No abstract available.
Acidosis, Respiratory* ; Alkalosis, Respiratory*

Gitelman syndrome (GS) is a renal tubular disorder of the thiazide-sensitive sodium chloride cotransporter, which is located in the distal tubule of the loop of Henle. We present a rare case of GS complicated by severe hyponatraemia and hypophosphataemia. A 17-year-old boy was admitted to our institution with fever and lethargy. The workup revealed typical features of GS, i.e. hypokalaemia, hypomagnesaemia and metabolic alkalosis. In this report, we discuss the differential diagnoses and rationale for accepting GS as the most likely diagnosis. This case was complicated by severe hyponatraemia (115 mmol/L) and hypophosphataemia (0.32 mmol/L). We concluded that the syndrome of inappropriate secretion of antidiuretic hormones could not be ruled out and that respiratory alkalosis was the most likely aetiology of hypophosphataemia. This case report also generates an interesting discussion on water and electrolyte metabolism.
Adolescent ; Alkalosis, Respiratory ; diagnosis ; Electrolytes ; Fever ; Gitelman Syndrome ; complications ; diagnosis ; Humans ; Hyponatremia ; complications ; diagnosis ; Hypophosphatemia ; complications ; diagnosis ; Lethargy ; Male ; Vasopressins ; secretion

This cross-sectional study involved 339 students aged 12-15 at Sapa and Yen Binh regions. It measured and compared indexes such as vital capacity (VC), forced expiratory volume 1 (FEV1), and Tiffeneau index. Results: there weren’t significant differences between VC, FEV1 and Tiffeneau indexes of students in both sexes of 2 regions (p<0.05). There is a close correlation between VC and height of student (r>0.9), and between FEV1 and height (r>0.9)
Preventive Medicine ; Public Health ; Alkalosis, Respiratory

The objective was to compare the two procedures of treatment for hypocalcemia in acute respiratory alkalosis performed by rebreathing into a small paper bag with that of the IV calcium replacement therapy. 25 patients with clinical manifestations of hypocalcemia admitted to the Department of Emergency, Cho Ray Hospital were prospectively included in this study. Patients were divided into two groups according to the time of day they visited the emergency department. Group I was treated by IV calcium replacement. Group II was treated rebreathing into a small paper bag without drug. In conclusion, group I had 3.80.8 minute and group II had 4.41.17 minute to disappear the manifestations of hypocalcemia. The average statistical test between these two groups in this study has shown that the two procedures were not different statistical significance
Alkalosis, Respiratory ; Respiratory Distress Syndrome, Adult ; Hypocalcemia ; Therapeutics

BACKGOUND: Gitelman's syndrome is manifested by hypokalemia, metabolic alkalosis, normal blood pressure, hyperreninemic hyperaldosteronism, hypomagnesemia and hypocalciuria. This study was carried out to investigate the effects of magnesium supplementation for correcting hypokalemia in Gitelman syndrome. METHODS: A Gitelman patient without hyperaldosteronism in our hospital was studied, oral supplementation periods of regimens for 60 days were divided into eight stages (each stage is at least over 5 days) such as 1 stage:no regimen supplementation period 2 stage:spironolactone 100 mg, alone period 3 stage:spironolactone 100 mg, MgO 1 g mixed period, 4 stage:spironolactone 100 mg, alone period, 5 stage:spironolactone 100 mg, MgO 1 g mixed period, 6 stage:spironolactone 150 mg, MgO 1 g mixed period, 7 stage: spironolactone 150 mg, MgO 1.5 g mixed period, 8 stage:spironolactone 150 mg, MgO 1.5 g, KCl 3.6 g mixed period. RESULTS: The highest value of plasm [K] was 3.3 mEq/L, the lowest value of TTKG was 2.6 during 3 stage, plasm [K] had tendency to increased and TTKG decreased, however next during 4 stage, the tendency of correcting hypokalemia diminished. The highest value of plasm [K] was only 3.3 mEq/L during 7 stage, the highest value of plasm [K] was 4.6 mEq/L during 8 stage. And the highest value of plasm ionized [Mg++] was 0.44 mmol/L during MgO 1.5 g supplementation. CONCLUSION: Magnesium alone fails to completely correct potassium and magnesium depletion despite tendency of correcting. Therefore, the optimal therapeutic regimens for correcting hypokalemia in Gitelman syndrome without hyperaldosteronism would be the magnesium and additional K supplementation.
Alkalosis ; Blood Pressure ; Gitelman Syndrome* ; Humans ; Hyperaldosteronism ; Hypokalemia* ; Magnesium* ; Potassium ; Spironolactone ; Gitelman Syndrome

