No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

No abstract available.
Humans ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Thyroid Gland*

No abstract available.
Humans ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Thyroid Gland*

BACKGROUND: Thyroid status in uremia is still inconclusive due to the complexicity of the system. No single pathogenetic event may explain the thyroid function abnormalities in end stage renal disease (ESRD). Defects at all levels of the hypothalamic-pituitary-thyroid axis have been identified. Regarding the thyroid dysfunction in ESRD it is well recognized that the TSH response to TRH is blunted and serum concentrations of thyroid hormones are decreased in patients with ESRD. Whether or not on maintenance hemodialysis. Restoration of renal function with renal transplantation resulted in normalization of all parameters of thyroid function with exception of blunted TSH response to TRH. We evaluated the long-term changes of the thyroid function in 10 patients to know whether the thyroid function and the hypothalamo-pituitary axis were improved with the recovery of the renal function under maintenance low-dosage steroid administration after renal transplantation. METHODS: These tests were performed during the morning in the fasting state in 10 ESRD patients before, 1 month and 6 years after renal transplantation (RT). Thyroid function tests. Serum T3, T4 were measured by RIA kit and serum TSH was measured by IRMA kit. TRH stimulation test. Serum blood samples were obtained 0, 30, 60, 90, 120 min after TRH (400microgram) administration. Statistical analysis. All grouped data were expressed as mean+/-SD. Student t-test was used to assess the statistical difference between any two means. RESULTS: 1) The mean basal level of serum T3 was reduced in ESRD patients (53.6+/-33.2ng/dL) and increased to the low normal level 1 month after RT (87.8+/-25.4ng/dL), improved to the normal level 6 years after RT (116.3+/-28.8ng/dL). 2) The mean basal level of T4 was within normal range before RT (5.9+/-1.1microgram/dL), after 1 month (6.2+/-1.2microgram/dL) and after 6 years (6.5+/-1.4microgram/dL) of RT. 3) The mean basal level of TSH was within normal range before RT (2.0+/-1.2microU/mL), after 1 month (1.1+/-0.7microU/mL), and after 6 years (0.7+/-0.5microU/mL) of RT. Rut the mean TSH level of 6 years of RT was significantly decreased within the normal range. 4) In ESRD the TSH response to TRH was blunted, had a diminished peak and delayed fall before RT. After 1 month of RT, the TSH response to TRH was persistently blunted, however showed more rapid fall of TSH. After 6 years of RT, the TSH response to TRH normalized, but the absolute level of TSH and the peak level of TSH to TRH were less than before and after 1 month of RT. CONCLUSIONS: The abnormalities of thyroid hormones in uremic patients were improved partially after 1 month of RT and almost completely after 6 years of RT. But the level of T3H and the peak level of TSH to TRH were low within normal range, these results may be a direct consequence of low-dosage and long-term glucorcorticoid administration.
Axis, Cervical Vertebra ; Fasting ; Follow-Up Studies* ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Reference Values ; Renal Dialysis ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones ; Uremia

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis, Tuberculous*

PURPOSE: The purpose of this study was to describe perceived conception of health, family support and health promoting behavior; as well as to assess factors that influence health promoting behavior. METHOD: Study participants were 165 elderly people over the age of 65, living in C city. The instruments were Laffery's health concept scale, the family support scale by Kang, and the health promoting behavior scale by Walker et al. RESULTS: 1. The scores for level of health concept ranged from 28 to 112, and had a mean score of 75.16. The scores for level of family support ranged from 11 to 55, and had a mean score of 41.55. The scores for health promoting behavior ranged from 40 to 160 with mean score of 98.07. For health promoting behavior the participants revealed that the most frequent practices were in nutrition, and the least frequent, in exercise. 2. Higher levels of health conception and family support were correlated with an improving level of health promoting behavior . 3. The factor most influencing health promoting behavior in elderly people was family support. Family support accounted for 11% of the variance in health promoting behavior. A combination of health conception, education level and dwelling pattern accounted for 23% of the variance in health promoting behavior. CONCLUSION: Perceived health conception and family support were identified as important variables for health promoting behavior in elderly people.
Aged* ; Education ; Family Health ; Fertilization* ; Health Status ; Humans

