Correlation between QoTc and serum as well as ionised calcium in sick neonates

Background: Hypocalcemia is a frequently observed clinical and laboratory abnormality in neonates with risk factors such as prematurity, infant of diabetic mothers and perinatal asphyxia. Hypocalcemia can be asymptomatic or can cause apnoea, seizures, jitteriness, stridor, cardiac abnormalities. Clinically as calcium levels are maintained within narrow ranges. It is therefore imperative to measure and correct any deficit at the earliest. Unfortunately, total serum calcium level correlates poorly with ionized calcium level. Measurement of ionized calcium is both time consuming and expensive and therefore the need for more rapid, inexpensive and non-invasive method for screening at risk-neonates. Serum calcium levels are known to affect the duration of the QoTc interval. Therefore establishing a good correlation between serum/ionized calcium levels and QoTc will validate ECG as a reliable marker of hypocalcemia. Objective was to find correlation between QoTc interval and serum calcium levels in sick neonates.Methods: Total 730 infants were for serum total calcium and ionized calcium levels. Off these 142 infants with hypocalcemia, 29 infants were excluded based on exclusion criteria. The remaining 113 neonates were subjected to three cycles of ECG measurement before correction of calcium and were taken as cases. QoTc intervals were measured and were correlated with corresponding serum total calcium and ionized calcium levels.Results: In this study, a moderate negative or downhill correlation was found between total serum calcium QoT (r = -0.694 and p = <0.001) and QoTc (r = -0.680 and p = <0.001). The ionized calcium levels were found to have strong negative or downhill correlation with QoT (r = -0.837 and p = <0.001), QoTc (r = -0.819 and p = <0.001). All these correlations were found to be statistically significant with p<0.05.Conclusions: QoTc interval can be used as a surrogate marker for blood total or ionized calcium levels.

Role of Intact Parathormone Levels as Early Predictor of Asymptomatic Hypocalcaemia after Total Thyroidectomy.

Asymptomatic hypocalcemia is one of the complications of total thyroidectomy. The symptoms of low calcium levels are sometimes evident only after about 48-72 hours after surgery. Serum calcium levels are not reliable in identifying these patients, because a large number of them are only those with transient hypocalcemia. This study was carried out to evaluate the role of intact parathormone levels in predicting asymptomatic hypocalcemia.METHODSThis cohort study was carried out among 43 patients, who underwent total or completion thyroidectomy. The serum ionized calcium & creatinine levels were measured preoperatively, to rule out pre-operative hypoparathyroidism. Following surgery (one-hour post operatively), the patients’ serum PTH levels and serum ionized calcium levels were measured. Simultaneously, hypocalcemia was clinically evaluated.RESULTSOut of 43 patients, 30 patients had low hypocalcemia (<1.1 mmol/l) one hour postoperatively. The incidence of initial asymptomatic hypocalcaemia post-surgery was 70.5%. All patients with low iPTH, except one, also had hypocalcaemia initially. The patient with normal calcium subsequently had hypocalcaemia at 6 hours.CONCLUSIONSWith the prediction of asymptomatic hypocalcemia in the early post-operative period, it is possible to start timely treatment and thereby prevent the complications of hypocalcemia.

Changes of ionized calcium binding adapter molecule 1 and pro-opiome-lanocortin expression in arcuate nucleus of hypothalamus induced by substantia nigra lesion with 6-hydroxydopamine / 中国病理生理杂志

