ABSTRACT
OBJECTIVE: The purpose of this study was to compare the National Diabetes Data Group (NDDG) with the American Diabetes Association (ADA) criteria proposed by Carpenter and Coustan for determining gestational diabetes using the 100 gm oral glucose tolerance test (GTT) in Korean women. METHODS: Seventeen-hundred pregnant women who underwent a 50 g oral GTT and delivered in the department of Ob/Gyn, Hanyang Univ Guri Hospital, between March, 1999 and February, 2004 were the subjects of this study. The women were categorized into A through D groups as follows: euglycemic control subjects (A), subjects with non gestational diabetes diagnosed by the NDDG and ADA criteria (B), subjects with gestational diabetes diagnosed by only the ADA criteria but not the NDDG criteria (C) and subjects with gestational diabetes diagnosed by only the NDDG criteria (D). The general characteristic and pregnancy outcomes were compared for each groups. The effectiveness of the ADA criteria was determinined by macrosomia and preeclampsia after controlling for confounding risk factors by logistic regression modeling. RESULTS: Of the 1700 pregnant women, 1420 women were classified in group A, 184 women were in group B, 28 women were in group C and 68 women were in group D. The group D showed more obese and less gestational weeks at delivery than the other groups. In pregnancy outcomes, groups B, C, and D showed more weighted average birth weight and higher frequency of macrosomia of the fetus than in group A. No differences existed among the 4 groups regarding intrauterine growth restriction, preeclampsia, and cesarean section. The risk factors of macrosomia were groups B, C, and D that shows glucose intolerance, obesity and more higher weight gain during pregnancy. Even after controlling for confounding risk factors by logistic regression modeling, groups B, C, and D were risk factors for macrosomia. Especially, the odds ratio for group C has shown a higher risk factor at 7.6 as compared to group D at 5.3. Glucose intolerance was not shown to be a risk factor of preeclampsia. CONCLUSION: Because glucose intolerance as shown in abnormal 50 g oral GTT is a risk factor for macrosomia and more weighted average birth weight of the fetus in Korean women, the diagnostic standards for Korean women are more suited to the ADA criteria compared to the NDDG criteria.
Subject(s)
Female , Humans , Pregnancy , Birth Weight , Cesarean Section , Diabetes, Gestational , Fetus , Glucose Intolerance , Glucose Tolerance Test , Logistic Models , Obesity , Odds Ratio , Pre-Eclampsia , Pregnancy Outcome , Pregnant Women , Risk Factors , Weight GainABSTRACT
Proliferative glomerulonephritis with monoclonal IgG deposits is a novel disease entity characterized by (1) glomerular monoclonal IgG deposits restricted to a single IgG subclass and a single light chain isotype, associated with proliferative GN; (2) granular deposits by EM; (3) no clinical and laboratory evidence of cryglobulinemia. A 47-year-old male presented with edema and muscle cramps. Urinalysis revealed protein 3+ and 5-9 RBC's/HPF. BUN/Cr were 25/1.7 mg/dL, 24 hour urine protein 5.4 g/day, and CCr 56.3 mL/min/1.73m2. Cryglobulin was negative. The histologic findings of the renal biopsy showed mesangial cell proliferation with double contour of GBM on LM, diffuse finely granular electron-dense deposit in subendothelial & mesangial area with no amyloid fibril on EM, and strong immune reactivity to IgG and kappa light chain along the glomerular basement membrane on IF. Serum and urine protein EP, IEP and immunofixation EP showed no evidence of monoclonal gammopathy. Bone marrow aspiration & biopsy were negative for plasma cell infiltration. The patient is on supportive management with an AII blocking agent.
Subject(s)
Humans , Male , Middle Aged , Amyloid , Biopsy , Bone Marrow , Edema , Glomerular Basement Membrane , Glomerulonephritis , Immunoglobulin G , Mesangial Cells , Muscle Cramp , Paraproteinemias , Plasma Cells , UrinalysisABSTRACT
Dicamba is 3, 6-dichloro-2-methoxybenzoic acid and classified as a chemically related chlorophenoxy herbicide. This herbicide has been widely used for control of broad-leaved weeds. The poisoning is uncommon and of low toxicity, but massive self-ingestion may be fatal. We experienced a case of dicamba poisoning with rhabdomyolysis and acute renal failure in a 53-year-old male. This patient showed vomiting, confused mental status, and myotonia. Electrolyte abnormalities, rhabdomyolysis, and acute renal failure also developed together with fever, hepatotoxicity, pancreatic toxicity, hematologic abnormalities and cardiac ischemia. He was treated by 7 sessions of hemodialysis with supportive treatment and recovered.
