• The Korean Journal of Physiology
• /
• 제21권2호
• /
• pp.291-296
• /
• 1987

There have been reports on the aberration of the control mechanisms of the blood pressure, hormone secretion, and renal functions in spontaneously hypertensive rats (SHR). However, the contribution of the renin-angiotensin system in the maintenance of high blood pressure in SHR is still controversial. Recently, it has been reported that the negative feedback short loop control mechanism of the renin-angiotensin system may be changed in SHR. In the present experiment, it was attempted to explore the possible alterations in the effect of arginine vasopressin (AVP) on the renal function in SHR. Experiments have been done in anesthetized SHR as well as in normotensive Wistar and Sprague-Dawley rats as control groups. Pharmacologic doses of AVP (10-13 mU/rat/10 min) decreased urine volume, excreted amount of creatinine and para-amino-hippuric acid. No differences in these parameters was observed between normotensive and hypertensive rats. AVP increased sodium and potassium excretion, but the responses in SHR were suppressed as compared with normotensive rats. Intravenous infusion of AVP also increased blood pressure in normotensive and hypertensive rats and a vasopressor effect of AVP was attenuated in SHR. There was a positive correlation between the changes in blood pressure and excreted amount of sodium during AVP infusion. These data suggest that the attenuated natriuretic effect of intravenous infusion of AVP may be due to a difference in renal tubular responsiveness to AVP but not due to a difference in vasopressor responsiveness.

• Journal of Korean Neurosurgical Society
• /
• 제52권2호
• /
• pp.75-79
• /
• 2012

Objective : The study examined the difference in the incidence of symptomatic cerebral vasospasm with magnesium supplementation in aneurysmal subarachnoid hemorrhage (SAH) in a Korean population. Methods : This retrospective analysis was performed in 157 patients diagnosed with aneurysmal SAH from January 2007 to December 2011 at a single center. Seventy patients (44.6%) received a combination treatment of nimodipine with magnesium and 87 patients (55.4%) received only nimodipine. A matched case-control study using propensity scores was conducted and 41 subjects were selected from each group. A dosage of 64 mmol/day of magnesium was administrated. Results : The infusion of magnesium did not reduce the incidence of symptomatic cerebral vasospasm (n=7, 17.1%, p=0.29) compared with simple nimodipine injection (n=11, 26.8%). The ratios of good clinical outcome (modified Rankin scale 0-2) at 6 months were similar, being 78% in the combination treatment group and 80.5% in the nimodipine only group (p=0.79). The proportions of delayed cerebral infarction was not significantly lower in patients with combination treatment (n=2, 4.9% vs. n=3, 7.3%; p=0.64). There was no difference in the serum magnesium concentrations between the patients with symptomatic vasospasm and without vasospasm who had magnesium supplementation. No major complications associated with intravenous magnesium infusion were observed. Conclusion : Magnesium supplementation (64 mmol/day) may not be beneficial for the reduction of the incidence of symptomatic cerebral vasospasm in patients with aneurysmal SAH.

