• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.121-126
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• 2009

Purpose: We investigated the clinical characteristics and demographics of patients who suffered from hydrofluoric acid chemical injury and the mechanism of damage. Methods: We retrospectively reviewed the medical records of patients who were exposed to hydrofluoric acid from March 2004 to March 2009 and who were seen at the emergency centers in two university teaching hospitals. Results: Forty four patients out of 47 patients suffered from chemical burn, while the injuries of the remaining 3 could not be identified by the medical records. A total of 17 hydrofluoric acid chemical injury patients were enrolled during the study period, and their mean age was $29.6{\pm}7.0$. All the patients were accidentally injured by contact with the material and none of them inhaled or ingested the material. Only 6 patients wore appropriate protective equipments and 5 underwent the water irrigation for more than 10 minutes. The most common exposure area was the hand and forearm (70.5%). Less than 1% of all of the patients had their total body surface (TBS) exposed to hydrofluoric acid (mean=0.35%). The mean time interval from calcium gluconate administration to pain relief was $33.6{\pm}8.8$ hours. Conclusion: When exposed to hydrofluoric acid, it is important to wear protective equipment and undergo water irrigation for more than 10 minutes. Pain and skin damage were observed in all the patients. After treatment, we concluded that administration of calcium gluconate and pain killers was successful in relieving pain, and the prognosis was also positive for the admitted and followed up patients when less than 1% of the TBS was exposed.

• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.307-309
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• 2017

A postpartum total uterine prolapse in a 2-years old Korean black goat was presented. This paper reports the clinical management of the case. The everted uterus was carefully assessed and gross debris were gently removed and disinfected with dilute povidone iodine solution. The prolapsed uterus was replaced with epidural anesthesia and retention suture was placed on the vulva. Broad spectrum antibiotics, calcium gluconate, and supportive therapy were administered. The patient made complete recovery.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.383-389
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• 2002

We experienced a case of partial DiGeorge syndrome in a $35^{＋5}$ week premature female infant presented with micrognathia, fish-shaped mouth, beaked nose, nasal regurgitation, obstructive sleep apnea, velopharyngeal insufficiency and late onset hypocalcemic seizures. The chromosome 22q11 microdeletion was found by the FISH method. The lab findings showed serum calcium level of 4.4 mg/dL, ionized calcium level of 0.49 mg/dL, phosphorous level of 7.5 mg/dL, magnesium level of 1.3 mg/dL and PTH-RIA level of <1 pq/mL. Initial treatment was done with 10% calcium gluconate infusion and magnesium sulfate followed by oral calcium gluconate and low phosphorousformula milk feeding. The serum calcium level was normalized in 6 days. Nasal regurgitation, desaturation with obstructive sleep apnea continued. T-cell functions & numbers(CD 3, CD 4, CD 8)were decreased but Ig G/A/M levels were normal. No visible signs of thymus shadow were seen in either chest X-ray & chest MRI. Electrocardiography and echocardiography showed normal heart. Kidney ultrasonographby showed right side mild hydronephrosis. Neurosonography was normal but EEG showed electrical partial seizure. Hearing assessment by BERA showed mild to moderate hearing impairment. Velopharyngoplasty is scheduled for further treatment. A brief review of literature was made.

• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.216-219
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• 2014

An 1-year-old, female, mixed-breed dog weighing 17 kg was referred for abrupt collapse. She had remarkable hypocalcemia and hyperphosphatemia, and survey radiographs revealed a severe gas-filled intestine. Treatment with serial injections of calcium gluconate was initiated promptly and most of the gastrointestinal distension disappeared after 4 h. However, the clinical signs were not resolved completely. The serum intact parathyroid hormone concentration was not elevated in the context of hypocalcemia, which suggested primary hypoparathyroidism. The clinical signs and laboratory abnormalities in the patient were resolved completely 3 days after administration of calcium gluconate and calcitriol. This case describes the unique presentation of severe gastrointestinal distension in a dog diagnosed with primary hypoparathyroidism.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.407-412
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• 2008

