The mainstay in the management of mild to moderately dehydrated children is fast rehydration by using hypotonic ORS (oral rehydration solution) and complete resumption of normal diet, including lactose- containing formula after 4 hours rehydration. Since the majority of young children with uncomplicated acute diarrhea will tolerate large amounts of undiluted non-human milk, withholding food and milk from children during diarrhea is not recommended anymore, regarding time to resolution and diarrhea control. In addition, routine dilution of milk and routine use of lactose-free formula are not necessary after fast ORS therapy. Breastfed infants and children fed with solid foods may safely continue receiving their usual diets during diarrhea instead of gradual reintroduction of feeding. However, young infants or children with severe diarrhea or malnutrition should be carefully treated under supervision if fed with lactose containing, non-human milk exclusively.
Child ; Diarrhea ; Diet ; Electrolytes ; Fluid Therapy ; Gastroenteritis ; Humans ; Infant ; Lactose ; Malnutrition ; Milk ; Nutritional Support ; Organization and Administration

A case of toxic epidermal necrolysis(TEN) in 20 years old female was presente d. The characteristic skin lesions of toxic epidermal necrolyais developed after oral administration of Aspirin for common cold. The cause of the disease. was probably due to Aspirin, but on the microscopic pathologic findings intraepithelial and subcorneal bullae which is characteristic in the staphylococcal induced TEN were noticed. She was treated with a massive systemic corticosteroids(Dexamethasone 12mg/d), antibiotics(Lincocin l.5grn/d), Fluids with electrolytes, sedatives and topical measures. So she was discharged with excellent results in a week of admission.
Administration, Oral ; Aspirin ; Common Cold ; Electrolytes ; Female ; Humans ; Hypnotics and Sedatives ; Skin ; Young Adult

Drug-induced toxic epidermal necrolysis (TEN) is a bullous erythematous disease that is characterized by the appearance of scaled lesions and large sheets of pilling on the skin. A caseof TEN occured in a 10 month old female patient. The characteristic skin lesions of TEN developed after oral administration of carbamazepine for a partial seizure. Thig case consists of prodrome of malaise, fever, anorexia, and conjunctivity followed by erythema & flaccid bullae formation. Diagnosis was confirmed by histologic findings. This patient was treated with a massive systemic corticosteroid, antibiotics, fluid and electrolytes, and topical measures. Authors experienced an extremely rare case of TEN dur to carbamazepine, So report it with a brief review of literature.
Administration, Oral ; Anorexia ; Anti-Bacterial Agents ; Carbamazepine ; Diagnosis ; Electrolytes ; Erythema ; Female ; Fever ; Humans ; Infant ; Seizures ; Skin ; Stevens-Johnson Syndrome*

Two cases of toxic epidermal necrolysis (Lyell) appearing on 69-year old male and 12year-old female were presented. The clinical manifestations of toxic epidermal necrolysis developed after oral administration of novaquing for common cold. The cause of the disease was probably due to novaquing (phenobarbital and sulpyrin). The 69 year-old male was expired despite intensive treatment with fluid and electrolytes, antibiotics, corticosteroids, vitamins, and topical measures, but 12 year-old female was cured successfully with treatment.
Administration, Oral ; Adrenal Cortex Hormones ; Aged ; Anti-Bacterial Agents ; Child ; Common Cold ; Electrolytes ; Female ; Humans ; Male ; Stevens-Johnson Syndrome* ; Vitamins

The aims of the study were to prepare polyelectrolyte nanocapsules effected by acid phosphatease (ACP) and to study prolonged-releasing performance of the nanocapsules in vitro. Using the layer by layer (LbL) self-assembly technique, polyelectrolyte-beta-glycerophosphoric acid nanocapsules were prepared. The morphologies of the nanocapsules were characterized by transmission electron microscopy (TEM) and biocompatibility was well examined by cell-culture method. The drug adriamycin would be loaded in nanocapsules for concentration gradient, the encapsulation efficiency could be calculated. Nanocapsules were reacted with acid phosphatease standard and HepG2 cells that express the ACP, respectively. The prolonged-releasing of adriamycin was verified and tumor cells apoptosis were measured. TEM images showed that the nanocapsule sizes were between 200-300 nm. The material biocompatibility was good until the concentration of nanacapsule was up to 250 microg/mL. The drug encapsulation efficiency reached 68.12%. The release rate of polyelectrolyte (PAH/PSS-beta-glycerophosphoric acid)s nanocapsules was higher than in the control nanocapsules at 48 h (38% Vs 15%) after its reaction to the ACP standard (P < 0.05). Compared with the control, nanocapsules could significantly inhibit the growth of HepG2 cells that expressed the ACP, and the efficiency of cell apoptosis was 7.59% higher at 24 h (13.73 Vs 6.14, P < 0.05). Polyelectrolytes (PAH/PSS-beta-glycerophosphoric acid) nanocapsules in vitro have response to acid phosphatease by which prolonged-releasing can be affected. This property can be used for treatment of some malignant and benign diseases with elevated acid phosphatease level.
Acid Phosphatase ; pharmacology ; Antibiotics, Antineoplastic ; administration & dosage ; Delayed-Action Preparations ; chemical synthesis ; Doxorubicin ; administration & dosage ; Electrolytes ; chemistry ; Hep G2 Cells ; Humans ; Nanocapsules