• The Korean Journal of Physiology
• /
• 제22권2호
• /
• pp.179-187
• /
• 1988

This study was conducted to investigate the effects of epinephrine and norepinephrine on basal gastric acid secretion and plasma gastrin and secretin concentration in the conscious rat. One hundred and eighty-four albino rats with gastric cannula were used after 18 hours or more of fast, with water ad libitum. In a restraint cage for collection of gastric juice, physiological saline (0.9% NaCl) was continuously infused into the jugular vein through a catheter for one hour at a rate of 1 ml/hr (control period). Immediately after the control period, epinephrine (1, 2, 4, 8 and $16{\mu}g/ml/hr)$, norepinephrine (1, 2, 4, 8 and $16{\mu}g/ml/hr)$ or physiological saline (1 ml/hr) was infused for another one hour. Gastric juice was collected at one hour interval for two hours infusion period. Adrenergic antagonists, phentolamine and propranolol were injected into the jugular vein 5 min prior to the infusion of epinephrine or norepinephrine at a dose of 0.2 mg/0.1 ml. Blood was sampled from the jugular vein for the radioimmunoassay of plasma gastrin and secretin after the collection of gastric juice. The results were as follows: 1) Both epinephrine and norephinephrine significantly increased gastric acid output in a dosedependent manner. 2) The effects of epinephrine and norepinephrine on the gastric acid secretion were antagonized by the pretreatment with phentolamine and propranolol. 3) Plasma gastrin and secretin concentrations were not significantly affected by the intravenous infusion of epinephrine and norepinephrine. It can be inferred from the above results that epinephrine and norepinephrine facilitate gastric acid secretion in conscious rats and the mechanism of which is attributed to ${\alpha}\;and\;{\beta}$ adrenergic receptors rather than gastrin and secretin.

• 대한임상독성학회지
• /
• 제10권1호
• /
• pp.33-36
• /
• 2012

Opioids are the one of the most commonly used drugs to control cancer pain all over the world. But, we should not overlook the potential risk of opioid intoxication because they have well-known detrimental side effects. The opioid intoxication can be diagnosed thorough various clinical manifestations. The altered mental status, respiratory depression, and miosis is very representative clinical features although these symptoms don't always appear together. Unfortunately the opioid-toxidrome can be varied. A 42 years old man came to our emergency room after taking about 900 mg morphine sulfate per oral. He was nearly alert and his respiration was normal. Even though his symptoms didn't deteriorated clinically, serial arterial blood gas analysis showed increase in PaCO2. So we decided to use intravenous naloxone. Soon, he was fully awaked and his pupils size was increased. After a continuous infusion of intravenous naloxone for 2 hours, PaCO2 decreased to normal range and his pupil size also returned to normal after 12 hours. Though the levels of serum amylase and lipase increased slightly, his pancreas was normal according to the abdominal computed tomography. He had nausea, vomit, and whole body itching after naloxone continuous infusion, but conservatively treated. We stopped the continuos infusion after 1 day because his laboratory results and physical examinations showed normal. As this case shows, it is very important to prescribe naloxone initially. If you suspect opioid intoxication, we recommend the initial use of naloxone even though a patient has atypical clinical features. In addition, we suggest intranasal administration of naloxone as safe and effective alternative and it's necessary to consider nalmefene that has a longer duration for opioid intoxication.

• Clinical and Experimental Pediatrics
• /
• 제58권11호
• /
• pp.454-458
• /
• 2015

Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

• Clinical and Experimental Pediatrics
• /
• 제59권1호
• /
• pp.35-39
• /
• 2016

Purpose: This study compared the efficacy and tolerability of intravenous (i.v.) phenobarbital (PHB) and i.v. levetiracetam (LEV) in children with status epilepticus (SE) or acute repetitive seizure (ARS). Methods: The medical records of children (age range, 1 month to 15 years) treated with i.v. PHB or LEV for SE or ARS at our single tertiary center were retrospectively reviewed. Seizure termination was defined as seizure cessation within 30 minutes of infusion completion and no recurrence within 24 hours. Information on the demographic variables, electroencephalography and magnetic resonance imaging findings, previous antiepileptic medications, and adverse events after drug infusion was obtained. Results: The records of 88 patients with SE or ARS (median age, 18 months; 50 treated with PHB and 38 with LEV) were reviewed. The median initial dose of i.v. PHB was 20 mg/kg (range, 10-20 mg/kg) and that of i.v. LEV was 30 mg/kg (range, 20-30 mg/kg). Seizure termination occurred in 57.9% of patients treated with i.v. LEV (22 of 38) and 74.0% treated with i.v. PHB (37 of 50) (P=0.111). The factor associated with seizure termination was the type of event (SE vs. ARS) in each group. Adverse effects were reported in 13.2% of patients treated with i.v. LEV (5 of 38; n=4, aggressive behavior and n=1, vomiting), and 28.0% of patients treated with i.v. PHB (14 of 50). Conclusion: Intravenous LEV was efficacious and safe in children with ARS or SE. Further evaluation is needed to determine the most effective and best-tolerated loading dose of i.v. LEV.

