OBJECTIVE: To evaluate the effect of sonication, repeated freeze-thaw cycles, calcium salt solution and their combination on the content of related growth factors (GFs) released by platelet rich plasma (PRP). METHODS: Twenty PRPs from healthy blood donors were divided into 9 groups, including sonication group, freeze-thaw group, calcium gluconate group, calcium chloride group, sonication + calcium gluconate group, sonication + calcium chloride group, freeze-thaw + calcium gluconate group, freeze-thaw + calcium chloride group, and sonication + freeze-thaw group. After PRP activated by above 9 methods, the content of transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), and platelet-derived growth factor-BB (PDGF-BB) were detected by ELISA. RESULTS: The platelet concentration of the samples was (966.7±202.6)×10⁹/L. The content of TGF-β1 in sonication + freeze-thaw group was the highest, while the lowest was in freeze-thaw group. The content of VEGF in freeze-thaw + calcium chloride group was the highest, while the lowest was in calcium gluconate group. The content of PDGF-BB in sonication + freeze-thaw group was the highest, while the lowest was in calcium gluconate group. There was no significant differences in the three GFs between calcium gluconate group and calcium chloride group. CONCLUSION Among the 9 activated methods of PRP, there is no difference between two calcium salt solutions. And the combination of repeated freeze-thaw cycles and sonication may be the best treatment method to promote PRP to release GFs, while calcium gluconate is the weakest way.
Humans ; Transforming Growth Factor beta1 ; Vascular Endothelial Growth Factor A ; Calcium Gluconate ; Calcium ; Calcium Chloride ; Becaplermin ; Platelet-Rich Plasma

Hydrofluoric acid is a highly dangerous and toxic inorganic acid, which is widely used in industrial fields and daily life. The risk of hydrofluoric acid burns is related to hydrofluoric acid mass fraction, duration of exposure to hydrofluoric acid, burn area, burn depth, and burn site, etc. Hydrofluoric acid has strong toxicity and tissue penetration ability. A small area of hydrofluoric acid burns can cause death in a short time. Therefore, improving the understanding of the mechanism of hydrofluoric acid burns and learning how to treat hydrofluoric acid burns in different sites can further improve the cure rate of hydrofluoric acid burns.
Burns, Chemical/therapy* ; Calcium Gluconate ; Humans ; Hydrofluoric Acid/adverse effects*

Dioscorea tokoro has long been used in Korean traditional medicine as a pain killer and anti-inflammatory agent. A 53-year-old male who consumed water that had been boiled with raw tubers of D. tokoro as tea presented with numbness and spasm of both hands and feet. Laboratory results showed hypocalcemia, hypoparathyroidism, and vitamin D insufficiency. During his hospital stay, colitis, acute kidney injury, and toxic encephalopathy developed. The patient received calcium gluconate intravenous infusion and oral calcium carbonate with alfacalcidol. His symptoms improved gradually, but hypocalcemia persisted despite the calcium supplementation. We suggest that ingestion of inappropriately prepared D. tokoro can cause symptomatic hypocalcemia in patients with unbalanced calcium homeostasis.
Acute Kidney Injury ; Calcium ; Calcium Carbonate ; Calcium Gluconate ; Colitis ; Dioscorea ; Eating ; Foot ; Hand ; Homeostasis ; Humans ; Hypesthesia ; Hypocalcemia ; Hypoparathyroidism ; Infusions, Intravenous ; Length of Stay ; Male ; Medicine, Korean Traditional ; Middle Aged ; Neurotoxicity Syndromes ; Spasm ; Tea ; Vitamin D ; Water