Purpose: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with the dissociated fluoride ions. The initial corrosive burn is caused by free hydrogen ion, and the second and more severe burn is caused by penetration of fluoride ions into subcutaneous tissues. Silver is a cation producing dressing, an effective antimicrobial agent, but older silver-containing formulations are rapidly inactivated by wound environment, requiring frequent replenishment. But, $Acticoat^{(R)}$ is a relatively new form of silver dressing which helps avoid the problems of earlier agents. The aim of this study is to evaluate effects of $Acticoat^{(R)}$, silver-containing dressing on the treatment for HF injury wound. Methods: From september 2006 to september 2007, the study was carried out with 10 patients who had HF partial thickness burns. $Acticoat^{(R)}$ dressing and 10% calcium gluconate wet gauze dressings in 10 cases. As a principle, in the emergency treatment, partial or complete removal of the nail and early bullectomy along with copious washing with normal saline was done, depending on the degree of HF invasion of the wound. Wound was dressed with $Acticoat^{(R)}$ and 10% calcium gluconate solution. The effect of dressing was investgated by serial bacterial culture and wound exudates assessment. Results: We therefore reviewed 10 cases of HF-induced chemical burns and treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae. Conclusion: As the industrial sector develops, the use of HF is increasing more and more, leading to increased incidences of HF-induced chemical burns. The education of patients regarding this subject should be empathized accordingly. In conclusion, $Acticoat^{(R)}$ dressing is a better choice for HF partial thickness burn injuries because of shorter healing time, less pain and more comfortable dressing.

• Asian-Australasian Journal of Animal Sciences
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• v.17 no.5
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• pp.705-711
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• 2004

Growth promoters were added to skim milk to retain the viability of Lactobacillus acidophilus and Bifidobacterium longum to help the product meet the "therapeutic minimum" at the time of consumption. The experiments were divided into two parts. The first part of the study used chicory inulin, isomalto-oligosaccharides and sucrose to investigate the effects of sugars on the activity of L. acidophilus and B. longum. The results indicated that the addition of isomalto-oligosaccharides stimulated growth of L. acidophilus and B. longum, resulting in a higher level of the probiotics after one month storage and yielded better $\beta$-galactosidase activity during fermentation. The second part studied the effects of three growth promoters on the viability of the probiotic cultures and the response surface method was employed to find the optimal ratio for addition of the growth promoters. The optimal ratio for added calcium gluconate, sodium gluconate and N-acetylglucosamine in fermented milk drinks were established. The response surface method proved to be a very effective way of optimizing the activity of probiotic cultures when developing a new fermented milk drink.

• Journal of Yeungnam Medical Science
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• v.32 no.1
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• pp.17-21
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• 2015

Amlodipine, a calcium channel blocker of the dihydropyridine group, is commonly used in management of hypertension, angina, and myocardial infarction. Amlodipine overdose, characterized by severe hypotension, arrythmias, and pulmonary edema, has seldom been reported in Korean literature. We report on a fatal case of amlodipine intoxication with complications including rhabdomyolysis and oliguric acute kidney injury. A 70-year-old woman with a medical history of hypertension was presented at the author's hospital 6 hours after ingestion of 50 amlodipine (norvasc) tablets (total dosage 250 mg) in an attempted suicide. Her laboratory tests showed a serum creatinine level of 2.5 mg/dL, with elevated serum creatine phosphokinase and myoglobin. The patient was initially treated with fluids, alkali, calcium gluconate, glucagon, and vasopressors without a hemodynamic effect. High-dose insulin therapy was also started with a bolus injection of regular insulin (RI), followed by continuous infusion of RI and 50% dextrose with water. Despite intensive treatment including insulin therapy, inotropics, mechanical ventilation, and continuous venovenous hemodiafiltration, the patient died of refractory shock and cardiac arrest with no signs of renal recovery 116 hours after her hospital admission.

