RESUMEN
No abstract available.
Asunto(s)
Adulto , Femenino , Humanos , Biomarcadores/sangre , Suelo de la Boca , Cuello/diagnóstico por imagen , Valor Predictivo de las Pruebas , Radiofármacos , Pertecnetato de Sodio Tc 99m , Disgenesias Tiroideas/sangre , Pruebas de Función de la Tiroides , Glándula Tiroides/efectos de los fármacos , Tirotropina/sangre , Tiroxina/sangre , Tomografía Computarizada por Rayos XRESUMEN
No abstract available.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Biomarcadores de Tumor/análisis , Biopsia , Carcinosarcoma/química , Quimioradioterapia Adyuvante , Resultado Fatal , Inmunohistoquímica , Neoplasias Pulmonares/química , Suelo de la Boca/química , Neoplasias de la Boca/química , Neumonectomía , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND: The prevalence of hypoglycemia is increasing due to the growing incidence of diabetes and the latest strict guidelines for glycated hemoglobin (HbA1c) levels under 7%. This study examined the clinical characteristics, causal factors, and medical costs of severely hypoglycemic patients in an emergency room (ER) of Uijeongbu St. Mary's Hospital. METHODS: The study consisted of a retrospective analysis of the characteristics, risk factors, and medical costs of 320 severely hypoglycemic patients with diabetes who presented to an ER of Uijeongbu St. Mary's Hospital from January 1, 2006 to December 31, 2009. RESULTS: Most hypoglycemic patients (87.5%, 280/320) were over 60 years old with a mean age of 69.5+/-10.9 years and a mean HbA1c level of 6.95+/-1.46%. Mean serum glucose as noted in the ER was 37.9+/-34.5 mg/dL. Renal function was decreased, serum creatinine was 2.0+/-2.1 mg/dL and estimated glomerular filtration rate (eGFR) was 48.0+/-33.6 mL/min/1.73 m2. In addition, hypoglycemic patients typically were taking sulfonylureas or insulin and a variety of other medications, and had a long history of diabetes. CONCLUSION: Severe hypoglycemia is frequent in older diabetic patients, subjects with low HbA1c levels, and nephropathic patients. Therefore, personalized attention is warranted, especially in long-term diabetics with multiple comorbidities who may not have been properly educated or may need re-education for hypoglycemia.
Asunto(s)
Humanos , Comorbilidad , Creatinina , Diabetes Mellitus , Urgencias Médicas , Tasa de Filtración Glomerular , Glucosa , Hemoglobinas , Hipoglucemia , Incidencia , Insulina , Prevalencia , Estudios Retrospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Insulin-mediated glucose uptake in insulin target tissues is correlated with interstitial insulin concentration, rather than plasma insulin concentration. Therefore, insulin delivery to the interstitium of target tissues is very important, and the endothelium may also play an important role in the development of insulin resistance. METHODS: After treating bovine aortic endothelial cells with angiotensin II (ATII), we observed the changes in insulin binding capacity and the amounts of insulin receptor (IR) on the cell membranes and in the cytosol. RESULTS: After treatment of 10(-7)M ATII, insulin binding was decreased progressively, up to 60% at 60 minutes (P<0.05). ATII receptor blocker (eprosartan) dose dependently improved the insulin binding capacity which was reduced by ATII (P<0.05). At 200 microM, eprosartan fully restored insulin binding capacity, althogh it resulted in only a 20% to 30% restoration at the therapeutic concentration. ATII did not affect the total amount of IR, but it did reduce the amount of IR on the plasma membrane and increased that in the cytosol. CONCLUSION: ATII decreased the insulin binding capacity of the tested cells. ATII did not affect the total amount of IR but did decrease the amount of IR on the plasma membrane. Our data indicate that ATII decreases insulin binding by translocating IR from the plasma membrane to the cytosol. The binding of insulin to IR is important for insulin-induced vasodilation and transendothelial insulin transport. Therefore, ATII may cause insulin resistance through this endothelium-based mechanism.
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Acrilatos , Angiotensina II , Angiotensinas , Membrana Celular , Citosol , Células Endoteliales , Endotelio , Glucosa , Imidazoles , Insulina , Resistencia a la Insulina , Plasma , Receptor de Insulina , Tiofenos , VasodilataciónRESUMEN
Strongyloides stercoralis is a soil-transmitted intestinal nematode that may cause long-lived auto-infection in the host. It is distributed worldwide, especially in the tropical and subtropical regions, but has been rarely reported in Korea. Chronic infections by S. stercoralis are mostly inapparent infections that carry nonspecific gastrointestinal and pulmonary symptoms. However, In immunocompromised patients such as those receiving long-term steroid therapy and patients with AIDS or malignant tumors, S. stercoralis can induce hyperinfection by autoinfection. This may lead to increased rate of complications such as resistance to chemotherapy and sepsis. In such cases mortality rate of up to 87% has been reported. We report a case of severe strongyloidiasis in a patient with chronic obstructive pulmonary disease who was receiving long-term steroid therapy. The chief complaint was repeated dyspnea and hematochezia, and strongyloidiasis was diagnosed by the presence of rhabditiform larvae of S. stercoralis in the fecal smear and isolation of filariform larvae from the stool culture. The patient developed septic shock during treatment with albendazole and showed clinical signs of hyperinfection of S. stercoralis. He eventually died despite aggressive treatment.
Asunto(s)
Humanos , Albendazol , Disnea , Hemorragia Gastrointestinal , Huésped Inmunocomprometido , Corea (Geográfico) , Larva , Enfermedades Pulmonares , Enfermedad Pulmonar Obstructiva Crónica , Sepsis , Choque Séptico , Strongyloides stercoralis , EstrongiloidiasisRESUMEN
Strongyloides stercoralis is a soil-transmitted intestinal nematode that may cause long-lived auto-infection in the host. It is distributed worldwide, especially in the tropical and subtropical regions, but has been rarely reported in Korea. Chronic infections by S. stercoralis are mostly inapparent infections that carry nonspecific gastrointestinal and pulmonary symptoms. However, In immunocompromised patients such as those receiving long-term steroid therapy and patients with AIDS or malignant tumors, S. stercoralis can induce hyperinfection by autoinfection. This may lead to increased rate of complications such as resistance to chemotherapy and sepsis. In such cases mortality rate of up to 87% has been reported. We report a case of severe strongyloidiasis in a patient with chronic obstructive pulmonary disease who was receiving long-term steroid therapy. The chief complaint was repeated dyspnea and hematochezia, and strongyloidiasis was diagnosed by the presence of rhabditiform larvae of S. stercoralis in the fecal smear and isolation of filariform larvae from the stool culture. The patient developed septic shock during treatment with albendazole and showed clinical signs of hyperinfection of S. stercoralis. He eventually died despite aggressive treatment.