• 대한수의사회지
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• 제44권7호
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• pp.649-653
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• 2008

• Tuberculosis and Respiratory Diseases
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• 제76권4호
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• pp.163-168
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• 2014

Background: Mycobacterial identification in active pulmonary tuberculosis (APTB) is confirmative, even though successful rates using self-expectorated sputum are limited. Sputum specimens collected by hypertonic saline nebulization showed higher bacteriologic diagnostic sensitivities over those of self-expectoration, mostly studied in smear-negative or sputum-scarce patients. The efficacy of induced sputum was rarely assessed in real clinical settings. Methods: A prospective randomized case-control study was performed in one hospital. The subjects highly suspicious of APTB were asked to provide 3 pairs of sputum specimens in 3 consecutive days. The first pairs of the specimens were obtained either by self-expectoration (ES) from the next day of the visit or sputum induction with 7% saline nebulization in clinic (SI), and the other specimens were collected in the same way. The samples were tested in microscopy, culture, and polymerase chain reaction (PCR). The outcomes of the bacteriological diagnosis were compared. Results: Seventy six patients were assigned to either ES (38 subjects, median age of 51, 65.8% male) or SI (38 subjects, median age of 55, 52.6% male). APTB was clinically confirmed in 51 patients (70.8%), 27 in ES and 24 in SI. Among the APTB, more adequate specimens were collected from SI (41/65, 63.1%) than ES (34/80, 42.5%) (p=0.01). Bacteriological confirmation was achieved in 14 (58.3%) patients in SI, and 13 (48.1%) in ES (p=0.46). In the same-day bacteriological diagnosis with microscopy and PCR, there were positive results for 9 patients (37.5%) in SI and 7 patients (25.9%) in ES (p=0.37). Conclusion: Sputum induction improves sputum specimen adequacy. It may be useful for the same-day bacteriological diagnosis with microscopic examination and PCR.

• The Korean Journal of Physiology
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• 제25권2호
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• pp.189-200
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• 1991

During the past few years it has been proposed that lithium clearance can be used as a reliable measure for the outflow of tubular fluid from the proximal tubule. This study was aimed to characterize the inflow dependent reabsorption of Na in renal tubule beyond the proximal tubule. For this purpose, lithium clearance was used as a measure for the inflow from the proximal tubule and the changes in reabsorption fraction of Na and water were determined in rabbits. Rabbits were pretreated with hypotonic saline solutions for an hour (50 mM/L NaCl, 20 ml/hr/kg). And then a hypertonic solution of 500 mM/L NaCl (20 ml/kg) was administered intraperitoneally in conjunction with a bolus of LiCl solution (2 mM/kg, i.v.) for conditioning the $C_{Li}$ and urine flow rate. To rule out the effect of $Li^+$ on tubular functions, a bolus of NaCl solution (2 mM/kg, i.v.) was administered. Fifteen, thirty, and sixty minutes after injection of hypertonic saline arterial blood and urine samples were taken. Urinary and plasma concentrations as well as urinary output of $Li^+,\;Na^+\;and\;K^+$ were measured. From these $C_{Li},\;C_{Na}$ and the reabsorption fraction of Na and water $(Fr_{Na}\;&\;FrH_2O)$ were calculated. These results were compared with those from control groups in which the same amount of isotonic saline (145 mM/L NaCl) and of 15% dextran solution were administered in the same way as that in experimental group. Followings are the results obtained. 1) The plasma concentration of $Na^+$ in rabbits injected with hypertonic saline reached the peak value after 15 min and thereafter no significant change was observed. Hematocrit values did not show any change, while urinary excretion of $Na^+$ increased markedly during the first 15 min and decreased thereafter. These results were not affected by an injection of a small amount of LiCl. 2) The clearances of $Li^+,\;Na^+\;and\;K^+$ in rabbits injected with hypertonic saline and LiCl solution decreased. 3) In spite of the variation in $C_{Li},\;Fr_{Na}$ did not show any significant change while $FrH_2O$ increased gradually. 4) $C_{Li}$ decreased also in rabbits received isotonic saline. $Fr_{Na}$ tended to be higher than that in hypertonic saline group, while $FrH_2O\;and\;Fr_{Na}$ did not associated with the decrease in $C_{Li}$. 5) $C_{Li}$ of the rabbits received dextran solution fluctuated persistently and $Fr_{Na}\;and\;FrH_2O$ did not change in along with $C_{Li}$ although $Fr_{Na}$ had a tendency to be higher than that in hypertonic saline group. 6) From the above results it was concluded that: (a) In rabbits with normal body store of $Na^+$, the $Fr_{Na}$ of renal tubule beyond proximal tubule. calculated from $C_{Li}$ as a measure of inflow from proximal tubule is constant in spite of variations in $C_{Li}$. (b) The $FrH_2O$ calculated from $C_{Li}$ is dependent largely upon ADH rather than inflow from proximal tubule. (c) When there is a decrease in plasma $Na^+$ concentration or ineffective body fluid. $Li^+$ reabsorption may occur in the thick segnent of Henle's loop and hence the determination of $Fr_{Na}$ and $FrH_2O$ will not be easy one, but $Fr_{Na}$ is constant under the same experimental conditions.

