• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.17-21
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• 2015

Amlodipine, a calcium channel blocker of the dihydropyridine group, is commonly used in management of hypertension, angina, and myocardial infarction. Amlodipine overdose, characterized by severe hypotension, arrythmias, and pulmonary edema, has seldom been reported in Korean literature. We report on a fatal case of amlodipine intoxication with complications including rhabdomyolysis and oliguric acute kidney injury. A 70-year-old woman with a medical history of hypertension was presented at the author's hospital 6 hours after ingestion of 50 amlodipine (norvasc) tablets (total dosage 250 mg) in an attempted suicide. Her laboratory tests showed a serum creatinine level of 2.5 mg/dL, with elevated serum creatine phosphokinase and myoglobin. The patient was initially treated with fluids, alkali, calcium gluconate, glucagon, and vasopressors without a hemodynamic effect. High-dose insulin therapy was also started with a bolus injection of regular insulin (RI), followed by continuous infusion of RI and 50% dextrose with water. Despite intensive treatment including insulin therapy, inotropics, mechanical ventilation, and continuous venovenous hemodiafiltration, the patient died of refractory shock and cardiac arrest with no signs of renal recovery 116 hours after her hospital admission.

• Clinical and Experimental Pediatrics
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• 제61권3호
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• pp.95-100
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• 2018

Purpose: This study aimed to evaluate the clinical findings in pediatric rhabdomyolysis and the predictive factors for acute kidney injury (AKI) in Korean children. Methods: Medical records of 39 Korean children, who were newly diagnosed with rhabdomyolysis from January 2008 to December 2015, were retrospectively analyzed. The diagnosis was made from the medical history, elevated serum creatinine kinase level >1,000 IU/L, and plasma myoglobin level >150 ng/mL. Patients with muscular dystrophy and myocardial infarction were excluded. Results: The median patient age at diagnosis was 14.0 years (range, 3-18 years), and the male to female ratio was 2.5. The most common presenting symptom was myalgia (n=25, 64.1%), and 14 patients (35.9%) had rhabdomyolysis-induced AKI. Eighteen patients (46.2%) had underlying diseases, such as epilepsy and psychotic disorders. Ten of these patients showed rhabdomyolysis-induced AKI. The common causes of rhabdomyolysis were infection (n=12, 30.7%), exercise (n=9, 23.1%), and trauma (n=8, 20.5%). There was no difference in the distribution of etiology between AKI and non-AKI groups. Five patients in the AKI group showed complete recovery of renal function after stopping renal replacement therapy. The median length of hospitalization was 7.0 days, and no mortality was reported. Compared with the non-AKI group, the AKI group showed higher levels of peak creatinine kinase and myoglobin, without statistical significance. Conclusion: The clinical characteristics of pediatric rhabdomyolysis differ from those observed in adult patients. Children with underlying diseases are more vulnerable to rhabdomyolysis-induced AKI. AKI more likely develops in the presence of a high degree of albuminuria.

• 한국식품과학회지
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• 제22권1호
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• pp.56-60
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• 1990

역류분배 방법을 이용한 단백질의 분리정제 가능성을 높이기 위하여 4가지 모델단백질에 대하여 수용성 액체 2상계에서의 분획계수를 pH 변화에 따라 조사하였다. 또한 역류분배를 이용한 다중분배추출방식으로 모델 단백질의 혼합물을 수준의 pH(4.5-12.0)에서 분획하였다. 그 결과 pH에 따라 단백질들의 등전점 차이로 인한 분획계수(K)값이 다르게 나타서, 다중분배를 행할 때 각 단백질 분획들이 위치하는 튜브번호가 다르게 되므로 역류분배 방법을 통한 단백질의 분리 가능성을 보여주었다.

