• Title/Summary/Keyword: Hypocalcemia

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Assessment of Nutritional Status and Survey of Dietary Habits in Predialysis Patients of Chronic Renal Failure (투석전 만성신부전 환자의 영양상태 평가 및 식습관 조사)

  • 노숙령;최윤정
    • Journal of the East Asian Society of Dietary Life
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    • v.13 no.5
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    • pp.408-424
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    • 2003
  • The purpose of this study was to analyze the nutritional status and dietary habits in predialysis patients of chronic renal failure(CRF). The patients group was composed of total 35 persons with chronic renal failure(diabetes exclusion), male 20, female 15 who were treated in the kidney internal department and the control group also composed of 35 persons, male 18, female 17 who were classified as normal by the medical examination. Their dietary habits, nutritional status and nutritional knowledge were investigated from two general hospitals in Inchon, middle of this year 2002. There were 31.4% of low weight patients (BMI below 20), 77.1% of anemia patients (serum hemoglobin below 12g/㎗), 6S.6% of hypertension patients with diastolic blood pressure over 90mmHg, 80% with systolic blood pressure over 140mmHg, 20% of hypercholesterolemia patients (serum cholesterol over 230mg/㎗), and 22.9% of hyperlipemia patients (serum triglyceride over 200mg/㎗). The cardiovascular disease seemed to be caused by the abnormality of lipid metabolism. The possibility of the bone disease was shown from patients of hyperphosphatemia (serum phosphorus over 4.7mg/㎗, 22.9%) and hypocalcemia (serum calcium below 8.4mg/㎗, 25.7%). Intake of insufficient calories which was caused by the lack of appetite affected on the nutritional status. The intake of most nutrients was not significantly different from the RDA for Koreans. Consequently, the patient groups took a lot of salt even after the diagnosis of CRF. But patients ate 6.lg of salt which were more than the recommended amount 2∼4g for patients with CRF. The patient groups, who had the experiences of nutritional counselling, had significantly higher nutritional knowledge related to CRF than control group. Unfortunately, patients could not have enough chances for nutritional counselling by the nutritionist even though they needed the nutritional informations and dietetic treatments. The continuous research is expected with regard to the detail plan for the improvement of nutritional support and the nutritional counselling because it is important to decide the requirements of nutrients for patients with kidney disease, considering the kidney function and status of nutrition.

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The serum level of 25-hydroxyvitamin D for maximal suppression of parathyroid hormone in children: the relationship between 25-hydroxyvitamin D and parathyroid hormone

  • Kang, Jung In;Lee, Yoon Suk;Han, Ye Jin;Kong, Kyoung Ae;Kim, Hae Soon
    • Clinical and Experimental Pediatrics
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    • v.60 no.2
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    • pp.45-49
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    • 2017
  • Purpose: Serum level of 25-hydroxyvitamin D (25-OHD) is considered as the most appropriate marker of vitamin D status. However, only a few studies have investigated the relationship between 25-OHD and parathyroid hormone (PTH) in children. To this end, this study was aimed at evaluating the lowest 25-OHD level that suppresses the production of parathyroid hormone in children. Methods: A retrospective record review was performed for children aged 0.2 to 18 years (n=193; 106 boys and 87 girls) who underwent simultaneous measurements of serum 25-OHD and PTH levels between January 2010 and June 2014. Results: The inflection point of serum 25-OHD level for maximal suppression of PTH was at 18.0 ng/mL (95% confidence interval, 14.3-21.7 ng/mL). The median PTH level of the children with 25-OHD levels of <18.0 ng/mL was higher than that of children with 25-OHD levels ${\geq}$ 18.0 ng/mL (P<0.0001). The median calcium level of children with 25-OHD levels<18.0 ng/mL was lower than that of children with 25-OHD levels${\geq}18.0ng/mL$ (P=0.0001). The frequency of hyperparathyroidism was higher in the children with 25-OHD levels<18.0 ng/mL than in the children with 25-OHD levels${\geq}18.0ng/mL$ (P<0.0001). Hypocalcemia was more prevalent in the children with 25-OHD levels<18.0 ng/mL than in the children with 25-OHD levels${\geq}18.0ng/mL$ (P<0.0001). Conclusion: These data suggest that a vitamin D level of 18.0 ng/mL could be the criterion for 25-OHD deficiency in children at the inflection point of the maximal suppression of PTH.

