No abstract available.
Drug Monitoring ; Mycophenolic Acid

Herein, we report a case of unusually elevated serum insulin level as a result of increased anti-insulin antibody (IA)-bound insulin after continuous subcutaneous insulin infusion therapy. Detecting free insulin (unbound IAs) levels after polyethylene glycol pre-treatment could be useful to assess functional insulin levels in diabetic patients receiving insulin therapy. The E170 insulin assay can estimate total insulin (bound IAs and free insulin) levels, but it does not measure the levels of exogenous insulin analogues.
Humans ; Insulin ; Insulin Antibodies ; Polyethylene Glycols

No abstract available.
Toxicology

BACKGROUND/AIMS: In countries with a higher risk of gastric atrophic gastritis, noninvasive tests are helpful for a more reliable diagnosis of Helicobacter pylori infection. The aim of this study was to evaluate the characteristics of seropositive subjects according to their stool H. pylori antigen test, serum pepsinogen (PG) assay, and endoscopic findings. METHODS: Consecutive subjects who visited Konkuk University Medical Center for upper gastrointestinal endoscopy for a regular check-up were included in a prospective setting if the serum anti-H. pylori immunoglobulin G assay was positive. A H. pylori antigen stool test was measured using a stool H. pylori antigen enzyme-linked immunosorbent assay kit on the same day as a serum PG assay and endoscopy. RESULTS: Of 318 seropositive subjects, 256 (80.5%) showed positive stool test findings. Subjects with a negative stool test result showed lower serum PG I (p < 0.001) and PG II (p < 0.001) levels and higher PG I/II ratio (p < 0.001) than those with a positive stool test. Chronic atrophic gastritis was more common in the positive stool test group than the negative stool test group on endoscopic finding (p = 0.009). A higher serum PG I level (p = 0.001) and a lower serum PG I/II ratio (p = 0.001) were independent risk factors for the presence of H. pylori antigen in stool. CONCLUSIONS: A high serum PG level denotes an ongoing current H. pylori infection with positive stool H. pylori antigen test findings. Seropositive subjects with increased gastric secreting ability tend to have H. pylori in their fecal material as reflected by a positive stool H. pylori antigen test finding.
Academic Medical Centers ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal ; Enzyme-Linked Immunosorbent Assay ; Gastritis, Atrophic ; Helicobacter pylori ; Helicobacter* ; Immunoglobulin G ; Pepsinogen A ; Prospective Studies* ; Risk Factors

We report a case of calcific bursitis of the shoulder in four-year-old boy who had severe pain and limitation of motion of the left shoulder joint for three days. Radiographs revealed the oval radiopaque lesion in the subacormial space, and the MR signal intensity of the mass was moderate on T2WI. Histological examination of the mass showed acute necrotizing inflammation with calcification.
Bursitis ; Humans ; Inflammation ; Male ; Shoulder ; Shoulder Joint

Cardiac arrest one day after cesarean section is extremely rare. Obstetrical clinicians have low experience to these serious situations necessitating immediate first aid and knowledge of its differential diagnosis. A 33-year-old woman underwent elective repeat cesarean section at 38 weeks of gestation under spinal anesthesia. The patient underwent uneventful course on that day. Loss of consciousness occurred one day after cesarean section during her first ambulation. Immediate cardiac compression was performed and eventually resulted in good recovery of her heartbeat. Her condition was suitable disseminated intravascular coagulation (DIC). She developed acute ischemic pancreatitis after cardiac arrest. We describe the consideration of amniotic fluid embolism with DIC as most appropriate in this case. To our knowledge, our case is one of the most dangerous conditions after the cesarean section. Here, we report our case with a review of literatures.
Adult ; Anesthesia, Spinal ; Cesarean Section ; Cesarean Section, Repeat ; Dacarbazine ; Death, Sudden, Cardiac* ; Diagnosis, Differential ; Disseminated Intravascular Coagulation ; Embolism, Amniotic Fluid ; Female ; First Aid ; Heart Arrest ; Humans ; Pancreatitis ; Pregnancy ; Pulmonary Embolism* ; Unconsciousness ; Walking

