Adipsic hypernatremia is a rare disease where patients do not feel thirst even in the increased serum osmotic pressure and results in electrolyte imbalance, severely increased osmotic pressure and neurologic symptoms like nausea, vomiting, and seizures. We report a 12-year-old male patient who had underwent a trans-sphenoidal surgery for craniopharyngioma newly diagnosed with adipsic hypernatremia after having growth hormone replacement for growth hormone deficiency. The patient visited emergency room complaining of generalized weakness, tremor in both legs, and poor oral intake including water after starting growth hormone replacement therapy. Laboratory test revealed serum sodium 168 mmol/L and serum osmolality 329 mOsm/kg, despite the patient didn't feel any thirst at all. We treated him with scheduled water intake of 2.5 L a day with intranasal vasopressin. He admitted to Soonchunhyang University Gumi Hospital and Soonchunhyang University Seoul Hospital for 4 times during the following 8 months and serum sodium level and osmolality was controlled by scheduled water intake combined with intranasal vasopressin treatment. It is still unclear whether growth hormone replacement worked as a trigger of hypernatremia.
Child ; Craniopharyngioma ; Drinking ; Emergency Service, Hospital ; Growth Hormone ; Gyeongsangbuk-do ; Humans ; Hypernatremia ; Leg ; Male ; Nausea ; Neurologic Manifestations ; Osmolar Concentration ; Osmotic Pressure ; Rare Diseases ; Seizures ; Seoul ; Sodium ; Thirst ; Tremor ; Vasopressins ; Vomiting ; Water

PURPOSE: The purpose of this paper was to identify blood pressure, interdialytic weight gain, thirst and intradialytic discomfort in subjects after applying individual low-sodium dialysis fluid (1,2,3 mEq/L) to hemodialysis patients for 12 weeks. METHODS: This study was a non-equivalent pre-post design. For 12 weeks, dialysate concentration was maintained at 1 mEq/L or 2 mEq/L or 3 mEq/L based on average sodium concentration of each individual, and the difference was compared after applying individually. RESULTS: Change in blood pressure significantly decreased in the group where in pre-hemodialysis systolic pressure decreased the gradient of sodium concentration in serum sodium and dialysis solution by 2mEq/L. Interdialytic weight gain, and thirst showed significant decrease in all three groups. But in all three groups, intradialytic discomfort among dialysis showed no significant changes. CONCLUSION: Although application of low sodium dialysis fluid showed no change in intradialytic discomfort, lowered blood pressure, thirst, and interdialytic weight gain, which could be used for individual showing increased interdialytic weight gain and increased blood pressure. There is need for continued study on this.
Blood Pressure ; Dialysis ; Humans ; Kidney Failure, Chronic ; Renal Dialysis ; Sodium ; Thirst ; Weight Gain

Primary polydipsia (PP) is marked by an increase in thirst, and most often presents in patients with psychiatric illnesses. Although uncommon in children, we experienced cases of PP in a 15-month-old boy and a 5-year-old girl. Both were admitted to the hospital with symptoms of polydipsia and polyuria that appeared 1–3 months before admission. Brain magnetic resonance imaging in both patients was normal. A water restriction test was performed after hospitalization and showed normal results. The symptoms improved after the parents were instructed to implement water-intake restriction for 2 weeks. Our report provides useful information for the treatment of PP in children.
Brain ; Child ; Child, Preschool ; Diabetes Insipidus ; Female ; Hospitalization ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Parents ; Polydipsia ; Polydipsia, Psychogenic ; Polyuria ; Thirst ; Water

OBJECTIVES: The aim of this study was to examine the current status of consumption of energy drinks among college students and investigate the effects of general environmental factors, health behavior factors, caffeine knowledge levels, and perceived stress levels on consumption of energy drinks. METHODS: A survey was conducted among a total of 479 college students in Gwangju, using self-administered questionnaires. The questionnaire consisted of items about general environmental factors, health behavior, caffeine knowledge, perceived stress, and energy drink consumption behaviors. RESULTS: 69.1% of participants experienced consumption of energy drinks, and specifically 82.8% of male students and 54.1% of female students experienced consumption of energy drinks (p < 0.001). The reasons for drinking energy drinks were found to be recovery from fatigue, curiosity, taste, habit, thirst relief, and stress relief. In addition, 40.7% of participants experienced drinking energy drinks mixed with alcohol, and specifically 48.6% of male students and 27.4% of female students reported drinking energy drinks with alcohol (p < 0.001). Moreover, 51.5% of participants responded that they experienced the effects of energy drinks, 31.9% reported experiencing adverse effects, and 41.1% were found to perceive the health risks. As a result of the assessment of caffeine knowledge, the participants showed a high level of knowledge of the arousal effect (77.7%) and the concentration increasing effect (70.8%) of caffeine, whereas they exhibited a low level of understanding of the health problems due to caffeine (32.6%) and adequate caffeine intake levels (24.4%). The higher levels of consumption experience of energy drinks was associated with higher body mass indexes (BMI) (p < 0.01), higher academic years (p < 0.01), lower levels of interest in health (p < 0.05), smoking (p < 0.001), alcohol consumption (p < 0.05), and higher levels of perceived stress (p < 0.05). CONCLUSIONS: The risk groups related to consumption of energy drinks among college students were identified as male students rather than female students, students in the third or fourth year of study associated with increased stress levels, and students with negative health behaviors. Therefore, support for diverse health and nutrition education for college students is required along with the improvement of internal and external environments of schools in order for college students to manage increased stress levels due to the schoolwork and preparation for employment and maintain positive health behaviors.
Alcohol Drinking ; Arousal ; Body Mass Index ; Caffeine ; Drinking ; Education ; Employment ; Energy Drinks ; Exploratory Behavior ; Fatigue ; Female ; Gwangju ; Health Behavior ; Humans ; Male ; Smoke ; Smoking ; Thirst