Change of Blood Magnesium Level in Diabetes Patients Undergoing Off-pump Coronary Artery Bypass Grafting

  • Seo, Si-Young;Moon, Seong-Min;Hyun, Kyung-Yae;Kim, Chong-Rak;Choi, Seok-Cheol
    • Biomedical Science Letters
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    • v.15 no.3
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    • pp.207-215
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    • 2009
  • We carried out this study to investigate differences of physiological variables between patients with (DM group) and without type II diabetes mellitus (Non-DM group) undergoing off-pump coronary artery bypass grafting (OPCABG). Postoperative $Mg^{++}$ and $Ca^{++}$ levels were lower, whereas $Na^+$ level was higher in DM group than those in Non-DM group. ICU (intensive care unit) stay time in DM group was longer than that of Non-DM group. Postoperative platelet counts tended to decrease, whereas C-reactive protein (CRP) and cardiac troponin-I (cTNI) levels tended to increase in DM group compared with Non-DM group. Postoperative albumin level was lower, while blood urea nitrogen (BUN) and creatinine levels were greater in DM group than those in Non-DM group. DM group had higher incidence of post-operative arrhythmias than Non-DM group. These results reveal that type II DM patients undergoing OPCAB may have higher incidences of postoperative hypomagnesemia, hypocalcemia and arrhythmias, and increases of CRP, cTNI, BUN, and creatinine levels than in Non-DM patients undergoing OPCAB. The perioperative check and control (supplement) of $Mg^{++}$ levels should be considered in cardiovascular surgery combined with DM.

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Tetany in a 13-Year-Old Girl with Wilson's Disease (테타니가 발생한 윌슨병 1예)

  • Ra, Chae-Ik;Kim, Sang-Yong;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.1
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    • pp.86-90
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    • 2011
  • Wilson's disease is an autosomal recessive disorder of copper metabolism consequence of which leads to accumulation of copper in the liver, brain, cornea and other tissues. The manifestations are more likely to be hepatic in the early childhood and neurological in the adolescents. In addition, the abnormalities that develop during disease progression may result in other manifestations such as hematologic, endocrine, or renal findings. We report a thirteen year-old girl who manifested tetany shortly after the initial diagnosis of Wilson's disease. Despite aggressive calcium, magnesium and vitamin D replacement, the hypocalcemia and hypomagnesemia did not respond to the therapy promptly. It took more than three weeks for blood levels of the minerals to be normal. We concluded that tetany occurred in our patient because of hypoparathyroidism as a rare complication of Wilson disease, vitamin D deficiency resulting from various conditions, and inconclusive hypomagnesemia.

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma

  • Kang, Jin Gu;Kim, Young Ah;Choi, Jung Eun;Lee, Soo Jung;Kang, Su Hwan
    • Journal of Yeungnam Medical Science
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    • v.37 no.3
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    • pp.202-209
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    • 2020
  • Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC. Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed. Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different. Conclusion: Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

DiGeorge syndrome who developed lymphoproliferative mediastinal mass

  • Kim, Kyu Yeun;Hur, Ji Ae;Kim, Ki Hwan;Cha, Yoon Jin;Lee, Mi Jung;Kim, Dong Soo
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.108-111
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    • 2015
  • DiGeorge syndrome is an immunodeficient disease associated with abnormal development of 3rd and 4th pharyngeal pouches. As a hemizygous deletion of chromosome 22q11.2 occurs, various clinical phenotypes are shown with a broad spectrum. Conotruncal cardiac anomalies, hypoplastic thymus, and hypocalcemia are the classic triad of DiGeorge syndrome. As this syndrome is characterized by hypoplastic or aplastic thymus, there are missing thymic shadow on their plain chest x-ray. Immunodeficient patients are traditionally known to be at an increased risk for malignancy, especially lymphoma. We experienced a 7-year-old DiGeorge syndrome patient with mediastinal mass shadow on her plain chest x-ray. She visited Severance Children's Hospital hospital with recurrent pneumonia, and throughout her repeated chest x-ray, there was a mass like shadow on anterior mediastinal area. We did full evaluation including chest computed tomography, chest ultrasonography, and chest magnetic resonance imaging. To rule out malignancy, video assisted thoracoscopic surgery was done. Final diagnosis of the mass which was thought to be malignancy, was lymphoproliferative lesion.

The Study on Characteristic and the Actual Condition of General Infant Formula and Special Infant Formula Published in Nation (국내(國內) 시판중(市販中)인 일반조제분유와 특수분유의 특성(特性)과 실태연구(實態硏究))

  • Lee Seoung-Hee;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.13 no.2
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    • pp.41-77
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    • 1999
  • The purpose of this research is that infant artificial feeding products is used in clonic with the study on characteristic, ingredients and indication of geneal and special modified milks. The result is as follows. 1. The main ingredients of four company products-Maeil , Namyang, Pasteur, Aebout is similar but the functional is different 2. General infant formula is divided into 100days, 5-6months, 12months, 24months and 36months out of consideration for growth and development of infant. 3. The indication and sorts of the special infant formula used at a hospital is as follows. PKU-1, PKU-2 formula is available for phenylketonuria. MPA formula is available for propionic acidemia and methylmalonic acidomia. UCD is available for urea cycle disorder Leucine-free formula is available for isovaleric acidemia. Maeil LP is available for hypocalcemia. MCT formula is available for indigestion and malabsorption of fat. BCAA-free formula is available for Maple syrup urine disease. Protein-free formula is available for limit of protein uptake or mixture of peculiar amino acid or higher uptake of mineral, vitamin, calory. Methionine-free formula is available for homocystinuria and hypermethioninemia. Premature infant is available for premature and low birth weight. 4. The special infant formula published in nation is as follows. Maeil soy A, Maeil MF1, Namyang hope doctor and Maeil HA is available for diarrhea. Maeil HA, Maeil HA-21 and Namyang hope allergy is available for hypoallergy. Maeil soy A is available for diarrhea of milk allergy. Maeil MF1 or Namyang hope doctor is available for acute bacterial or viral temporal diarrhea. Maeil HA is available for allergic chronic diarrhea. Maeil HA and Namyang hope allergy as eHP-formula is available for chronic diarrhea for lactose intolerance and milk allergy. Maeil-21 as pHP-formula for neonates with allergy family, allergic symptoms such as atopic dermatitis, asthma except digestive system.