• The Korean Journal of Pain
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• 제3권1호
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• pp.55-58
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• 1990

대상포진 후 신경통은 통증치료실에서 당면하는 가장 치료하기 어려운 질환중의 하나로서 현재까지 교감신경 차단, 경피적 전기자극, 약물요법 등 여러 방법이 소개되어 있으나 어느것이나 만족스럽지 못하다. 저자는 상기의 모든 방법을 동원하여 통증의 제거에 실패한 60세의 여자환자에 지주막하로 45 ml의 냉식염수를 주입하여 폐부종, cauda equina syndrome 등을 포함한 심한 합병증을 경험하였기에 문헌과 함께 고찰해 보고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5799-5804
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• 2014

Background: Radiofrequency ablation (RFA) is the most widely used and studied method internationally for the local treatment of liver tumors. However, the extension of coagulation necrosis in one RFA procedure is limited and incomplete coverage of the damaged area can lead to a high local recurrence rate. Objective: In this study, we compared the effects of different solutions in enhancing hepatic radiofrequency by establishing a rabbit VX2 liver cancer model. We also determined the optimal solution to maximise effects on the extent of RFA-induced coagulation necrosis. Methods: Thirty VX2 tumor rabbits were randomly assigned to five groups: group A, RFA alone; group B, RFA with anhydrous ethanol injection; group C, RFA with 5% hypertonic saline injection; group D, RFA with lidocaine injection; and group E, RFA with a mixed solution. Routine ultrasound examinations and contrast-enhanced ultrasound (CEUS) of the ablation areas were performed after RFA. Then, we measured the major axis and transverse diameter and compared the areas of coagulation necrosis induced by RFA. Results: The mean ablation area range increased in groups B, C and especially E, and the scopes were greater compared with group A. Preoperative application of anhydrous ethanol, hypertonic saline, lidocaine and the mixed solution (groups B, C, D and E, respectively) resulted in larger coagulation necrosis areas than in group A (p<0.05). Among the groups, the coagulation necrosis areas in group E was largest, and the difference was statistically significant compared with other groups (p<0.05). Pathological findings were consistent with imaging results. Conclusions: A mixture of dehydrated alcohol, hypertonic saline and lidocaine injected with RFA increases the extent of coagulation necrosis in the liver with a single application, and the mixed solution is more effective than any other injection alone.

• The Korean Journal of Pain
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• 제32권3호
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• pp.196-205
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• 2019

Background: Hypertonic saline (HS) injections for decompressive neuroplasty (DN) can cause pain. We assessed whether a continuous infusion of HS through an infusion pump would reduce injection-related pain compared with repeated bolus administrations. Methods: Fifty patients scheduled for DN were randomized to either the bolus injection or the continuous infusion group. After appropriately placing the epidural catheter, 4 mL of 5% NaCl was injected as four boluses of 1 mL each at 15-minute intervals or infused over 1 hour using an infusion pump. The severity of pain induced by HS injection, as measured by the 11-point numerical rating scale (NRS), was the primary outcome. The severity of low back or lower extremity pain, as measured by the 11-point NRS and Oswestry Disability Index (ODI), 3 months following the procedure, was the secondary outcome. Results: Data from 21 patients in the bolus group and 23 in the continuous infusion group were analyzed. No statistically significant difference in injection-related pain was identified between the two groups during the initial HS administration (P = 0.846). However, there was a statistically significant reduction in injection-related pain in the continuous infusion group compared to the bolus injection group from the second assessment onwards (P = 0.001, < 0.001, and < 0.001, respectively). No significant between-group differences in the NRS and ODI scores 3 months post-procedure were noted (P = 0.614 and 0.949, respectively). Conclusions: Our study suggests that administering HS through a continuous infusion is a useful modality for reducing HS injection-related pain during DN.