AIM:To observe the expression of tyrosine hydroxylase (TH), ionized calcium binding adapter molecule 1 (Iba1) and pro-opiomelanocortin (POMC) in rat arcuate nucleus (Arc) of hypothalamus induced by substantia nigra (SN) lesion with 6-hydroxydopamine (6-OHDA).METHODS:According to the random number table, 20 SD rats were randomly divided into 6-OHDA group and control group.6-OHDA was injected into the bilateral SN of the rats in 6-OHDA group, and the same volume of saline was injected into the same position of the rats in control group.After 6 weeks, the rats were sacrificed and the brains were obtained.Immunofluorescence staining and Western blot were used to detect TH expression in the SN, and TH, Iba1 and POMC expression in the Arc.RESULTS:Compared with control group, no significant change of body weight in 6-OHDA group was observed, but the weight of retroperitoneal fat decreased from (7.550±0.670) g to (3.895±0.465) g (P<0.01).The number of TH immunoreactive neurons in SN decreased from 56±5 to 14±2 (P<0.05), and the TH protein level decreased from 0.75±0.11 to 0.41±0.09 (P<0.01).In the Arc, the number of TH immunoreactive neurons decreased from 21±2 to 10±3 (P<0.05), the number of Iba1 immunoreactive neurons increased from 12±2 to 30±5 (P<0.05), and the number of POMC immunoreactive neurons increased from 16±4 to 31±2 (P<0.05).In the hypothalamus, the TH protein level decreased from 0.35±0.05 to 0.21±0.02 (P<0.01), the Iba1 protein level increased from 0.23±0.06 to 0.51±0.04 (P<0.01), and the POMC protein level increased from 0.37±0.05 to 0.65±0.03 (P<0.01).CONCLUSION:The changes of TH, Iba1 and POMC expression in Arc of 6-OHDA-treated rats may involved in the fat loss in Parkinson's disease.

Effects of Dianxianqing Granule on the IL-6 Content and GFAP,Iba-1 Expressions in Hippocampus Tis-sue of Rats with Kainate-induced Epilepsy / 中国药房

OBJECTIVE:To study the effects of Dianxianqing granule on the interleukin(IL-6)content and glial fibrillary acid-ic protein(GFAP),ionized calcium linker molecules 1(Iba-1)expressions in hippocampus tissue of rats with kainate-induced epi-lepsy,and explore its mechanism of preventing and treating epilepsy. METHODS:Rats were randomly divided into sham operation group (distilled water),model group (distilled water),phenytoin group (0.03 g/kg,positive control) and Dianxianqing granule low-dose,medium-dose,high-dose groups(4.74,9.47,18.94 g/kg,calculated by crude drug),20 in each group. Rats were intra-gastrically administrated once a day,for 7 d. After 1 h of last administration,except for sham operation group,rats in other groups received single injection of kainite in hippocampus CA1 of left side to induce the epilepsy model. Behavioral changes and death of rats were observed. After 24 h of modeling,enzyme-linked immunosorbent method was used to detect the IL-6 content in hippocam-pus tissue of rats,Nissl staining was used to count the hippocampus neurons,and immunohistochemistry was used to detect the GFAP,Iba-1 expressions in hippocampus tissue of rats. RESULTS:Compared with sham operation group,rats in model group had obvious epilepsy symptoms after modeling,and parts of rats died;IL-6 content and number of neurons in hippocampus tissue were obviously decreased (P<0.01), while GFAP, Iba-1 expressions were obviously enhanced (P<0.01). Compared with model group,epilepsy symptoms and death in each administration group had improved,while IL-6 content in hippocampus tissue were in-creased to varying degrees,with no statistical significance (P>0.05). The numbers of neurons in phenytoin group,Dianxianqinggranule medium-dose, high-dose groups were obviously in-creased(P<0.01);GFAP expression was obviously decreased (P<0.01). Iba-1 expressions in hippocampus tissue in phenyt-oin group,Dianxianqing granule high-dose group were obvi-ously decreased (P<0.01). CONCLUSIONS:Dianxianqing granule can play the role in preventing and treating epilepsy by inhibiting GFAP,Iba-1 expressions in hippocampus tissue and in-creasing the number of neurons in hippocampus tissue.