• 센서학회지
• /
• 제24권2호
• /
• pp.113-118
• /
• 2015

Intravenous (IV) infusion set is one of the most common treatment methods applied to hospitalized patients. However, it is necessary to check the injection of IV solution in order to prevent patients from any possible medical injuries. In this paper, using the optical sensors to detect exhaustion of IV solution was proposed. The optical sensor is coplanar structure composed of LED and photodiode which is installed according to focal distance of the lens. These two elements detect exhaustion of IV solution at the desired point conveniently. Through the results of experiments using various wavelength of LED (R.G.B), the blue LED was selected to the optimum light source. The suggested optical sensor can detect exhaustion of IV solution by the differences in the amount of light which is caused by properties such as total reflection, refractive index and scattering. From the implementation, the detector is applicable to both containers of IV solution, glass bottle and plastic pack. And also the result shows apparent differences according to existence of IV solution even if the IV solution color and illumination were changed.

• The Korean Journal of Pain
• /
• 제32권1호
• /
• pp.30-38
• /
• 2019

Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

• Pediatric Infection and Vaccine
• /
• 제5권1호
• /
• pp.147-151
• /
• 1998

On the treatment of Kawasaki disease, approximately 10% of children treated with IVIG have persistent or recrudescent fever despite IVIG treatment. We had experienced two children with Kawasaki disease who did not respond after multiple dosages of IVIG. They were treated within the first 10 days of onset of fever and were given oral aspirin (100mg/kg/day) and IVIG(2gm/kg) in a single infusion for 8 to 10 hours. The first child had not resolution of symptoms after three intravenous doses of IVIG(total 4gm/kg). And then treated with high dose methylprednisolone(30mg/kg) for 2 to 3 hours intravenously without symptoms improvement. On fifth hospital days, he was retreated with IVIG (2gm/kg) again with ultimate resolution of symptoms. The second child had resolution of symptoms after three intravenous doses of IVIG(total 4gm/kg). No adverse events were associated with the administration of IVIG or steroid. We reported two cases of IVIG non-responded Kawasaki disease with a brief review of the related literatures.

• The Korean Journal of Physiology and Pharmacology
• /
• 제17권4호
• /
• pp.367-373
• /
• 2013

Contribution of the vestibular end organ to regulation of arterial pressure was quantitatively compared with the role of baroreceptors in terms of baroreflex sensitivity and c-Fos protein expression in the rostral ventrolateral medulla (RVLM). Baroreflex sensitivity and c-Fos protein expression in the RVLM were measured in conscious rats that had undergone bilateral labyrinthectomy (BL) and/or baroreceptor unloading. BL attenuated baroreflex sensitivity during intravenous infusion of sodium nitroprusside (SNP), but did not significantly affect the sensitivity following infusion of phenylephrine (PE). Baroreflex sensitivity became positive following sinoaortic denervation (SAD) during infusion of PE and attenuated sensitivity during infusion of SNP. Baroreflex sensitivity also became positive following double ablation (BL+SAD) during infusion of PE, and attenuated sensitivity during infusion of SNP. c-Fos protein expression increased significantly in the RVLM in the sham group after SNP administration. However, the BL, SAD, and SAD+BL groups showed significant decreases in c-Fos protein expression compared with that in the sham group. The SAD group showed more reduced c-Fos protein expression than that in the BL group, and the SAD+BL group showed less expression than that in the SAD group. These results suggest that the vestibular system cooperates with baroreceptors to maintain arterial pressure during hypotension but that baroreceptors regulate arterial pressure during both hypotension and hypertension. Additionally, afferent signals for maintaining blood pressure from the vestibular end organs and the baroreceptors may be integrated in the RVLM.