• Journal of Environmental Health Sciences
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• v.14 no.2
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• pp.73-87
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• 1988

This study was performed to investigate the effect of lactose in 4 different concentrations against the protective effect of calcium on the acute lead poisoning in rats after 4 weeks treatment. In this animal experiment, 70 albino male weanling rats (50-70g of body weight) of Sprague-Dawley strain were used. Lead was dissolved in the distilled water and intubated at the dose of 400mg lead (as acetate)/ kg of body weight/day. Calcium and lactose were administered in drinking water ad libiturn dissolved with the solution of 0.7% calcium gluconate mixed with 40, 80, 160 and 320mM lacotse respectively. The results obtained were summarized as follows: 1. The rate of body weight gain in all treated groups turned out to be lower than that in the control group during 4 weeks treatment. The slow-down of body weight gain was the most significantly observed in the group treated with lead only ( p < 0.05). 2. The relative spleen weight in lead only treated group was significantly lower than that of lead + calcium, lead + calcium + 80mM lactose treated group ( p < 0.05). 3. The value of RBC, WBC, Hb and Hct showed a decreasing tendency in the group treated with lead only ( p < 0.05), however, a significant decrease was not observed in the group treated with lead + calcium. On the other hand, the protective effect of calcium was deteriorated in the group treated with lead + calcium + lactose. 4. The activity of $\delta$-aminolevulinic acid dehydratase ($\delta$-ALAD activity) showed the same tendency as No. 2. 5. The lead concentration in the blood (PbB) showed an increasing tendency and the interrelation among the different groups was also identical with No. 2. 6. With a statistical approach, it was found out that the activity of $\delta$-ALAD and the lead concentration in the blood show a relation of inverse proportion(r=-0.7301). The diagram was interpreted with the logarithmic equation InY = 5.5357-0.0251X (X:PbB, Y:$\delta$-ALAD activity). 7. In the histopathological findings of the kidney, the protective effect of calcium was observed. However, the protective effect of calcium was restricted in the group treated with lead + calcium + lactose. As a conclusion, the intensity of the acute ingested lead poisoning was obviously reduced by calcium, however, the protective effect of calcium was deteriorated in proportion with the concentration of the lactose to be administered. On the other hand, it was also noted that the deterioration was lightly restrained in the group treated with the physiological concentration of 80mM lactose than the results shown in the groups treated with lactose of other concentrations.

• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.1
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• pp.43-45
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• 2010

A 22-year-old woman was referred to our emergency department for the treatment of a chemical injury on her arm. She had accidentally spilled 99% trifluoroacetic anhydride (TFAA) over her left forearm during an organic chemistry experiment. She visited a primary care unit, and then she was referred to our hospital for inactivation of the released fluoride ions. Her skin lesions were different from those caused by hydrofluoric acid (HF) injury. The injured area showed painful whitish maculae and patchy areas with accentuated rim. No vesiculation and bulla formation was detected. We intradermally injected a 5% solution of calcium through a 24-gauge needle into the burned skin. After the injection, she complained of more severe pain. Although TFAA contains fluorine, it does not release free fluoride ions on contact with the skin, unlike HF. In fact, application of calcium gluconate for TFAA burns is not recommended. Rather, it should be avoided since it increases pain and local abscess formation.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.603-605
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• 2009

A 7-year-old intact female, Miniature Schnauzer dog was presented with an acute seizure episode and tremors. Fever and panting were noted when presented. Physical examination revealed apparent forelimb muscle rigidity, fasciculations and stiff gait. Characteristic laboratory findings in this dog were severe hypocalcemia with hyperphosphatemia. The low serum concentration of intact parathyroid hormone and ionized calcium levels were consistent with the diagnosis of primary hypoparathyroidism. In addition, there were increased urinary excretion of calcium and decreased urinary excretion of phosphorus in this case. Urgent treatment was initiated with 10% calcium gluconate. The dog remained healthy with vitamin D analogue and oral calcium supplementation. A transient hyperphosphatemia was controlled well with sevelamer hydrochloride. To the author's knowledge, this is the first case report describing the clinical and laboratory characteristic features of canine primary hypoparathyroidism and its clinical outcome in Korea.