Effects of Dianxianqing Granule on the IL-6 Content and GFAP,Iba-1 Expressions in Hippocampus Tis-sue of Rats with Kainate-induced Epilepsy / 中国药房

OBJECTIVE:To study the effects of Dianxianqing granule on the interleukin(IL-6)content and glial fibrillary acid-ic protein(GFAP),ionized calcium linker molecules 1(Iba-1)expressions in hippocampus tissue of rats with kainate-induced epi-lepsy,and explore its mechanism of preventing and treating epilepsy. METHODS:Rats were randomly divided into sham operation group (distilled water),model group (distilled water),phenytoin group (0.03 g/kg,positive control) and Dianxianqing granule low-dose,medium-dose,high-dose groups(4.74,9.47,18.94 g/kg,calculated by crude drug),20 in each group. Rats were intra-gastrically administrated once a day,for 7 d. After 1 h of last administration,except for sham operation group,rats in other groups received single injection of kainite in hippocampus CA1 of left side to induce the epilepsy model. Behavioral changes and death of rats were observed. After 24 h of modeling,enzyme-linked immunosorbent method was used to detect the IL-6 content in hippocam-pus tissue of rats,Nissl staining was used to count the hippocampus neurons,and immunohistochemistry was used to detect the GFAP,Iba-1 expressions in hippocampus tissue of rats. RESULTS:Compared with sham operation group,rats in model group had obvious epilepsy symptoms after modeling,and parts of rats died;IL-6 content and number of neurons in hippocampus tissue were obviously decreased (P<0.01), while GFAP, Iba-1 expressions were obviously enhanced (P<0.01). Compared with model group,epilepsy symptoms and death in each administration group had improved,while IL-6 content in hippocampus tissue were in-creased to varying degrees,with no statistical significance (P>0.05). The numbers of neurons in phenytoin group,Dianxianqinggranule medium-dose, high-dose groups were obviously in-creased(P<0.01);GFAP expression was obviously decreased (P<0.01). Iba-1 expressions in hippocampus tissue in phenyt-oin group,Dianxianqing granule high-dose group were obvi-ously decreased (P<0.01). CONCLUSIONS:Dianxianqing granule can play the role in preventing and treating epilepsy by inhibiting GFAP,Iba-1 expressions in hippocampus tissue and in-creasing the number of neurons in hippocampus tissue.

Calcemic response to burns differs between adults and children: A review of the literature

OBJECTIVES: The calcemic and parathyroid hormone (PTH) responses to severe burn injury appear to differ between children and adults. In our limited studies children exhibited hypocalcemic hypoparathyroidism consistent with up-regulation of the parathyroid calcium-sensing receptor (CaSR) while adults did not, suggesting a developmental cutoff in cytokine-mediated up-regulation of the CaSR. This difference may be clinically important as published studies indicate that extracellular calcium (Ca) may stimulate the inflammatory response. The aim of this study was to examine the existing literature on burns to see if the differences between pediatric and adult calcemic and PTH responses to burn supported our findings providing stronger evidence to support this developmental difference. METHODS: We reviewed the National Library of Medicine database using the terms burns, PTH and ionized calcium and found 9 articles from 8 different medical centers; one was eliminated due to mixing of adults and children. RESULTS: There were 245 burn patients reported from the literature, 178 pediatric and 67 adults. The data are mostly consistent with our reported findings. Of the 10 pediatric patients with severe burns that we studied, mean ionized Ca concentration was below the lower limit of normal of 1.10 mM. The 67 adult burn patients reported in the literature had a mean blood ionized Ca concentration that was within the adult normal range or was lower than normal but with secondary hyperparathyroidism. Moreover, serum PTH concentrations were uniformly low in the 178 children in the burn literature but normal or mildly elevated in the 67 adults. CONCLUSIONS: These results support the hypothesis that the difference between pediatric and adult victims is consistent with an age-related CaSR response to cytokine stimulation and may be consistent with a lower level of inflammation in children. Ionized Ca and PTH might serve as possible therapeutic targets to lower the inflammatory response in burn victims.

Study of Serum Total Calcium, Ionized Calcium and Total Protein Concentrations in Postmenopausal Women.

