• 대한지역사회영양학회지
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• 제6권1호
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• pp.76-83
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• 2001

This study was designed to determine serum osmolality and to investigate the association among serum osmolality, health-related factors and biochemical indices. Two hundred thirty seven elderly(86 male, 151 female : mean age 73.8) residing in the chungbuk area participated. Sociodemographic data and self-perceived health status were obtained by interview, and biochemical parameters were measured. The mean serum osmolaity was 301.2$\pm$10.1 mOsm/kg(range 240.8~328.9 mOsm/kg) and serum osmolality of the females(302.4 mOsm/kg) was significantly(p＜0.05) higher than that of the males(299.0 mOsm/kg). Only 11.0% of the elderly were within the accepted normal range(280~295 mOsm/kg) and the majority of the subjects were in a hyperosmolar state(60.8% : 296~307 mOsm/kg). It was observed that serum osmolality was reduced with increasing age but not statistically significant. There was no significant difference in serum osmolality according to marital status. Serum osmolality was significantly lower(p＜0.05) in the elderly with higher self-perceived health scores than the elderly with lower self-perceived health scores, however no significant difference was observed between the presence or absence of disease. Serum osmolality tended to be higher(p=0.06) in the elderly with difficulty in mobility than the elderly who have no problem in mobility. Serum osmolality tended to be higher(p=0.06) among drug users compared to that of non-users. There was a significant association between serum osmolality and serum albumin in females but not in males. Significant associations were shown between serum osmolality and serum transferrin in both sexes. However, there was no significant correlation between serum osmolality and hemoglobin or hematocrit except with hematocrit in females only. The results of this study indicated that the elderly were dehydrated and hydration state seems to influence health status and, the elderly should be encouraged to drink an adequate amount of fluids. Also, the hydration state is required to be assessed and considered for the interpretation of biochemical parameters.

• 대한한의학회지
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• 제21권1호
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• pp.99-102
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• 2000

Central diabetes insipidus(CDI) results from deficient vasopressin(antidiuretic hormone) secretion and causes polydipsia and polyuria. Its etiologic diagnosis is confirmed with an increase of urine osmolality by administering desmopressin(DDAVP) after water restriction. Because cm is caused by deficiency of vasopressin, up to now, desmopressin, a synthetic analog of vasopressin, has been the drug of choice in the treatment of CDI. However, under such treatment, CDI patients suffer from the continual administration of DDAVP throughout one's life and high cost of the treatment We administrated oriental herb medicine on a cm patient in a state of discontinuance of DDAVP. Prior to the study, brain sella MRI was scanned to exclude germinoma. In addition, urine analysis, serum and urinary osmolality, daily urinary volume, serum electrolyte levels were measured. Chungsimyunjatang was administered for 15 days, and urine analysis, urine osmolality, daily urinary volume, serum Na were measured several times again during the therapy, As a result, urinary frequency increased, serum Na slightly elevated, but specific gravity of urine, urinary osmolality severely decreased and daily urinary volume substantially increased. However, the frequency of DDAVP treatment was reduced from four times per day to once or twice a day with the continual administration of the Chungsimyunja-tang for two months after the discharge.

• Journal of Yeungnam Medical Science
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• 제9권1호
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• pp.110-120
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• 1992

경뇨도 전립선 절제술을 시행한 환자 30명을 대상으로 하여 furosemide부여에 따른 혈중 나트륨치와 삼투질 농도를 비교 관찰한 결과 다음과 같은 결론을 얻었다. 1. 혈중 나트륨치는 대조군에서 술전에 비해 10분, 20분, 30분, 수술직후에 의의있는 감소(p<0.05)가 있었으나 실험군에서는 변화가 없었다. 2. 혈장 삼투질농도와 유효 삼투질농도는 대조군에서 술전치와 비교시 술중 30분과 수술직후에 의의있는 감소(p<0.05)가 있었으나 실험군에서는 잘 유지가 되었다. 이상의 결과로 보아 술중 흡수된 관류액의 영향을 줄일 목적으로 furosemide를 투여한 실험군에서 대조군에 비해 혈중나트륨치와 삼투질농도를 잘 유지시키기에 그 예방적 투여가 의의있다고 사료되며 특히 울혈성 심부전이나 신부전이 있는 환자의 수술시 furosemide를 투여하면 그 의의가 더 클 것으로 사료된다.

