BACKGROUND: The Chinese hamster ovary cells transfected with human TSH receptor cDNA (hTSHR-CHO), expressing functional human TSH receptors, are known to be more sensitive in detection of thyroid stimulating antibodies than FRTL-5 cells. There has been no report on the usefulness of these cells to measure thyroid stimulation blocking antibody (TSBAb) activity which is frequently found in patients with primary myxedema, METHODS: We established the optimal assay condition of measurement of TSBAb using hTSHR-CHO cells, and simultaneously measured TSBAb activities with FRTL-5 cells and with hTSHR-CHO cells in 49 patients with primary myxedema, compared them with their thyrotropin binding inhibitor immunoglobulin (TBII) activities. RESULTS: 1) hTSHR-CHO cells specifically bound bTSH and were stimulated by bTSH in terms of cyclic AMP generation in a dose dependent manner. 2) Myxedema IgG suppressed TSH-stimulated cAMP production of hTSHR-CHO cells in a dose dependent manner reaching plateau at the concentration of I g/L. Normal pooled IgG has no suppressive action at the concentration of less than 1 g/L, but caused significant suppression at the concentration of greater than 1g/L. 3) TSBAb activities measured by hTSHR-CHO cells in 49 patients with primary myxedema were as follows: Four of 25 TBII-negative cases (16%) and 22 of 24 TBII-positive cases (92%) had TSBAb activities. Most of TSBAb positive patients (95%), especially in TBII positive cases, showed very high activities of more than 90%. 4) TSBAb activities measured by hTSHR-CHO cells and those by FRTL-5 cells were both positive in 24 patients (49%), both negative in 18 patients (37%), and were discrepant in 7 patients (14%). The TSBAb activities measured with hTSHR-CHO cells and those measured with FRTL-5 cells were significantly correlated (r=0.71, p< 0.01). 5) Forty five percent of patients with primary myxedema had all of 3 kinds of activities (TBII, hTSHR-CHO cell TSBAb, FRTL-5 cell TSBAb), 37% of them had none of 3 activities and 18% of them had 1 or 2 kinds of activities only. CONCLUSION: The usefulness of hTSHR-CHO cells in measurements of TSBAb activities were confirmed. The TSBAb activities of most patients with primary myxedema measured by hTSHR-CHO cells were concordant with those measured by FRTL-5 cells. However, a small subset of patients (18%) had discrepant results in assays of TSH receptor antibodies according to the differences in TSH receptors (rat, human and porcine) used in assay. Such discrepancy may be explained by heterogeneity in epitopes for blocking TSH receptor antibodies.
Animals ; Antibodies ; Asian Continental Ancestry Group* ; Cricetinae ; Cricetulus* ; Cyclic AMP ; DNA, Complementary ; Epitopes ; Female ; Humans ; Humans* ; Hypothyroidism* ; Immunoglobulin G ; Immunoglobulins ; Immunoglobulins, Thyroid-Stimulating ; Myxedema ; Ovary* ; Population Characteristics ; Receptors, Thyrotropin* ; Thyroid Gland* ; Thyrotropin

No abstract available.
Graves Disease* ; Pregnancy*

The purpose of this study is to present the physiological and anatomical observations on the effect of cerebral hemispherectomy and total hemispherectomy including ipsilateral thalamus in albino rabbits. In this study, twenty healthy male albino rabbits weighing 1.8-2.0 kg were subjected to one stage removal of one cerebral hemisphere including unilateral basal ganglia and thalamus (total hemispherectomy) and unilateral cerebral hemisphere preserving basal ganglia (cerebral hemispherectomy). In 8 albino rabbits, cerebral hemispherectomy was performed and in 12, total hemispherectomy. These experimental animals were frequently observed for periods varying from a few days to three weeks. The postoperative physiological findings were as follows : All survived experimental animals demonstrated early and rapid return of consciousness, giving evidence of awareness of environment noting objects in their remaining ipsilateral homonymous visual field. After recovery form anesthesia, all experimental animals were able to move their contralateral limbs, however when they attempted to walk they staggered to the opposite side for a while. A few days later they showed almost same motor function and walked making circle to the operated side. About two weeks later, they could walk as normal rabbits. Following unilateral cerebral hemispherectomy or total hemispherectomy, all animals were able to respond to painful stimuli on the contralateral side when they awoke from aneshesia. The grade of response to painful stimuli was gradually getting better until about one week postoperatively, but there were some deficit in the contalateral side comparing to the ipsilateral side when examined on postoperative three weeks. Contralateral homonymous hemianopsia was considered to be a permanent neurologic deficit in all experimental animals. The brain stem and spinal cord, removed during two or three weeks postoperatively, were stained with Luxol fast blue staining method, however, there was no evidence of bilateral pyramidal innervation in all experimental animals.
Anesthesia ; Animals ; Basal Ganglia ; Brain Stem ; Cerebrum ; Consciousness ; Extremities ; Hemianopsia ; Hemispherectomy* ; Humans ; Male ; Neurologic Manifestations ; Rabbits ; Spinal Cord ; Thalamus ; Visual Fields