Iatrogenic calcinosis cutis is due to the intravenous administration of calcium gluconate or calcium chloride to treat hypocalcemia. The arthors report three cases of calcinosis cutis with calcifications involving the upper or lower extremities in neonates following the extravasation of calcium gluconate. Three neonates, a 2-week-old girl, 4-week-old boy, and a 4-week-old girl, were consulted for indurated nodules after the intravenous administration of calcium gluconate at the intensive care unit. Complete remission of palpable nodule and calcification was observed on the radiograph at three weeks, four weeks and six months after the initial presentation in each. All three neonates with iatrogenic calcinosis curtis were resolved spontaneously without functional and cosmetic complications. According to enhancement of the patient's cognition about benign disease, a suitable explanation of the disease and avoiding unnecessary treatment through an early diagnosis of iatrogenic calcinosis cutis will reduce a number of potential medical malpractice disputes.
Administration, Intravenous ; Calcinosis ; Calcium Chloride ; Calcium Gluconate ; Calcium ; Cognition ; Dissent and Disputes ; Early Diagnosis ; Female ; Humans ; Hypocalcemia ; Infant, Newborn ; Intensive Care Units ; Lower Extremity ; Male ; Malpractice

Suicide through naphthalene poisoning is rare. Prolonged hemolytic anemia and hemoglobinuria are typical symptoms of naphthalene poisoning. We report an unusual case of naphthalene poisoning. The decedent was an 87-year-old female who intentionally ingested over 5 g of naphthalene. After more than 5 hours, she was found in a drowsy state. During initial examination, hemoglobin level and urine test results were normal. Aspartate aminotransferase and alanine aminotransferase levels were elevated (854 and 1,197 U/L, respectively). Metabolic acidosis was found on arterial blood gas analysis. The patient was treated conservatively by administration of activated charcoal, calcium gluconate, insulin, and glucose. However, the patient died after 1 day of hospital admission. On autopsy, the liver showed toxic hepatitis with confluent necrosis. Naphthalene concentrations in the blood and gastric contents were 5.4 and 5.8 mg/L, respectively. In conclusion, the decedent ingested naphthalene and died due to liver failure without hemolysis.
Acidosis ; Aged, 80 and over ; Alanine Transaminase ; Anemia, Hemolytic ; Aspartate Aminotransferases ; Autopsy* ; Blood Gas Analysis ; Calcium Gluconate ; Charcoal ; Drug-Induced Liver Injury* ; Female ; Glucose ; Hemoglobinuria ; Hemolysis ; Humans ; Insulin ; Intention ; Liver ; Liver Failure ; Naphthalenes ; Necrosis ; Poisoning* ; Suicide

PURPOSE: To review clinical symptoms, laboratory findings, and treatment of transient neonatal hypocalcemia. METHODS: Medical records of full-term (gestational age ≥37 weeks) neonates diagnosed with hypocalcemia, aged <31 days, were investigated retrospectively. Using a cut-off of 3 days after birth, cases of neonatal hypocalcemia were classified as early or late. Hypocalcemia was defined as ionized calcium level <4 mg/dL or serum calcium level <7.5 mg/dL. Hyperphosphatemia was defined as serum phosphate level >8 mg/dL. Relative hypoparathyroidism was defined as hypocalcemia and hyperphosphatemia with parathyroid hormone level within the normal range (10–65 pg/mL). RESULTS: Of 68 included neonates, 62 were diagnosed with hypoparathyroidism with hypocalcemia and hyperphosphatemia, and 26 had seizures. Mean serum calcium level of the seizure group was 5.99 mg/dL, which was significantly lower than that of the non-seizure group (6.46 mg/dL, P=0.012). The recovery duration for calcium and phosphate levels was long, at 5.8 and 10.7 days, respectively. The calcium level recovery duration was significantly different between the seizure and non-seizure groups (P=0.034), but the phosphate level recovery period was not significantly different (P=0.194). Of 17 patients with diarrhea, 10 had confirmed rotavirus infection. Most patients with hypocalcemia responded well to oral calcium lactate and intravenous calcium gluconate, and the treatments could be discontinued after a certain period. CONCLUSION: Transient neonatal hypocalcemia is associated with hypoparathyroidism. The major symptom in late neonatal hypocalcemia was the occurrence of seizures. Serum calcium level was lower and the recovery period was longer in the seizure group, but most cases exhibited favorable progress.
Calcium ; Calcium Gluconate ; Diarrhea ; Humans ; Hyperphosphatemia ; Hypocalcemia* ; Hypoparathyroidism ; Infant, Newborn* ; Lactic Acid ; Medical Records ; Parathyroid Hormone ; Parturition ; Reference Values ; Retrospective Studies ; Rotavirus Infections ; Seizures

