RESUMO
A 70-year-old woman developed sick sinus syndrome associated with thyrotoxicosis. Initial T3 was above 800ng/dl and TSH was below 0.05IU/ml. But sinus node dysfunction was resolved upon achieving a euthyroid state. This clinical course suggest that transient reversible sinus node dysfunction could be developed due to thyrotoxicosis.
Assuntos
Idoso , Feminino , Humanos , Síndrome do Nó Sinusal , TireotoxicoseRESUMO
No abstract available.
Assuntos
Transplante de Medula Óssea , Medula Óssea , Células Precursoras Eritroides , PatologiaRESUMO
No abstract available.
Assuntos
Coagulação Intravascular Disseminada , Plasma , Tifo por ÁcarosRESUMO
No abstract available.
Assuntos
Cintilografia , Pertecnetato Tc 99m de Sódio , Glândula Tireoide , Neoplasias da Glândula TireoideRESUMO
In the previous studies, we found that lumbrokinase an, extract from Korean earthworm, had a strong in vitro thrombolytic effect, and that when added to thrombin had a significant effect in reducing fatality rate in thrombin-induced lung infarction mice model. To determine whether it also has in vivo thrombolytic effect in cerebral embolism model using 9 Spraw Dawly male rats of 200 to 300gm, we cannulated the extemal carotid artery lene tubes and occluded the pterygopalatine arteries. Via the extemal carotid artery, we injected 1 mm3 of human blood clots which were previously mixed with Tc-99m sulfur colloid. After confirming the intracranially situated clot by camera, we injected 3cc of following fiuids to each group of three rats: saline, urokinase, lumbrokinase fraction m Then using Gamma camera of 64*64 m obtained for 1 minute in every 30 minutes. After 150 minutes radioactivities of the clots in the brain were 3.02%, 21 02% urokinase, and lumbrokinase treated animals respectively. In the liver, the uptake of radioactivities was accordingly increased. Brain sections showed no Significant intracranial bleeding in any of the treated animals. Therefore, we conclude that lumbrokinase has in vivo thromboembolism model without producing significant intracranial bleeding. However, compared with its in vitro effects the in vivo effects appear to be less potent. Futher experiments with better designed animal models are warranted.
Assuntos
Animais , Humanos , Masculino , Camundongos , Ratos , Artérias , Encéfalo , Artérias Carótidas , Câmaras gama , Hemorragia , Infarto , Embolia Intracraniana , Fígado , Pulmão , Modelos Animais , Oligoquetos , Radioatividade , Coloide de Enxofre Marcado com Tecnécio Tc 99m , Trombina , Tromboembolia , Ativador de Plasminogênio Tipo UroquinaseRESUMO
No abstract available.
Assuntos
Humanos , Adenilil Ciclases , Doença de Graves , Glândula TireoideRESUMO
In thirty patients with acute leukemia and severe aplastic anemia receiving random single donor platelet transfusions, the development of refractoriness by consecutive platelet transfusions with cytapheresis and its relationship to the appearance of anti-platelet antibodies were investigated. The median number of platelet transfusions inducing refractoriness was 13 times, and 20% of the patients remained unrefractory despite of the repeated multiple platelet transfusions up to 20 to 25 times. The results of anti-platelet antibody tasts by the enzyme-linked immunosorbent assay(ELISA) and immunofluorescent techniques(IFT) showed no statistically significant relationship with the refractoriness (p greater than 0.1). Although there was significant correlation between the results of ELISA and IFT, both tests were insufficient to find out refractoriness even with the use of pooled platelets from multiple donors as target cells. This study shows that 13 single donor platelet transfusions result in refractoriness, that both ELISA and IFT are insufficient to detect refractoriness despite of their significant correlation, and that other methods than these are needed in order to detect alloimmunization.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anemia Aplástica/terapia , Anemia Refratária/etiologia , Anticorpos/metabolismo , Plaquetas/imunologia , Transfusão de Sangue , Leucemia/terapiaRESUMO
