Analysis of Erroneous Overestimation of Blood Glucose in Patients on Continuous Ambulatory Peritoneal Dialysis with Icodextrin / 대한신장학회잡지

PURPOSE: Icodextrin in peritoneal cavity is absorbed via the lymphatics to the blood and metabolized to maltose and maltriose which may interfere with correct measurement of glucose. In an attempt to evaluate the effects of icodextrin on the erroneous results of blood glucose, we measured blood glucose by different methods. METHODS: Peripheral capillary blood and venous blood were obtained from 12 patients using icodextrin and from 12 patients not using icodextrin. Venous blood glucose was measured by using the laboratory technique (glucose oxidase method), and capillary blood glucose was measured by using a Surestep (glucose oxidase method) and an Acucheck (GDH-PQQ method). To estimate icodextrin and its metabolites indirectly, we calculated osmolal gap. We measured blood icodextrin and its metabolites with amyloglucosidase in icodextrin group. RESULTS: In icodextrin group, glucose was overestimated in the results of the GDH-PQQ method (delta= GDH-GOD=56.2+/-30 mg/dL [vein] 58+/-32 mg/dL [capillary]), but in the control group, there were no significant differences in the results between the glucose oxidase method and the GDH-PQQ method. There was a correlation between the osmolal gap and the differences in the results (delta=GDH-GOD) (r=0.741, p=.006 [vein], r=0.671, p=.017 [capillary]). Blood icodextrin and its metabolites were related with the differences in the results (delta=GDH-GOD) (p=.026, r=0.635), but there was no significant correlation between the osmolal gap and the icodextrin and its metabolites (p=0.086, r=0.515). CONCLUSION: Icodextrin and its metabolites may lead to erroneously high blood glucose levels when measured by GDH-PQQ method. It is necessary to be aware of this factor in order to prevent overlooking dangerous hypoglycemia.

Taxonomic Studies on the Genus Crepidotus in Korea

For investigation of the species diversity of the Genus Crepidotus in Korea and constructing a key to Korean Crepidotus species, a total of 65 specimens, collected from 18 locations from 1982 to 2002, were observed for morphological characters of carpophores and other features. All the specimens have been preserved in the herbarium of the National Institute of Agricultural Sciences and Technology, R.D.A., Suwon, Korea. The specimens were identified according to the classification systems given by Hesler and Smith(1965), Nordstein(1990), Orton(1960), Pilat(1948), Senn-Irlet(1991, 1992, 1993) and Singer(1951, 1973, 1986). In this study, a total of 10 Crepidotus species were confirmed. Among them, Korean common names were designated to six unrecorded species as follows: C. uber; C. hygrophanus; C. latifolius; C. obscurus; C. subverrucisporus; and C. circinatus. A key to 10 Crepidotus species has been constructed.