This study aimed to assess the effects of dehydration on echocardiographic indices in healthy cats: specifically, it aimed to assess the effects of volume depletion on diastolic function. Nine experimental cats were subjected to both a dehydration and placebo protocol separated by a 21-day washout period. Echocardiography was performed at baseline and on completion of each protocol. Results were compared between the two protocols. Volume depletion was induced by intravenous administration of furosemide. Volume depletion showed a significant association with increased interventricular septal and left ventricular free wall thickness at end-diastole, decreased left ventricular internal diameter at end-diastole, and left atrial diameter at end-systole. The peak early (E) and late (A) diastolic filling velocities, and the peak early diastolic velocities (E′) were significantly decreased by dehydration. Volume depletion did not affect peak longitudinal strain rate during early diastole, E/A, or E/E′. Volume depletion significantly affected the echocardiographic diastolic indices and conventional echocardiographic parameters in healthy cats.
Administration, Intravenous ; Animals ; Cats ; Dehydration ; Diastole ; Echocardiography ; Furosemide ; Hypertrophy

INTRODUCTIONLymphoedema results from impaired lymphatic transport leading to the pathologic accumulation of protein-rich lymphatic fluid in the interstitial space, most commonly in the extremities. Primary lymphoedema, a developmental abnormality of the lymphatic system, may become evident later in life when a triggering event exceeds the capacity of normal lymphatic flow.

CLINICAL PICTUREWe present a 3-year-old nephrotic syndrome patient with an unusual localisation for primary lymphoedema.

TREATMENT AND OUTCOMEThe patient was treated with conservative approach and she was cured.

CONCLUSIONIn this particular case, lymphoedema developed at an unusual localisation, which has not been recorded before.

Albumins ; administration & dosage ; Child, Preschool ; Diuretics ; administration & dosage ; Female ; Furosemide ; administration & dosage ; Humans ; Infusions, Intravenous ; Lymphedema ; drug therapy ; etiology ; Nephrotic Syndrome ; complications ; Oliguria ; etiology

BACKGROUND/AIMS: The diagnosis of refractory ascites means a poor prognosis for patients with liver cirrhosis. The definition of refractory ascites has already been established, but using the dosage of diuretics that correlates with the definition of refractory ascites in an out-patient department will lower the compliance of the patient, as well as causing serious complications, such as hepatic encephalopathy and hyponatremia, as the dosage of diuretics is increased. Due to this fact, it is very difficult to apply this definition of refractory ascites to patients in a domestic out-patient department. In this study, in situations where there are difficulties in applying the diuretics dosage according to definition of refractory ascites, we tried to find out whether measuring the value of urine sodium after the administration of intravenous furosemide can be the standard in early differentiation of the response to diuretics treatment. METHODS: We reviewed 16 cases of liver cirrhosis with ascites and classified them into two groups by the response to diuretics. The diuretics-responsive ascites group was 8 cases and the diuretics-unresponsive ascites group consisted of 8 cases. After admission, we examined the patients' CBC, biochemical liver function test, spot urine sodium, and 24 hour creatinine clearance. After the beginning of the experiment, all diuretic therapy was stopped for 3 days. Daily we examined the patients' CBC, biochemical liver function test, and in the 3rd experiment day, we measured 24-hour urine volume and sodium. In the 4th experiment day, after sampling for ADH, plasma renin activity and plasma aldosterone level, we administrated the furosemide 80 mg I.V, and measured the amount of 8 hour urine volume and sodium. RESULTS: The plasma aldosterone level was significantly higher in the diuretics- unresponsive ascites group than in the diuretics-responsive ascites group. In the 4th experiment day, the amount of urine volume and sodium was very significantly lower in the diuretics-unresponsive ascites group than in the diuretics-responsive ascites group (1297.5 +/- 80.9 vs 2003.7 +/- 114.6 ml, p<0.005, 77.3 +/- 8.2 vs 211.8 +/- 12.6 mEq, p<0.001). CONCLUSIONS: In out-patient departments, the measurement of urine sodium 8 hours after administrating 80 mg of intravenous furosemide, will help in differentiating ascites patients with lower treatment response to diuretics.
Adult ; Aged ; Ascites/*drug therapy/etiology/urine ; Diuretics, Sulfamyl/*administration & dosage ; English Abstract ; Female ; Furosemide/*administration & dosage ; Humans ; Infusions, Intravenous ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Sodium/*urine