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A Case of Type I Vitamin D-dependent Rickets with Unilateral Aplasia of Kidney (일측성 신장 무형성을 동반한 제 1형 비타민 D 의존성 구룻병 1례)

  • Lim, Dong-Hee;Jung, Ji-In;Yim, Hyung-Eun;Eun, Baik-Lin;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.111-115
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    • 2008
  • Vitamin D-dependent rickets(VDDR) is a rare autosomal disorder, characterized by hypocalcemia, hypophosphatemia, increased alkaline phosphatase, secondary hyperparathyroidism and many other clinical features. Type I VDDR is due to congenital defects of renal 1${\alpha}$-hydroxylase, the enzyme responsible for the conversion of 25-(OH)D3 to 1,25-$(OH)_2D3$. Type II VDDR arise from target organ resistance to 1,25-$(OH)_2D3$. Unilateral renal aplasia is generally thought to result from a lack of induction of the metanephric blastema from the ureteral bud, which may be secondary to ureteral bud maldevelopment and/or to a problem with the formation of the mesonephric duct. The incidence of unilateral renal aplasia is approximately 1/500-3,200. Type 1 VDDR associated with unilateral renal aplasia has not been reported yet. Thus we report a case of a 3 month old female infant diagnosed as type 1 VDDR with unilateral aplasia of kidney.

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A Clinical Analysis of Primary Hyperparathyroidism -A Report of II Cases- (원발성 부갑상선 기능항진증 -11예 보고-)

  • Kang Young-Tae;Oh Sang-Hun;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.206-213
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    • 1998
  • Primary hyperparathyroidism is still uncommomn disease in Korea. However the frequency of this disease has been slowly increased with routine measurement of serum calcium and increasing awareness of hyperparathyroidism in recent years. The diagnosis is established by a persistent elevation of serum calcium and parathyroid hormone and by clinical evaluation. This is a report of eleven patients with primary hyperparathyroidism treated with surgical operation during a period from 1983 to 1997 at Department of Hospital. Authors analyzed the cases to evaluate clinical characteristics and outcome of surgical treatment retrospectively. The result was as follows. 1) In sex distribution, female patients were eight and three were male, the age distribution ranged from 18 to 67 years. 2) The presenting clinical manifestations were renal and urinary stone in eight, bone pain or fracture in six, muscle weakness in four, neurologic symptoms in four, neck mass in three, hypertension in two, and G-I symptoms in one. 3) All patients showed hypercalcemia and elevated serum parathyroid hormone level. 4) Preoperative localization study was performed with computerized tomography, ultrasonography, MRI, arteriography and thyroid scaning. 5) The tumor locations were left lower in eight, left upper in one, right lower in one, and right upper location was one case. 6) Histopathologic findings disclosed adenoma in all cases. 7) All patients were treated by surgical excision and postoperatively transient hypocalcemia occurred in six patients, but no other complication was developed.

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Patholgic Finding and Surgical Consideration in Micropapillary Carcinoma of the Thyroid (갑상선 미세유두암의 병리학적 소견 및 수술적 고려)

  • Lee, Hyun-Chul;Kim, Woon-Won;Oh, Sang-Hoon;Kim, Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.189-193
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    • 2008
  • Objectives:The incidence of micropapillary thyroid carcinoma(MPC) which is very good prognosis is increasing due to ultrasonography and accurate fine neede aspiration cytology. MPC defined papillary thyroid carcinoma below 1cm. According to the size, histophaothogic feature is different, lymph node metastasis and capsular invasion occur occasionally. So, we consider different treatment according to the size of MPC. Matrials and Methods:We reviewed and analyzed the record of 216 MPC patients operated at department of general surgery Busan Paik Hospital since 1995 January to 2005 Desember retrospectively. Result:The sex ratio was 1:9.29(male;21, female;195). Total thyroidectomy 20cases(9.3%), subtotal thyroidectomy 141cases(65%), lobectomy 52cases(24%), completion operation 3cases(1.4%) were done. Combined diseases were follicular carcinoma 4cases, follicular adenoma 11cases, thyroiditis 46cases, nodular hyperplasia 44cases. Lymph node metastasis 56cases and capsular invasion 56cases were presented. Group A(<5mm) was 53cases, group B(5-10mm) was 163cases. Group B showed higher lymph node metastasis and capsular invasion(P<0.05). Multiple carcinoma Showed higher capsular invasion than single carcinoma (P<0.05). Complications were post operative bleeding 1case, husky voice 1case, hypocalcemia 1case. Conclusion:We can consider more extensive operation in 5-10mm of MPC patients.