Subject(s)
Humans , Male , Middle Aged , Acute Kidney Injury , Dicamba , Fever , Ischemia , Myotonia , Poisoning , Renal Dialysis , Rhabdomyolysis , VomitingABSTRACT
Milk-Alkali syndrome can be caused by ingesting large amount of calcium and absorbable alkali. Coincident with promotion of calcium therapy for the treatment of osteoporosis in postmenopausal women and secondary hyperparathyroidism in patients with chronic renal failure, the Milk-Alkali syndrome is now a common cause of hypercalcemia. We experienced a case of a woman who had took calcium for hypoparathyroidism after thyroidectomy (and incidental parathyroidectomy) for thyroid papillary adenocarcinoma. Recently she ingested unusually large amount of calcium (10.8 g/day) for a week mistakenly. She presented voiding difficulty, anorexia and irritability with the triad of hypercalcemia, metabolic alkalosis and acute renal failure. All the metabolic abnormalities were normalized and renal function was improved with fluid and diuretic therapies.
Subject(s)
Female , Humans , Acute Kidney Injury , Adenocarcinoma, Papillary , Alkalies , Alkalosis , Anorexia , Calcium Carbonate , Calcium , Hypercalcemia , Hyperparathyroidism, Secondary , Hypoparathyroidism , Kidney Failure, Chronic , Osteoporosis , Thyroid Gland , ThyroidectomyABSTRACT
Ovarian mucinous cystadenoma of borderline malignancy was consisted of intestinal mucinous cystadenomas of borderline malignancy and Mullerian mucinous papillary borderline tumors. Mullerian mucinous papillary tumors was lined by mucinous epithelium of endocervical type and characterized by papillae architecturally similar to those of serous borderline tumors. These tumors have clinical and pathologic differences from those of intestinal mucinous cystadenomas of borderline malignancy.We report a case of ovarian Mullerian mucinous papillary cystadenomas of borderline malignancy with review of literature.
Subject(s)
Female , Cystadenoma, Mucinous , Cystadenoma, Papillary , Epithelium , Mucins , OvaryABSTRACT
367 patients with hypertensive intracranial hemorrhage, admitted to Masan Koryo neurosurgical department from Jan. 1988 to Dec. 1991, have been clinically analyzed. The results were as follows: 1) The group consisted of 176 males and 191 females. The peak age of the patients was at their 6th decade. Seasonal distribution of the incidence was peaked at spring and autumn. 2) 51.0% of these hemorrhage was located in putamen, 19.9% in thalamus, 12.5% in subcortex, 8.7% in cerebellum and 7.9% in brain stem. Patients with brain stem hemorrhage showed relatively poor prognosis compared with subcortex or cerebellar hemorrhage. 3) The level of consciousness at admission has significant relation to prognosis especially in non-operative group. 4) 130 patients underwent surgical treatment. In delayed operation group which was performed after at least 3 days from attack, good prognosis was obtained. 5) In 146 patients(39.8%), IVH was accompanied, which lead to poor prognosis. Especially in patients with thalamic hemorrhage, the incidence of IVH reached to 71.2%. 6) Overall outcome of 367 patients was good in 40.9%, and poor in 25.9%. Total motality rate was 33.2%.
Subject(s)
Female , Humans , Male , Brain Stem , Cerebellum , Consciousness , Hemorrhage , Incidence , Intracranial Hemorrhage, Hypertensive , Prognosis , Putamen , Seasons , ThalamusABSTRACT
367 patients with hypertensive intracranial hemorrhage, admitted to Masan Koryo neurosurgical department from Jan. 1988 to Dec. 1991, have been clinically analyzed. The results were as follows: 1) The group consisted of 176 males and 191 females. The peak age of the patients was at their 6th decade. Seasonal distribution of the incidence was peaked at spring and autumn. 2) 51.0% of these hemorrhage was located in putamen, 19.9% in thalamus, 12.5% in subcortex, 8.7% in cerebellum and 7.9% in brain stem. Patients with brain stem hemorrhage showed relatively poor prognosis compared with subcortex or cerebellar hemorrhage. 3) The level of consciousness at admission has significant relation to prognosis especially in non-operative group. 4) 130 patients underwent surgical treatment. In delayed operation group which was performed after at least 3 days from attack, good prognosis was obtained. 5) In 146 patients(39.8%), IVH was accompanied, which lead to poor prognosis. Especially in patients with thalamic hemorrhage, the incidence of IVH reached to 71.2%. 6) Overall outcome of 367 patients was good in 40.9%, and poor in 25.9%. Total motality rate was 33.2%.
Subject(s)
Female , Humans , Male , Brain Stem , Cerebellum , Consciousness , Hemorrhage , Incidence , Intracranial Hemorrhage, Hypertensive , Prognosis , Putamen , Seasons , ThalamusABSTRACT
A case of extracerebral cavernous hemangioma located within the middle cranial fossa and involving superior petrosal sinus is described in a 58-year-old woman presented with left ocular pain and severe headache. We treated her with operation under the preoperative impression of meningioma which was removed totally. Postoperative pathologic diagnosis was a cavernous hemangioma.