Total and ionized serum magnesium and calcium levels during magnesium sulfate administration for preterm labor

OBJECTIVE: This study aimed to estimate the association between total and ionized magnesium, and the changes in serum magnesium and calcium levels in patients with preterm labor during magnesium sulfate (MgSO4) administration. METHODS: The study population included 64 women who were candidates for intravenous MgSO4 treatment for preterm labor. Serial blood samples were taken and measured total magnesium (T-Mg), ionized magnesium (I-Mg), total calcium (T-Ca), and ionized calcium (I-Ca) levels every one-week interval (1st, 2nd, 3rd). RESULTS: There was no significant difference in T-Mg and I-Mg levels during MgSO4 administration (P>0.05). There was no significant difference in T-Ca and I-Ca levels during MgSO4 administration (P>0.05). Compared before and after administration of MgSO4, T-Mg and I-Mg levels and T-Ca levels were changed allow statistically significant (P 0.05). There was significant correlation between levels of I-Mg and T-Mg (I-Mg=0.395×T-Mg+0.144, P < 0.01). CONCLUSION: There were no significant differences in serum Mg and Ca levels during MgSO4 administration for preterm labor. Compared to the before and after administration of MgSO4, only I-Ca levels were not substantially changed. There are significant correlations between I-Mg and T-Mg levels during administration of MgSO4 and I-Mg level seemed to have more correlation with adverse effect than T-Mg.

Oxidative Stress Markers in the Venous Plasma of Women with Preterm Labor and Preterm Premature Rupture of Membranes / 대한주산의학회잡지

PURPOSE: This study was performed to investigate the oxidation and antioxidation capacity in the maternal venous plasma of preterm labor with intact membranes, and premature rupture of membranes (PPROM), and also to evaluate their roles in the pathophysiology of PPROM. METHODS: Seventy five women in the following categories had venous blood retrieved: (1) Group A, normal pregnancy (n=24). (2) Group B, preterm labor with intact membranes (n=25). (3) Group C, preterm premature rupture of membranes (n=26). Malondialdehyde (MDA) levels as a marker of lipid peroxidation by thiobarbituric acid reaction, protein carbonyl content by 2,4-dinitrophenylhydrazine reaction, and total antioxidant capacity by oxygen radical absorbance capacity assay (ORAC) were measured. Mann-Whitney U test, Kruskal-Wallis test were used for statistical analysis. RESULTS: Lipid peroxide levels in the venous plasma of group B and C were significantly higher than those of group A (group B: 4.59+/-0.30, group C: 5.40+/-0.22 vs. group A: 3.90+/-0.26 nmol/mg protein, P<0.05). Lipid peroxide levels in the venous plasma of group C were significantly higher than those of group B (P<0.05). Protein carbonyl levels in the venous plasma of group C were significantly higher than those of group A (group C: 5.68+/-0.42 vs. group A: 5.43+/-0.41 nmol/mg protein, P<0.05). There was no significant difference of protein carbonyl levels in the venous plasma between group A and B. ORAC levels in the venous plasma of group B and C were significantly lower than those of group A (group B: 117.90+/-0.48, group C: 111.68+/-1.23 vs. group A: 119.14+/-1.12 mM/mL, P<0.05). ORAC levels in the venous plasma of group C were significantly lower than those of group B (P<0.05). CONCLUSION: In the blood of the women with preterm premature rupture of membranes, the lipid peroxidation was increased and the antioxidant capacity was decreased compared to women with normal pregnancy and preterm labor with intact membranes. These results suggest that oxidative stress was increased in preterm premature rupture of membranes.

Comparison of oxidative stress markers in umbilical cord blood after vaginal and cesarean delivery

OBJECTIVE: The purpose of our study was to investigate the effect of the mode of delivery on the oxidant and antioxidant system in umbilical cord blood. METHODS: We performed gas analysis of umbilical venous blood and umbilical arterial blood immediately after delivery in 38 women; eighteen women had a vaginal delivery while 20 women delivered via cesarean section at over 37 weeks gestation. We examined lipid peroxide concentration by thiobarbituric acid reaction, protein carbonyl content by 2,4-dinitrophenylhydrazine reaction, and total antioxidant capacity by oxygen radical absorbance capacity assay. RESULTS: Lipid peroxide levels in umbilical venous blood were significantly higher in patients delivering by planned cesarean section (1.81 +/- 0.06 nmol/mg protein) than those with vaginal delivery (1.24 +/- 0.05 nmol/mg protein) (P < 0.05). Antioxidant capacity in umbilical venous blood was significantly higher in patients delivering by planned cesarean section (119.70 +/- 0.13 microM/microL) than those with a vaginal delivery (118.70 +/- 0.29 microM/microL) (P < 0.05). There was no significant difference in the carbonyl content of umbilical venous blood or in the lipid peroxide, carbonyl content, and total antioxidant capacity of umbilical arterial blood. CONCLUSION: Lipid peroxidation levels and antioxidant capacity in umbilical venous blood were higher in patients delivering by planned cesarean section than those with a vaginal delivery. Therefore, we propose that both the mother and neonate are exposed to higher oxidative stress during cesarean section delivery.