• Clinical and Experimental Pediatrics
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• 제48권5호
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• pp.518-522
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• 2005

목 적 : 급성 세기관지염에 대한 치료로 보조 요법에 더해 기관지 확장제 흡입치료의 효과가 많이 보고되고 있다. 세기관지의 폐색에는 평활근의 수축이 관여하지만 어린 영아에서는 기관지 점막의 부종과 점액이나 상피세포 탈락물의 축적이 더 중요한 원인이기에, 본 질환으로 입원한 영아에서 ${\beta}_2$ 자극제와 정상 식염액을 혼합하여 흡입하는 대신, 점막 부종을 감소시키고 기도 축적물의 제거를 향상시킬 수 있는 고장성 식염액을 혼합하여 흡입했을 때의 치료효과를 알아보고자 하였다. 방 법 : 2003년 10월부터 2004년 5월까지 본원에 급성 세기관지염으로 입원한 1세 미만 환아 83명을 대상으로 하였다. 환아는 무작위로 두 그룹으로 나뉘어 입원과 동시에 초기 상태 평가가 이루어진 후 흡입 치료를 받았다. 치료는 이중 맹검법을 사용하여 fenoterol 2 mL(0.5 mg)에 0.9% saline solution 2 mL를 혼합하거나 fenoterol 2 mL에 3% saline solution 2 mL를 혼합하여 네뷰라이져로 6시간 간격으로 하루 4회 흡입하도록 하였다. 24, 48, 72시간째 흡입 전과 흡입 후 20분에 각각의 임상평가 점수를 측정하여 시간의 경과에 따른 변화를 검토하였고, 두 군의 총 입원일수도 비교하였다. 결 과 : 입원 72시간 동안, 두 그룹의 흡입 치료 직전의 임상평가 점수는 각각 시간이 지남에 따라 통계학적으로 유의하게 향상되었으며(P<0.05), 이는 3% 식염액 흡입군에서 유의하게 더 현저하였다(P<0.05). 평균 입원 일수는 0.9% 식염액 흡입군과 3% 식염액 흡입군 각각에서 $7.4{\pm}2.0$일과 $5.9{\pm}1.9$일로 두군간에 유의한 차이를 보였다(P<0.05). 흡입 치료와 관련된 부작용은 관찰되지 않았다. 결 론 : 급성 세기관지염으로 입원한 영아의 치료에서 3% saline solution에 혼합한 fenoterol 흡입 치료는 0.9% saline solution에 혼합한 fenoterol에 비해 더 효과적으로 임상 증상을 호전시켰다.

• Journal of Yeungnam Medical Science
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• 제27권2호
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• pp.159-164
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• 2010

Hematoma of gastric wall is very rare, and occasionally associated with coagulopathy, trauma, peptic ulcer disease, and therapeutic endoscopy. Ischemic gastric necrosis is also rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Endoscopic submucosal injection of hypertonic saline-epinephrine (HS-E) is a safe, cost-effective, and widely used therapy for hemostasis but it may cause tissue necrosis and perforation. We describe a case of gastric wall hematoma with oozing bleeding after endoscopic gastric mucosa biopsy in 71-year old woman with chronic renal failure and angina pectoris undergoing anti-platelet medication. We injected a small dose of HS-E (7ml) for controlling oozing bleeding. Two days later, endoscopy showed huge ulcer with necrotic tissue at the site of previously hematoma. Therefore we should pay particular attention for hematoma and mucosal necrosis when performing endoscopic procedure in a patients with high bleeding and atherosclerotic risk.

• The Korean Journal of Pain
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• 제14권2호
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• pp.245-248
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• 2001

Lysis of epidural adhesion has been done in patients with refractory lumbar radiculopathies. Cauda equina syndrome is a rare complication of epidural block. We report on a case of cauda equina syndrome following epidural adhesiolysis in a patient with spinal stenosis. The patient complained of numbness of the perineum, weakness of the left leg, an inability to void and fecal incontinence. She was treated with medication, bladder training and physical therapy, and finally recovered 1 month after the procedure without any sequelae. We suggest that the causative factors are osmotic damage produced by the subarachnoid injection of large doses of hypertonic saline and temporary neural compression due to spinal stenosis.

• The Korean Journal of Pain
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• 제27권1호
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• pp.3-15
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• 2014

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.