Most of primary hyperparathyroidism results from parathyroid adenoma, and is characterized by hypercalcemia, reduced bone density, frequent renal stone, gastric ulcer, duodenal ulcer, muscle weakness, depression, hypertension, anemia, and rarely brown tumor. We had a case of an 80-year-old man having brown tumor caused by primary hyperparathyroidism on the right 10th rib confirmed by CT guided bone biopsy. The patient presented with decreased level of consciousness, acute gastric ulcer, acute duodenal ulcer, GB stones, renal insufficiency, depression, and osteoporosis. Serum calcium level was 16.7 mg/dL and the intact parathyroid hormone level was 3901pg/mL. A parathyroid mass was detected by neck CT and 99mTc-tetrofosmin parathyroid scan. The parathyroid tumor was removed and confirmed as a parathyroid adenoma by pathology. After operation, the patient was treated with vitamin D and calcium in response to the resulting hungry bone syndrome. The intact PTH level returned to a normal range after the removal of the parathyroid adenoma.
Aged, 80 and over ; Anemia ; Biopsy ; Bone Density ; Calcium ; Consciousness ; Depression ; Duodenal Ulcer ; Humans ; Hypercalcemia* ; Hyperparathyroidism, Primary ; Hypertension ; Muscle Weakness ; Neck ; Osteoporosis ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Pathology ; Reference Values ; Renal Insufficiency ; Ribs ; Stomach Ulcer ; Vitamin D

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

No abstract available.
Carotid Artery Diseases* ; Diabetic Neuropathies* ; Humans

The elderly population has recently increased significantly, and therefore the number of elderly patients with diabetes is also rapidly increasing. There are many physical, mental, and societal differences among elderly diabetic patients. Therefore, before initiating any form of glucose-lowering therapy in the elderly, it is necessary to assess overall patient health status, coexisting illnesses, the social environment, and degree of cognitive function. The elderly may also be at increased risk of adverse events, particularly hypoglycemia, during drug therapy for glucose control. Glucose control should remain an individualized target while minimizing the risk of hypoglycemia in elderly diabetic patients. This article summarizes treatment options with respect to oral glucose-lowering agents and insulins that are effective in elderly patients.
Aged ; Diabetes Mellitus ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Insulins ; Social Environment

A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.
Blister ; Bronchi ; Lung ; Stents ; Thoracic Surgery

BACKGROUND: In the acute phase of myocardial infarction, the hemostatic mechanism is known to be activated. However, it remains unclear whether increased activity of the hemostatic mechanism is only a marker of the acute thrombotic episode or precedes its appearance. It is also inapparent whether a hypercoagulable state persist for a prolonged period after the apparent resolution of these disorders. METHODS: In a group of 23 patients with acute myocardial infarction who received fibrinolytic therapy with urokinase(group A) or tPA(group B), the plasma level of fibrinogen, antithrombin compared to those of the 10 normal controls. RESULTS: The plasme level of fibrinogen was significantly decreased in both group A and B before and 4 to 24 hours after thrombolytic therapy compared to that of normal controls. But it was increased 7 to 14 days after thrombolytic therapy. In a few of the patients, the plasma level of FDP and D-dimer were positive before thrombolytic therapy and in the most patients they were positive 4 hours after thrombolytic therapy. The plasma level of AT-III was significantly increased in both group A and B before thrombolytic therapy compared with that of normal controls, but, after thrombolytic therapy, there was no significant change in its level. CONCLUSIONS: In the patients with acute myocardial infarction, the thrombolysis occurred before thrombolytic therapy and it lasted for 24 hours after thrombolytic therapy.
Antithrombin III* ; Fibrinogen ; Humans ; Myocardial Infarction* ; Plasma ; Thrombolytic Therapy*