A Total of 498 cases of hemophilia which were reported by sixteen medical centers in Korea were reviewed and analyzed. Hemophilia A comprised 425 cases (85.3%) and the remaining 73 cases (14.7%) were hemophilia B. One case was female and all other cases were male. There were known hemophilia patients in the family in 43.0% of cases and the involved members were brothers, maternal cousins, maternal uncles, and maternal grandfathers in descending order of frequency. The major symptoms of the patients were hemorrhagic, such as easy bruising and hemarthrosis followed by prolonged bleeding after trauma and soft tissue hematoma. The incidence of hemarthrosis increased significantly with age. The pediatric age group below the age of 15 consisted of 67.1% of the cases. According to the age at diagnosis, half (54.2%) of the severe cases were diagnosed before the age of 1 year. APTT was prolonged over 40 seconds in all cases and 291 cases showed severe prolongation over 80 seconds. Of 498 cases 273 cases (54.8%) belonged to the severe form (factor VII or IX level, less then 1%), whereas 182 cases (36.5%) and 43 cases (8.7%) belonged to the moderate (factor VIII or IX, 2-5%) and mild form (factor VIII or IX, 6-25%), respectively, Chronic arthropathy was present in 236 cases (49.6%), and the incidence increased significantly with age. The management of chronic arthropathy most commonly employed was rehabilitation in 25.4% of cases, but in 50.8% no management was given at all. The involved joints in descending order of frequency were knees, elbows and ankles. The complications were intracranial hemorrhage, Gl bleeding and nerve palsy in 48, 24, and 13 cases, respectively.
Assuntos
Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Anticorpos Anti-HIV/imunologia , Hemofilia A/complicações , Hemofilia B/complicações , Artropatias/etiologia , Inquéritos e QuestionáriosRESUMO
A Total of 498 cases of hemophilia which were reported by sixteen medical centers in Korea were reviewed and analyzed. Hemophilia A comprised 425 cases (85.3%) and the remaining 73 cases (14.7%) were hemophilia B. One case was female and all other cases were male. There were known hemophilia patients in the family in 43.0% of cases and the involved members were brothers, maternal cousins, maternal uncles, and maternal grandfathers in descending order of frequency. The major symptoms of the patients were hemorrhagic, such as easy bruising and hemarthrosis followed by prolonged bleeding after trauma and soft tissue hematoma. The incidence of hemarthrosis increased significantly with age. The pediatric age group below the age of 15 consisted of 67.1% of the cases. According to the age at diagnosis, half (54.2%) of the severe cases were diagnosed before the age of 1 year. APTT was prolonged over 40 seconds in all cases and 291 cases showed severe prolongation over 80 seconds. Of 498 cases 273 cases (54.8%) belonged to the severe form (factor VII or IX level, less then 1%), whereas 182 cases (36.5%) and 43 cases (8.7%) belonged to the moderate (factor VIII or IX, 2-5%) and mild form (factor VIII or IX, 6-25%), respectively, Chronic arthropathy was present in 236 cases (49.6%), and the incidence increased significantly with age. The management of chronic arthropathy most commonly employed was rehabilitation in 25.4% of cases, but in 50.8% no management was given at all. The involved joints in descending order of frequency were knees, elbows and ankles. The complications were intracranial hemorrhage, Gl bleeding and nerve palsy in 48, 24, and 13 cases, respectively.
