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

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.
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: Resting ankle brachial pressure index is a non-invasive method to assess the patency of lower extremity arterial system and it can be measured using traditional Doppler method or photoplethysmography. Automated blood pressure measurement is a easy and quick method for measurement of ankle brachial pressure index, but usefulness of this method have not been investigated. So we evaluated the accuracy of Automated blood pressure measurement device as flow detector in determining the ankle brachial pressure index in comparison to photoplethysmography. METHODS: A total 136 subjects containing 117 diabetic patients and 19 volunteers were included in the study. With each subject in the supine position, dorsalis pedis arterial pulses were palpated by examiner. And the brachial and ankle systolic blood pressure were recorded using photoplethysmography (Rheoscreen, Medis, Germany) and automated blood pressure measurement device (MD-800, Meditec, Korea). Ankle brachial pressure index for each leg was separately calculated by dividing the ankle systolic pressure by the higher brachial systolic pressure. Statistical analyses were performed by SPSS for Windows (version 10.0 SPSS Inc.) RESULTS: Brachial and ankle systolic pressure measured using automated blood pressure measurement device were higher than photoplethysmography and correlations between both method were significant (r=0.886, r=0.844). Ankle brachial pressure index derived using automated blood pressure measurement have a better correlation with photoplethysmography method (r=0.622) than pulse palpation (r=0.255). The subject was considered to have peripheral arterial disease if either leg ABI was 0.9 or less. Peripheral arterial disease was more frequent when it was defined using photoplethysmography (13.8%) vs automated blood pressure measurement device (6.3%). The sensitivity of the automated blood pressure measurement is 32.4%, the specificity is 97.8% and the accuracy is 88.8% for peripheral arterial disease defined using photoplethysmography. CONCLUSION: Automated blood pressure measurement was easier and quicker and less expensive as compared with photoplethysmography. Automated blood pressure measurement was not sensitive but more accurate as compared with pulse palpation. So we recommend that it be used on a routine screening basis of peripheral arterial disease in primary care.
Ankle* ; Blood Pressure* ; Humans ; Leg ; Lower Extremity ; Mass Screening ; Palpation ; Peripheral Arterial Disease ; Photoplethysmography* ; Primary Health Care ; Sensitivity and Specificity ; Supine Position ; Volunteers

The surgery of large cerebral arteriovenous malformation(AVM) may be complicated by the potential for serious brain swelling and hemorrhage during operation and/or postoperative period due to "normal perfusion pressure breadthrough(NPPB)". The authors present two cases of successful management of large AVM which anticipated the development of 'NPPB' using hypotension and preoperative embolization. The one case admitted with intraventricular hemorrhage and intracerebral hematoma due to rupture of large occipital AVM. We managed him with one-stage resection, followed by postoperative hypotension successfully. The another case was interesting. He had the history of intracranial hemorrhage about 13 years ago. We treated him conservatively at that time. He also had the another attack of intracranial hemorrhage in 1979. We performed angiography which revealed large AVM around trigon of left lateral ventricle. He also had another one time of intracranial hemorrhage in 1985. In 1986, We decided to treat him surgically and repeated angiography which showed enlarged AVM compare to size of AVM in previous angiogram of 1979 definitely. We embolized this lesion with Ivalon(R)(polyvinyl alcohol) and confirmed decreased size of AVM. During waiting the surgical resection, another intracranial hemorrhage occurred and recovered without surgical management. In May 1987, we decided to do operation and performed preoperative angiography, which showed reenlarged of previous embolic obliterated AVM. We resected that AVM successfully and discharged him without any aggravation of previous neurological signs. The pathologic findings of resected embolized AVM revealed infiltration of neurtrophils within vessel walls and foreign body material, surrounded by multinucleated foreign body giant cells, epitheloid cells in the vessel lumen. We reviewed the literature and discussed the enlargement of AVM, the treatment of large AVM, especially in point of view about 'NPPB' and pathologic findings of embolized AVM with Ivalon(R)(polyvinyl alcohol).
Angiography ; Brain Edema ; Foreign Bodies ; Giant Cells, Foreign-Body ; Hematoma ; Hemorrhage ; Hypotension ; Intracranial Arteriovenous Malformations* ; Intracranial Hemorrhages ; Lateral Ventricles ; Perfusion ; Postoperative Period ; Rupture