Total abdominal hystrectomy is the most common surgery of Gynecology. It's complication are taken very important. Although neuropathy, especially femoral nerve injury, is rare, recently we have experienced a case of femoral neuropathy after total abdominal hystrectomy. We present this case with a brief review of literature.
Femoral Nerve* ; Femoral Neuropathy ; Gynecology

The nerve conduction study with the inching method has been performed to characterize the nature of lesion (focal of diffuse) within the carpal tunnel and to increase the diagnostic sensibility of the carpal tunnel syndrome (CTS). The sensory nerve conduction velocity of finger-to-palm (F-P) segment of median never or the ratio of sensory nerve conduction velocity of palm-to-wrist (PW) segment to F-P segment of the median nerve (P-W/F-P ratio) was also measured to differentiate the CTS from the early peripheral polyneuropathy, which may only involve the median nerve. Conduction times of the sensory median nerve between the midpalm and the distal forearm in 2cm increments were measured orthodromically in controls (n=32) and CTS patients. The P-W/F-P ratio in control, CTS without diabetes mellitus (DM) (n=23), CTS with DM (n=9), and diabetic peripheral polyneuropathy (DP) groups was compared. The criteria for focal lesion within the carpal tunnel were defined as follows 1) If the maximal conduction time is located at 4-2cm segment distal(designated as '-') to distal wrist crease, it must be prolonged more than 4 times that of the adjoining distal segment or 6 times that of adjoining proximal segment. 2) If the maximal conduction time is located at -6--4cm segment, it must be beprolonged more than 4 times that of the adjoining proximal segment. According to above criteria, the incidened of focal lesion within the carpal tunnel was 84.4%(27/32) and the most common segment of focal lesion was -4--2cm segment(85.2%, 23/27). The P-W/F-P ratio was more decreased in CTS without DM (0. 55 + 0. 11) and CTS with DM(O.68+0.07) groups than control(0382+0.09) and DP(O.81+0.09) groups(P<0.01). In CTS groups, it was more decreased in CTS without DM group than CTS with DM group(p<0.05). So the measurement of sensory nerve conduction velocity of F-P segment of median nerve or the P-W/F-P ratio is helpful not only to evalucate the early distal involvement of peripheral neuropathy but also to establish the subclinical involvement of the segment distal to transverse carpal ligament in CTS with DM group.
Carpal Tunnel Syndrome* ; Diabetes Mellitus ; Forearm ; Humans ; Ligaments ; Median Nerve ; Neural Conduction ; Peripheral Nervous System Diseases ; Polyneuropathies ; Wrist

OBJECTIVE: The objective of this study was to assess the effect of folic acid and multivitamin use during pregnancy on the risk of developing of hypertensive disorder of pregnancy. METHODS: Two reviewers independently determined all prospective cohort study, retrospective cohort study, large population based cohort study, retrospective secondary analysis, and double blinded, placebo-controlled, randomized clinical trial published using PubMed Medline database, KERIS (Korea Education and Research Information Service), Scopus, and the Cochrane Central Register of controlled trials comparing before conception throughout pregnancy intake oral multivitamin containing folic acid or folic acid alone. Meta-analyses were estimated with odds ratios and 95% confidence intervals (CIs) using random effect analysis according to heterogeneity of studies. RESULTS: Data from six effect sizes from six studies involving 201,661 patients were enrolled. These meta-analyses showed multivitamin containing folic acid or folic acid alone was not significantly effective in reducing gestational hypertension or preeclampsia incidence (odds ratio, 0.91; 95% CI, 0.81 to 1.03) than the placebo. And the difference of effective sizes of preeclampsia and gestational hypertension according to two dependent variables, multivitamin and folic acid were not significant, respectively (point estimate, 0.66; 95% CI, 0.46 to 0.96). CONCLUSION: These meta-analyses demonstrate multivitamin containing folic acid or folic acid alone was not significantly effective in reducing gestational hypertension or preeclampsia incidence.
Cohort Studies ; Education ; Female ; Fertilization ; Folic Acid* ; Humans ; Hypertension, Pregnancy-Induced* ; Incidence ; Odds Ratio ; Population Characteristics ; Pre-Eclampsia* ; Pregnancy* ; Prospective Studies ; Retrospective Studies