Assuntos
Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Anticorpos Anti-HIV/imunologia , Hemofilia A/complicações , Hemofilia B/complicações , Artropatias/etiologia , Inquéritos e QuestionáriosRESUMO
Although it has been suggested that the calcium antagonist verapamil has beneficial effects on ischemic myocardium, its effect during coronary reperfusion has not been studied in detail. The purpose of this study was to investigate the inhibitory effect of verapamil on myocardial damage quantitatively using 111 In-anticardiac myosin antibody (ACM Ab) and qualitatively using electronmicroscopic method. Anesthetized open-chest dogs were subjected to 1 hour of occlusion of the left anterior descending coronary artery (LAD) followed by 90 minutes of reperfusion. Regional myocardial blood flow was determined by injecting 85Sr-microsphere prior to LAD reperfusion, and regional myocardial damage was measured by injecting 111In-ACm Ab at 30 minutes after LAD reperfusion. Six dogs were randomly selected as saline control and verapamil-treated (0.6 mg/kg. hr) groups each. Saline or verapamil was infused at 40 minutes after LAD occlusion and continued through the experiment. 1) Verapamil produced significant (P<0.05 by Wilcoxon rank sum test) decrease in heart rate, mean arterial blood pressure and double product. There was no significant change in pulmonary hemodynamics or cardiac output. 2) Stroke volume was reduced significantly (P<0.05 by Wilcoxon rank sum test) after 30 minutes of LAD reperfusion in the control group, but it was preserved in the verapamil-treated group. 3) There was an inverse exponential relationship between 111In-ACm Ab localization and regional blood flow in both control (r=-0.86) and verapamil treated (r=-0.71) groups. Significant difference between the two groups was found in exponential curve (p[t]<0.05). 4) A lesser uptake of 111in-ACM Ab was observed in the verapamil treated group compared with that in the control group in the region where the regional blood flow was lower than 30+/- of normal. 5) In the control group, the myocardium showed swelling, contraction bands, and electron dense granules in the mitochondria which were proven to be calcium aggregates. In the verapamiltreated grooup, the myocardium showed fewer electro dense granules and mild degree of contraction bands. This study supports the concept that verapamil reduces the myocardial damage following coronary reperfusion in myocardial infarction and may reduce contraction band necrosis.
Assuntos
Animais , Cães , Pressão Arterial , Cálcio , Débito Cardíaco , Vasos Coronários , Frequência Cardíaca , Hemodinâmica , Mitocôndrias , Infarto do Miocárdio , Reperfusão Miocárdica , Miocárdio , Miosinas , Necrose , Fluxo Sanguíneo Regional , Reperfusão , Volume Sistólico , VerapamilRESUMO
Hemorrhagic fever with renal syndrome in Korea (Korean hemorrhagic fever) is an acute viral disease characterized by fever, hemorrhage and renal failure. In Korean patients, the disease manifests more distinctive bleeding tendencies than those of hemorrhagic fever with renal syndrome found in western countries. To investigate the nature and role of the coagulation, fibrinolysis, kinin and immune system in the pathogenesis of such a hemorrhagic manifestation, alterations of these systems were assessed from the early phase of the disease. Decreased platelet count and shortened platelet survival were observed with giant platelets in the peripheral blood. The marked prolongations of bleeding time, prothrombin time and partial thromboplastin time were noticed with the decreased plasma activities of coagulation factors II, V, VIII, IX and X. Shortened half life of fibrinogen, increased fibrinogen-fibrin degradation product, with decreased plasma levels and activities of plasminogen, alpha 2-plasmin inhibitor and antithrombin III were found. On thrombelastogram, the existence of procoagulant activity was confirmed, and prolonged reaction time and clot formation time with decreased maximum amplitude were observed. The appearance of circulating immune complexes was found along with decreased C3 and normal C4 in the serum. Significant decrease of serum C3 was evident in the patients with disseminated intravascular coagulation. These findings of coagulopathy were normalized within ten days of the illness in most cases. Therefore, it can be concluded that disseminated intravascular coagulation and thrombocytopenia in the early phase, and azotemia developing later might play an important role in the pathogenesis of bleeding tendency in Korean hemorrhagic fever.