Injection pain of propofol remains a common clinical problem. Previous studies demonstrated that propofol injection pain was alleviated by applying nitroglycerin ointment to the skin of injection site, which inspires us to test whether venous vasodilation induced by fluid preload could alleviate the pain. Different types or volumes of fluid preload were compared. 200 ASA I-II adult patients were randomly assigned to five groups of 40 each. A 20 G cannula was established on the dorsum or wrist of the hand. When fluid preload given with Plasma-Lyte A 100 mL (P100 group), 250 mL (P250 group), 500 mL (P500 group), 0.9% saline 500 mL (N500 group) or Gelofusine 500 mL (G500 group) was completed within 30 min, respectively, Propofol (0.5 mg/kg, 1%) was injected at a rate of 0.5 mL/s. A blind investigator assessed the pain using a four-point scale. Incidence of pain in P100, P250, and P500 groups was 87.5%, 57.5% and 35%, respectively (P<0.05). The median pain intensity score was significantly lower in P500 group than that in P250 and P100 groups (P<0.05 and P<0.01, respectively). Comparison of the effect of different types of solution preload indicated that the highest incidence of pain was in N500 group (62.5%) (N500 vs. P500, P=0.014; N500 vs. G500, P=0.007). The median pain intensity score in N500 group was higher than that in P500 group (P<0.05) and G500 group (P<0.05). There was no significant difference between P500 and G500 groups. It is suggested that Plasma-Lyte A or Gelofusine preload with 500 mL before propofol injection is effective in alleviating propofol-induced pain.
Adolescent ; Adult ; Aged ; Electrolytes ; administration & dosage ; therapeutic use ; Female ; Humans ; Injections, Intravenous ; adverse effects ; methods ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; prevention & control ; Plasma Substitutes ; administration & dosage ; therapeutic use ; Polygeline ; administration & dosage ; therapeutic use ; Propofol ; administration & dosage ; adverse effects

OBJECTIVETo find out the optimal concentration, infusion rate and dosage of saline for resuscitation.

METHODSForty-five dogs were used to establish hypovolemic shock models. The dogs were resuscitated with saline of different concentrations and different dosages under different infusion rates, and the resuscitation results were compared.

RESULTSThe best concentration was 7.5%, the best rate of infusion 20 ml/min (a volume equivalent to 15% of the shed blood) and the best dosage 5.71 ml/kg. The method was effective for resuscitation, the mean arterial pressure (MAP) could be elevated to 89% of the baseline, and this MAP could be kept for more than one hour.

CONCLUSIONSUsing 7.5% sodium chloride solution equivalent to 15% of the shed blood at an infusion rate of 20 ml/min can achieve a best resuscitation result.

Animals ; Blood Pressure ; Blood Volume ; Body Weight ; Dogs ; Electrolytes ; blood ; Female ; Male ; Resuscitation ; Saline Solution, Hypertonic ; administration & dosage ; Shock, Hemorrhagic ; physiopathology ; therapy

QT interval prolongation is associated with an increased risk of ventricular arrhythmia in various conditions. Cardiac electrophysiologic abnormalities including QT interval prolongation are well documented in patients with advanced liver cirrhosis. We report two cases of patients with QT interval prolongation on preoperative electrocardiography who exhibited repetitive ventricular arrhythmias with significant hemodynamic deterioration during liver transplantation. For the treatment and prevention of ventricular arrhythmias during the intraoperative period, we performed intravenous administration of lidocaine and isoproterenol, corrected imbalances of electrolytes including potassium and magnesium, and prepared a defibrillator. These cases emphasize that preoperative recognition of QT interval prolongation and adequate management to prevent fatal arrhythmias are important in patients undergoing liver transplantation.
Administration, Intravenous ; Arrhythmias, Cardiac* ; Defibrillators ; Electrocardiography ; Electrolytes ; Hemodynamics ; Humans ; Intraoperative Complications ; Intraoperative Period ; Isoproterenol ; Lidocaine ; Liver Cirrhosis ; Liver Transplantation* ; Magnesium ; Potassium