Capnometer has been used in anesthesia for the evaluation of pulmonary ventilation because of its nonivasive and continuous monitoring advantges. We studied pulmonary ventilation effects with arterial blood gas parameter between normoventilation and hyperventilation with capnometric control during 1 hr duration. We devided two group. Control group was maintained PetCO2 38 mmHg and experimental group PetCO2 28 mmHg and four times arterial blood gas sample were done. The results were as follows. 1) Serum K+ concentration was decreased siginifcantly in hyperventilation group. 2) Arterial pH changes were observed respiratory alkalosis in experimental group and respiratory acidosis in control group. 3) (a-t)PCO2 differnce were increased in both group and especially control group with correlation of time duration. 4) No arrhythmia were detected in both group. We conclude that only capnometric control of pulmonary ventilation is not suffieient and it has to be combined periodic ABGS and resetting of ventilation mode.
Acidosis, Respiratory ; Alkalosis, Respiratory ; Anesthesia ; Arrhythmias, Cardiac ; Hydrogen-Ion Concentration* ; Hyperventilation* ; Pulmonary Ventilation ; Ventilation

Action of neuromuscular blocking agents are known to be largely affected by acid-base imbalance. In general, acidosis potentiates and alkalosis antagonizes the action of the neuromuscular blockers. To evaJuate the effects of acid-base imbalance on the neuromuscular actions of atracurium or vecuronium in 24 cats, we induced respiratory and metabolic acid-base imbalance and performed cumulative dose response studies. The results are as follows; 1) ED(50) and ED(95) of the atracurium was smaller in metabolic acidosis than those of respiratory and metabolic alkalosis. 2) ED(50) of vecuronium was not affected by acid-base imbalance in either agent. 3) Duration and recovery index were not affected by acid-base imbalance in either agent. 4) In atracurium group, serum potassium and calcium values during respiratory or metabolic alkalosis were smaller than those of control, but did not influence the neuromuscular action of atracurium. 5) Dose-response curve of the atracurium shifted to the right with metabolic acidosis, respiratory acidosis, metabolic alkalosis and respiratory alkalosis in order, but acid-base imbalance did not influence the dose-response curve of the vecuronium. In conclusion, the potency might be increased in respiratory and metabolic acidosis with atracurium, but not with vecuronium. However, action and recovery were not influenced by a experimental imbalance in either agent.
Acid-Base Imbalance ; Acidosis ; Acidosis, Respiratory ; Alkalosis ; Alkalosis, Respiratory ; Animals ; Atracurium* ; Calcium ; Cats ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Potassium ; Vecuronium Bromide*

No abstract available.
Niemann-Pick Disease, Type A*

No abstract available.
Niemann-Pick Disease, Type A*

Acquired renal tubular disorder can be observed in various disease processes, especially autoimmune diseases. Gitelman syndrome is an autosomal recessive disease characterized by hypokalemic metabolic alkalosis, hypomagnesemia, and hypocalciuria. This disorder is caused by mutation in the SLC12A3 gene, which encodes the thiazide - ensitive NaCl cotransporter (NCCT). Acquired Gitelman syndrome has been reported and the majority has been associated with Sjogren's syndrome. The presence of circulating auto - antibodies to NCCT was suggested as a mechanism of acquired Gitelman syndrome. Treatment of acquired Gitelman syndrome was done with supplements of potassium and magnesium and prednisone was effective in some cases. Acquired Gitelman syndrome should be included in the differential diagnosis of renal involvement in patients with autoimmune diseases, especially Sjogren's syndrome.
Alkalosis ; Antibodies ; Autoimmune Diseases ; Diagnosis, Differential ; Gitelman Syndrome ; Humans ; Magnesium ; Potassium ; Prednisone ; Sjogren's Syndrome