Assuntos
Humanos , Injúria Renal Aguda/complicações , Transtornos da Coagulação Sanguínea/etiologia , Medula Óssea/patologia , Proteínas do Sistema Complemento/metabolismo , Orthohantavírus , Coreia (Geográfico) , Viroses/complicaçõesRESUMO
Twenty male patients with Korean hemorrhagic fever were evaluated with thrombelastography (TEG) to assess the changes in coagulation system, and the results were compared with those of conventional coagulation tests. Procoagulant activity in the plasma was determined by comparing the reaction time "r" of the normal plasma and that of the mixture of equal parts of the normal plasma and the patient's plasma. The TEG was found to be a useful measure of the changes in the coagulation profile, and provided instant accurate assessment of the patient's hemostatic function. Presence of the procoagulant activity was demonstrated in the plasma of the patients and indicated occurrence of active intravascular coagulation during the early stage of the disease.
Assuntos
Adulto , Humanos , Masculino , Coagulação Sanguínea , Fatores de Coagulação Sanguínea/análise , Febre Hemorrágica com Síndrome Renal/sangue , TromboelastografiaRESUMO
The delineation of the functioning renal parenchyma by the scintiscanning technique has made it possible to supplement diagnostic informations obtained by ordinary urological laboratory data, intravenous pyelography, retrograde pyelography or aortic angiography. More recently, the Hean labeled neohydrin has turned out to be preferable to I131 labeled diodrast or hippuran for renoscintigram for that the former is more readily taken up by the renal cortex and retained by the renal tubules for certain period of time, while the latter istoo rapidly excreted in the urine to reveal satisfactory pictures of renoscan and the technique is complicated. In the present study, renal scintillation scanning and body surface counting in vivo by Hg203 neohydrin were performed on 10 normal cases and 50 patients, 2 renal tumor (Wilm's tumor), 12 renal tuberculosis, 6 renal calculi, 5 nephritis, 10 hydronephrosis. 1 nephrotic syndrome. 5 pyelonephritis, 1 polycystic kidney, 3 congenital anomalies (horse-shoe kidney) and 5 hypertension. After intravenous administration of about 100 microcuries of Hg203 labeled neohydrin, in vivo surface counting over the kidneys, liver, spleen, heart and thigh was performed prior to scan such kidneys at 5, 30, 60 and 90 minutes, respectively, by scintillation detector with 1.5 inches thick Na I crystal. Upon adequate concentration of Hg203 neohydrin in the kidneys, the outline of functioning renal parenchyma can then be recorded by scintillation scanning apparatus, 19 honey cone collimator. In body surface counting, the radioisotope concentration over normally functioning renal parenchyma is good, whereas the concentration over diseased parenchyma is poor and the hepatic uptakeof the isotope shows high, instead. This procedure would also be of diagnostic value in patients with renal vascular disease, by revealing renal function test. In renoscintigram of the patients having presumable renal diseases by ordinary urological survey and pyelographic techniques, space occupying lesions and dot irregularities of the kidney can be presented as filling defect on renoscan. Split renal function studies usually give some information about total functioning capacity of each kidney but no detailed information in limited areasof a kidney with segmental lesion can be drawn. The renal angiogram details in a precise way the size and course of the renal arteries, but contributes no information about function of the parenchyma. The renal biopsy is also a valuable diagnostic procedure which may provide a specific diagnosis if the biopsy is obtained from the right site of diseased area. And the radioisotope renogram has been used to detect unilateral renal disease and it provides some information about the vascular supply and functional capacity of each kidney but this procedure does not supply any knowledge on segmental renal lesion nor segmental renal function. The technique of renoscintigram using Hg203 neohydrin which supplements the disadvantages of conventional methods of renal function study is at the present most qualified to supply more knowledge on segmental renal function and morphological finding as well. Further-more, disappearance of the isotope from the blood and its urinary excretion rate were determined as no harm at all to the human body. In summary, the renoscintigram is of particular help in establishing the diagnosis of renal diseases where pyelographic evidence is equivocal or lacking and the diagnostic significance of this method is promising.