The paper is to report the pharmacokinetics of furosemide in rats living at plain area and high altitude. After intragastric administration of furosemide (2.87 mg x kg(-1)), serial blood samples (0.5 mL) were collected by retro-orbital puncture at 0, 20 min, 40 min, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 h, samples were determined by LC-MS/MS, and plasma concentration-time data were analyzed by DAS 2.0 software to get the related pharmacokinetic parameters. The main pharmacokinetic parameters: area under curve (AUC), mean residence time (MRT), the biological half-life (t1/2) and the peak concentration (C(max)) of furosemide, were significantly increased at high altitude, the time to reach peak concentration (t(max)) and clearance (CL) was significantly decreased. This study found significant changes on the pharmacokinetics of furosemide under the special environment of high altitude. This finding may provide some references for clinical rational application of furosemide at high altitude.
Administration, Oral ; Altitude ; Animals ; Area Under Curve ; Chromatography, Liquid ; Furosemide ; administration & dosage ; metabolism ; pharmacokinetics ; Half-Life ; Male ; Rats ; Rats, Wistar ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

The effects of antihypertensive drugs on the choroidal blood flow in rabbits were studied by an apparatus based on the principle of internal calorimetry of Grayson. Thermistors, as the sensing elements, were fastened on the scleral surface of the eye, and determinations were performed up to 60 minutes after intravenous administrations of drugs. The drugs studied were: ganglion blocking agents (pentholinium tartarate, 4 mg; hexamethonium bromide, 1 mg; and mecamylamine chloride, 0.15mg), alpha-methyldopa, 4 mg; guanethidine, 0.5 mg; reserpine, 0.2 mg; hydralazine, 5 mg; and diuretics (dichlorothiazide, 2.5 mg; frusemide, 2.5 mg). Except the diuretics, all the drugs employed produced considerable increase in the choroidal blood flow. The relationships between blood pressure, intraocular pressure and the choroidal blood flow were discussed and the clinical applications were suggested.
Administration, Intravenous ; Antihypertensive Agents* ; Blood Pressure ; Calorimetry ; Choroid* ; Dental Calculus ; Diuretics ; Furosemide ; Ganglion Cysts ; Guanethidine ; Hexamethonium ; Hydralazine ; Intraocular Pressure ; Mecamylamine ; Methyldopa ; Rabbits* ; Reserpine

OBJECTIVETo observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.

METHODSSalt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.

RESULTSAfter 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7 +/- 12.1 mmHg vs. 2.8 +/- 5.2 mmHg, P < 0.01; 12.2% +/- 12.0% vs. 2.5% +/- 4.4%, P < 0.001, respectively). There was a similar trend for diastolic blood pressure (8.4 +/- 6.4 mmHg vs. 3.7 +/- 6.4 mmHg, P = 0.052; 13.2% +/- 10.6% vs. 6.8% +/- 10.1%, P = 0.053, respectively).

CONCLUSIONSSalt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.

Adolescent ; Aging ; physiology ; Blood Pressure ; drug effects ; Blood Volume ; Female ; Furosemide ; pharmacology ; Humans ; Infusions, Intravenous ; Male ; Sodium Chloride ; administration & dosage ; pharmacology ; Systole

We report two cases of macular edema treated with the oral administration of furosemide. The first case presented here was a 78-year-old male patient with visual disturbance of the left eye. He had been taking an oral agent for diabetes and had chronic renal failure for 7 years. From 10 days prior to the visit, he had visual disturbance of the left eye accompanied by systemic edema. There were no specific findings in the anterior segment, but sub-retinal fluid was observed in the left fundus. Macular edema was observed on fluorescein angiography and optical coherence tomography; therefore, the oral administration of furosemide was initiated. After seven days, the sub-retinal fluid disappeared. The second case was a 43-year-old female patient with visual disturbance of the left eye who had been taking hypoglycemic agents for diabetes for 13 years. There were no specific findings in the anterior segment, but flame-shaped retinal hemorrhages were scattered over both posterior poles, neovascularization was observed in the left eye, and, of particular note, sub-retinal fluid was detected in the macula of the left eye. Macular edema was also observed on fluorescein angiography and optical coherence tomography, and oral administration of furosemide was initiated. After 3 weeks, the macular edema had significantly decreased.
Administration, Oral ; Adult ; Aged ; Diabetes Complications/diagnosis/*drug therapy ; Diuretics/administration & dosage/*therapeutic use ; Female ; Fluorescein Angiography ; Furosemide/administration & dosage/*therapeutic use ; Humans ; Macular Edema/diagnosis/*drug therapy ; Male ; Tomography, Optical Coherence