OBJECTIVES: The aim of this study was to examine the current status of consumption of energy drinks among college students and investigate the effects of general environmental factors, health behavior factors, caffeine knowledge levels, and perceived stress levels on consumption of energy drinks. METHODS: A survey was conducted among a total of 479 college students in Gwangju, using self-administered questionnaires. The questionnaire consisted of items about general environmental factors, health behavior, caffeine knowledge, perceived stress, and energy drink consumption behaviors. RESULTS: 69.1% of participants experienced consumption of energy drinks, and specifically 82.8% of male students and 54.1% of female students experienced consumption of energy drinks (p < 0.001). The reasons for drinking energy drinks were found to be recovery from fatigue, curiosity, taste, habit, thirst relief, and stress relief. In addition, 40.7% of participants experienced drinking energy drinks mixed with alcohol, and specifically 48.6% of male students and 27.4% of female students reported drinking energy drinks with alcohol (p < 0.001). Moreover, 51.5% of participants responded that they experienced the effects of energy drinks, 31.9% reported experiencing adverse effects, and 41.1% were found to perceive the health risks. As a result of the assessment of caffeine knowledge, the participants showed a high level of knowledge of the arousal effect (77.7%) and the concentration increasing effect (70.8%) of caffeine, whereas they exhibited a low level of understanding of the health problems due to caffeine (32.6%) and adequate caffeine intake levels (24.4%). The higher levels of consumption experience of energy drinks was associated with higher body mass indexes (BMI) (p < 0.01), higher academic years (p < 0.01), lower levels of interest in health (p < 0.05), smoking (p < 0.001), alcohol consumption (p < 0.05), and higher levels of perceived stress (p < 0.05). CONCLUSIONS: The risk groups related to consumption of energy drinks among college students were identified as male students rather than female students, students in the third or fourth year of study associated with increased stress levels, and students with negative health behaviors. Therefore, support for diverse health and nutrition education for college students is required along with the improvement of internal and external environments of schools in order for college students to manage increased stress levels due to the schoolwork and preparation for employment and maintain positive health behaviors.
Alcohol Drinking ; Arousal ; Body Mass Index ; Caffeine ; Drinking ; Education ; Employment ; Energy Drinks ; Exploratory Behavior ; Fatigue ; Female ; Gwangju ; Health Behavior ; Humans ; Male ; Smoke ; Smoking ; Thirst

PURPOSE: In surgical procedures under general anesthesia, 6 to 8 hours of a nulla per os (NPO; nothing by mouth) has been regarded as essential for prevention of respiratory complication such as aspiration. However, recent studies have reported that oral intake of water and other clear fluids up to 2 hours before induction of anesthesia does not increase respiratory problems. The purpose of this pilot study is to investigate the safety and efficacy of a newly developed carbohydrate-rich solution in elective hernia repair surgery patients. METHODS: A group of 30 adult patients scheduled for elective surgeries under general anesthesia were enrolled. The enrolled study group of patients was permitted to drink a carbohydrate-rich solution until two hours before the operation without volume limitation. Respiratory complication was investigated in the patients using the carbohydrate-rich solution until two hours before induction of general anesthesia. The feelings of thirst, hunger sense were measured pre- and post-operatively. In addition, hoarseness of voice, nausea and vomiting were investigated post-operatively. Satisfaction regarding the short time of fasting was measured. Visual analogue scale (VAS) was used for measurement of these six variables. RESULTS: No patients showed serious respiratory complication such as dyspnea, desaturation. Eight of 30 study group patients complained of mild hoarseness. Most symptoms of hoarseness were mild, with VAS score less than 3 out of 10. Two patients complained 5 out of 10. Six patients felt nausea and 1 patient had vomiting. Pre/post-operative hunger sense and thirst feeling were 1.63/1.60 and 1.90/5.76, respectively. The satisfaction score was 3.00 out of 4. CONCLUSION: Allowing the administration of an oral carbohydrate-rich solution in elective surgery patients requiring general anesthesia is safe without serious respiratory complications and effective in providing satisfaction.
Adult* ; Anesthesia ; Anesthesia, General ; Dyspnea ; Fasting ; Herniorrhaphy ; Hoarseness ; Humans ; Hunger ; Nausea ; Pilot Projects* ; Thirst ; Vomiting ; Water

