No abstract available.

No abstract available.

Hypoparathyoidism is rarely reported during pregnancy or the puerperium. Since hypocalcemia during pregnancy increases the mortality and morbidity of fetus, neonate, and mother, the early diagnosis and treatment of hypocalcemia, especially hypocalcemic crisis, might be very important to reduce severe complications. We experienced a case of hypocalcemic crisis induced by hypoparathyroidism developed after Cesarean section. This case represents symptoms and signs of hypocalcemia such as dyspnea, tingling sensation of upper and lower limbs, chest pain during hypocalcemic crisis. Physicians should be aware of the symptoms and signs, and treatment of hypocalcemic crisis.
Cesarean Section* ; Chest Pain ; Dyspnea ; Early Diagnosis ; Female ; Fetus ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Infant, Newborn ; Lower Extremity ; Mortality ; Mothers ; Postpartum Period ; Pregnancy ; Sensation

OBJECTIVES: Obesity and osteoporosis have been increasing for decades but their relationship to bone mineral density (BMD) and fat mass has not been defined. The aim of this study was to investigate how changes in body composition affect BMD after a weight reduction. MATERIALS AND METHODS: We reviewed 48 middle-aged obese women who had participated in our diet program and succeeded in reducing their weight. Body composition was measured by the dual-energy X-ray absorptiometry method, and metabolic syndrome was defined as described in the ATP-III guidelines. All differences between baseline and 12 weeks later were expressed as [{12th week data-baseline data}/baseline datax100]. RESULTS: The mean age of the participants was 38.29+/-10.89 years, and the mean follow-up time was 85 days. The mean body mass index was 31.50+/-5.19 kg/m2. Basal BMD decreased with age and increased with weight and appendicular lean mass. In a regression analysis, appendicular lean mass was positively correlated with leg BMD (R2=0.235, B=0.015, P<0.001) and age (B=-0.002, P=0.046), and appendicular lean mass (B=0.019, P=0.049) was the main determinant of total BMD (R2=0.272). After weight reduction, the total body BMD change ratio (R2=0.281) was negatively related to the change of fat mass, trunk fat mass (B=-0.042, P=0.087) and waist circumference (B=-0.108, P=0.014). CONCLUSIONS: Our findings suggest that BMD is determined by muscle mass, and that changes in central obesity may also affect BMD.
Absorptiometry, Photon ; Body Composition ; Body Mass Index ; Bone Density ; Diet ; Female ; Follow-Up Studies ; Humans ; Leg ; Muscles ; Obesity ; Obesity, Abdominal ; Osteoporosis ; Waist Circumference ; Weight Loss

OBJECTIVES: Psychiatric patients are known to use alternative medicine more frequently than medical patients. However, the factors increasing the frequency of use are not clearly understood. In an attempt to find predictive factors for the use of alternative medicine, we conducted a questionnaire survey on outpatients in psychiatric and endocrinology units of a university hospital. METHODS: A total of 'first come, first served' consecutive sample of 95 psychiatric outpatients and 100 medical outpatients as a control group were surveyed. The questionnaire contained sociodemographic information, use of alternative medicine, clinical information, and depressiv symptoms. RESULTS: As a result, 62.1% of psychiatric and 23.0% of medical patients reported to have used at least one type of alternative medicine during the past 12 months. Logistic regression analysis revealed predictive factors for alternative medicine user as being psychiatric patients (odds ratio=4.09, 95% confidence interval 2.11-7.95, pc<0.001) and those who didn't finish high school (OR=30.23, 95% CI 3.68-248.18, p=0.002). CONCLUSION: The finding of low education as a predictive factor is contrary to Western findings, which suggested higher education as a predictive factor for use of alternative medicine. This finding needs to be replicated and investigated for culturally different illness concept and behavior. These finding suggest that asking the patient's use of alternative medicine should be a part of routine psychiatric history taking.
Complementary Therapies* ; Education ; Endocrinology ; Fibrinogen ; Humans ; Logistic Models ; Outpatients* ; Surveys and Questionnaires ; Risk Factors

A 49-year-old man with liver cirrhosis and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic patients with normokalemia as controls. Also, the renin-aldosterone stimulation testing on this patient performed by sodium restricted diet and furosemide, upright position and by angiotensin converting enzyme inhibition (captopril, 50 mg) showed the blunted renin and aldosterone responses to each of these stimuli, almost no changes from baseline renin and aldosterone levels, it was concluded that the underlying defect responsible for hyperkalemia in this case was hyporeninemic hypoaldosteronism and this was aggravated by other factors or drugs affecting potassium homeostasis.
Aldosterone/blood ; Captopril/pharmacology ; Furosemide/pharmacology ; Humans ; Hyperkalemia/*etiology ; Hypertension/*complications ; Hypoaldosteronism/*complications ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Renin/blood

