• Journal of Gastric Cancer
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• 제6권3호
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• pp.198-201
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• 2006

저나트륨혈증은 항암화학요법 중에 발생하는 전해질 장애 중의 하나이며, 조기에 발견하여 치료하지 않을 경우 급사할 수 있다. 저나트륨혈증을 유발하는 여러 원인중에 항이뇨호르몬과다분비증후군(syndrome of inappropriate antidiuretic hormone, SIADH)이 항암화학요법을 시행받은 환자들에게서 발생하였다고 보고되고 있다. SIADH를 유발하는 항암제는 아직까지 몇 가지 외에는 많이 알려져 있지 않다. 본 예는 위암으로 위전절제술, 비장절제술, 횡행결장구역절제술을 시행 받은 55세 여자로 수술 후 복막전이가 발견되어 S-1 ($80\;mg/m^{2}$)과 cisplatin ($60\;mg/m^{2}$)을 이용한 항암화학요법 중 SIADH가 발생하였다. 환자는 3% 생리식염수를 투여한 후 저나트륨혈증이 정상화되어 퇴원하였다.

• 수면정신생리
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• 제2권1호
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• pp.23-30
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• 1995

유뇨증은 발병기전이 단일한 원인으로 설명되기 어려운 임상적으로 복합적인 질병이다. 유전적 요인, 신경근육계 및 비뇨기계의 미성숙, 심리사회적 요인이나 대소변 가리기 훈련의 이상, 그리고 생물학적 요인 등 여러 가지 원인론들이 있으나 아직 확실한 것은 없다. 그러나 최근 신경생리학적 연구와 신경 내분비학적 연구들의 결과, 야뇨증과 수면주기와의 관련성이나 야간의 항이뇨호르몬 (antidiuretic hormone) 분비 저하와의 관련성 등 보고되어 야뇨증의 치료에 있어 새로운 접근을 가능하게 하고 있다. Vasopressin 이 우수한 치료율, 안전성, 적은 부작용 등으로 새로운 치료약물로서 시도되고 있으나 재발율이 높아, imipramine또는 vasopressin의 투여와 Bell-alarm행동요법을 병행하여 치료하는 것이 바람직하다.

• 대한수의학회지
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• 제51권4호
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• pp.319-323
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• 2011

A 12-year-old spayed female Yorkshire terrier dog was presented with two-weeks history of lethargy, mental dullness and polydipsia. Neurologic examination revealed proprioceptive defect of all limbs and loss of swallowing gag reflex. The dog revealed persistent dehydration, hypernatremia, hyperosmolarity and hyposthenuria. On magnetic resornance imaging (MRI), the mass were heterogeneous signality on T1 weighted images, hyperintense signality on T2 weighted image with contrast enhancement on hypothalamohypophyseal lesion. Based on these findings, the dog was suspected as having pituitary gland tumor. Through water deprivation test and response to desmopressin acetate (1-deamino-8-D-arginine, DDAVP), this case was diagnosed by central diabetes insipidus (CDI). This paper reports the clinical sign, MRI, response to the exogenous antidiuretic hormone of CDI due to suspected pituitary tumor in a dog and DDAVP administration was evaluated effective therapy to correct hypernatremia induced by CDI.

• 대한두경부종양학회지
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• 제3권1호
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• pp.85-90
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• 1987

The syndrome of inappropriate ADH secretion(SIADH) is a clinical disorder in which there is continual release of antidiuretic hormone(ADH) unrelated to plasma osmolality. It may occur usually in association with malignant tumors below the clavicle and other pulmonary disorders which are capable of synthesizing, storing and releasing ADH into the circulation but rarely with the head and neck tumors yet. We experienced a patient with unexplained hyponatremia associated with laryngeal carcinoma. The clinical and laboratory diagnostic studies suggested that patient's sodium deficiency was secondary to the SIADH. Subsequent resection of the neoplasm, total laryngectomy led to resolution of hyponatremia, suggesting that a tumor associated humoral factor, such as vasopressin or vasopressin like substance, was responsible for the electrolyte disturbance.