This study was conducted to observe the effects of intravenously administered 6% hydroxyethylstarch 130/ 0.4 solution and furosemide on the outcome of acute pancreatitis patients. Patients admitted to our center from October 16, 2007 through August 31, 2009 were given intravenous infusions of 6% hydroxyethylstarch 130/0. 4 solution (1 000-2 000 ml administered for an adult) soon after admission. At the same time, furosemide was administered as intravenous bolus, trying to maintain a fluid balance. The dose level of hydroxyethylstarch was gradually lowered from the second day after admission. A total of 135 patients (54% of patients with a Ranson's score > or = 3 and 61% with a Balthazar CT score > or = D) were treated with our protocol. Only 4% and 7% patients developed pancreatic and systemic complications respectively; only 1 patient underwent necrosectomy. The in-hospital mortality rate was 4%. It was estimated that, on the average, 18. 3% of blood volume was lost on admission. Our study suggest that intravenously administered 6% hydroxyethylstarch 130/0. 4 solution and furosemide might be beneficial for patients with acute pancreatitis. Plasma extravasation is a central event of acute pancreatitis. The reversal of hypovolemia is crucial for the success in treatment of acute pancreatitis.
Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Furosemide ; administration & dosage ; Humans ; Hydroxyethyl Starch Derivatives ; administration & dosage ; Hypovolemia ; prevention & control ; Infant ; Infusions, Intravenous ; Injections, Intravenous ; Male ; Middle Aged ; Pancreatitis ; drug therapy ; Young Adult

OBJECTIVETo investigate the ototoxicity of co-administration of kanamycin and furosemide in mouse and establish a reliable model to induce a sensorineural hearing loss.

METHODSCBA/J mice strain was selected, with the age around 3-4 weeks old, to be received a single subcutaneous injection of kanamycin at dose of 1 g/kg and another single intraperitoneal injection of furosemide at dose of 0.4 g/kg 30 - 45 min afterward. The auditory brainstem response (ABR) threshold shift was tested. The series of experimental methods including propidium iodide, phalloidin staining, semithin section toluidine blue staining, TUNEL, scanning electron microscopy and transmission electron microscopy were applied to observe the characteristics of the lesion of cochlea and hair cells. The time course was set as following: before injection, 12, 24, 48 hours and 1, 2, 4, 12 weeks after injections, respectively.

RESULTSThe ABR threshold shift was firstly presented a significant increase at 12 h after injection at 2, 4, 8 kHz, then the ABR threshold kept going up during next 36 h until it was presented a stable level around 90 dB. Pathological examination showed an absence of outer hair cells at basal turn rapidly since 12 h after treatment, and then by 48 h the most commonly observed lesion, where all outer hair cells throughout the length of the cochlea were killed, in the contrast, however, the inner hair cells loss were delayed and mild. TUNEL-positive nuclei demonstrated that most hair cells died via an apoptotic pathway. In scanning electron microscopy abundance of necrotic outer hair cells were detected by 24 h after treatment, in which reticular lamina were collapsed. Then all outer hair cells were replaced by expansion of heads of supporting cells. At 48 h after treatment, marginal cells presented a swollen and some of them were observed to be fused. In addition, spherical cell extrusion appeared to leak out from some marginal cells. By 2 weeks, nearly all microvillus were lost and marginal cells presented a shape of stone-like change. A significant and progressive decrease in strial vascularis thickness was found, of which the reason probably related with a reduction in volume of marginal cells.

CONCLUSIONThis systemic protocol eliminates hair cells extensively in vivo, and it could be a reliable model to examine different aspects of cochlear pathology in transgenic or mutant mice strains.

Animals ; Cell Death ; Cochlea ; drug effects ; pathology ; Disease Models, Animal ; Drug Synergism ; Evoked Potentials, Auditory, Brain Stem ; Furosemide ; administration & dosage ; adverse effects ; Hair Cells, Auditory ; cytology ; pathology ; Kanamycin ; administration & dosage ; adverse effects ; Mice ; Mice, Inbred CBA

Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.
Acute Kidney Injury ; Administration, Intravenous ; Aged ; Alkalies ; Alkalosis ; Calcium Citrate ; Calcium* ; Creatinine ; Eating ; Enterocolitis, Pseudomembranous ; Fractures, Compression ; Furosemide ; Humans ; Hypercalcemia* ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Lethargy ; Osteoporosis ; Pneumonia, Aspiration ; Renal Insufficiency ; Renal Replacement Therapy ; Respiration, Artificial ; Sepsis ; Spine