Menopause and ageing is associated with accelerated loss of cortical bone. Osteoporotic fractures are common cause of morbidity and mortality in adult Indian women due to ageing. This study was conducted to evaluate the levels of serum calcium, ionized calcium and total protein levels in postmenopausal women and to assess its relation with ageing. Study includes 70 women (40 post menopausal and 30 premenopausal women) serum alkaline phosphatase, serum calcium, ionized calcium and total proteins, serum albumin were estimated in both cases and controls. There is decrease in serum calcium in postmenopausal; women when compared to premenopausal women. There was no significant change in ionized calcium in both cases and controls. ALP is highly significant P<0.001. In postmenopausal women suggesting there is high alkaline phosphotase activity in postmenopausal women as a result of the inhibitory effects of estrogen on bone turnover rate which is dependent on age and body mass index. Decrease in serum albumin was seen in postmenopausal women which is the reason for decrease in serum calcium level which is inturn related to ageing effect.

Serum intact parathyroid hormone levels in cats with chronic kidney disease / Avaliação das concentrações séricas de paratormônio intacto em gatos com doença renal crônica

Chronic kidney disease (CKD) is frequently observed in cats and it is characterized as a multisystemic illness, caused by several underlying metabolic changes, and secondary renal hyperparathyroidism (SRHPT) is relatively common; usually it is associated with the progression of renal disease and poor prognosis. This study aimed at determining the frequency of SRHPT, and discussing possible mechanisms that could contribute to the development of SRHPT in cats at different stages of CKD through the evaluation of calcium and phosphorus metabolism, as well as acid-base status. Forty owned cats with CKD were included and divided into three groups, according to the stages of the disease, classified according to the International Renal Interest Society (IRIS) as Stage II (n=12), Stage III (n=22) and Stage IV (n=6). Control group was composed of 21 clinically healthy cats. Increased serum intact parathyroid hormone (iPTH) concentrations were observed in most CKD cats in all stages, and mainly in Stage IV, which hyperphosphatemia and ionized hypocalcemia were detected and associated to the cause for the development of SRHPT. In Stages II and III, however, ionized hypercalcemia was noticed suggesting that the development of SRHPT might be associated with other factors, and metabolic acidosis could be involved to the increase of serum ionized calcium. Therefore, causes for the development of SRHPT seem to be multifactorial and they must be further investigated, mainly in the early stages of CKD in cats, as hyperphosphatemia and ionized hypocalcemia could not be the only factors involved.

A doença renal crônica (DRC) em gatos é frequentemente observada e caracteriza-se como alteração multissistêmica, causada por alterações metabólicas, e o hiperparatireoidismo secundário renal (HPTSR) seria o mais comum e usualmente está associada com progressão da doença renal e mau prognóstico. Esse estudo teve como objetivo determinar a frequência do HPTSR, e discutir os possíveis mecanismos que podem contribuir para o desenvolvimento de SRHPT em gatos em diferentes estágios de DRC, pela avaliação do metabolismo do cálcio e fósforo, bem como do equilíbrio ácido-base. Quarenta gatos com DRC foram divididos em três subgrupos, de acordo com a classificação proposta pela International Renal Interest Society (IRIS), Estágio II (n=12), Estágio III (n=22) e Estágio IV (n=6). O grupo-controle foi composto por 21 gatos clinicamente saudáveis. O aumento das concentrações séricas de paratormônio intacto (PTHi) foi observado na maioria dos casos, mas principalmente no Estágio IV, no qual a hiperfosfatemia e a hipocalcemia ionizada parecem estar associadas ao desenvolvimento do HPTSR. No entanto, nos Estágios II e III, observou-se hipercalcemia ionizada, sugerindo que, nestes estágios, o desenvolvimento do HPTSR possa estar associado a outros fatores, e a acidose metabólica pode estar envolvida com o desenvolvimento de hipercalcemia ionizada. Assim, outros fatores, além da hiperfosfatemia e da hipocalcemia ionizada, possam estar envolvidos com o desenvolvimento do HPTSR, principalmente nos estágios iniciais da DRC. Futuros estudos são necessários para uma melhor compreensão da fisiopatologia do HPTSR em gatos.

