A 27-year-old woman developed Wemicke's encephalopathy in the 16th week of her first pregnaney. She had thyroid storm and abnormal liver function. Her thyrotoxic symptom and abncemal liver function was recovered after medication of antithyroid drug, steroid, hepatotonic drug and administration of thiamine(fursulthiamin), but the fetus was lost, Thereafter her thyroid function returned to normal and euthyroid state was maintained without medication of antithyroid drug, but her neurological defect was remained. We suggest that severe hyperemesis gravidarum is a possible risk factor of the thyroid storm and Wemicke's encephalopathy in patients with hyperthyroidism, and consider the check of the thyroid function. The need for parenteral thiamine supplementation and medication of antithyroid drug is warranted in patients with severe hyperemesis gravidarum which lasts longer than 3 weeks and abnormal thyroid function.
Adult ; Female ; Fetus ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism ; Liver* ; Pregnancy ; Risk Factors ; Thiamine ; Thyroid Crisis* ; Thyroid Gland* ; Wernicke Encephalopathy*

Backgrounds: Thyroid hormones play a fundamental role in the initiation and maintenance of somatic growth in mammalian species, and the insulin-like growth factors(IGFs) occupy a position of central importance in the growth of all tissues. To evaluate the changes in serum insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding proteins in hyperthyroid and hypothyroid patients, sera was obtained from 19 hyperthyroid patients, 9 hypothyroid patients, and 10 healthy volunteers. Methods: IGF-I concentration was determined by radioimmunoassay, and changes in IGFBPs were assesed by Western Ligand Blotting. To evaluate the binding pattern of IGF-I & IGFBPs, autoradiographs were obtained. Results & Conclusion: IGF-I levels were increased significantly in hyperthyroid patients(mean ±SE, 267.88±9.80 ng/ml, p<0.05) and decreased significantly in hypothyroid patients(154.81±1.43 ng/ml, p<0.01) compaired to healthy control group(209.45±.60 ng/ml). Autoradiograph of serum IGFBPs from patients with hyperthyroidism and hypothyroidism did not show any change in the intensity of IGFBP-3 bands(40-45 KD) and IGFBP-1 bands, but in hyperthyroid patients, it showed increased intensity of IGFBP-2 band compared to healthy control group and hypothyroid patients.
Equidae ; Healthy Volunteers ; Humans ; Hyperthyroidism ; Hypothyroidism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Radioimmunoassay ; Thyroid Hormones

Because the 'Tsunami of type 2 diabetes' is presently rolling on a global scale, owing to the ever-increasing prevalence of obesity, increasing physical inactivity, and aging populations worldwide, the economic burden of diabetes caused by increased health resource use and lost productivity increase rapidly. So prevention in general population and good glycemic controls become even more important with earlier diagnosis and more aggressive cardiovascular prevention and treatment. Diabetes requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is very complex and requires that many issues, beyond glycemic control, be solved by the active governmental policy. Lifestyle modifications are the cornerstones of management of type 2 diabetes. The progressive nature of type 2 diabetes requires use of one or more oral agents and eventually insulin, along with lifestyle modification and intensification. Rapid achievement of the target goals often prompts providers to consider combination therapy to target different pathogenic mechanisms and manage both fasting and postprandial blood glucose levels. Maintenance of glycemic control over the lifespan of a patient with diabetes is overwhelmingly likely to require combination therapy with oral diabetes medications. Ultimately, because of the progressive nature of the disease and the progressive decline in pancreatic beta-cell function, insulin therapy is almost always obligatory to achieve optimal glycemic goals.
Achievement ; Aging ; Blood Glucose ; Diabetes Mellitus ; Efficiency ; Fasting ; Health Resources ; Humans ; Insulin ; Life Style ; Obesity ; Prevalence ; Self Care

No abstract available.
Emergencies* ; Emergency Medicine* ; Humans

The origins of medullary carcinoma (MTC) and papillary carcinoma (PTC) of the thyroid are embryologically different. Tumors showing concurrent medullary and papillary features are rare and they represent less than 1% of all thyroid malignancies. Hereditary MTC is an autosomal dominantly inherited disease which is genetically determined as part of the MEN 2A, MEN 2B, or variants of MEN 2A such as familial MTC. Germline mutations of the RET gene are the underlying cause of the majority of cases of hereditary medullary carcinomas. The pathogenesis of concurrent PTC with familial MTC has rarely been known. Genetic analysis of the RET oncogene has so far provided conflicting results. Here we describe a family whose sibling was affected by both PTC & MTC, and the family carried a germ-line point mutation in the RET extracellular domain that converted cysteine 634 into tryptophan (C634W).
Carcinoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Cysteine ; Factor IX ; Germ-Line Mutation ; Humans ; Multiple Endocrine Neoplasia Type 2a ; Multiple Endocrine Neoplasia Type 2b ; Oncogenes ; Point Mutation ; Siblings ; Thyroid Gland ; Thyroid Neoplasms ; Tryptophan

