• 대한임상독성학회지
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• 제3권1호
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• pp.56-59
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• 2005

Blister beetles produce cantharidin, which is toxic to people and animals. Cantharidin has been believed to be an aphrodisiac and an abortifacient based on its tendency to cause marked irritation to the genitourinary system leading to priapism in men and pelvic congestion in women for many years. Cantharidin was used by oriental traditional medicine for more than 2000 years. Typical signs related to cantharidin ingestion are gastrointestinal tract and urinary tract irritation, endotoxemia, shock and myocardial dysfunction. Cantharidin is a severe irritant to epithelial linings (gastrointestinal tract, urinary tract, and skin) and develop systemic inflammatory response syndrome. We report a case of corrosive esophagogastritis and acute renal failure by ingestion of cantharidin.

• Journal of Chest Surgery
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• 제30권5호
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• pp.501-505
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• 1997

초 저체온 및 순환정지하 개심수술시 Aprotinin을 사용하는 경우 혈관내 응고와 관련된 신기능장애 등의 합병증이 증가된다는 보고가 있다. 저자들은 1992년 11월부터 95년 8월까지 초저체온 및 순환정지하에서 대 동맥 수술을 한 44례 환자 중 고농도 Aprotinin을 사용한 20명의 환자를 대상으로 수술 후 주요장기에 미치 는 aprotinin의 영향을 조사하였다. 초저체온하 순환정지 시에는 좌측대퇴동맥을 통하려 저혈류로 순환시켜 흉부대동맥내로 공기유입이 되지 않도록 하였으며 순환정지시간이 길어질 것으로 예상되거나 대동맥궁을 치 환하는 경우에는 선택적뇌관류를 하였다. 순환정지시 활성응고시간은 639초에서 1531초로 1례를 제외한 모 든 환자에서 활성응고시간을 750초 이상 유지하였다. 대상환자 20례중 수술사망은 4례에서 발생하였다. 사망원인은 출혈 1례, 폐출혈 1례, 좌 관상동맥 박리에 따른 좌심실 기능부전이 1례, 근리고 다발성 뇌경색이 1례 있었다. 수술 후 뇌손상이 2례에서 발생하였으나 1례는 수술전 부터 자측 총경동맥 박리가 원인이었고 1례에서는 그 원인을 알 수 얼었다. 생존한 환자중 수 술 후 신 기능이나 간기능의 이상은 얼\ulcorner다. 결론적으로 초저체온 및 순환정지를 이용한 대동맥수술시 avotinin을 사용한 결과 ACT를 750초이상 충분 히 유지하고, low flow retrograde perfusion을 유지하는 경우 신기능의 장애를 포함한 혈관내 응고와 관련된 합 병증이 증가되지 않고, 안전하게 사용할 수 있는 것으로 나타났다.

• Childhood Kidney Diseases
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• 제14권2호
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• pp.132-142
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• 2010

저칼륨혈증의 경우 약제 또는 백혈구 증가증 등에 의해서 칼륨이 일시적으로 세포내로 이동하는 재분포에 의해서 생기는 저칼륨혈증을 먼저 감별한다. 칼륨소실에 의한 결핍의 경우 소변 칼륨 농도 또는 TTKG를 구하고, 감소되어 있는 경우에는 칼륨의 신외성 손실, 칼륨 섭취의 부족 등을 감별한다. 증가되어 있는 경우 신장을 통한 칼륨의 소실을 생각하고, 고혈압이 동반되어 있지 않을 경우 산증과 관련된 경우, 구토에 의한 경우, 세뇨관에서의 칼륨 재흡수 장애 또는 칼륨의 분비가 증가되는 경우를 생각할 수 있다. 고혈압이 동반되어 있을 경우 혈장 레닌과 알도스테론을 측정하여 레닌이 증가되어 있을 경우, 혈장 레닌이 정상 또는 낮으면서 혈장 알도스테론만 증가한 경우, 혈장 알도스테론은 증가되어 있지 않지만 알도스테론 이외에 광물부신겉질호르몬의 작용이 증가하는 경우를 감별한다. 증상은 무기력, 경련, 근육통, 횡문근 융해증, 변비, 장폐쇄, 부정맥, 지각이상 등이 있다. 치료는 원인 질환의 치료 및 칼륨공급이다. 고칼륨혈증은 재분포에 의한 경우, 가성 고칼륨혈증, 진성 고칼륨혈증을 감별해야 한다. 진성 고칼륨혈증이면서 사구체 여과율이 감소되어 있는 경우 신부전 또는 체내 칼륨 부하가 증가하는 경우를 감별한다. 사구체 여과율이 15 mL/min/$1.73m^2$ 이상인 경우에는 혈장 레닌과 알도스테론을 검사한다. 모두 낮을 경우, 혈장 레닌은 정상이지만 알도스테론만 낮은 경우, 혈장 알도스테론의 농도는 정상이지만 알도스테론의 작용을 저해되는 경우 등을 감별해야 한다. 증상은 부정맥, 감각 이상, 허약 등이 있다. 치료는 calcium gluconate, 인슐린, 베타2작용제, 중탄산염, furosemide, resin, 투석 등이 있으며, 칼륨을 제한하고 원인 약물이 있을 경우 이를 중단해야 한다.

