• Childhood Kidney Diseases
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• v.2 no.1
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• pp.9-13
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• 1998

Purpose: The old reference range of serum anion gap(AG) may be excessive compared with value measured by new electrolyte analyzers. Therefore, we studied to establish a new reference range of AG using an autoanalyzer. Methods: With the use of analyzer(Hitachi 747 by enzymatic methods), serum Na and Cl were measured, and with the use of analyzer(CX-3 by differental rage pH), serum $TCO_2$ was measured. We measured AG(=Na-($Cl+HCO_3$)) in 395 stable patients with normal serum albumin and creatinine levels of the pediatric in-patients and out-patients for preoperative examination from march 1997 to July 1997. Results: The normal serum$ AG(mean{\pm}SD)$ were neonate, $11.2{\pm}3.2$ mEq/L; infancy, $11.8{\pm}2.7$ mEq/L; early childhood, $12{\pm}2.7$ mEq/L; late childhood, $11.7{\pm}3.2$ mEq/L; adolescence, $9.6{\pm}2.7$ mEq/L; adult, $9.0{\pm}2.7$ mEq/L. Normal serum AG in more than 10 years of age was significantly lower than the previous normal value and also the difference of AG between more than 10 years and less than 10 years was statistically significant(P<0.05). Conclusions: We suggest to measure serum AG according to each type of analyzers.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.36-40
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• 2013

Ethylene glycol poisoning is treated mainly by alcohol dehydrogenase inhibition therapy and hemodialysis. Early recognition and initiation of treatment is important because toxic metabolites increase over time by hepatic metabolism; however, there is no confirmative diagnostic tool in our clinical setting. Therefore, diagnosis is dependent on history, high anion gap acidosis, high osmolal gap, etc.. Diagnosis and treatment are delayed in cases where history taking is not possible, such as a mental changed patient. Authors report on two cases of ethylene glycol poisoning by contrasting clinical outcomes, demonstrating the importance of early diagnosis and treatment for achievement of a good outcome.

• Journal of the Korean Institute of Electrical and Electronic Material Engineers
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• v.23 no.2
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• pp.118-123
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• 2010

The eco-friendly technologies have been extended as matter of international concern due to various diseases and syndromes according to an environmental pollution. In this study, we have manufactured a ceramic cluster with thick film type for anion generation equipment which is maximized anion but minimized ozone contents generated. To develop the formulation of ceramic cluster, we conducted the $Mg_2SiO_4$ powders doped with 10 vol% glass frits as Na-Zn-B-O system and sintered at $1050^{\circ}C$ for 2 hours in air for starting materials and investigated the matching properties between the Ag-Pd electrode and the starting materials. The sintered sample for the composition of cluster has 6.7 of dielectric constant and 32 kV/mm of withstand voltage. The yield of anions was measured according to an electrode pattering, discharge gap between electrode, and thickness of electrode protective layer in the cluster of thick film type. We have manufactured the ceramic clusters with optimized thick film structure that have an anion over a hundred particles and the ozone of 0.6 ppb generated.

• Journal of Veterinary Science
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• v.21 no.2
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• pp.17.1-17.11
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• 2020

Dehydration, electrolyte disturbance, and acid-base imbalance are the most significant consequences of diarrhea in calves. We aimed to determine blood gas, hematological, electrolyte, and biochemical values and investigate the relationship between the physical status and blood parameters in Korean native calves (KNCs) with diarrhea. One hundred eighty KNCs with diarrhea (age < 75 days) were investigated. Blood samples were collected from the external jugular vein and analyzed using a portable clinical blood gas analyzer. The measured parameters were statistically compared according to the status of physical activity, dehydration, or prognosis. The mean values of parameters in the Calves with diarrhea showed metabolic acidosis, hyponatremia, and azotemia. The mean values of potassium, chloride, hematocrit, and hemoglobin were in the upper limit of their reference ranges. More than 75% of the calves had metabolic acidosis caused by bicarbonate loss, and 63.6% had high blood urea nitrogen (BUN) values. Moreover, BUN showed the highest correlation with the physical activity status and dehydration. pH, base excess of the extracellular fluid (BE), anion gap, potassium, hematocrit, bicarbonate, and hemoglobin were closely correlated with physical deterioration and dehydration (p < 0.001). BUN, pH, BE, and anion gap were closely correlated with physical deterioration and dehydration. These correlations between clinical symptoms and blood gas parameters can be clinically relevant in predicting the status of parameters according to clinical symptoms.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.235-241
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• 2009

Purpose : The purpose of this study was to determine the clinical value of bicarbonate gap (BG) in acute gastroenteritis by comparison of clinical manifestations and laboratory findings. Methods : We retrospectively analyzed 135 patients who had acute gastroenteritis. We classified them into two groups: $BG{\leq}-5$ (group A), BG>-5 (group B). We made a comparative study for clinical manifestations, serum electrolyte, albumin, protein, blood urea nitrogen (BUN), creatinine, anion gap (AG), delta anion gap (${\Delta}AG$) and delta bicarbonate (${\Delta}HCO_3{^-}$) between the two groups. Results : The duration of hospitalization and diarrhea was significantly longer in group A than group B. In laboratory findings, serum sodium, serum total $CO_2$, total protein, $AG_{corrected}$ and ${\Delta}AG$ were lower in group A than group B. ${\Delta}HCO_3{^-}$ and chloride were higher in group A than group B. Conclusion : BG may be a sensitive predictor enough to access the severity of acute gastroenteritis.

