• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.1
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• pp.1-9
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• 2009

Purpose: Paraquat, a globally used herbicide, is highly toxic to human beings. Hence, we reviewed some cases of paraquat poisoning in Korea. Methods: We analyzed the clinical and laboratory findings of 50 patients poisoned with paraquat retrospectively. The patients were admitted to the department of internal medicine in the Eumseong KeumWang hospital from January 2008 to December 2008. Results: Among 50 cases of paraquat poisoning, 28 cases were male. Twenty-four cases (48%) were over 60 years old. Fourty-nine patients ingested paraquat on purpose as suicidal attempts, while 1 patient underwent accidental ingestion. Seven patients swallowed less than one mouthful of paraquat, of which 4 patients survived. Eleven patients swallowed two mouthfuls of paraquat, of which 8 patients survived. Thirty-two patients swallowed over three mouthfuls of paraquat and they all died. Thirty-one patients with leukocytosis died. Twenty-one patients with metabolic acidosis died. Increased levels of blood amylase and glucose were related to high mortality, and increased level of blood creatinine was related to severe mortality. Hemoperfusions were accomplished in 27 patients of paraquat poisoning, of which 12 patients survived. Conclusion: Paraquat is a highly toxic herbicide. When patients arrive at the hospital, laboratory findings, urine paraquat concentrations, arrival time, and the amount of paraquat consumed must be considered for treatment plan.

• Journal of Chest Surgery
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• v.2 no.2
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• pp.133-140
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• 1969

We observed 56 cases of nontraumatic pneumothorax clinically and statistically, which had been experienced at the deparment of chest surgery. St. Mary`s Hospital,Catholic Medical College in theserecent years. 1] In the underlying pathology of spontaneous pneumothorax, nontuberculous origin [60.7%], especially due to pulmonary emphysema or blebs[17.8%], especially due to pulmonary emphysema or blebs[17. 8%], tended to increase as the reports of foreign countries, but tuberculous origin was still high in our country[39.3%]. Considering the 14 cases, unknown underlying pathology, the most of them might have scattered blebs which were not revealed in chest Roentgen films. 2] The principle treatment done in our clinic was as follows; The patients, below 20% lung collapse were treated by bed rest and abdominal respiration. The patients, between 20% and 40% lung collapse were treated by repeated pleural aspiration or closed thoracotomy followed. The cases,over 40% lung collapse were treated by closed thoracotomy initially. 3] The average duration of indweIling catheter was 3 to 4 days in the closed thoracotomy. We used to not remove the indwelling catheter early to promote pleural adhesion. 4] Sometimes, the closed thoracotomy drainage induces bronchial irritation and asthmatic attacks, especially in old age group accompanying pulmonary emphysema. In these cases, respiratory difficulties and acidosis should be prevented and controlled with medical treatment including steroid therapy.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.79-84
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• 1998

Benign symmetric lipomatosis was initially described in 1846 by Sir Benjamin Brodie. In 1888, Otto Madelung presented 33 cases of benign symmetric lipomatosis and described the classic“horse collar”cervical distribution of the lipomatous tissue. Launois and Bensaude described benign symmetric lipomatosis as a distint syndrome characterized by a diffuse, symmetric, fatty accumulation in the cervical region. This disease is rare condition affecting mostly middle aged alcoholic men and associated with many systemic diseases such as diabetes mellitus, hyperuricemia, renal tubular acidosis, liver enzyme abnormality etc. The condition does not spontaneously involute and surgical excision is the only proven method of treatment, and recurrence is frequent. We experienced six patients of benign symmetric lipomatosis who underwent surgical excision via collar incision which afford wide exposure of the entire cervical area. We report them with the review of literature.