• 동의생리병리학회지
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• 제18권1호
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• pp.84-92
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• 2004

The present study examined the effects of Taekunyukmijiwhang-tang (TV) on blood pressure and renal function in nitric oxide (NO)-dependent hypertensive rats. A phamacological inhibition of nitric oxide synthase (NOS) for 4-6 weeks produces renal vasoconstriction, renal dysfunction, and progressive severe hypertension. Treatment of rats with NG-Nitro-L-arginie methylester (L-NAME) (100 mg/L, 6 weeks), which is a nonspecific NOS inhibitor, cause a sustained increase in systolic blood pressure (SBP), along with the decrease in expression of ecNOS in the kidney and thoracic aorta. The expression of Na, K-ATPase α1 subunit in the kidney was also reduced in the L-NAME induced hypertensive rats group. The renal functional parameters including urine osmolality (Uosm), creatinine clearance (Ccr), which is an index of glomerular filtration (GFR) were decreased in rat with L-NAME induced hypertension. while solute-free water reabsoption (TcH₂O) was unchanged in all experimental group. However, the group combined treated with TV and L-NAME did not develop hypertension and expression of ecNOS in the aorta was restored. The expression of Na/sup +/, K/sup +/-ATpase α1 subunit in the kidney was markedly restored in L-NAME-induced hypertension rats by administration of TV along with the restoration of urinary volume (UV) and sodium excretion (UNaV), whlie Na/sup +/, K/sup +/-ATPase /β1 subunit was not altered. These results suggest that TV attenuates an increase in SSP in the L-NAME induced hypertension and restores partially renal function, which seems to be caused by up-regulation of expression of Na/sup +/, K/sup +/-ATPase α1 subunit in the kidney and ecNOS in thoracic aorta.

• 대한한의학방제학회지
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• 제31권3호
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• pp.157-169
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• 2023

Gracilaria Verrucosa (GV), a seaweed used in traditional Korean medicine, was studied for its effects on MI-induced heart failure in rats. MI is caused by a blocked coronary artery, leading to severe cardiac dysfunction. The study used a rat model to assess cardiac changes over time and evaluate the impact of GV on heart failure. Ischemia was induced through LAD ligation surgery, and the extent of ischemic area was measured as a prognostic factor. GV extract administration significantly improved cardiac morphology and reduced cardiac weight compared to the MI group. GV treatment also improved cardiac function, as evidenced by positive effects on chamber dilation during MI-induced heart failure. Parameters such as ejection fraction (EF) and fractional shortening (FS) were measured. The MI group showed decreased EF and FS compared to the sham group, while these parameters improved in the GV group. GV treatment also reduced levels of LDH, CPK, and CK-MB in the serum, indicating reduced myocardial damage. Histological analysis revealed that GV treatment attenuated cardiac hypertrophy and fibrosis, with reduced collagen deposition in the myocardium. Immunohistochemistry analysis showed suppressed expression of TGF-β1 and collagen 1, involved in fibrosis. In conclusion, GV showed potential in improving cardiac function in a rat model of MI-induced heart failure. It alleviated myocardial damage, attenuated cardiac hypertrophy and fibrosis, and suppressed fibrotic markers. Further studies are needed to explore its clinical efficacy and underlying mechanisms in cardiac diseases beyond animal models.

• Biomolecules & Therapeutics
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• 제6권4호
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• pp.383-388
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• 1998