The effects of rehabilitative training on neural function and the expression of glial fibrillary acidic protein and ionized calcium binding adaptor molecule-1 after traumatic brain injury / 中华物理医学与康复杂志

Objective To study the effectsof rehabilitative training on neural function and the expression of glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule-1 (Iba-1) in rats after traumatic brain injury.Methods A left hemisphere traumatic brain injury model was established in ninety Sprague-Dawley rats.They were then randomly divided into a rehabilitation training group,an immobilization group and a free-running group,with 30 rats in each group.Another thirty rats received sham injury as the shamoperated group.Beginning 4 days post-operation the rats of the rehabilitation training group were given balancing,rotating and walking exercises three times daily,15 min/time,6 d/week.The immobilization group was fixed in mesh cages.The rats of the free-running and sham-operated groups were reared in normal cages without any special training exercise.The rats of all 4 groups were given neural and motor function tests to assess the functional outcome.Immunofluorescence staining was used to evaluate the expressions of GFAP (the marker of astrocytes) and Iba-1 (the marker of microglia) in the cortex close to the iujured region at 3 days,1 week,2 weeks,3 weeks and 4 weeks after injury.Results The average neural and motor function test scores in the rehabilitation training group were significantly better than those in the immobilization and free-running groups at the 2nd week and thereafter.The average scores in the free-running group were significantly better than those in the immobilization group at the 4th week after injury.The immunofluorescence staining showed that the expression of GFAP was lowest in the rehabilitation group at the 2nd week and thereafter.Iba-1 expression was significantly lower only at the 3rd week and beyond.Conclusion Rehabilitative training can improve nerve function recovery in rats after traumatic brain injury,and the functional enhancement may be partially attributed to the downregulation of activated astrocytes and microglia.

Value of ionized hypocalcaemia in surgical serious patients ZHU / 国际外科学杂志

Ionized calcium is a divalent cation involved in many critical cellular processes,such as regulating intracellular enzyme activity,signal transduction,gland secretion,hormone-receptor bind and activating clotting mechanism,but ionized hypocalcaemia is commonly found in critically illness,for instance serious trauma,major operation,sepsis and severe pancreatitis.The article reviews ionized hypocalcaemia with correlation of the prognosis and ill severity of surgical serious patients.

Clinical significance of plasma ionized calcium and total calcium measurement in diagnosis of tumor-associated hypercalcemia / 中国医师进修杂志

Objective To evaluate the clinical significance of plasma ionized calcium (ICa) and total calcium (TCa) measurement in diagnosis of tumor-associated hypercalcemia. Methods The heparin lithium anticoagulated plasma were collected and measured with ion selective electrode (ISE) and orthocresolphthalein complexone (OCPC) method for ICa and TCa in 77 patients with malignant tumor (tumor group) and 44 healthy controls (control group). Meanwhile,plasma albumin and pH value were measured to correct TCa (cTCa) and ICa(nICa). The results were analyzed. Results The levels of cTCa,ICa and nICa in tumor group were significantly higher than those in control group(P＜ 0.01 ) ,but there was no significant difference of TCa between two groups (P ＞ 0.05 ). cTCa ＞ 2.70 mmol/L, nICa ＞ 1.35 mmol/L as the hypercalcemia eritical value, the positive rate of nICa and cTCa were 18.18% (14/77) and 6.49% (5/77)respectively,the difference was significant (P = 0.023). Conclusion Determination of ICa may be more clinical meaningful than TCa for tumor-associated hypercalcemia.