PURPOSE: This study was designed to examine the effects of a weight control program on body weight and the sense of efficacy for control of dietary behavior in psychiatric inpatients. METHODS: A quasi-experimental design was used. Data were collected from March 1 to September 30, 2007. Female mentally ill patients in closing psychiatry ward of H University Hospital participated in the study (16 persons in the experimental group and 13 in the control group). RESULTS: The weight control program including diet therapy, exercise, education and behavior modification therapy decreased the rate of weight gain in female mentally ill patients taking atypical antipsychotics, and effectively increased a sense of efficacy for control of dietary behavior. CONCLUSION: Weight control program had a positive effect as a nursing intervention to decrease obesity and to increase the sense of efficacy for control of dietary behavior of psychiatric inpatients in psychiatric inpatients.
Adult ; Cognitive Therapy ; Diet Therapy ; Exercise ; Female ; Health Behavior ; Hospitals, Psychiatric ; Humans ; Inpatients/psychology ; Mentally Ill Persons/*psychology ; Middle Aged ; Patient Education as Topic ; Psychiatric Nursing ; *Weight Loss

No abstract available.
Panniculitis*

Decreased number of the Neuropeptide-Y[NPY] immunoreactive neurons in the corpus striatum and primary motor cortex of aged rat was detected by the immunohistochemical method. The animals were categorized into control and aged group and we used 10 Sprague-Dawley rat weighing 250-300gm for control group. 10 Sprague-Dawley rat weighing over 600gm for aged group. The number of NPY-immunoreactive neurons in corpus striatum and primary motor cortex were counted under the light microscope and the following results were obtained. 1. The NPY-immunoreactive neurons were evenly distributed in corpus striatum and in the primaty motor cortex, the NPY-immunoreactive neurons were concentrated within the layer II, III and layer V, VI. The typical NPY-immunoreactive perikarya was multipolar shape. 2. Decreased number of NPY-immunoreactive neurons were detected in some areas of corpus striatum and primary mortor cortex of the aged rat. 3. Decrease of NPY-immunoreactive neurons were most prominent in the caudate-putamen and there were moderate decrease of NPY-immunoreactive neurons in the primary motor cortex, mild decrease of NPY-immunoreactive neurons in the nucleus accumbens but the NPY-immunoreactive neurons were not observed in the globus pallidus in both control and aged rat. NPY is supposed to act as a neurotransmitter of local circuit neurons in the striatum and may exert its potent vasoconstrictor effects on cerebral vessels which influences on the microcirculation of cerebral cortex and striatum. So our results seems to provide an important data on change of the function in the striatum and primary motor cortex of aged rat brain.
Aging ; Animals ; Brain ; Cerebral Cortex ; Corpus Striatum* ; Globus Pallidus ; Microcirculation ; Motor Cortex ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Neurotransmitter Agents ; Nucleus Accumbens ; Rats* ; Rats, Sprague-Dawley

When a patient with severe trauma is admitted to the emergency room (ER), they are evaluated before transfer to either the intensive care unit (ICU) or operating room. To minimize the time until a definitive treatment can be provided, direct operating room resuscitation can be performed. In this hospital the ER was closed during the hospital’s transition to a coronavirus disease 2019-dedicated hospital, and direct ICU resuscitation for patients with trauma was performed for a short period. To perform effective trauma resuscitation, all ICU beds were reorganized to achieve a modified, experienced nurse: patient ratio (1:2-3) and 2 beds were assigned for trauma ICU resuscitation alone. The equipment for initial resuscitation was installed and ICU nurses received training. Consultations with the hospital administration, nursing, and pharmaceutical departments were completed in advance to avoid formal problems. Conversion of the ICU for direct resuscitation procedures was performed in 4 patients.

Coronavirus disease was first reported in December 2019, and the World Health Organization declared it as a pandemic on March 11, 2020. The virus is known to attack various vital organs, including the respiratory system. Patients sometimes require positive pressure ventilation and tracheostomy. Because tracheostomy is a droplet-spreading procedure, medical staff should protect themselves against the risk of transmission of this contagious viral disease. In our case, we performed tracheostomy for a 70-year-old man with coronavirus disease 2019 (COVID-19) who had required more oxygen with gradual weakness of respiratory muscle to maintain his arterial oxygen saturation. We focused on the risks of the medical staffs and patients, and minimized them at the same time using temporary balloon over-inflation, pre-operative adjustment of endotracheal tube position, and attachment of a transparent film dressing to the surgical field without stopping the ventilator while following routine safety measures. Fourteen days after the tracheostomy, all participating medical staff members were healthy and asymptomatic. The patient was discharged 105 days after the COVID-19 diagnosis.