• 대한임상독성학회지
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• 제17권2호
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• pp.47-57
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• 2019

Purpose: Osmolar gap (OG) has been used for decades to screen for toxic alcohol levels. However, its reliability may vary due to several reasons. We validated the estimated ethanol concentration formula for patients with suspected poisoning and who visited the emergency department. We examined discrepancies in the ethanol level and patient characteristics by applying this formula when it was used to screen for intoxication due to toxic levels of alcohol. Methods: We retrospectively reviewed 153 emergency department cases to determine the measured levels of toxic ethanol ingestion and we calculated alcohol ingestion using a formula based on serum osmolality. Those patients who were subjected to simultaneous measurements of osmolality, sodium, urea, glucose, and ethanol were included in this study. Patients with exposure to other toxic alcohols (methanol, ethylene glycol, or isopropanol) or poisons that affect osmolality were excluded. OG (the measured-calculated serum osmolality) was used to determine the calculated ethanol concentration. Results: Among the 153 included cases, 114 had normal OGs (OG≤14 mOsm/kg), and 39 cases had elevated OGs (OG>14). The mean difference between the measured and estimated (calculated ethanol using OG) ethanol concentration was -9.8 mg/dL. The 95% limits of agreement were -121.1 and 101.5 mg/dL, and the correlation coefficient R was 0.7037. For the four subgroups stratified by comorbidities and poisoning, the correlation coefficients R were 0.692, 0.588, 0.835, and 0.412, respectively, and the mean differences in measurement between the measured and calculated ethanol levels were -2.4 mg/dL, -48.8 mg/dL, 9.4 mg/dL, and -4.7 mg/dL, respectively. The equation plots had wide limits of agreement. Conclusion: We found that there were some discrepancies between OGs and the calculated ethanol concentrations. Addition of a correction factor for unmeasured osmoles to the equation of the calculated serum osmolality would help mitigate these discrepancies.

• 한국동물위생학회지
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• 제45권2호
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• pp.139-143
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• 2022

A 10-year-old, spayed female miniature schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University due to evaluation of sudden polyuria (PU) and, polydipsia (PD) (540 mL/kg/day) with severe anemia and weight loss. Blood examination results were normal except for severe anemia (hematocrit, [HCT]: 11.8%). Urinalysis revealed a urine specific gravity (USG) of 1.003, whereas urine sediment was not specific. Urine osmolality was 90 mOsm (reference range: 800~2500 mOsm), and plasma osmolality was 303 mOsm. No specific lesions were found using diagnostic imaging including radiography, ultrasonography and magnetic resonance imaging (MRI). The serum cortisol level was normal in cosyntropin stimulation test. Plasma arginine vasopressin (AVP) concentration was <0.4 pg/mL (reference range: 3.49~5.45 pg/mL). Blood transfusion was initiated in addition to an oral prescription of desmopressin acetate (DDAVP, 0.1 mg/head) thrice a day for one week. The patient was rechecked for clinical signs, urine osmolality, and USG; the clinical signs of PU/PD were resolved, urine osmolality increased to 1106 mOsm, and, USG increased to 1.021. Considering the improved clinical signs, and increased urine osmolality, and USG after DDAVP treatment, the dog was diagnosed with central diabetes insipidus. USG and urine osmolality increased to >1.030 and 2200 mOsm, respectively. Anemia also gradually improved and HCT increased to >37%. DDAVP was tapered to 0.1 mg/head twice a day and all clinical signs in the patient have completely resolved.

• Neonatal Medicine
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• 제25권3호
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• pp.131-135
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• 2018

Hyponatremia is defined as a plasma sodium concentration of <135 mEq/L. It is a common electrolyte imbalance in newborns. We report the case of a term neonate with cleft lip, cleft palate, imperforate anus, normal male karyotype, and chronic hyponatremia. On the 4th day of life, he showed hyponatremia (plasma sodium concentration 130 mEq/L) with low serum osmolality (275 mOsm/kg), high urine sodium (116.7 mEq/L), and high urine osmolality (412 mOsm/kg). His thyroid and adrenal functions were normal. Despite intravenous and oral sodium supplementation and hydrocortisone treatment, hyponatremia persisted. Brain magnetic resonance imaging showed normal results. He was diagnosed as having reset osmostat, a rare subtype of the syndrome of inappropriate secretion of antidiuretic hormone characterized by a subnormal threshold for antidiuretic hormone secretion, with hypotonic hyponatremia.