Early Prediction of Hypocalcemia Demanding Treatment after Total Thyroidectomy

PURPOSE: The clinical manifestation of hypocalcemia is usually delayed until 48 to 72 hours after a thyroidectomy. A reliable predictor of postoperative hypocalcemia demanding treatment will shorten the hospital stay. This study prospectively evaluated the clinical and biochemical characteristics of patients who had hypocalcemia demanding treatment along with their predictive values. METHODS: The data was collected from 44 patients who underwent a total thyroidectomy at Chungbuk National University hospital from September 2003 to July 2004. There were 38 females and 6 males. Thirty-one patients were diagnosed with thyroid carcinoma. The serum calcium, phosphorous, ionized calcium, and PTH levels were measured at 6, 12, 24, and 48 hours after surgery. The clinical and biochemical characteristics of the patients who demanded treatment (Treated) were compared with those of the other patients (Control). Statistical analysis was carried out using a student t-test and a chi2 test. RESULTS: Among the 44 patients, 11 patients (25.0%) required calcium supplementation. The clinical characteristics except for age were not different between the two groups. The serum calcium, calcium ion, and PTH levels were significantly lower in the treated group from as early as 6 hours after surgery. In order to predict hypocalcemia demanding treatment with both a sensitivity and a specificity of approximately 90%, the biochemical cut-off value would be 15 pg/ml PTH at 6 hours, 4.0 mg/dl of a minimal ionized calcium within 24 hours, and 7.9 mg/dl calcium at 48 hours after a total thyroidectomy. CONCLUSION: Hypocalcemia demanding treatment can be predicted early and reliably after a total thyroidectomy by measuring the postoperative changes in the serum calcium, ionized calcium, and PTH levels.

The Effect of Milk Ingestion on Ionized Calcium Level During Single Donor Plateletpheresis: Prospective Randomized Study / 대한수혈학회지

BACKGROUND: We have done a prospective randomized study to assess the effect of milk ingestion on ionized calcium level and can prevent hypocalcemia during single donor plateletpheresis. METHODS: Between August 2003 and September 2003, thirty single platelet donors who visited Apheresis Unit in St. Mary's Hospital were prospectively randomized into whether milk ingestion (experimental group, n=15) or not (control group, n=15) before apheresis. Plateletpheresis were performed using COBE Spectra LRS TM. Serum ionized calcium level and vital signs were monitored before, 30 minutes after, and completion of apheresis procedure. RESULTS: Vital signs(systolic BP, diastolic BP, pulse) in each time were not significantly different between two groups. Ionized calcium level at finish time tends to elevate compared to those at after 30 minutes in Experimental group (1.08mmol/L at basal, 0.86mmol/L after 30min, 0.93mmol/L at finish time). But ionized calcium levels at finish time significantly decreased than those at baseline level in Control group(1.05mmol/L on basal, 0.91mmol/L after 30min, 0.73mmol/L at finish time)(p=0.0054). Ionized calcium levels at finish time were significantly increased in Experimental group compared to control group(p=0.002). CONCLUSION: These results demonstrated that milk ingestion before apheresis can prevent the decrease of serum ionized calcium level and simple recommendation of milk ingestion can prevent hypocalcemia during plateletpheresis.

Apoptotic Change in Response to Magnesium Therapy after Moderate Diffuse Axonal Injury in Rats

The biochemical factors related to moderation of secondary or delayed damage to the central nervous system (CNS) remain undefined. We have recently demonstrated that the weight- drop induced moderate diffuse axonal injury (mDAI) in rats causes a rapid decline in serum ionized magnesium (Mg2+) and a significant increase in the amount of serum ionized calcium (Ca2+) relative to Mg2+ (Ca2+/ Mg2+). For three hours, serum Mg2+ levels remained significantly depressed at 76% of preinjury values (p 0.05). Head trauma resulted in a small decrease of Ca2+ (about 10%), but a significant increase in the amount of Ca2+/Mg2+ (mean value in control group: in injured group for 3 hours after trauma =4.65 +/-0.012 : 5.69 +/-0.015, p< 0.05) was observed. In order to further investigate the relationship between Mg2+ and brain injury, the effect of Mg2+ treatment on posttraumatic histological changes (apoptotic changes) was examined following the weight-drop induced brain injury. At 30 min postinjury, animals treated with MgSO4 (750micro Ml/kg) showed significant improvements of apoptotic changes when compared to the control group (54.8 +/- 1.7, 51.5 +/- 3.2 at 12, 24 h in control group, 24.8 +/- 2.6, 20.5 +/- 1.4 at 12, 24 h in treated group, p< 0.05). The early decline in serum Mg2+ and the increase in the amount of Ca2+/Mg2+ immediately following brain trauma uncovered by these findings suggest that they may be a critical factor in the development of irreversible tissue injury. If this proves to be the case, treatment with MgSO4 may be effective in improving histological findings following experimental traumatic brain injury in rats.