It is well known that unilateral nephrectomy induces a series of morphological changes in the remaining kidney. These morphological changes called as "compensatory hypertrophy and hyperplasia" are associated with numerous functional changes of the remnant kidney, such as relative increase in the glomerular filtration rate and the renal plasma flow as well as changes in the renal concentrating ability. However, changes in the water and electrolytes excretion following unilateral nephrectomy have not been extensively studied. Hence, this investigation was undertaken to study the excretory pattern of water and electrolytes through the remaining kidney following unilateral nephrectomy. Experiments were carried out in 23 hydropenic dogs, weighing 10~16 kg, of which 5 dogs were used for acute experiments (4 hrs. after nephrectomy) and 18 dogs for chronic experiments (2 weeks, 4 weeks and 6 weeks after nephrectomy). Following intravenous administration of appropriate amounts of inulin and PAH, plasma and urine samples were obtained and were analyzed for the concentration of inulin, PAH, osmolarity, Na, K and urea. In chronic experiments, Animals were allowed to have free access to the food and water during intervals. Four slices of the tissue from papilla to cortex were cut for each kidney. The Na, K, Cl and urea concentrations of the slice were then determined in slice extracts. Also four slices of the kidney cortex were obtained and analyzed for concentration of PAH. Results may be briefly summarized as follows. 1. After unilateral nephrectomy, the weight of the remaining kidney increased about 30 percent in 2-6 Weeks. 2. During 1 hours after unilateral nephrectomy, the glomerular filtration rate (GFR) of the remaining kidney showed no significant changes while the renal plasma flow (RPF) decreased gradually to a level below the control. In chronic experiments, the GFR showed no change after the nephrectomy whereas the RPF showed a 20 percent increased, thus reducing the filtration fraction. 3. During 1 hours after unilateral nephrectomy, the urine osmolarity revealed no significant changes while the fractional excretion of the filtered osmotic substance, water, sodium and potassium were gradually increased, indicating relative impairments of the tubular reabsorption of these substances. 4. During 2.-,6 weeks after unilateral nephrectomy, the renal concentrating ability of the remaining kidney was significantly impaired. The fractional excretion of the filtered water was most markedly increased while the tubular reabsorption of urea was somewhat increased. 4. No significant changes in plasma composition was noted in all animals, indicating that the overall homeostatic mechanism is apparently well maintained even after unilateral nephrectomy, 6. PAH concentration in the slices of renal cortex after unilateral nephrectomy were markedly increased, suggesting that the increase of PAH uptake on the renal cortex is partially attributable to a increase of the tubular mass of remaining kidney. 7. Medullary and papillary Na and Cl concentration was somewhat lower in the chronic experiments, indicating that the renal concenting operation is impaired in unilateral nephrectomized kidney primarily because of corresponding reduction in the medullary osmotic gradient. However, total papillary osmotic concentration at a given urine osmolarity was no significantly changed in before and after unilateral nephrectomy.
Administration, Intravenous ; Animals ; Dogs ; Electrolytes ; Filtration ; Glomerular Filtration Rate ; Hypertrophy ; Inulin ; Kidney ; Kidney Cortex ; Nephrectomy* ; Osmolar Concentration ; Plasma ; Potassium ; Renal Plasma Flow ; Sodium ; Urea ; Water

The widely used polyethylene glycol (PEG)-based solutions have been proven effective for bowel preparation when 4 L of the solution is administered before colonoscopy. However, large volumes of the solutions are generally poorly tolerated. A new PEG-based solution consisting of 2 L of PEG and a high dose of ascorbic acid has recently become available. Electrolyte abnormalities caused by PEG-based solutions have rarely been reported. We report on a case of acute severe hyponatremia with associated generalized tonic-clonic seizures after bowel preparation with a low-volume PEG plus ascorbic acid solution in a 74-year-old woman with no history of seizures. She took a beta blocker, an angiotensin-converting enzyme inhibitor, and glimepiride for hypertension and diabetes mellitus. She showed general weakness, nausea, agitation, muscle cramping, and seizures after ingestion of the PEG plus ascorbic acid solution. Her serum sodium level was 112 mEq/L. Her symptoms improved after intravenous administration of hypertonic saline. Physicians should pay attention to screening for electrolytes and development of neurological symptoms during bowel preparation.
Administration, Intravenous ; Aged ; Ascorbic Acid* ; Colonoscopy ; Diabetes Mellitus ; Dihydroergotamine ; Eating ; Electrolytes ; Female ; Humans ; Hypertension ; Hyponatremia* ; Mass Screening ; Muscle Cramp ; Nausea ; Polyethylene Glycols* ; Seizures* ; Sodium