Effect of Interventions by Using Checklist for the Management of Steam Sterilizers and Sterilized Items in Out-patient Clinics and Clinical Laboratories / 병원감염관리

BACKGROUND: This study was performed to evaluate the results of intervention activities on the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories. METHODS: A checklist was developed and used to monitor and evaluate the adequacy of sterilizers and sterilized items at out-patient clinics and clinical laboratories in a tertiary-care hospital. The checklist consisted of 7 items: condition of the material used for packaging sterile items, maintenance of shelf-life records, sterilizer cleanliness, maintenance of expiry date details of sterilized items, sterilization conditions, use of chemical indicators, and the results of biological indicators. Monitoring and additional intervention activities were carried out once every week for 53 weeks from August 2007 to July 2008. The study period was divided into 2 terms, early and late intervention; the duration of each term was 6 months, and we compared the ratio of adequacy of management of sterilizer and sterilized items between the 2 terms. RESULTS: There were a total of 795 observations from 15 departments in 1 year. Sterility of the materials used for packaging increased from 87.4% in the first 6-month term to 97.9% in the second 6-month term. Records for shelf-life increased from 89.6% to 98.5% in the same period, while the figures for maintaining expiry date details of sterilized items and for steam sterilizer cleanliness increased from 92.6% to 99.2%, and from 91.9% to 98.5 (P<0.05), respectively. CONCLUSION: Our intensive checklist-based intervention was effective in improving the management of steam sterilizers and sterile items in out-patient clinics and clinical laboratories.

Are Food Constituents Relevant to the Irritable Bowel Syndrome in Young Adults?: A Rome III Based Prevalence Study of the Korean Medical Students

BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is prevalent in general population. This study investigates the prevalence of IBS in medical college students in Korea as well as the influence of dietary habits and nutritional intake on IBS. METHODS: This study is a cross-sectional study of 319 students (239 males and 80 females, age 22.3 +/- 2.5 years) from the 6 grade levels of the Medical College in Korea. All students filled out a self-reported questionnaire for ROME III criteria. They also completed a questionnaire to validate dietary habits and food frequency in Korean. RESULTS: The overall prevalence of IBS was 29.2% without correlation to age, body mass index and grade level in Medical School. However, the prevalence was significantly higher in females than males (33/80 vs 60/239, P = 0.007). There were no significant differences between the IBS-group and the non-IBS group in aspect of nutrition. Not only the diet habits, but also the daily nutritional intake, and even the breakdown into the 12 micronutrients, yielded no significant differences between the 2 groups. CONCLUSIONS: Twenty-nine percent of the medical college students have IBS with a greater prevalence in females. The dietary habits and nutritional intake of the students might not be associated with IBS.

A Case of Amyotrophic Lateral Sclerosis Presented as Oropharyngeal Dysphagia

Amyotrophic lateral sclerosis is a rare disease. It is a fatal neurodegenerative disease characterized by progressive muscular paralysis reflecting degeneration of motor neurons which leads to muscle weakness and muscle wasting. Respiratory failure limits survival to 2-5 years after disease onset. Several clinical manifestations including dysphagia can result in reductions in both the quality of life and life expectancy. Dysphagia occurs at onset in about one third of case, although generally it occurs in later stage of the disease. Evaluation of dysphagia includes video-fluoroscopic swallow study, radiological esophagogram, flexible endoscopic examination, ultrasound examination, conventional manometry and electromyography. We report a case of amyotrophic lateral sclerosis in a 54-year-old man presenting oropharyngeal dysphagia which was diagnosed by high resolution esophageal manometry presenting abnormality of the upper esophageal sphincter.

Association of P-Wave Dispersion With Paroxysmal Atrial Fibrillation in Patients With Acute Anterior Wall ST Segment Elevation Myocardial Infarction

BACKGROUND AND OBJECTIVES: P-wave dispersion (PWD) is a well-known electrophysiologic parameter of atria which are prone to fibrillation. Although paroxysmal atrial fibrillation (PAF) following an acute myocardial infarction (AMI) is not uncommon, the relationship between PWD and PAF following AMI has not been determined. SUBJECTS AND METHODS: We reviewed the electrocardiograms, recorded on admission and every day during hospitalization, of 144 patients with primary anterior AMIs and measured the P-wave duration. The left atrial diameter and left ventricular ejection fraction (LVEF) were evaluated by echocardiography. RESULTS: PAF occurred in 20 patients. The maximum P-wave duration and PWD were found to be significantly higher in patients with PAF than those without PAF (120.1+/-8.6 vs. 109.2+/-12.2 ms, p<0.001; and 68.5+/-11.9 vs. 48.7+/-9.6 ms, p<0.001, respectively). The minimum P-wave duration was significantly lower in patients with PAF than in patients without PAF (51.6+/-13.3 vs. 60.4+/-11.7 ms, respectively, p=0.003). There was no significant difference in the left atrial diameter between patients with PAF and patients without PAF (37.3+/-4.4 vs. 36.8+/-5.1 mm, respectively p=0.652); however, the LVEF was significantly different in the patients who developed PAF compared to those who did not develop PAF (38.5+/-11.4 vs. 45.1+/-8.7%, respectively, p=0.003). CONCLUSION: The maximum P-wave duration and PWD were significant predictive factors of PAF in patients with anterior wall ST elevation AMI based on univariate analysis. On the basis of multivariate analysis, age was an independent predictive parameter for PAF as well.

Hemoclipped Dieulafoy's Lesion in Giant Diverticulum in the 3rd Portion of Duodenum / 대한소화기내시경학회지

A duodenal diverticulum is common in the second portion of the duodenum and can occur at any age. An obstruction, bleeding, perforation, diverticulitis are not an uncommon complicationa of duodenal diverticulum. As a rare complication, bleeding in the duodenal diverticulum may be massive, and duodenal diverticulum is resected primarily as a result of the difficulty in determining the site of bleeding. However, there has been a recent increase in endoscopic diagnosis and the treatment of diverticular bleeding. Band ligation increases the risk of duodenal diverticular perforation because of the thin diverticular wall. An endoscopic hemoclip is a preferable method for endoscopic sclerotherapy. We report a 48- year-old man with a giant duodenal diverticulum that was treated with a hemoclip. The duodenal diverticular perforation was treated effectively with supportive care.