• Title/Summary/Keyword: Electrolyte imbalance

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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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    • v.23 no.4
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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.

Copper Deficient Anemia in Severe Protein-Energy Malnutrition due to Child Abuse (아동학대로 인해 발생한 중증 단백-에너지 영양실조 환아에서 동반된 구리결핍증 빈혈 1예)

  • Byun, Sung-Hwan;Jeon, Je-Deok;Chang, Soo-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.60-65
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    • 2007
  • An unconscious 5-year-old girl was admitted to the Intensive Care Unit. She was neglected by her parents; she suffered from inadequate nutritional, medical and emotional care. The girl appeared to be emotionally detached, dehydrated and malnourished; she had edematous extremities, moderately bruised skin and brittle coarse hair. Laboratory testing showed electrolyte imbalance, anemia, pneumonia, copper deficiency, and liver dysfunction in addition to severe protein-energy malnutrition (PEM). Medical intervention was followed by improvement of most of the symptoms. During the rehabilitation phase, the patient showed a voracious appetite and gained weight too fast. The liver became enlarged and the patient developed a mild fever due to excessive nutrition. The microcytic anemia with severe PEM did not responded to iron supplementation possibly due to the copper deficiency. Addition of copper without zinc and iron helped to improve the anemia. The patient was discharged to a childcare center where she received cognitive and psychosocial therapy.

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Congenital Chloride Diarrhea in Dizygotic Twins

  • Seo, Kyung Ah;Lee, Na Mi;Kim, Gwang Jun;Yun, Sin Weon;Chae, Soo Ahn;Lim, In Seok;Choi, Eung Sang;Yoo, Byoung Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.3
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    • pp.195-199
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    • 2013
  • Congenital chloride diarrhea (CLD) is a rare inherited autosomal recessive disorder. Mutations of the solute carrier family 26 member 3 gene cause profuse, chloride ion rich diarrhea, which results in hypochloremia, hyponatremia and metabolic alkalosis with dehydration. If a fetal ultrasound shows bowel dilatation suggestive of bowel obstruction, or if a neonate shows persistent diarrhea and metabolic alkalosis, CLD should be considered in the differential diagnosis. The severity of CLD varies, but early detection and early therapy can prevent complications including growth failure. We report a case of dizygotic twins affected by CLD who had been born to non-consanguineous parents. Both of them showed growth failure, but one of the twins experienced worse clinical course. He showed developmental delay, along with dehydration and severe electrolyte imbalance. He was diagnosed with CLD first at 6-month age, and then the other one was also diagnosed with CLD.

Two Cases Study on the Disease with Ascites (복수 환자 2례에 대한 임상적 고찰)

  • Lee, Ik-Haeing;Kim, Jin-Gyu;Lee, Woon-Suk;Kim, Ju-Youn;Kim, Eun-Young;Kim, Chong-Dae;Kim, Soo-Jung
    • The Journal of Internal Korean Medicine
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    • v.22 no.2
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    • pp.271-278
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    • 2001
  • Ascites is commonly caused by portal vein pressure accentuation or peritoneal disease. Also, the use of diuretic and ascitic puncture have been the mainstays of ascites treatment. Objective : Experimental studies were done to research the effects of herbal medication on diseases with ascites (ex. liver cirrhosis, peritoneal carcinoma) on two patients. Methods : For measuring the response about the ascites, we observed this clinical symptoms : weight, abdominal circumference (umbilical circumference, upper abdominal circumference), and lab finding. Result : In both cases, clinical symptoms and ascites improved with herbal medication. Second, abdominal circumference decreased. Third, there was no electrolyte imbalance. Conclusion : This test shows that herbal medication has a strong effect on decreasing the intractable ascites.

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

  • Choi, Smi;Yang, Young-Hee;Jung, Yun
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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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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CNS Complications in Childhood Cancer (소아 종양 환아의 중추 신경계 합병증)

  • Jeong, Yoo Jin;Seo, Yeon Kyong;Hong, Seung-A;Kim, Heung Sik;Kim, Jun Sik;Lee, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1112-1117
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    • 2003
  • Purpose : Recent advances in the methods of treating cancer in young patients have led to both an increased frequency of CNS complications as well as prolonged life expectancy. We intend to analyze the clinical aspects and laboratory findings of patients with CNS complications during and after treatment. Methods : We reviewed the medical records of 174 childhood cancer patients treated with chemotherapy admitted to the Dept. of Pediatrics, Keimyung University Dongsan Hospital, from January 1995 to November 2002. Among them, 15 cases with CNS complications were investigated in this study. Results : CNS abnormalities were found in 13 patients by CT or MRI during treatment such as leukoencephalopathy(n=7), mineralizing microangiopathy(n=4), brain infarction(n=3), intracranial hemorrhage(n=1), and hypoxic ischemic encephalopathy(n=1). It was found that two patients had two or more CNS abnormalities. Two patients who had no imaging abnormalities had convulsions, possibly after the addition of intrathecal methotrexate. The patients with intracranial hemorrhage and brain infarction had rapid and fatal clinical courses. The hypoxic ischemic encephalopathy following electrolyte imbalance completely recovered after correction of electrolyte. Conclusion : The CNS complications that occur during and after chemotherapy influence prognoses significantly, and remain neurologic sequelae. Therefore early diagnosis and prophylaxis for CNS complications and regular physical examination of patients who have recieved cancer therapy are strongly recommended.

