• Childhood Kidney Diseases
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• v.16 no.2
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• pp.89-94
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• 2012

Purpose: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. Methods: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. Results: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. Conclusion: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.

• The Journal of Dong Guk Oriental Medicine
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• v.4
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• pp.161-187
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• 1995

This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1213-1218
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• 2002

Purpose : Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram. Methods : The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG). Results : The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case. Conclusion : Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.

• The Korean Journal of Physiology
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• v.15 no.2
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• pp.103-109
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• 1981

In order to determine the dose-response relationship of ethanol on blood pressure and renal function, 2 doses of ethanol were intubated into albino rats. For a direct measurement of arterial blood pressure, a polyethylene catheter(PE 10) was implanted in the abdominal aorta, and the other end of the catheter was pulled out of the back of the neck. The experiment was conducted after the rats recovered from the surgery. After emptying their bladders, the rats were placed in a metabolism cage. Mean arterial pressure (MAP) was measured and arterial blood samples were collected through the catheter. Following the collection of the control urine sample, 1 ml of 10 g% (low dose), or 30 g% (high dose) of ethanol/100 g BW was intubated. 1 ml of water/100 g BW was intubated into the control group. MAP and blood samples were taken every hour, and urine samples were collected every 90 min for 3 hours. Blood alcohol concentrations reached a peak at 1 hour (low dose: $105.0{\pm}7.5$, high dose: $214.7{\pm}20.2\;mg%$) and decreased linearly thereafter. Following alcohol ingestion, MAP began to decrease at 15 min and remained at a significantly low level thoughout the 3 hours experimental period(low dose: $112{\pm}2{\rightarrow}102{\pm}4$, high dose: $117{\pm}2{\rightarrow}100{\pm}8\;mmHg$). Urine Flow increased markedly during the first 90 min of ethanol ingestion (low dose: $0.88{\pm}0.20{\rightarrow}1.04{\pm}0.22$, high dose: $0.56{\pm}0.11{\rightarrow}1.35{\pm}0.18\;ml/1.5\;hr$) and decreased during the second 90 min period(low dose: $0.25{\pm}0.06$, high dose: $0.22{\pm}0.06\;ml/1.5\;hr$). Urine flow of the control group decreased gradually during the experiment $(0.88{\pm}0.10{\longrightarrow}0.59{\pm}0.09{\rightarrow}0.45{\pm}0.09\;ml/1.5\;hr)$. These results indicate that the blood-pressure-lowering and diuretic effects of ethanol are dose-related: higher doses of ethanol produce a greater decrease in blood pressure and greater diuresis.

• The Korean Journal of Physiology
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• v.24 no.2
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• pp.319-329
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• 1990

Effects of atrial natriuretic peptide (ANP) on blood pressure, plasma lenin activity, aldosterone and renal excretion were compared in conscious spontaneously hypertensive rats (SHR) and normotensive Wistar rats fed low, medium or high sodium diet (2, 10, 25 mmol NaCl/100g diet) for 6 weeks. ANP infusion (380 ng/kg/min for 20 min) produced reductions in blood pressure, plasma renin activity, and aldosterone level, but marked increases in hematocrit, urine flow, and excretions of sodium and potassium. The low sodium group showed a significantly enhanced aldosterone lowering effect of ANP than the high sodium group. However, three salt groups showed no difference in effects of ANP on blood pressure, plasma renin activity, hematocrit and diuresis. Natriuretic response to ANP was significantly greater in the high salt-than in the low sait-SHR, but was not different between the Wistar salt groups. There were strain differences in effects of ANP: SHR showed greater responses of blood pressure and natriuresis than Wistar rats. Above results indicate that aldosterone-lowering and natriuretic effects of ANP were modifed by different dietary sodium intakes. However, blood pressure- and renin-lowering, or diuretic effects of ANP were not affected by dietary sodium intakes. The mechanisms whereby dietary sodium intakes alter the effects of ANP in the pathogenesis of hypertension are not clear.

• The Korean Journal of Pharmacology
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• v.22 no.2
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• pp.79-87
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• 1986

Recently it has been shown that central dopaminergic system regulates the renal function and that intracerebroventricularly (icv) administered dopamine (DA) produces antidiuresis and antinaturiuresis, resembling icv norepinephrine, and evidence has been accumulated which would suggest the involvement of adrenergic system in the DA effects. It was attempted therefore in this study to see whether the DA effect is influenced by pretreatment of yohimbine which is known as a specific ${\alpha}_2-adrenoceptor$ antagonist. Yohimbine produced, when given icv in doses of $100\;{\mu}g/kg$, marked antidiuresis and antinatriuresis along with decreases in renal perfusion and glomerular filtration. DA, in doses of $15\;{\mu}g/kg$, also produced antidiuresis and antinaturiuresis. However, after yohimbine-pretreatment DA $15\;{\mu}g/kg$ improved renal hemodynamics, and electrolyte excretion and urine flow rate transiently increased. With $150\;{\mu}g/kg$ DA, the antidiuresis was more marked in the control group. But the yohimbine-pretreated animals responded with marked diuresis and natriuresis, sodium excretion increasing more than three-fold, which lasted for 20 minutes. $K^+-excretion$, osmolar clearance as well as free-water reabsorption increased. Renal hemodynamics improved partly. Apomorphine, a DA agonist, when given icv in doses of $150\;{\mu}g/kg$, produced diuresis and naturiuresis, concomitant with increased renal hemodynamics. Yohimbine-pretreatment however did not abolish the apomorphine-induced diuresis and naturiuresis. Antidiuresis and antinatriuresis elicited by norepinephrine, $10\;{\mu}g/kg$, was not affected by yohimbine-pretreatment. These results indicate that the renal effects of icv DA is not so simple as those of norepinephrine, and the diuretic natriuretic cffect which had been masked by the hemodynamic effect becomes manifest only when the decreases in hemodynamics were removed by the pretreatment of yohimbine. It was further suggested that those DA receptors which mediate the natriuretic response to icv DA is not affected by yohimbine, whereas those receptors involved in the decrease in renal hemodvnamics are blocked by yohimbine. And the possibility of involvement of adrcnergic system in the DA action is not substantiated.