No abstract available.

PURPOSE: Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF.METHODS: We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018.RESULTS: Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis.CONCLUSION: Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.
Anemia ; Cohort Studies ; Heart Failure ; Heart ; Hospitalization ; Humans ; Mass Screening ; Mortality ; Prevalence ; Prospective Studies ; Risk Factors ; Statistics as Topic ; World Health Organization

No abstract available.
Humans

BACKGROUND: Ventricular remodeling after myocardial infarction increase mortality and morbidity. Two-dimensional echocardiography in acute myocardial infarction provides a useful diagnostic tool for evaluation of ventricular remodeling. The aims of this study were to verify whether follow-up two-dimensional echocardiography could detect ventricular enlargement after acute myocardial infarction and to find early echocardiographic predictors and clinical charateristics of ventricular enlargement. METHODS: Two-dimensional echocardiography was done prospectively at 2 week, 3 month, and 6 month after the first Q-wave acute myocardial infarction in 18 patients. The control group was 11 patients of a normal chest roentgenogram and echocardiogram who were studied for chest pain or arrhythmia. The patients were divided by the mean value of the control group left ventricular end-diastolic volume index(LVEDVI) 56.8ml/m2. The group A was more than 60ml/m2(the control group LVEDVI 56.8ml/m2) and the group B was less than 60ml/m2 of LVEDVI at 2 week post myocardial infarction. The left vantricular volume was measured by the modified disk method at the apical four chamber view. The wall motion abnormality of left ventricle was examined by the recommendation of the American Society of Echcardiography. RESULTS: The left vntricular end-diastolic volume and the left ventricular end-systolic volume were enlarged after 3 month of acute myocardial infarction in the group A compare with those of the control group. There was no ventricular enlargement during 6 month after myocardial infarction in the group B. The frequency of ventricular enlargement was increased in anterior myocardial infarction. There was no difference in left ventricular ejection fraction at 2 week post myocardial infarction between the group A(51.4+/-15.7%) and the group B(50.8+/-10.3%). The wall motion score index more than 1.5 at 2 week post myocardial infarction means the enlarged LVEDVI more than 60ml/m2 and the group of ventricular enlargement. CONCLUSION: The left ventricular enlargement could be diagnosed by the follow-up two-dimensional echocardiography in acute myocardial infarction. The echocardiographic early predictors of ventricular enlagement were the left ventricular end-diastolic volume greater than 60ml/m2 and increased wall motion score index more than 1.5 at 2 week post myocardial infarstion. The anterior myocardial infarction was the electrocardiographic predictor of ventricular dilatation. Therefore these early predictors could identify the patients of ventricular enlargement and these patients could be a candidate of follow-up echocardiography and of a specific treatment for limiting ventricular remodeling.
Arrhythmias, Cardiac ; Chest Pain ; Dilatation ; Echocardiography* ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mortality ; Myocardial Infarction* ; Prospective Studies ; Stroke Volume ; Thorax ; Ventricular Remodeling

