• YAKHAK HOEJI
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• v.55 no.3
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• pp.247-250
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• 2011

An increase in ventricular pressure can alter cardiac excitation and contraction. Recent report has demonstrated that fluid pressure (FP) suppresses L-type $Ca^{2+}$ current with acceleration of the current inactivation in ventricular myocytes. Since the L-type $Ca^{2+}$ channels known to be regulated by intracellular pH ($pH_i$), this study was designed to explore whether pressurized fluid flow affects pHi in isolated rat ventricular myocytes. A flow of pressurized (~16 dyne/$cm^2$) fluid, identical to that bathing the myocytes, was applied onto single myocytes, and intracellular $H^+$ concentration was monitored using confocal $H^+$ imaging. FP significantly decreased $pH_i$ by $0.07{\pm}0.01$ pH units (n=16, P<0.01). Intracellular acidosis enhances the activity of $Na^+-H^+$ exchanger (NHE). Therefore, we examined if the NHE activity is increased by FP using the NHE inhibitor, HOE642. Although HOE642 did not alter $pH_i$ in control conditions, it decreased $pH_i$ in cells pre-exposed to FP, suggesting enhancement of NHE activity by FP. In addition, FP-induced intracellular acidosis was larger in cells pre-treated with HOE642 than in cells under the control conditions. These results suggest that FP induces intracellular acidosis and that NHE may contribute to extrude $H^+$ during the FP-induced acidosis in rat ventricular myocytes.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.2
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• pp.126-130
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• 2007

Metformin is antihyperglycemic, not hypoglycemic. It causes neither insulin release from the pancreas nor hypo glycemia, even when taken in large doses. But, there are several reports of metformin-associated lactic acidosis (MALT). We present a case report of severe lactic acidosis most probably resulting from high doses of metformin in a patient with no known contraindications for metformin. A 43-year-old female was admitted to the emergency department due to a metformin overdose. She had diabetes for 6 years, well-controlled with metformin and novolet. One hour before admission, she impulsively took 50g metformin (100 mg or 100 tablets). Physical examination for symptoms revealed only irritability, and laboratory evaluation revealed only mild leukocytosis. After one hour the patient was drowsy, and arterial blood gas analysis showed severe lactic acidemia Seven hours after ED arrival, she commenced hemofiltration treatment and was admitted to the intensive care unit. Continuous venovenous hemodiafiltration was initiated. Forty-eight hours later, full clinical recovery was observed, with return to a normal serum lactate level. The patient was discharged from the intensive care unit on the third day. A progressive recovery was observed and she was discharged from the general word on the thirteenth day.

• Asian-Australasian Journal of Animal Sciences
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• v.27 no.8
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• pp.1181-1188
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• 2014

The aim of this study was to evaluate protein expression patterns of liver in response to subacute ruminal acidosis (SARA) induced by high-concentrate diet. Sixteen healthy mid-lactating goats were randomly divided into 2 groups and fed either a high-forage (HF) diet or a high-concentrate (HC) diet. The HC diet was expected to induce SARA. After ensuring the occurrence of SARA, liver samples were collected. Proteome analysis with differential in gel electrophoresis technology revealed that, 15 proteins were significantly modulated in liver in a comparison between HF and HC-fed goats. These proteins were found mainly associated with metabolism and energy transfer after identified by matrix-assisted laser desorption ionization/time of flight. The results indicated that glucose, lipid and protein catabolism could be enhanced when SARA occurred. It prompted that glucose, lipid and amine acid in the liver mainly participated in oxidation and energy supply when SARA occurred, which possibly consumed more precursors involved in milk protein and milk fat synthesis. These results suggest new candidate proteins that may contribute to a better understanding of the mechanisms that mediate liver adaptation to SARA.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.2
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• pp.129-132
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• 2004

Ethylene glycol poisoning can cause profound morbidity and is almost universally fatal if untreated. Central nervous system depression, pulmonary edema, and acute oligulic renal failure with crystalluria are among the most commonly encountered complication of ingestion. Ingestion of ethylene glycol may be an important contributor in patients with metabolic acidosis and subsequent renal failure. The diagnosis of ethylene glycol poisoning is based on nonspecific clinical symptoms and signs and indirect and direct laboratory measurement of ethylene glycol. As a result, diagnosis and treatment sometimes can be delayed. We describe 52-year-old man who visited to emergency department with mental change of unknown origin. The patient has high anion gap metabolic acidosis and renal failure due to ingestion of antifreeze that contained ethylene glycol. We used hemodialysis for elimination technique. The patient was discharged with minimal complication.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.2
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• pp.110-113
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• 2005

Glyphosate containing herbicides are an alternative to paraquat and have been widely used with increasing frequency in suicide attempts throughout Asia. It is an organophosphorus compound that is not a cholinesterase inhibitor. Daejangun powder consists of glyphosate ammonium, surfactant and another herbicide, oxyfluorfen. A 60-year-old man ingested about 300 g of Daejangun powder with 500 ml of water in a suicide attempt. He was brought to emergency room 6 hours after the ingestion and showed severe metabolic acidosis (pH 6.75), marked leukocytosis (WBC 35,800/$mm^3$), hypoglycemia (glucose 13 mg/dL) and increased liver enzymes (AST/ALT 1,683/418 IU/L). Later he developed aspiration pneumonia, acute renal failure and hyperchloremic acidosis. Upper gastrointestinal endoscopy which performed 5 days after the ingestion revealed corrosive injuries (grade 1) in both esophagus and stomach. However, intensive treatment with supportive measures improved the abnormal findings almost completely 4 weeks after the ingestion.