Change in Serum Concentration of Magnesium and Calcium Ions Following Moderate Diffuse Axonal Injury in Rats: Preliminary Study

OBJECTIVE: Traumatic brain injury has been shown to result in a decrease of the brain-free magnesium concentration that is associated with the development of neurologic deficits. However, changes in free magnesium homeostasis have not been characterized in other fluid compartments. We examine the ionized serum magnesium(Mg2+) and ionized serum calcium(Ca2+) in the moderate diffuse axonal injury of rat model. METHODS: We designed a study to determine whether ionized serum magnesium(Mg2+) and / or ionized serum calcium(Ca2+) levels correlate with moderate diffuse axonal injury(mDAI). A new ion-selective electrode was used to determine Mg2+ and Ca2+ level in the serum, prior to and following weight-drop induced mDAI. RESULTS: Serum Mg2+ remained significantly depressed to about 76% of preinjury values for 3 hours (0.73+/-0.01 mg/dL, 0.79+/-0.03 mg/dL, 0.84+/-0.03 mg/dL at 1, 2, 3 hours after trauma, respectively) compared to control group (1.07+/-0.03 mg/dL, p<0.05), but not in total serum magnesium(tMg). Mg2+/ tMg was shown a significant decrease for first 3 hours (49%, 53.4%, 56.4% at 1, 2, 3 hours after trauma respectively) compared to control group (70.9%, p<0.05). Head trauma resulted in small decrease of Ca2+, but there was a significant increase in the amount of Ca2+/ Mg2+(mean value in control group: in injured group for 3 hours after trauma = 4.65+/-0.012: 5.71+/-0.015, p<0.05). Apoptotic change was shown at 3 hours after mDAI and apoptotic index(AI) was significantly increased at 12 and 24 hours after trauma (54.8+/-1.7, 51.5+/-3.2 at 12, 24 hours, p<0.05). CONCLUSION: These findings suggest that the early decline in serum Mg2+ and increase in the amount of Ca2+/ Mg2+ following brain trauma may be a critical factor in the development of irreVersible tissue injury and early treatment with magnesium salt may be effective in histological changes following experimental traumatic brain injury in the rat.

The Influence of Low Calcium Concentration Hemodialysis on Cardiovascular Response / 대한신장학회잡지

