원
    • 사상체질의학회지
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    • 제22권4호
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    • pp.85-97
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    • 2010
  • 1. Objectives The purpose of this study is to investigate the effects of oral administration of distilled Suhwagije-tang in aging rats. 2. Methods The SD rats used in this experiment were 6, 48 and 68 weeks old. These groups were treated with distilled water(DW), 1% Vitamin C(Vit. C) and 50% Suhwagije-tang(SGT) distillate respectively, once a day for 4 weeks. Blood samples were taken from heart and the levels of various parameters in serum were analysed. 3. Results and Conclusions (1) At all concentration of SGT, survival rates of liver cells were higher than the control group. (2) The rate of which the 10W-SGT group gained weight was significantly higher than that of the control groups. (3) The levels of albumin in serum of 10W-SGT group were significantly increased in comparison to those of the DW group. The levels of ALP, total cholesterol and HDL-cholesterol in serum of 52W-SGT group were significantly decreased in comparison to those of the DW group. (4) The levels of testosterone in serum of SGT groups showed no significantly changes in comparison to those of the control groups. Testosterone levels were naturally decreased with advancing years, so 72W-DW group's testosterone level was significantly decreased in comparison to those of 10W-DW group's. In contrast, 72W-SGT group's level was the highest in comparison to those of the control groups and those of deviation from 10W, 52W and 72W in SGT groups was also smaller than control groups'. (5) The levels of glucose, total-bilirubin, ALT, AST, BUN, CRP, hs-CRP, homocystein, Na, K, Na/K ratio, Cl and Ca in serum of SGT groups showed no significantly changes in comparison to those of the control groups. These results suggest that oral administration of Suhwagije-tang distillate should be effective in promoting growth and preventing rapid decline of testosterone in aging rats does not cause any imbalance in liver, kidney and electrolyte.