• Korean Journal of Veterinary Research
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• v.61 no.4
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• pp.40.1-40.6
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• 2021

Acid-base disorder is a common problem in veterinary emergency and critical care. Traditional methods, as well as the Stewart method based on strong ion difference concepts and the Fencl-Stewart method, can be used to analyze the underlying causes. On the other hand, there are insufficient comparative study data on these methods in cats. From 2018 to 2020, 327 acid-base analysis data were collected from 69 sick and 18 healthy cats. The three most well-known methods (traditional method, Stewart method, and Fencl-Stewart method) were used to analyze the acid-base status. The frequency of acid-base imbalances and the degree of variation according to the disease were also evaluated. In the traditional acid-base analysis, 5/69 (7.2%) cats showed a normal acid-base status, and 23.2% and 40.6% of the simple and mixed disorders, respectively. The Fencl-Stewart method showed changes in both the acidotic and alkalotic processes in 64/69 (92.8%), whereas all cats showed an abnormal status in the Fencl-Stewart method (semiquantitative approach). The frequencies of the different acid-base imbalances were identified according to the analysis method. These findings can assist in analyzing the underlying causes of acid-base imbalance and developing the appropriate treatment.

• Journal of Veterinary Science
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• v.21 no.1
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• pp.6.1-6.12
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• 2020

Currently, the optimal resuscitation fluid remains debatable. Therefore, in the present study, we designed a trometamol-balanced solution (TBS) for use as a resuscitation fluid for hemorrhagic shock. Hemorrhagic shock was induced in 18 male Wistar-Kyoto rats, which were assigned to normal saline (NS), Ringer's solution (RS), and TBS groups. During the hemorrhagic state, their hemodynamic parameters were recorded using an Abbott i-STAT analyzer with the CG4+ cartridge (for pH, pressure of carbon dioxide, pressure of oxygen, total carbon dioxide, bicarbonate, base excess, oxygen saturation, and lactate), the CG6+ cartridge (for sodium, potassium, chloride, blood glucose, blood urea nitrogen, hematocrit, and hemoglobin), and enzyme-linked immunosorbent assay kits (calcium, magnesium, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, and albumin). Similar trends were found for the parameters of biochemistries, electrolytes, and blood gas, and they revealed no significant changes after blood withdrawal-induced hemorrhagic shock. However, the TBS group showed more effective ability to correct metabolic acidosis than the NS and RS groups. TBS was a feasible and safe resuscitation solution in this study and may be an alternative to NS and RS for resuscitation in hemorrhagic shock patients without liver damage.

• Journal of Dairy Science and Biotechnology
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• v.40 no.1
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• pp.15-22
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• 2022

This study evaluated the levels of D(-)-lactate and L(+)-lactate, and the ratio of D(-)-lactate to total lactate (D(-)-lactate + L(+)-lactate) of 15 lactic acid bacteria (LAB) using an enzymatic method. D(-)-lactate and L(+)-lactate levels in the LAB ranged from 0.31 to 13.9 mM and 0.76 to 39.3 mM, respectively, in Bifidobacterium sp.; 1.08 to 11.7 mM and 0.69-13.0 mM in Lactobacillus sp.; 0.72 to 20.3 mM and 0.98 to 32.3 mM in Leuconostoc sp., and 33.0 mM and 39.2 mM in Pediococcus acidilacti KCCM 11747. The ratio of the range of D(-)-lactic acid to total lactic acid was 28.98%-45.76% in Bifidobacterium sp., 41.18%-61.02% in Lactobacillus sp., 29.85%-42.36% in Leuconostoc sp., and 45.71% in P. acidilacti KCCM 11747. In the future, there is a need to test for D(-)-lactate in various fermented products to which different LAB have been added and study the screening of LAB used as probiotics that produce various concentrations of D(-)-lactate.

• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.126-130
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• 2023

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have become increasingly prescribed because of their proven protective effects on the heart and kidneys, and carbohydrate-restricted diets are popular therapeutic approaches for patients with obesity and diabetes. A 28-year-old obese woman with recently diagnosed diabetes developed euglycemic diabetic ketoacidosis (DKA) while on dapagliflozin, an SGLT2 inhibitor, and following a carbohydrate-restricted diet. She presented with nausea, vomiting, and epigastric pain. Hospital tests showed a blood glucose of 172 mg/dL, metabolic acidosis, and increased ketone levels, confirming euglycemic DKA. Treatment involved discontinuing dapagliflozin and administering fluids, glucose, and insulin. She recovered and was discharged on the fourth day. This is considered a case of euglycemic DKA induced by SGLT2 inhibitors and triggered by a carbohydrate-restricted diet. This case highlights the importance of physicians in confirming the symptoms and laboratory results of DKA, even in patients with normal blood glucose levels taking SGLT2 inhibitors and following carbohydrate-restricted diets. It is also crucial to advise patients to maintain an adequate carbohydrate intake.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.1
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• pp.14-21
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• 2014

Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.6
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• pp.861-882
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• 2000

The seed, or grain, of modern cultivars of Lupinus angustifolius, commonly known as Australian sweet lupins (ASL), is an established feed resource for the intensive animal industries of Australia, Japan, Korea and several other countries in Asia and Europe. Since the introduction of ASL to the world marketplace about 25 years ago, researchers in many countries have found them to be a valuable component of the diet of beef and dairy cattle, sheep, pigs, poultry, finfish and crustaceans. The seed of ASL contains ~32% crude protein (CP) (~35% DM basis) and 5% oil. The main storage carbohydrates in the seed are the ${\beta}$-galactans that comprise most of the cell-wall material of the kernel and the cellulose and hemicellulose of the thick seed coats. ASL seeds contain about 40% non-starch polysaccharides (NSP) and a negligible amount of starch. This makes them an excellent ingredient for ruminant diets, as the risk of acidosis is very low. The seed of modern cultivars of domesticated Lupinus species contain negligible amounts of lectins and trypsin inhibitors so they do not require preheating before being used as an ingredient in feeds for monogastric species. They have a high digestibility coefficient for protein, >90% for most species, but a low energy digestibility, ~60%, which is mostly due to the high content of NSP. The low content of methionine (0.22%) and of lysine (1.46%) is typical of the legumes. The lysine availability for pigs is >70%. Lupin kernels contain ~39% CP (~42% DM basis), 6% oil and 30% NSP. They have a higher digestible energy for pigs and finfish and a higher metabolisable energy for poultry than whole seed. Commercial operations rarely achieve complete separation of kernel from hull and it is more likely that the kernel fraction, called splits or meats, will contain ~36% CP. The replacement of soybean meal or peas with ASL in cereal-based diets for most intensively reared animals, birds and fish is possible provided lysine, methionine and digestible energy levels are kept constant. This makes ASL economically competitive in many, but not all, circumstances.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.381-387
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• 2005

Malignant hyperthermia is a catastrophic, hypermetabolic syndrome that arises in susceptible individuals when they are exposed to certain inhalational anesthetics or muscle relaxants. It is characterized by hyperthermia, tachycardia, acidosis, and muscle rigidity. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. We experienced a 24 year old male Malignant hyperthermia presented for orthognathic surgery under $O_2-N_2O$-sevoflurane anesthesia without succinylcholine. Two half hours after induction, tachycardia developed and was followed by unstable blood pressure and hyperpyrexia. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated by the intravenous administration of dantrolene sodium. The diagnosis of an acute malignant hyperthermia reaction by clinical criteria can be difficult because of the nonspecific nature and variable incidence of many of the clinical signs and laboratory findings. So the malignant hyperthermia clinical grading scale is recommended for use as an aid to the objective definition of this disease. This clinical grading system provides a new and comprehensive clinical case definition for the malignant hyperthermia syndrome. We recently encountered a case of delayed malignant hyperthermia during sevoflurane anesthesia that was successfully treated by the intravenous administration of dantrolene sodium. In conclusion, exposure to sevoflurane should be avoided in patients thought to be susceprible to malignant hyperthermia.