OBJECTIVE: Arterial compliance (AC) reflects the buffering function of the vessel. Low AC caused by arterial stiffness increases pulse pressure amplitude. Therefore, Low AC must be correlated with high cardiovascular mobidity and mortality in HD patients. Dialysate calcium concentration is potentially a main determinant of serum ionized calcium level and the vasoconstriction is associated with high calcium concentration. Therefore, We conducted a study for evaluation of the interdialytic effects of treatment with a low dialysate calcium (LdCa) concentration and high dialysate calcium (HdCa) concentration on the changes of AC, BP, biochemical parameters. METHODS: Eight HD patient (mean age 45.5, sex ratio 1 : 1) were studied. The mean HD period was 3 years. Arterial Compliance, stroke Volume, SBP, DBP, PP, MAP, Ionized Ca, T-CO2, P and CaxP product were compared after treatment with a LdCa and HdCa concentration for each 10 sessions. RESULTS: AC were 0.143+/-0.076 mm2/kPa in baseline, 0.166+/-0.097 mm2/kPa in LdCa (1.25 mmol/L) dialysate, 0.142+/-0.082 mm2/kPa in HdCa (1.75 mmol/L) dialysate. SBP, DBP, MAP and PP were 157.75+/-15.97, 94.25+/-9.48, 114.12+/-10.56, 63.50+/-10.87 mmHg in baseline and 135.25+/-13.00, 78.75+/-11.24, 98.37+/-15.14, 56.50+/-5.95 mmHg in LdCa dialysate and 160.50+/-15.36, 94.05+/-10.34, 115.75+/-9.64, 62.00+/-15.71 mmHg in HdCa dialysate. Ionized Ca were 4.66+/-0.40 mg/dL in baseline, 4.45+/-0.28 mg/dL in LdCa dialysate and 4.65+/-0.43 mg/dL in HdCa dialysate. However, there were no changes of other biochemical parameters. CONCLUSION: Treatment with LdCa dialysis, by minimizing the risk for LdCa-induced hypocalcemia, may have a beneficial role in the prevention of the ongoing reduction of arterial compliance in HD patients and thus improve cardiovascular prognosis.

Effects of low calcium concentration dialysate on blood pressure,ionized calcium and serum endothelin-1 of uremic patient with hypertension during hemodialysis / 中国实用内科杂志

Objective To evalute effects of low calcium concentration dialysate on blood pressure,ionized calcium and serum endothelin-1 of uremic patient with hypertension during hemodialysis.Methods 60 uremic patients with hypertension during hemodialysis in the Shengjing Hospital of China Medical University were dialysated with different calcium concentration(1.75 mmol/L followed by 1.25 mmol/L).TO measurearterial blood pressure,ionized calcium and serum endothelin-1 before and after each dialysis session.Results The post-dialysis blood pressure,ionized calcium and serum endothelin-1 level of uremic patients using DCa1.75 with hypertension during hemodialysis were increased significantly than those of pre-dialysis and post-dialysis with DCa1.25(P

The dynamic changes of serum ionized calcium in hemorrhagic fever with renal syn drome / 西安交通大学学报(医学版)

ObjectiveTo study the regularity of the changes and the role of serum ionized Calci um in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS). MethodsSerum was detected at different stages of HFRS by selective electrode, and analized the relationship between serum with blood urea Nitrogen and creatinine. ResultsSerum was much lower (P＜0.05) during hypotension shock stage and diuretic stage, and significantly lower(P＜0.01) during oliguria stage. The decrease of serum level was correlated to the state of illness aggravated. There is a negative relativity between serum and blood urea Nitrogen and creatinine (P＜0.01) in the patients. ConclusionSerum levels in patients may be related to the severity of the disease and renal function.

Comparison of Conventional Chiron 348 pH/blood Gas/electrolytes Analyzer and i-STAT Portable Clinical Analyzer / 대한구급학회지

BACKGROUND: The development of so-called "Point-of-care" (POC) devices for blood or urine analysis has resulted in many systems that are widely used at home or at the bedside. We evaluated the performance of the I-STAT portable clinical analyzer for measuring blood gases (pH, PCO2, PO2) and whole blood electrolytes (sodium, potassium and ionized calcium) with reference to a conventional blood gas analyzer (Chiron 348 pH/ blood gas/electrolytes). METHODS: Thirty samples from the arterial blood were simultaneously analyzed with I-STAT system and with Chiron 348 pH/blood gas/ electrolytes analyzer. Differences between results of two methods were analyzed by paired t-test (p<0.05). RESULTS: PO2, PCO2 and Na measured with I-STAT system and Chiron 348 PH/ blood gas/ electrolytes analyzer showed no significant differences. pH, calculated HCO3, K and Ca measured by two methods showed significant difference, but observed differences would not affect clinical decisions except ionized calcium. CONCLUSIONS: This study shows that blood gas and electrolyte analysis using the I-STAT portable device is comparable with that performed by a conventional Chiron 348 pH/blood gas/ electrolytes analyzer except ionized calcium.