• Clinical and Experimental Pediatrics
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• 제59권4호
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• pp.202-204
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• 2016

A 15-year-old boy, who was diagnosed with Alport syndrome and end-stage renal disease, received a renal transplant from a living-related donor. On postoperative day 1, his daily urine output was 10,000 mL despite normal graft function. His laboratory findings including urine, serum osmolality, and antidiuretic hormone levels showed signs similar to central diabetes insipidus, so he was administered desmopressin acetate nasal spray. After administering the desmopressin, urine specific gravity and osmolality increased abruptly, and daily urine output declined to the normal range. The desmopressin acetate was tapered gradually and discontinued 3 months later. Graft function was good, and urine output was maintained within the normal range without desmopressin 20 months after the transplantation. We present a case of a massive polyuria due to transient deficiency of antidiuretic hormone with the necessity of desmopressin therapy immediately after kidney transplantation in a pediatric patient.

• 한국수산과학회지
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• 제54권5호
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• pp.676-684
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• 2021

Euryhaline teleost have extraordinary ability to deal with a wide range of salinity changes. To study the seawater adaptability of rainbow trout Oncorhynchus mykiss (body weight 638±54 g, length 38.6±2 cm) to salinity increase fish were transferred from freshwater to 7, 14, 21, 28 and 32 psu and checked for mortality over 5 days. No mortality was observed in 0-32 psu. In fish transferred to 0-32 psu, blood osmolality was maintained within physiological range. The changes of serum enzyme activities (aspartate transaminase, AST and alanine transaminase, ALT) showed no significant level during experimental period. To explore the underlying molecular physiology of gill and kidney responsible for body fluid regulation, we measured mRNA expression of five genes, Na⁺/K⁺/2Cl^- cotransporter1 (NKCC1), aquaporin3 (AQP3), cystic fibrosis transmembrane conductance regulator (CFTR), glucocorticoid receptor (GR) and growth hormone receptor (GHR) in response to salt stress. Based on our result, rainbow trout could tolerate gradual transfer up to 32 psu for 5 days without mortality under physiological stress. This study suggests to alleviate osmotic stress to fish, a gradually acclimation to increasing salinity is recommended.

• 한국수산과학회지
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• 제55권6호
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• pp.894-902
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• 2022

This study investigated the effects of photoperiod (NL 12L:12D and LL 24L:0D) and body sizes (30 g and 50 g) on parr-smolt transformation, post-smolt growth and blood properties in the off-season parr-smolt stage of Atlantic salmon reared in a recirculating aquaculture system (RAS). Potential off-season salmon smolt were reared in a freshwater RAS for 80 days and then all experimental fish were transferred to seawater. In both LL groups (LL-30 and LL-50), we recorded and increase in specific growth rate and reduction in feed conversion, although there were no significant difference in body size. The values of osmolality, and serum Na⁺, Cl^- and cortisol concentrations in the LL groups were maintained at lower levels than in NL group fish, and LL group fish were observed to recover to the pre-seawater adaptation state more rapidly than those in the NL group. ID chips were inserted in all smolts reared in freshwater. These fish were subsequently transferred to full-strength seawater and thereafter individual growth rates were monitored for 120 days. The results indicated that compared with smolt reared under natural photoperiodic condition, 24 h lighting in freshwater contributed to enhancing post-smolt specific growth rate in seawater.

• 한국양식학회지
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• 제16권3호
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• pp.151-158
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• 2003

수온 2$0^{\circ}C$에서 넙치가 수용된 실험구에 ClO$_2$를 농도별로 처리하여 10분간 노출시킨 다음 해수를 유수하면서 넙치의 생존과 생리상태에 미치는 영향을 조사하였다. ClO$_2$ 처리직후의 잔류농도 0.51 ppm에서는 90분이 지나면 모든 개체가 사망하였고, 0.43 ppm에서는 3시간 후의 생존율이 13.3%, 0.34 ppm에서는 24시간이 경과하는 동안 평균 92.0%가 생존하였으며, 0.43과 0.51 ppm에서 넙치의 반수치사시간(($LT_{50}$)은 각각 103분과 32분이었다. 0.34~0.51 ppm $CIO_2$에 노출된 넙치의 Ht, Hb 및 혈청 전해질과 삼투질 농도는 $CIO_2$ 농도가 높고 노출 후 시간이 지날수록 대조군에 비해 유의하게 높은 값을 나타내었다. 0.27 ppm의 경우 Ht, Hb및 혈청 전해질과 삼투질 농도는 대조군과 차이는 없었으나 혈청 glucose 농도는 $CIO_2$ 노출 후 시간이 경과할수록 높아지는 현상을 보여 주었다. 또한 SS 농도가 높은 해수는 SS가 낮은 해수에 비해 잔류 $CIO_2$가 빠르게 환원되었다.