BACKGROUND: Lipoprotein(a)[Lp(a)] is a subspecies of low-density lipoprotein and has been shown to be associated with pathogenesis of thrombosis-related disease. It is already known that patients with diabetic nephropathy are usually complicated by vascular complications such as coronary artery diseases and cerebrovascular accidents. According to the recent data, Lp(a) level tends to be increased as the proteinuria is increased and renal function are decreased. We evaluated the Lp(a) level to know whether its level is correlated to the severity of diabetic nephropathy. METHODS: We investigated Lp(a) levels in eighty-one patients with Type 2 (non-insulin-dependent) diabetic patients. They were divided into four groups according to the level of urinary albumin excretion and serum creatinine level: Group 1 (n=30): normal renal function + urine microalbumin or=1.5mg/dL. Blood samples were obtained during the morning in the fasting state and separated serum from the it and reserved at -70degrees C. Lp(a) concentration was checked by one-step sandwich ELISA test. All grouped data were expressed as mean+/-SD. ANOVA and unpaired t-test was used to assess the statistical difference between any two means. RESULTS: Lp(a) levels were 30.2+/-4.6mg/dL in Group 1, 42.7+/-8.2mg/dL in group 2, 73.4+/-19.7mg/dL in group 3, and 80.7+/-14.8mg/dL in group 4. The level of Lp(a) in group4, group 3, and group 2 was significantly higher than that of group 1 respectively (P=0.009, 0.001, 0.038). However, no significant correlation was observed between the level of Lp(a) and that of total cholesterol, triglyceride and total lipid in all groups. CONCLUSIONS: these results indicate that Lp(a) concentrations are increased in the patients with diabetic nephropathy with microalbuminuria or overt proteinuria. So, the presence of albuminuria may be the important determinant for the elevated Lp(a) level in diabetic nephropathy.
Albuminuria ; Cholesterol ; Coronary Artery Disease ; Creatinine ; Diabetic Nephropathies* ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Humans ; Lipoprotein(a)* ; Lipoproteins* ; Proteinuria ; Stroke ; Triglycerides ; Urinalysis

Hypoxia-inducible factor-1 (HIF-1) is composed of HIF-1alpha and HIF-1beta, and is a master regulator of oxygen homeostasis, playing critical roles in physiological and pathological processes. Normally, the formation and transcriptional activity of HIF-1 depend on the amount of HIF-1alpha, and the expression of HIF-1alpha is tightly controlled by the cellular oxygen tension. Recent progress in the study of its regulation mechanism provided clues as to how HIF-1alpha is regulated by oxygen. It appears that HIF-1alpha is not regulated only by the oxygen tension, but also by various other stimuli, such as transition metals, nitric oxide, reactive oxygen species, growth factors, and mechanical stresses. In this review, we summarize the oxygen-dependent and -independent regulation of HIF-1alpha, and the respective physiological and pathological meanings.
Animals ; Growth Substances/metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; Molecular Structure ; Nitric Oxide/metabolism ; Oxygen/*metabolism ; Reactive Oxygen Species/metabolism ; Stress, Mechanical ; Transcription Factors/chemistry/genetics/*metabolism ; Transition Elements/metabolism

We report a case of polycythemia vera combined with coagulation disorder. The patient was 54 years old man who complained of continuous bleeding after incision of skin abscess 20days ago. Laboratory tests were revealed prolonged aPTT and slightly prolonged PT. Coagulation factor, I, VIII, IX, XI and fibrinogen decreased, however FDP did not increased. It appears that patient with polycythemia vera have chronic activation of coagulation system, probably initiated by activation of factor XII. Platelet aggregation test to ADP, collagen, epinephrine was also revealed poor response.
Abscess ; Adenosine Diphosphate ; Blood Coagulation Factors ; Collagen ; Epinephrine ; Factor XII ; Fibrinogen ; Hemorrhage ; Humans ; Platelet Aggregation ; Polycythemia Vera* ; Polycythemia* ; Skin

We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation.
Female ; Humans ; Iridectomy/*methods ; Iris/*surgery ; *Laser Therapy ; Lasers, Solid-State ; Lens Implantation, Intraocular/*adverse effects ; Middle Aged ; *Phakic Intraocular Lenses ; Pigment Epithelium of Eye/pathology ; *Postoperative Complications ; Recurrence ; Reoperation ; Trabecular Meshwork/pathology ; Uveitis, Anterior/etiology