A 32 year-old-man was admitted because of paraparesis. Hypertension and hypokalemia was noted with increased aldosterone level in his serum. Computerized tomography of abdomen showed well-defined an ovoid mass of low density in the right adrenal gland. Right adrenalectomy was done and pathologic findings showed a golden yellow color adenoma with large clear cells. Postoperatively there was reversal of hypertension and hypokalemia. We present a case of periodic paralysis due to aldosterone producing adrenal cortical adenoma with brief review of literature.
Abdomen ; Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocortical Adenoma* ; Aldosterone* ; Hypertension ; Hypokalemia ; Paralysis* ; Paraparesis

BACKGROUND: GH3 cells are a well characterized and widely used model used for the in vitro study of growth hormone (GH) secretion. Thyrotropin releasing hormone (TRH) binds to receptors belonging to the family of G protein-coupled receptors, and secrets both GH & prolactin. Phospholipase D (PLD) is an enzyme that hydrolyses phosphatidylcholine to yield phosphatidic acid and choline, and plays important roles in cellular proliferation and hormonal secretion. To elucidate the pathway of the action of TRH in GH3 cells, we investigated the activities of PLC and PLD in GH3 cells treated with TRH or phorbor 12-myristate 13-acetate (PMA). METHODS: GH3 cells were labeled with [3H] myristate, followed by incubation of with 0.3% ethanol, prior to before the addition of the agonists. The total lipids were extracted from the harvested cells following treatment with the agonists. The PLD activity was assessed by measuring [3H] phosphatidylethanol from the [3H] phospholipid using thin layer chromatography. RESULTS: TRH (1 muM) stimulated the PLC activity by 44-fold over that of the control values. TRH (1 microM), mastoparan (5 muM), and PMA (500 muM) for 30 minutes increased PLD activity by 1.9, 1.5 and 2.2 fold, respectively, in comparison to the controls. The PLD activities after 15, 30, 60, 120 and 240 min treatments of TRH (1 microM) were 142%, 170%, 172%, 160% and 115%, respectively. CONCLUSION: These results suggest that TRH stimulates not only the PLC activity, but also the PLD activity in GH3 cells.
Cell Proliferation ; Choline ; Chromatography, Thin Layer ; Ethanol ; Growth Hormone ; Humans ; Myristic Acid ; Phosphatidic Acids ; Phosphatidylcholines ; Phospholipase D* ; Phospholipases* ; Prolactin ; Thyrotropin-Releasing Hormone

Steroid myopathy is one of the most common drug-induced myopathy. We report a case of iatrogenic steroid myopathy in a 61-year-old female who had taken herb medication more than 2 months. She presented a slowly progressive proximal muscle weakness and wasting with typical features of cushing syndrome. Needle EMG showed typical myopathic patterns. The muscle biopsy revealed a pronounced muscle fiber atrophy and fatty degenerative change without inflammation. In addition, there was a selective type 2 fiber depletion on ATPase staining in pH 9.4 buffer. Her muscle powers and bulks were slowly improved after discontinuation of herb medication with phenytoin and physical therapy.
Adenosine Triphosphatases ; Atrophy ; Biopsy ; Cushing Syndrome* ; Female ; Humans ; Hydrogen-Ion Concentration ; Inflammation ; Middle Aged ; Muscle Weakness ; Muscular Diseases* ; Needles ; Phenytoin

BACKGROUND: There have been many reports that 1,5-Anhydroglucitol (1,5-AG) was a better marker than the hemoglobin A1c (HbA1c) or fructosamine for monitoring the control of glucose in patients with Diabetes Mellitus (DM). However, there was difficulty in performing the tests on the patient's samples in the hospital laboratory because the measurement was possible only with gas chromatog-raphy or high performance chromatography. Recently, a reagent that can measure 1,5-AG on the automatic chemistry analyzer was introduced. We evaluated the analytical and clinical characteris-tics of the reagent. METHODS: We measured the 1,5-AG with the Lana(TM) (Japan Chemistry Medicine, Tokyo, Japan) on the automatic chemistry analyzer, TBA-30FR (Toshiba, Otawara, Japan). We evaluated the pre-cision, the recovery rate, the lower detection limit, the reference value, and the correlation with other clinical markers for glucose control of the DM patient. RESULTS: The within-run precisions of abnormal and normal samples were 1.27% and 1.41%. The between-day precisions were 2.34% and 4.56%, respectively. The recovery rate was 100.1% and 100.7% in abnormal and normal samples, respectively. The lower detection limit was 0.05 mg/L. The reference value from the healthy people was from 12.7 to 50.9 mg/L. The correlation coefficients of the 1,5-AG with glucose and HbA1c were -0.45 and -0.63, respectively. CONCLUSIONS: The newly introduced reagent for 1,5-AG that could be applied with the automatic chemistry analyzer was enough to satisfy the analytical features and it showed better correlation with HbA1c than with the fasting blood glucose. We expect that the Lana(TM) can be used in hospital lab-oratories to monitor the blood glucose control of DM patients and more studies on the clinical value of the 1,5-AG can be done with the convenient reagent such as this.
Biomarkers ; Blood Glucose ; Chemistry ; Chromatography ; Diabetes Mellitus ; Fasting ; Fructosamine ; Glucose ; Humans ; Laboratories, Hospital ; Limit of Detection ; Reference Values