• The Korean Journal of Physiology and Pharmacology
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• v.16 no.2
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• pp.91-95
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• 2012

The role of the kidney in combating metabolic acidosis has been a subject of considerable interest for many years. The present study was aimed to determine whether there is an altered regulation of renal acid base transporters in acute and chronic acid loading. Male Sprague-Dawley rats were used. Metabolic acidosis was induced by administration of $NH_4Cl$ for 2 days (acute) and for 7days (chronic). The serum and urinary pH and bicarbonate were measured. The protein expression of renal acid base transporters [type 3 $Na^+/H^+$ exchanger (NHE3), type 1 $Na^+/{HCO_3}^-$ cotransporter (NBC1), Na-$K^+$ ATPase, $H^+$-ATPase, anion exchanger-1 (AE-1)] was measured by semiquantitative immunoblotting. Serum bicarbonate and pH were decreased in acute acid loading rats compared with controls. Accordingly, urinary pH decreased. The protein expression of NHE3, $H^+$-ATPase, AE-1 and NBC1 was not changed. In chronic acid loading rats, serum bicarbonate and pH were not changed, while urinary pH was decreased compared with controls. The protein expression of NHE3, $H^+$-ATPase was increased in the renal cortex of chronic acid loading rats. These results suggest that unaltered expression of acid transporters combined with acute acid loading may contribute to the development of acidosis. The subsequent increased expression of NHE3, $H^+$-ATPase in the kidney may play a role in promoting acid excretion in the later stage of acid loading, which counteract the development of metabolic acidosis.

• Journal of The Korean Society of Grassland and Forage Science
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• v.33 no.4
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• pp.313-318
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• 2013

A study was conducted to determine if subacute ruminal acidosis (SARA) induced by feeding high level of non-structural carbohydrates results in increases in lipopolysaccharides (LPS) of peripheral blood in dairy cattle. In this experiment four Holstein steers, two of which having ruminal canulae with indwelling probes placed for measuring long term pH changes, were alloted into two dietary treatments in a cross-over design, where an acidogenic diet (AD) was formulated by including high amount of non-structural carbohydrates (NSC) based on corn silage and corn flake as TMR ingredients. Data for ruminal pH change and plasma LPS concentration were compared against normal diet (ND) which contained grass hay as forage and low NSC ingredients. Feeding AD for more than 14 days to animals brought about a pH change as low as less than 5.8 for more than 4 hours, which made good contrast to ND fed animals. Decreased ruminal pH also had an effect on LPS concentrations which showed significantly higher level for AD compared with ND. Therefore, plasma LPS concentration may be used as an effective indicator to verify acidosis whether it is acute or chronic. Na-bentonite and Propylene glycol, which are frequently included in dairy TMR as additives, helped decrease ruminal pH by buffering and then ultimately alleviates SARA. Therefore, it could also be helpful to lower the occurrence of laminitis which is often caused by increased blood endotoxin (LPS) concentration.

• 대한약리학회:학술대회논문집
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• 2006.10a
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• pp.120.1-120.1
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• 2006

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.52-56
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• 2008

Amitraz is used as farm-animal insecticide. Its side effects in humans are related to its pharmacological activity on alpha 2-adrenergic receptors. The case describes a previously healthy 46-year-old woman who intentionally ingested approximately 250mL of liquid amitraz. She presented with vomiting, altered mental status, miosis, dry mouth, hypopnea, metabolic and respiratory acidosis, hypotension, hypothermia, polyuria, metabolic acidosis, elevated serum aminotransferase and abdominal distension. Supportive treatments including mechanical ventilation, hydration, dopamine infusion, bicarbonate infusion and gastric decompression resulted in improvement. By hospital day 3, she recovered with resolution of abdominal distension. It is paramount to recognize amitraz poisoning when a pesticide-intoxicated patient presets with signs and symptoms consistent with organophosphate intoxicated patients but with greater alpha 2-adrenergic related symptoms such as decreased bowel motility and xerostomia.

• Biomedical Science Letters
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• v.21 no.4
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• pp.241-247
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• 2015

Lactate and ketone bodies are considered biological markers for ketosis and several inherited metabolic disorders. In the current study, the specific ratios of lactate and ketone bodies as analytical tools for differential diagnosis of various lactic acidosis were devised. The study included a protein precipitation step following tert-butyldimethylsilyl derivatisation. Total run time was approximately 30 min including sample preparation and GS/MS analysis. The limits of detection were below 0.1 pg/mL over the targeted 4 analytes. The calibration curve was linear over the concentration range of $0.001{\sim}250{\mu}g/mL$ for pyruvate, beta-hydroxybutyrate, and acetoacetate ($R^2$ > 0.99). Inter-day accuracy and precision were 87.7~94.8% with RSD of 2.5~5.7% at 2 levels. Absolute recoveries (%) of target analytes were 87.0~98.4%. The method was validated for the quantification of lactate and ketone bodies for differentiation of lactic acidosis.