PURPOSE: The purpose of this study was to examine the effects of frozen gauze with normal saline on thirst and the oral health of patients with nasal surgery. METHODS: A quasi-experimental, nonequivalent control group pretest-post test design was used. Participants (n=52) received either gauze frozen with normal saline (n=26), or wet gauze (n=26). The subjective thirst level and oral health of the participants were assessed before the intervention, 30 minutes after the first intervention, 30 minutes after the second intervention, and 30 minutes after the third intervention. RESULTS: After oral hygiene was provided twice, the thirst level was improved in patients receiving the gauze frozen with normal saline. After oral hygiene was provided a third time, the thirst level was improved in patients receiving the gauze frozen with normal saline. CONCLUSION: Gauze frozen with normal saline can be effective for oral hygiene in reducing the thirst level and improving the oral health in nasal surgery patients.
Humans ; Nasal Surgical Procedures* ; Oral Health* ; Oral Hygiene ; Thirst*

Insulin deficiency due to destruction of pancreatic beta-cells is a typical characteristic of type 1 diabetes mellitus (DM). In 2000 Imagawa proposed a novel diagnostic model defining "fulminant type 1 DM" as developing rapidly without any evidence of autoimmunity, and ever since there have been many reports regarding the matter in Japan. In 2004, the first fulminant type 1 diabetes case was reported in Korea; however, there have been few reports since then. We present a case of a 60-year-old man who suffered from excessive thirst and polyuria after myalgia. Laboratory findings revealed a high blood glucose level and evidence of diabetic ketoacidosis, but the HbA1c level was within the normal range. The serum C-peptide level was very low and antibodies to glutamic acid decarboxylase were negative. These findings suggested fulminant type 1 diabetes. This patient has shown improvement in symptoms and examination results without complications after being treated with insulin therapy with hydration, throughout 6-months follow-up period.
Aged* ; Antibodies ; Autoimmunity ; Blood Glucose ; C-Peptide ; Diabetes Mellitus ; Diabetes Mellitus, Type 1* ; Diabetic Ketoacidosis ; Follow-Up Studies ; Glutamate Decarboxylase ; Humans ; Insulin ; Japan ; Korea ; Middle Aged ; Myalgia ; Polyuria ; Reference Values ; Thirst

PURPOSE: This study was aimed to compare the effect between wet gauze with cold normal saline and wet gauze with cold water on thirst, oral cavity condition, and saliva pH among postoperative patients. METHODS: This study was a quasi-experimental study with 56 participants. The experimental group received wet gauze with cold normal saline, and control group received wet gauze with cold water for three times at 15 minute intervals. Data were collected using visual analog scale for thirst, oral assessment guide for oral cavity condition and acidity tape for saliva pH. Measurement were made before applying the gauze and at 15min, 30min, and 45min after applying gauze. Data were analyzed using repeated measured ANOVA. RESULTS: Thirst, oral cavity condition, and saliva pH improved in both groups with increasing number of gauze application. Thirst for the experimental group improved more than for the control group (F=4.29, p=.009), oral cavity condition except saliva, and saliva pH were not significantly different between the groups. CONCLUSION: This study results indicated that nurses can apply wet gauze with cold normal saline to reduce thirst and saliva acidity, and to improve the oral cavity condition for postoperative patients.
Humans ; Hydrogen-Ion Concentration* ; Mouth* ; Saliva* ; Sodium Chloride ; Thirst* ; Visual Analog Scale ; Water* ; Xerostomia

Adipsic hypernatremia is a rare disorder of hypothalamic osmoreceptor dysfunction for thirst. It is frequently associated with a deficiency in antidiuretic hormone (ADH) release. We report the first case in Korea of adipsic hypernatremia combined with subnormal ADH response to osmotic stimuli without any demonstrable structural lesion. A 69-year-old woman was admitted to the hospital with general weakness. In a hypernatremic hyperosmolar state, she denied thirst and did not drink spontaneously. Her plasma ADH level was markedly subnormal but she had no large volume of dilute urine. Investigation of osmoregulation by infusion of hypertonic saline revealed adipsia and an absolute deficiency in antidiuretic hormone release, despite a serum osmolarity in excess of 321 mOsmol/kg. There was no structural lesion of the hypothalamus and no abnormal finding in hypothalamic-pituitary function. After diagnosis, she was treated successfully with intentional water intake alone.
Aged ; Female ; Humans ; Hypernatremia ; Hypothalamus ; Korea ; Osmolar Concentration ; Plasma ; Thirst ; Water-Electrolyte Balance