No abstract available.
Burns* ; Calcium Gluconate* ; Calcium* ; Hydrofluoric Acid* ; Injections, Subcutaneous*

No abstract available.
Burns* ; Calcium Gluconate* ; Calcium* ; Hydrofluoric Acid* ; Injections, Subcutaneous*

BACKGROUND/AIMS: To prevent hypocalcemia after parathyroidectomy (PTX), parenteral calcium is required in addition to oral calcitriol and calcium. After switching to oral calcium, patients can be discharged from the hospital. The aim of this study was to analyze the clinical characteristics and outcomes of PTX performed at a single Korean center and to investigate the associated laboratory factors used to analyze the total amount of postoperative calcium required. METHODS: We enrolled 91 hemodialysis patients undergoing PTX from November 2003 to December 2011. We collected clinical and laboratory data preoperatively, 12 and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively. RESULTS: In total, 59 patients underwent PTX with autotransplantation (AT), 6 underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent limited PTX. Total PTX without AT showed the lowest recurrence rate. At all postoperative time points, the mean levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) decreased significantly, compared with preoperative levels; however, alkaline phosphatase (ALP) increased significantly from 48 hours postoperatively to discharge (p < 0.001). On multiple linear regression analysis, the total amount of injected calcium during hospitalization showed a significant correlation with preoperative ALP (p < 0.001), preoperative iPTH (p = 0.037), and Deltaphosphorus at 48 hours (p < 0.001). We developed an equation for estimating the total calcium requirement after PTX. CONCLUSIONS: Preoperative ALP, preoperative iPTH, and Deltaphosphorus at 48 hours may be significant factors in estimating the postoperative calcium requirement. The formula for postoperative calcium requirement after PTX may help to predict the duration of postoperative hospitalization.
Administration, Intravenous ; Administration, Oral ; Adult ; Aged ; Biomarkers/blood ; Calcium/blood ; Calcium Carbonate/*administration & dosage ; Calcium Compounds/*administration & dosage ; Calcium Gluconate/*administration & dosage ; *Decision Support Techniques ; *Dietary Supplements ; Female ; Humans ; Hyperparathyroidism, Secondary/blood/diagnosis/*surgery ; Hypocalcemia/diagnosis/etiology/*prevention & control ; Lactates/*administration & dosage ; Linear Models ; Male ; Middle Aged ; Models, Biological ; Multivariate Analysis ; Parathyroid Hormone/blood ; Parathyroidectomy/*adverse effects ; Phosphorus/blood ; Recurrence ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult

Amlodipine, a calcium channel blocker of the dihydropyridine group, is commonly used in management of hypertension, angina, and myocardial infarction. Amlodipine overdose, characterized by severe hypotension, arrythmias, and pulmonary edema, has seldom been reported in Korean literature. We report on a fatal case of amlodipine intoxication with complications including rhabdomyolysis and oliguric acute kidney injury. A 70-year-old woman with a medical history of hypertension was presented at the author's hospital 6 hours after ingestion of 50 amlodipine (norvasc) tablets (total dosage 250 mg) in an attempted suicide. Her laboratory tests showed a serum creatinine level of 2.5 mg/dL, with elevated serum creatine phosphokinase and myoglobin. The patient was initially treated with fluids, alkali, calcium gluconate, glucagon, and vasopressors without a hemodynamic effect. High-dose insulin therapy was also started with a bolus injection of regular insulin (RI), followed by continuous infusion of RI and 50% dextrose with water. Despite intensive treatment including insulin therapy, inotropics, mechanical ventilation, and continuous venovenous hemodiafiltration, the patient died of refractory shock and cardiac arrest with no signs of renal recovery 116 hours after her hospital admission.
Acute Kidney Injury* ; Aged ; Alkalies ; Amlodipine* ; Arrhythmias, Cardiac ; Calcium Channels ; Calcium Gluconate ; Creatine Kinase ; Creatinine ; Eating ; Female ; Glucagon ; Glucose ; Heart Arrest ; Hemodiafiltration ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Insulin ; Myocardial Infarction ; Myoglobin ; Pulmonary Edema ; Respiration, Artificial ; Rhabdomyolysis* ; Shock ; Suicide, Attempted ; Tablets ; Water