Oxidative stress has been considered to be a major contributor to the pathogenesis of the diabetic macrovascular and microvascular complications. In the absence of an appropriate antioxidant defense mechanism, increased oxidative stress leads to the activation of stress-sensitive intracellular signaling pathways and the formation of gene products that cause damage and contribute to the late complications ofdiabetes. The source of reactive oxygen species (ROS) in the pancreatic beta cells and insulin sensitive cells has postulated to be the mitochondrial electron transport chain. NAD(P)H oxidase-dependent ROS production is also important as the source both in pancreatic beta cells and other cells. NAD(P)H oxidase mediated ROS can alter parameters of signal transduction, insulin secretion, insulin action, cell proliferation and cell death. Additionally, oxidative stress as the pathogenic mechanism linking insulin resistance with dysfunction of both pancreatic beta cells and endothelial cells, eventually leads to diabetes and its complications. Further investigation of the mechanisms and its therapeutic interventions based on focusing NAD(P)H oxidase associated ROS production in the islet cells and other islet cells are needed
Cell Death ; Cell Proliferation ; Electron Transport ; Endothelial Cells ; Insulin ; Insulin Resistance ; Insulin-Secreting Cells ; Islets of Langerhans ; Mitochondria ; NADPH Oxidase ; Oxidative Stress ; Reactive Oxygen Species ; Signal Transduction

No abstract available.
C-Peptide

Macrovascular and microvascular diseases are currently the principal causes of morbidity and mortality in subjects with diabetes. Disorders of the physiological signaling functions of reactive oxygen species (superoxide and hydrogen peroxide) and reactive nitrogen species (nitric oxide and peroxynitrite) are important features of diabetes. In the absence of an appropriate compensation by the endogenous antioxidant defense network, increased oxidative stress leads to the activation of stress-sensitive intracellular signaling pathways and the formation of gene products that cause cellular damage and contribute to the vascular complications of diabetes. It has recently been suggested that diabetic subjects with vascular complications may have a defective cellular antioxidant response against the oxidative stress generated by hyperglycemia. This raises the concept that antioxidant therapy may be of great benefit to these subjects. Although our understanding of how hyperglycemia-induced oxidative stress ultimately leads to tissue damage has advanced considerably in recent years, effective therapeutic strategies to prevent or delay the development of this damage remain limited. Thus, further investigation of therapeutic interventions to prevent or delay the progression of diabetic vascular complications is needed.
Compensation and Redress ; Diabetic Angiopathies ; Hydrogen ; Hyperglycemia ; Nitrogen ; Oxidative Stress ; Oxygen ; Reactive Nitrogen Species ; Reactive Oxygen Species

No abstract available.
Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Humans

No abstract available.
Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Humans

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

Central diabetes insipidus caused by pineal gland neoplasm is rare. Here, we describe a case of central diabetes insipidus and pineal germinoma with seeding to pituitary stalk along CSF pathway. A 27 year-old male patient was admitted due to polyuria, polydipsia, headache, vomiting, diplopia, and decreased visual acuity for recent two months. Urine osmolality measured after water deprivation was below 100mOsm/kg. However, urine osmolality increasd above 300 mOsm/kg with pitressin administration. Brain MRI showed a 2cm sized mass with seeding into pituitary stalk along CSF in pineal region. Surgical biopsy revealed pineal germinoma. Two cycles of chemotherapy with etoposide and cis-platin were done followed by brain irradiation(2,500cGy). Follow up brain MRI after second chemotherapy showed complete remission. The patient had no neurologic and endocrinologic deficit after the treatment.
Adult ; Biopsy ; Brain ; Diabetes Insipidus* ; Diabetes Insipidus, Neurogenic ; Diplopia ; Drug Therapy ; Etoposide ; Follow-Up Studies ; Germinoma ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Osmolar Concentration ; Pineal Gland ; Pinealoma ; Pituitary Gland ; Polydipsia ; Polyuria ; Vasopressins ; Visual Acuity ; Vomiting ; Water Deprivation