• 한국식품과학회지
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• 제22권2호
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• pp.177-182
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• 1990

역류분배방법을 이용한 단백질의 분리정제 효율을 높이기 위하여, 4가지 모델단백질에 대하여 수용성액체 2상계에서의 분획계수를 KCl 농도와 pH변화에 따라 조사하였다. 또한, 역류분배방법을 이용한 다중분배 추출방식으로 모델단백질의 혼합물을 KCl 농도(0, 50, 250, 500mM)와 pH(4.5, 5.5, 6.5, 9.0, 12.0)를 달리한 20가지 조건에서 분획하였다. 그 결과 KCl 농도와 pH에 따라 단백질들의 분획계수(K)값이 다르게 나타나서, KCl을 첨가함으로서 역류분배방법을 이용한 단백질 분리효율을 향상시킬 수 있는 가능성을 보여 주었다. 단백질에 따라 분리가 잘 일어나는 KCl 농도와 pH는 다르게 나타나서 myoglobin의 경우 KCl 50mM, pH5.5조건의 14번 튜브 상층부와 KCl 250mM, pH6.5조건의 13번 튜브의 상층부에서 잘 분리가 되었으며, BSA의 경우는 KCl 250mM, pH4.5 조건의 14번 튜브에서 분리되었고, lysozyme의 경우는 KCl 50MM, pH4.5조건의 19번 튜브와 KCl 50mM, pH5.5의 16번 튜브 상층부에서 분리가 되었다.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.113-117
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• 2012

Primary aldosteronism is characterized by hypertension, hypokalemia, and metabolic alkalosis, associated with excessive aldosterone production and suppressed plasma renin activity. Hypokalemia-induced rhabdomyolysis has been rarely reported in primary aldosteronism patients. This paper reports a case of primary aldosteronism presented with rhabdomyolysis due to severe hypokalemia. A 48-year-old male with a three-year history of hypertension presented himself at the authors' hospital with generalized weakness and myalgia in both legs over a period of several days. His laboratory findings showed hypokalemia (1.8 mEq/L) with elevations of his serum creatine phosphokinase and serum myoglobin. His plasma aldosterone level was also elevated, and his plasma renin activity was reduced. An abdominal computed tomography revealed a 2.0 cm hypodense mass in the left adrenal gland, which suggested adrenal adenoma. The accordingly underwent laparoscopic adrenalectomy. Three months later, his plasma potassium level and blood pressure became normal without the use of medications.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.25-30
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• 2013

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia ($Na^+$ 98 mEq/L), hypokalemia ($K^+$ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.

• 생명과학회지
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• 제22권6호
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• pp.713-722
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• 2012

Landrace와 Berkshire의 longissimus dorsi muscle으로부터 단백질 발현양상의 차이를 보기 위하여 2-DE실험을 통하여 분석한 결과 Landrace 에서 특이적으로 발현 양이 증가한 단백질들은 serum albumin precursor, troponin T (TnT; slow skeletal muscle), myoglobin였다. Berkshire에서 특이적으로 발현 양이 증가한 단백질들은 heat shock 27 kDa protein 1, troponin T (fast skeletal muscle), muscle creatine kinase, phosphoglucomutase 1, triosephosphate isomerase (Tpi 1), adenylate kinase isoenzyme 1 (AK1)였다. Landrace의 longissimus dorsi muscle에서는 slow skeletal muscle과 연관된 단백질들이 발현된 반면에 Berkshire에서는 fast skeletal muscle, 물질대사경로, 에너지 생산과 관련된 단백질들이 발현되었다. Berkshire를 이용하여 성장단계별로 단백질 발현을 분석해 본 결과 growing Berkshire에서 발현이 증가한 단백질은 aldehyde dehydrogenase 1 family, member L1 (ALDHL1)와 muscle creatine kinase이고 finishing Berkshire에서 발현이 증가한 단백질은 heat shock 27 kDa protein 1, TnT (slow skeletal muscle), TnT (fast skeletal muscle), serum albumin precursor, PGM 1, AK 1, Tpi 1였다. 이 결과는 Finishing Berkshire의 등심에서는 growing Berkshire에 비교하여 골격근육, 에너지물질대사, 세포골격 등이 보다 활성화된 것으로 사료된다.