A Case Report for the Effects of the Modified Fasting Therapy (Gamrosu) on Obese Patients with Hypertension (감로수 절식요법을 적용한 고혈압 비만환자 증례보고)

  • Kim, Dong-Hwan;Oh, Dal-Seok;Shin, Seung-Uoo;Shin, Hyun-Taeg
    • Journal of Korean Medicine for Obesity Research
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    • v.16 no.1
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    • pp.70-77
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    • 2016
  • Gamrosu was originally conceptualized from Jeho-tang, a selected thirst quencher of the kings in Chosun Dynasty and Saeng-Maek-san, a qi-vigorating summer beverage recommended by Dongeuibogam. It is a modified fasting therapy beverage which is manufactured from the single herbal medicines composed of those two prescriptions. This study was conducted on 6 obese patients with hypertension. A modified fasting therapy with Gamrosu was practised on them for 10 consecutive days. After the therapy, their average blood pressures were descended from 148/89 mmHg to 119/79 mmHg. The modified fasting therapy with Gamrosu is supposed to be more effective than general diet program or dietary sodium reduction on controlling hypertension. And, Gamrosu improves anti-hypertensive effect by reducing the side effects, such as fatigue, electrolyte imbalance, heartburn, nausea, and headache, during the modified fasting therapy.

A Case of Metastatic Brain Tumor Patient with Nausea and Vomiting Treated with Gamibokryungbanha-tang (전이성 뇌종양 환자에게 발생한 오심(惡心), 구토(嘔吐)에 대해 가미복령반하탕으로 호전된 치험 1례)

  • Jeong, Jong-Soo;Park, Jae-Woo;Yoon, Seong-Woo
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.956-962
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    • 2007
  • In cancer patients showing nausea and vomiting, a number of factors can be considered as the cause including brain tumor, electrolyte imbalance, gastrointestinal diseases or types of chemotherapy agents and dose of the drugs. Though nausea and vomiting can be minimized through the use of various anti-emetic drugs, many people still suffer from severe nausea and vomiting with poor quality of life compared with patients who do not show significant nausea and vomiting. In this report, we introduce a case of a cancer patient who suffered from severe nausea and vomiting. The patient was female and 59 years old with NSCLC (non small cell lung cancer) with metastatic brain tumor. Though western conventional medical treatment was used to reduce the symptoms, persistent nausea and vomiting were noted during the admission period. Herbal decoction Gamibokryungbanha-tang was used for nausea and vomiting which were uncontrolled under conventional western medicine; the patient showed remarkable improvement in terms of frequency and severity of nausea and vomiting. Further study will be needed in order to determine the long-term effectiveness of oriental medical treatment on cancer patient with nausea and vomiting.

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A Clinical Study of Congenital Intestinal Atresia and Stenosis (선천성 장폐쇄 및 협착에 대한 임상적 고찰)

  • Kim, Sang-Woo;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.3 no.2
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    • pp.117-125
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    • 1997
  • Seventy neonates with congenital intestinal atresia and stenosis who were treated at pediatric surgical service. Hanyang University Hospital from September 1979 to December 1996 were analyzed retrospectively. The lesion occurred in 27 cases at the duodenum, in 26 cases at the jeiunum, in 13 cases at the ileum and in 2 cases at the pylorus and colon each. There were 10 multiple atresias and 7 apple-peel anomaly cases. The atresia predominated over the stenosis by the ratio of 4 : 1. Male to female ratio was 1.3 : 1. The average gestational age was 38 weeks, and the average birth weight was 2,754 grams. Though 22.9 % were borne prematurely and 34.3 % had low birth weight, 92.3 % of them had a weight appropriate for gestational age. Polyhydramnios(40 %) was more frequently observed in duodenal and jeiunal atresia while microcolon in ileal atresia(58.3 %). Weight loss and electrolyte imbalance occurred more frequently in the duodenal stenosis cases because of delayed diagnosis. Twenty(55.6 %) of 37 jeiunoileal atresia cases had evidence of intrauterine vascular accident : 4 intrauterine intussusception, 3 intrauterine volvulus and 3 strangulated intestine in gastroschisis, and 10 cases of intrauterine peritonitis. There were one or more associated anomalies in 45 patients (64.3 %). Preoperatively proximal loop volvulus developed in 3 cases and proximal loop perforation in 5 cases and one case each of distal loop perforation, duodenal perforation and midgut volvulus occurred in the jeiunoileal atresia. Overall mortality rate was 20 %.

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Hyperinfection of Strongyloides stercoralis (분선충의 Hyperinfection 1례)

  • Shin, Kyeong-Cheol;Chun, Jun-Ha;Park, Chan-Weon;Lee, Choong-Ki;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.518-524
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    • 1993
  • Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders, characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold: correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been used corticosteroid for persisting polyarthritis.

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