• Journal of Yeungnam Medical Science
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• 제6권1호
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• pp.205-211
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• 1989

저자들은 복통과 고혈압으로 입원하여 급성간헐성 포르피리아증으로 진단된 47세 여자 환자에서 고혈압, 말초 신경장애, 항이뇨호르몬 부적절분비증, 뇌경색을 동반한 다양한 임상양상을 보인 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 약학회지
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• 제45권6호
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• pp.683-693
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• 2001

This study was attempted to investigate the effect of raclopride, a dopamine $D_2$ receptor antagonist, on renal function in dog. Raclopride (70-220$\mu\textrm{g}$/kg), when given intravenously, Produced antidiuresis along with the decrease in free water clearance ( $C_{H_2O}$), urinary excretion of sodium and potassium ( $E_{Na}$ , $E_{K}$), partially decreased osmolar clearance ( $C_{osm}$) and increased reabsorption rates of sodium and potassium in renal tubules ( $R_{Na}$ , $R_{K}$). Raclopride administered into a renal artery did not influence on renal function in small doses (10 and 30$\mu\textrm{g}$/kg), whereas exhibited the decrease of urine volume (Vol) and $C_{H_2O}$ both in experimental and control kidney in much dose (100$\mu\textrm{g}$/kg), at this time, the decreased rates of both Vol. and $C_{H_2O}$) were more prominent in control kidney rather than that elicited in experimental kidney, and then only via was decreased in control kidney but increased in experimental kidney. Raclopride administered via carotid artery (30-200$\mu\textrm{g}$/kg) did not influence at all on renal function. Antidiuretic action induced by raclopride given intravenously was not affected by renal denervation. Raclopride given into carotid artery was little effect on renal function without relation to renal denervation. Above results suggest that raclopride produces antidiuresis by potentiation of antidiuretic hormone (ADH) action in blood without increase of ADH secretion in posterior pituitary gland, it is not related to renal nerve function in dogs.ogs.s.

• Tuberculosis and Respiratory Diseases
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• 제66권4호
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• pp.324-328
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• 2009

상기 환자는 진행성 비소세포폐암으로 진단 받고 carboplatin과 gemcitabine의 전신적 항암치료 후에 전신 쇠약 동반한 저나트륨혈증으로 병원에 내원하여 SIADH로 진단받고 carboplatin 약제 중단 후 호전되었다. 이러한 항암제 투여 후에 유발된 SIADH는 여러 가지 원인과의 감별을 요하며, carboplatin에 의해 유발된 SIADH의 보고는 드물기에 증례로 이를 문헌 고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권1호
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• pp.7-10
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• 1993

The final purpose of oral & maxillofacial trauma is functional & esthetic repair. Nowadays, severe trauma involving with the head & neck trauma is increasing. After these trauma occurs, the patients develop similar signs & symptoms with the postoperative healing period, as like thurst, hypertention, excitability, disorientation, convulsion, et al. Because SIADH which is one of important complications after head trauma, shows similar clinical features after operation, we should pay attention to detect it. SIADH shows characteristic laboratory findings, as like hyponatremia, urine hyperosmolality, increased plasma ADH level, continued renal excretion of sodium, so we can easily distinguish it from postoperative conditions. This paper reports two cases, one was the case of the mandibular fracture and cerebral contusion, which included permanent SIADH. The other was the case of the multiple teeth injury and cerebral contusion, which was transient SIADH. We treated them with water restriction, hypertonic saline, and diuretics.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.71-78
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• 2015

The incidence of acute kidney injury (AKI) in critically ill pediatric patients has been reported as increasing to 25 %, depending on population characteristics. The etiology of AKI has changed over the last 10-20 years from primary renal disease to the renal conditions associated with systemic illness. The AKI in pediatric population is associated with increased mortality and morbidity, and prevention is needed to reduce the consequence of AKI. It is known that the most important risk factors for AKI in critically ill pediatric patients are clinical conditions to be associated with decreased renal blood flow, direct renal injury, and illness severity. Renal hypoperfusion leads to neurohormonal activation including renin-angiotensin-aldosterone system, sympathetic nervous system, antidiuretic hormone, and prostaglandins. Prolonged renal hypoperfusion can result in acute tubular necrosis. The direct renal injury can be predisposed under the condition of renal hypoperfusion, and appropriate treatment of volume depletion is important to prevent AKI. The preventable causes of AKI include contrast-induced nephropathy, hemodynamic instability, inappropriate mediation use, and multiple nephrotoxic insults. Given the evidence of preventable factors for AKI, several actions such as the use of protocol for prevention of contrast-induced nephropathy, appropriate treatment of volume depletion, vigorous treatment of sepsis, avoidance of combinations of nephrotoxic medications, and monitoring of levels of drugs should be recommended.

• Clinical and Experimental Pediatrics
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• 제56권6호
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• pp.260-264
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• 2013

Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.