Cell therapy using stem cells has produced therapeutic benefits in animal models of COPD. Secretory mediators are proposed as one mechanism for stem cell effects because very few stem cells engraft after injection into recipient animals. Recently, nanovesicles that overcome the disadvantages of natural exosomes have been generated artificially from cells. We generated artificial nanovesicles from adipose-derived stem cells (ASCs) using sequential penetration through polycarbonate membranes. ASC-derived artificial nanovesicles displayed a 100 nm-sized spherical shape similar to ASC-derived natural exosomes and expressed both exosomal and stem cell markers. The proliferation rate of lung epithelial cells was increased in cells treated with ASC-derived artificial nanovesicles compared with cells treated with ASC-derived natural exosomes. The lower dose of ASC-derived artificial nanovesicles had similar regenerative capacity compared with a higher dose of ASCs and ASC-derived natural exosomes. In addition, FGF2 levels in the lungs of mice treated with ASC-derived artificial nanovesicles were increased. The uptake of ASC-derived artificial nanovesicles was inhibited by heparin, which is a competitive inhibitor of heparan sulfate proteoglycan that is associated with FGF2 signaling. Taken together, the data indicate that lower doses of ASC-derived artificial nanovesicles may have beneficial effects similar to higher doses of ASCs or ASC-derived natural exosomes in an animal model with emphysema, suggesting that artificial nanovesicles may have economic advantages that warrant future clinical studies.
Animals ; Cell- and Tissue-Based Therapy ; Emphysema* ; Epithelial Cells ; Exosomes ; Fibroblast Growth Factor 2 ; Heparan Sulfate Proteoglycans ; Heparin ; Lung ; Membranes ; Mice ; Models, Animal ; Pulmonary Disease, Chronic Obstructive ; Stem Cells

BACKGROUND: Chronic obstructive pulmonary disease is characterized by emphysema, chronic bronchitis, and small airway remodeling. The alveolar destruction associated with emphysema cannot be repaired by current clinical practices. Stem cell therapy has been successfully used in animal models of cigarette smoke- and elastase-induced emphysema. However, the optimal dose of mesenchymal stem cells (MSCs) for the most effective therapy has not yet been determined. It is vital to determine the optimal dose of MSCs for clinical application in emphysema cases. METHODS: In the present study, we evaluated the therapeutic effects of various doses of MSCs on elastase-induced emphysema in mice. When 3 different doses of MSCs were intravenously injected into mice treated with elastase, only 5x10(4) MSCs showed a significant effect on the emphysematous mouse lung. We also identified action mechanisms of MSCs based on apoptosis, lung regeneration, and protease/antiprotease imbalance. RESULTS: The MSCs were not related with caspase-3/7 dependent apoptosis. But activity of matrix metalloproteinase 9 increased by emphysematous lung was decreased by intravenously injected MSCs. Vascular endothelial growth factor were also increased in lung from MSC injected mice, as compared to un-injected mice. CONCLUSION: This is the first study on the optimal dose of MSCs as a therapeutic candidate. This data may provide important basic data for determining dosage in clinical application of MSCs in emphysema patients.
Airway Remodeling ; Animals ; Apoptosis ; Bronchitis, Chronic ; Emphysema ; Humans ; Lung ; Matrix Metalloproteinase 9 ; Mesenchymal Stromal Cells* ; Methods ; Mice ; Models, Animal ; Pancreatic Elastase* ; Pulmonary Disease, Chronic Obstructive ; Regeneration ; Stem Cells ; Tobacco Products ; Vascular Endothelial Growth Factor A

BACKGROUND: Mesenchymal stem cells (MSCs) obtained from bone marrow or adipose tissue can successfully repair emphysematous animal lungs, which is a characteristic of chronic obstructive pulmonary disease. Here, we describe the cellular distribution of MSCs that were intravenously injected into mice with elastase-induced emphysema. The distributions were also compared to the distributions in control mice without emphysema. METHODS: We used fluorescence optical imaging with quantum dots (QDs) to track intravenously injected MSCs. In addition, we used a human Alu sequence-based real-time polymerase chain reaction method to assess the lungs, liver, kidney, and spleen in mice with elastase-induced emphysema and control mice at 1, 4, 24, 72, and 168 hours after MSCs injection. RESULTS: The injected MSCs were detected with QD fluorescence at 1- and 4-hour postinjection, and the human Alu sequence was detected at 1-, 4- and 24-hour postinjection in control mice (lungs only). Injected MSCs remained more in mice with elastase-induced emphysema at 1, 4, and 24 hours after MSCs injection than the control lungs without emphysema. CONCLUSION: In conclusion, our results show that injected MSCs were observed at 1 and 4 hours post injection and more MSCs remain in lungs with emphysema.
Adipose Tissue ; Animals ; Bone Marrow ; Cell Tracking ; Emphysema* ; Fluorescence ; Humans ; Injections, Intravenous ; Kidney ; Liver ; Lung ; Mesenchymal Stromal Cells* ; Mice ; Optical Imaging ; Pulmonary Disease, Chronic Obstructive ; Quantum Dots ; Real-Time Polymerase Chain Reaction ; Spleen