Medicine
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Penetrating aortic ulcer (PAU) and rupture of a superior mesenteric artery branch is a rare but potentially life-threatening condition. ⋯ Acute aortic syndrome (AAS) and acute coronary syndrome (ACS) may be difficult to distinguish, particularly for elderly patients with extensive atherosclerotic disease. Antithrombotic agent administration should be carefully considered.
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Case Reports
Adult severe encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum: A case report.
Clinically mild encephalitis/encephalopathy with a reversible splenial lesion of the corpus callosum (MERS) is a recently identified clinically and radiologically distinct syndrome. Clinical symptoms and lesions on the magnetic resonance imaging (MRI) often disappear in 1 week or a few weeks. However, MERS manifesting as a severe clinical course with significant sequela has not yet been reported. ⋯ MERS is a rare clinicoradiological syndrome, which can manifest as severe symptoms as well. Early diagnosis and treatment should be emphasized, and the diagnostic value of MRI is highlighted. Clinicians should be alert to the potential sequela.
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Observational Study
Sonographic assessment of carpal tunnel syndrome in diabetic patients with and without polyneuropathy.
The objective of this study is to determine whether the cross sectional area (CSA) measurement of the median nerve at the wrist differ between carpal tunnel syndrome (CTS) in diabetic patients with and without diabetic polyneuropathy (DPN). This study included 44 patients with type II diabete millitus (DM) with CTS, 32 patients with CTS and DPN, 46 patients with idiopathic CTS, and 42 healthy subjects. Ultrasonographic measurement of the CSA of the median nerve was made at the level of the wrist, together with nerve conduction studies. ⋯ The median nerve CSA at wrist was significantly smaller in patients with CTS and DPN compared with diabetic patients with CTS only. The median nerve CSA at the wrist was larger in diabetic patients with CTS than patients with idiopathic CTS and CTS with DPN. Median nerve CSA can help to differentiate between diabetic patients with CTS with and without DPN.
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Observational Study
Association between muscle strength and type 2 diabetes mellitus in adults in Korea: Data from the Korea national health and nutrition examination survey (KNHANES) VI.
Diabetes mellitus (DM) is a significant chronic disease, and health burden from DM is increasing. Recently, studies on the relationship between handgrip strength, which is a measuring tool for muscle strength, and type 2 DM were published. However, the results have been conflicting. ⋯ Multivariable logistic regression analyses showed that handgrip strength was significantly inversely associated with type 2 DM and insulin resistance. The high-sensitivity C-reactive protein (hs-CRP), an inflammation-related biomarker, mediated approximately 10% of the association between handgrip strength and type 2 DM. Using large, well-defined, nationally representative cross-sectional data on adults in Korea, we found that handgrip strength, which is an indicator of muscle strength, was associated with type 2 DM.
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Clinical Trial Observational Study
Predicting effective remifentanil concentration in 95% of patients to prevent emergence cough after laryngomicroscopic surgery.
Smooth emergence or cough prevention is a clinically important concern in patients undergoing laryngomicroscopic surgery (LMS). The purpose of this study was to estimate the effective concentration of remifentanil in 95% of patients (EC95) for the prevention of emergence cough after LMS under propofol anesthesia using the biased coin design (BCD) up-down method. A total of 40 adult patients scheduled to undergo elective LMS were enrolled. ⋯ Compared with patients receiving lower concentrations of remifentanil, the incidence of hypoventilation before extubation and extubation time were significantly higher in those receiving remifentanil Ce of 3.0 ng/mL. However, hypoventilation incidence after extubation and staying time in the recovery room were comparable between the 2 groups. Using a BCD method, the EC95 of remifentanil Ce for the prevention of emergence cough was estimated to be 2.92 ng/mL (95% CI: 2.72-2.97 ng/mL) after LMS under propofol anesthesia.