The present study was aimed to investigate the preventive effects of rebamipide on the multiple organ dysfunction in a rat model of circulatory shock induced by bacterial endotoxin (E. coli lipopolysaccharide; LPS) in comparison with that of methotrexate. Endotoxemia for 6 hours resulted in little change in the levels of hemoglobin and neutrophils. However, treatment with methotrexate decreased significantly the numbers of circulating neutrophils. Significant increases in serum alanine aminotransferase (ALT,958 $\pm$ 250 lU/L, p<0.001) and aspartate aminotransferase (AST, 1350 $\pm$ 295 lU/L, p<0.001) levels induced by endotoxemia were significantly decreased by rebamipide and methotrexate. The increased level of lactic acid dehydrogenase (LDH) by LPS (2850 $\pm$ 467 lU/L, p<0.05) was significantly inhibited by rebamipide, but not by methot.elate. The elevated serum creatinine (1.2$\pm$0.1, p.0.05) and urea levels (55.3$\pm$6.5 mg/dL, p.0.01) by LPS were also decreased by rebamipide, but not by methotrexate. In line with these results, the plasma concentration of tumor necrosis factor-$\alpha$ (TNF-7,167 $\pm$ 20 pg/mL) was significantly increased upon injection of endotoxin at 1 hour by 1570$\pm$100 pg/mL, and declined to 312$\pm$35 pg/mL at 6 hours. The TNF-$\alpha$ level at 6 hours was significantly decreased by rebamipide to 207$\pm$8 pg/mL (P<0.05). Taken together, it is summarized that rebamipide inhibits the development of multiple ogran dysfunction by inhibition of neutrophil activation in association with inhibition of TNF-$\alpha$ formation in a murine model of endotoxemia.

• 대한한의학방제학회지
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• 제30권3호
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• pp.123-135
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• 2022

Oryeongsan (ORS), a formula composed of five herbal medicines, has long been used to treat impairments of the regulation of body fluid homeostasis. The purpose of this study was to determine the antihypertensive and renal protective effects of ORS in rats with hypertension. Spontaneously hypertensive rats (SHR) were divided into two groups with similar mean baseline systolic blood pressure (SBP). Then, 1 mL/kg of vehicle (distilled water) or 1.5, 3 g/kg of ORS extract were administered orally once a day for 4 weeks. SBP and diastolic blood pressure (DBP) were measured at weeks 1, 2, 3 and 4. At the end of the experiment, blood was collected, and heart were removed for histology. By the 2 weeks after initiation of treatment, the ORS treated group had significantly lower SBP than SHR rats. The ORS treatment significantly improved blood pressure and echocardiogram parameters compared to hypertensive rats. Additionally, the left ventricular (LV) remodeling and LV dysfunction were significantly improved in ORS treated group hypertensive rats. Furthermore, an increase in fibrotic area has been observed in SHR rats compared with Wistar-Kyoto rats (WKY). Furthermore, administration of ORS significantly attenuated cardiac fibrosis in hypertensive rats. Therefore, these findings suggest that ORS has a protective effect on heart failure by alleviating hypertensive heart disease and cardiovascular dysfunction in SHR.

• 대한치과마취과학회지
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• 제3권2호
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• pp.98-102
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• 2003

Patients in end-stage renal disease (ESRD) and chronic renal failure present a number of challenges to the anesthesiologist. They may be chronically iii and debilitated and have the potential for multiorgan dysfunction. A 65-year-old male patient with ESRD was scheduled for oral cancer surgery under general anesthesia. He was in regular hemodialysis three times a week and secondary hypertension with left ventricular hypertrophy was accompanied. He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysis, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 9 hours. During the anesthesia, he did not have any problem but persistently increasing serum potassium level. After anesthetic emergence, he was transferred to intensive care unit for mechanical ventilation. So we report this successful case of anesthetic management in a patient with ESRD for oral cancer surgery, which massive bleeding and long anesthetic time were inevitable in, from the preoperative preparation to anesthetic emergence.

• 대한핵의학회지
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• 제19권2호
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• pp.43-50
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• 1985

With the improvement of hemodialysis, the course of the disease in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (early and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis. 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe due to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

• 동의생리병리학회지
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• 제20권1호
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• pp.181-186
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• 2006

A pharmacological inhibition of nitric oxide synthase (NOS) in rats produces vasoconstriction, renal dysfunction, and hypertension. The present study was aimed at investigating whether the methanol extract of Serous commixta cortex (MSC) ameliorates $N^G$-nitro-L-arginine methylester (L-NAME) induced hypertension in rats. Treatment of rats with L-NAME (10 mg/kg/day in drinking water, 5 weeks) caused a sustained increase in systolic blood pressure (SBP). Administration of MSC (100 or 200 mg/kg/day, p.o) significantly lowered the SBP in the L-NAME-treated rats and this effect was maintained throughout the whole experimental period. Moreover, ecNOS expression in aorta and kidney tissue from L-NAME treated rats was significantly restored dy administration of MSC. Furthermore, the impairment of acetylcholine (ACh)-induced relaxation of aortic rings in the L-NAME treated rats was reversed dy administering of MSC. The renal functional parameters including urinary volume, sodium excretion, and creatinine clearance (Ccr) were also restored by administering MSC. Taken together, the present study suggeststhat MSC prevents the increase in SBP in rats with L-NAME-induced hypertension, which may result from the up-regulation of the vascular and renal ecNOS/No system.