• 대한임상독성학회지
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• 제14권2호
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• pp.136-143
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• 2016

Purpose: In patients with altered mentality caused by drugs or unknown causes, ammonia is checked to facilitate differential diagnosis or diagnose hepatic coma. This helps early prevention and treatment of brain damage due to hyperammonemia. This study was conducted to evaluate clinical characteristics of intoxicated adult patients with hyperammonemia. Methods: We evaluated 95 patients with hyperammonemia among intoxicated patients above the age of 15 who visited our ED from January 2013 to December 2015. We analyzed the demographic characteristics and type of poisoning substance, reason for ingestion, toxicological characteristics such as elapsed time from ingestion to hospital visit, lab, clinical progression and complications. Data were evaluated using the student's t test or Mann-Whitney U test for continuous variables, and Chi-square test and Fisher's exact test for frequency analysis of categorical variables. Results: When compared to healthy individuals, patients with hyperammonemia showed statistical significance on their SOFA score (p=0.016) and poison severity score (p<0.001). Additionally, patients with hyperammonemia showed significantly different initial serum AST level (p=0.012) and maximum serum AST level during the hospital stay (p=0.026) when compared to healthy individuals. Moreover, individuals with sustained hyperammonemia compared to transient hyperammonemia showed clinically significant SOFA scores (p<0.001), poison severity scores (p=0.007), mortality rates in the ICU (p=0.021), as well as different duration of hospital stay (p=0.037), serum creatinine level (p=0.002), erythrocyte sedimentation rate (p=0.025), and serum myoglobin (p=0.015). Conclusion: Most poisoning-induced hyperammonemia cases were transient and recovered without special treatment. Therefore, hyperammonemia is almost non-specific among poisoning patients.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.121-126
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• 2011

Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

• 한국진공학회:학술대회논문집
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• 한국진공학회 2014년도 제46회 동계 정기학술대회 초록집
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• pp.127-127
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• 2014

인체 내 소량의 생체성분(혈액, 소변 등)을 감지하는 바이오센서 기술은 질병 진단뿐만 아니라 예방 및 관리로 의료서비스 확대, 개인 맞춤형 진료 및 의료비 감소 효과를 가져올 수 있는 기술이다. 광바이오센서는 광학적인 측정방법을 이용하여 다양한 생화학물질들의 상호 반응을 검출해 낼 수 있는 바이오센서로 현재 활발하게 연구가 진행되고 있다. 광 바이오센서는 생체성분 내에 존재하는 전하를 가진 많은 이온들 및 Salt 농도 등에 영향을 받지 않기 때문에 나노 와이어를 이용한 FET (field-effect transistor)형 바이오센서에 비해 많은 장점을 가지고 있다. 일반적으로 광 바이오센서는 형광물질, 인광물질, 발색물질, 방사선 물질 등의 발광물질을 인식물질에 표지하여 인식물질과 분석물질과의 반응유무를 표지된 발광물질의 광학 신호를 감지하여 분석물질을 검출해내는 표지식 광 바이오센서 기술이 상용화되고 있다. 그러나 이러한 분석 방법은 민감도는 우수하지만 분석 시간이 매우 느리고, 고가의 분석 장비 및 복잡한 제조 공정 등의 단점들을 가지고 있다. 이러한 단점들을 극복하기 위하여 생화학 반응 유무를 표지물질 없이 광학적 방식으로 직접 측정할 수 있는 비표지식 광 바이오센서 기술이 최근 들어 많이 연구되고 있다. 본 논문에서는 광파장 이하의 주기를 가진 주기적 공진 격자 표면에서 일어나는 바이오 항원-항체 반응에 대한 공진 반사 파장을 측정하여 생체성분 내에 존재하는 바이오 항원을 고감도로 검출할 수 있는 비표지식 공진반사광 바이오센서 기술을 소개하고자 한다. 공진반사광 바이오센서를 이용하여 human serum내에 존재하는 심근경색 마커인 troponin I (cTnI), creatine kinase MB (CK-MB), myoglobin (MYO)을 0.1 ng/mL 이하의 농도까지 고감도로 측정할 수 있었다.