• Childhood Kidney Diseases
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• v.24 no.2
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• pp.115-119
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• 2020

Distal renal tubular acidosis (dRTA) is a rare renal tubular disorder characterized by normal anion gap metabolic acidosis, hypokalemia, and high urine pH. It can be inherited or acquired. In untreated pediatric patients with dRTA, rickets and growth retardation are common. We report the case of a 12-year-old Lao girl who presented with typical clinical features of dRTA with severe bone deformities that developed after a bed-ridden state due to a bicycle accident at the age of 8 years. Initial laboratory tests revealed metabolic acidosis with a normal anion gap, hypokalemia, and alkali urine. Renal ultrasonography revealed bilateral medullary nephrocalcinosis. Whole exome sequencing revealed no pathogenic mutations. After treatment with oral alkali, potassium, and vitamin D, she could walk and run. Later, she underwent corrective orthopedic surgeries for bony deformities. Thus, in pediatric dRTA patients, despite severe symptoms remaining untreated, accurate diagnosis and proper management can improve quality of life.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.15-21
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• 2012

Purpose: Toxic alcohols are responsible for accidental and suicide motivated poisonings, resulting in death or permanent sequelae for the afflicted patients. Major therapeutic modalities in these cases include treatment with alcohol dehydrogenase inhibitors and extracorporeal elimination. There have been a number of case reports of toxic alcohol intoxication in Korea. The purpose of this study was to review the clinical characteristics of patients suffering toxic alcohol intoxication. Methods: We retrospectively reviewed the medical records of patients who presented with toxic alcohol intoxication at 8 emergency departments (ED) from Jun 2005 to Nov 2011. Patients who ingested methanol, isopropyl alcohol, ethylene glycol, and other alcohols except ethanol, were included in this study. The clinical characteristics of these patients were analyzed to include anion and osmolar gap, and estimated concentration of alcohol in the body. Results: During the study period, 21 patients were identified who had ingested toxic alcohol (methanol; 12 patients, ethylene glycol; 9 patients). At ED arrival, the mean anion gap was $18.7{\pm}6.9$ and the osmolar gap was elevated in 13 patients. Oral and IV ethanol were administrated to 11 patients in order to inhibit alcohol dehydrogenase. Extracorporeal elimination procedures such as hemodialysis were performed in 9 patients. There were no fatalities, but the one patient suffered permanent blindness. Conclusion: This study found that ethylene glycol and methanol were the substances ingested which produced toxic alcohol intoxication. The patients presented with high anion gap metabolic acidosis and were typically treated with oral ethanol and hemodialysis.

• Korean Journal of Veterinary Research
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• v.37 no.4
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• pp.883-897
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• 1997

Present study was undertaken in order to find out the most significant laboratory test for the early diagnosis of ethylene glycol poisoning in dogs. Seven dogs weighing from 5.0kg to 19.3kg were administered orally 6ml or l0ml of ethylene glycol per kilogram of body weight. In addition to clinical observations, blood samples were taken from the jugular vein on 0, 1, 3, 6, 12, 24 and 48 hours or until death after the adminisration and examined for the hematological, blood chemical, venous blood gas and electrolyte changes. Urine samples were simultaneously taken and examined for pH, protein, glucose and calcium oxalate crystals in the sediments. The results were as follows : 1. All dogs showed marked hypothermia in addition to the characteristic signs of ethylene glycol poisoning until death. 2. No significant hematological changes were observable after the administration of ethylene glycol except the secondary dehydration and stress leukogram. 3. Chemical values related to the liver function(serum glutamic pyruvic transaminase, total serum protein, serum albumin, serum total bilirubin) showed no significant changes during the experimental period in all dogs. 4. Chemical values related to the renal function(BUN and creatinine) showed significant(p<0.0l, p<0.001) increase from 24 hours to death in all dogs. 5. All dogs showed significant(p<0.01, p<0.001) decrease in blood pH from 3 hours to death after the ethylene glycol administration. 6. All dogs showed significant(p<0.05, p<0.01, p<0.001) increaes in anion gap from 1 hour to death after the ethylene glycol administration. 7. All dogs showed significant(p<0.05, p<0.01) decrease in urine pH from 1 hour to 6 hours after the administration of ethylene glycol. 8. Characteristic envelope form of calcium oxalate crystals were found in the urinary sediment from 6 hours after the administration of ethylene glycol in all dogs. 9. Histologically calcium oxalate crystals were found in the renal rubles in all dogs. 10. From these results, it may be concluded that the examinations of urinary sediments for the calcium oxalate crystals, blood or urinary pH and blood anion gap are most reliable tests for the early diagnosis of ethylene glycol poisoning in dogs.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.72-82
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• 2021

Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acid-base analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning. Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart's approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests. Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality. Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.

• Carbon letters
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• v.9 no.2
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• pp.131-136
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• 2008

In order to investigate the effect of doping C, N, B and F elements on $TiO_2$ for reducing the band gap, the heat treatment of $TiO_2$ was carried out with tetraethylammonium tetrafluoroborate. Through XRD and XPS analysis, the C, N, B and F doped anatase $TiO_2$ was confirmed. According to the increase of temperature during treatment, the particle size was increased due to aggregation of $TiO_2$ with elements (B, C, N and F). To investigate the capacity of photocatalyst for degradation of dye under solar light, the degradation of acridine orange and methylene blue was conducted. The degradation of dyes was carried out successfully under solar light indicating the effect of doping elements (B, C, N and F) on $TiO_2$ for reducing the band gap effectively.