A case of pretibisl myxederna in typical Graves disease was described. A 50-year-old woman revealed diffuse toxic goiter, exophthalmos, and pretibial myxedema. From light and electron microscopic findings, large amount of acid mucopolysaccharides were deposited in the stroma and fibroblssts. In spite of elevation of TBII (a kind of thyroid stimulatory factors, negative direct immunofluorescence of lesional skin and no response. of pretibial myxedema to the treatment with antithyroid drug (propylthiouracil) suggested stimulstory factors of fibroblasts might be different from those of thyroid gland.
Exophthalmos ; Female ; Fibroblasts ; Fluorescent Antibody Technique, Direct ; Glycosaminoglycans ; Goiter ; Graves Disease* ; Humans ; Middle Aged ; Myxedema* ; Skin ; Thyroid Gland

To test the hypothesis that hyperinsulinemia and/or abnormalities of red cell membrane Na^+ transport are concerned in the pathogenesis of hypertension, we investigated the relationship between blood pressure, insulin level and red cell membrane Na^+ transport in patients with acromegaly which is frequently associated with hypertension, hyperinsulinemia and abnormalities of red cell membrane Na^+ transport.The results were as follows;1) BMI and both systolic and diastolic blood pressure were significantly higher in patients with acromegaly than in control subjects.2) Fasting glucose and insulin levels were higher, and both serum glucose and insulin responses after a 75g glucose load were significantly increased in patients with acromegaly as compared with control subjects.3) Vmax of Na^+-Li^+ countertransport were significantly higher in patients with acromegaly than in control subjects while red cell Na^+ concentration and Vmax of Na^+, K^+ ATPase were similar in the two groups.4) In multiple stepwise regression analysis, age was directly correlated with both systolic and diastolic blood pressure in acromegaly. On the other hand both insulin level and red cell membrane Na^+ transport showed little correlation with either systolic or diastolic pressure. 5) Prevalence of hypertension in acromegaly was 39%(9 out of 23) and only age except for blood pressure was significantly higher in hypertensive acromegalic patients than in normotensive acromegalic patients while GH level, insulin levels and red cell membrane Na^+ transport were similar in the two groupsThese results suggest that hyperinsulinemia or abnormalities of red cell membrane Na^+ transport are not causally related to hypertension in patients with acromegaly.
Acromegaly ; Adenosine Triphosphatases ; Blood Glucose ; Blood Pressure ; Cell Membrane ; Fasting ; Glucose ; Hand ; Humans ; Hyperinsulinism ; Hypertension ; Insulin ; Prevalence

An adequate supply of dietary iodine is essential for the synthesis of the thyroid hormons. The measurement of dietary iodine intake is important for the clinical assessment of thyroid disease, especially in areas where iodine intake is excessive or deficient.To evaluate dietary iodine intake in Korean and its effects on thyroid function, we measured urinary iodine excretion with morning urine by electrode method in 184 normal subjects, 96 postpartum women and 181 patients with thyroid disease from October 1994 to February 1995. The results were as follows;1) In normal control, the mean value of urinary iodine excretion was 3.8+-2.7mg/L (range 0.1-15.0mg/L). However, there was no sex and age differences in the urinary iodine excretion.2) In postpartum women, the urinary iodine excretion was 9.0+-10.8mg/L who were not taken high iodine diet(Miyok-Guk), the mean value was statistically higher than normal control(p<0.01) and significant increased the urinary iodine excretion after eating of high iodine diet(p<0.01).3) In volunteer, there were increase of urinary iodine excretion more than 10 folds after high iodine diet and medication.4) The urinary iodine excretion in patients with thyroid diseases was not different from normal control, and there were no significant differences of urinary iodine excretion among the patient groups. The urinary iodine excretion in the acute stage of patients with subactue thyroiditis or painless thyroiditis was significantly increased compared to the recovery stage. However, it was not significantly different from that of normal control.In conclusion, urinary iodine excretion in Korean population is very high comparing to the reported data in Western population but similar with Japanese. The urinary iodine excretion is significant increase( more than 10-folds of basal level) after high iodine diet or high iodine containing medication in postpartum women or healthy persons. As a clue of destruction induced thyrotoxicosis, the urinary iodine excretion measurement is not valid in area where iodine intake is excessive like Korea.
Asian Continental Ancestry Group ; Diet ; Eating ; Electrodes ; Humans ; Iodine ; Korea ; Methods ; Postpartum Period ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis ; Thyrotoxicosis ; Volunteers