BACKGROUND: It is known that metabolic syndrome (MetS) is associated with chronic kidney disease. We evaluated and compared the prevalence of reduced kidney function in MetS and its components by estimated glomerular filtration rate (eGFR) using an equation based on creatinine (eGFRcr), cystatin C (eGFRcys), and combined creatinine-cystatin C (eGFRcr-cys) in Korean adults. METHODS: We analyzed data from 3,649 adults who participated in a comprehensive health examination. RESULTS: Mean values of eGFRcys were higher compared with mean values of eGFRcr (96.1±18.2 mL/min/1.73 m² vs. 91.2±13.6 mL/min/1.73 m²) in total subjects. The prevalence of reduced kidney function increased with age (9.6% for eGFRcys vs. 5.8% for eGFRcr-cys vs. 4.9% for eGFRcr, in subjects aged ≥60 years), and significantly increased with MetS, abdominal obesity, hypertension, high triglyceride, low high density lipoprotein (HDL), and high insulin resistance. The prevalence of MetS, abdominal obesity, hypertension, high insulin resistance, low HDL, and hepatic steatosis was significantly increased in subjects with reduced kidney function. This increased prevalence and the odds ratio of reduced kidney function for prevalence of MetS was highest for eGFRcys, followed by those of eGFRcr-cys, and eGFRcr. CONCLUSION: The prevalence of reduced kidney function by eGFR was significantly increased in subjects with MetS and its related components. eGFRcys and eGFRcr-cys were superior to eGFRcr in detecting reduced kidney function.
Adult* ; Creatinine* ; Cystatin C* ; Glomerular Filtration Rate* ; Humans ; Hypertension ; Insulin Resistance ; Kidney* ; Lipoproteins ; Obesity, Abdominal ; Odds Ratio ; Prevalence* ; Renal Insufficiency, Chronic ; Triglycerides

In order to find out the relationship between blood viscosity and the development of an ischemic symptom(clinical vasospasm) following an aneurysmal subarachnoid hemorrhage(SAH), was checked daily the hematocrit(Hct), blood viscosity and plasma viscosity from admission day to 14 days after SAH in 33 patients. Twelve patients with diseases except those with a SAH were selected as a control group. We analyzed the difference of the average hematocrit, blood viscosity, and plasma viscosity between the control group, non-spasm group and spasm group on admission, and then the period of preoperative, postoperative with mannitolization, and postoperative without mannitolization. We also analyzed the change of those according to the SAH day, and the relationship between the blood viscosity and the level of hematocrit in each group. As a result, aneurysmal SAH patients with clinical vasospasm showed a higher plasma viscosity than the control(1.82+/-0.21 vs. 1.55+/-0.14, respectively : p<0.01) and clinical non-spasm(1.82+/-0.21 vs. 1.66+/-0.12, respectively : p<0.05) group of patients on admission statistically. In the spasm group, the blood viscosity was raised during the spasm risk period(SAH 7-10 days). The level of the hematocrit in the spasm group was lower than the non-spasm group and most of them checked below 30% after surgery. In the relationship between the level of hematocrit and the blood viscosity, the spasm group showed a relatively higher blood viscosity than the non-spasm group. These results suggest that the blood viscosity has some role in the development of ischemic symptoms after a subarachnoid hemorrhage, but major determinants such as erythrocyte aggregation, plasma fibrinogen concentration and platelet aggregation which affect the microcirculation have a more important role. Therefore, when hemodilution are used for prevention or improvement of ischemic symptoms after subarachnoid hemorrhage, the level of the hematocrit and the focus on decreasing the major determinants of the viscosity in microcirculation should be considered.
Aneurysm* ; Blood Viscosity* ; Erythrocyte Aggregation ; Fibrinogen ; Hematocrit* ; Hemodilution ; Humans ; Mannitol ; Microcirculation ; Plasma* ; Platelet Aggregation ; Spasm ; Subarachnoid Hemorrhage* ; Viscosity*