• Title/Summary/Keyword: hypoglycemia

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A Case of Long-Term Management of Insulinoma in a Maltese Dog (말티즈 개에서 인슐린종의 장기간 관리 증례)

  • Park, So-Young;Kang, Byeong-Teck;Kang, Ji-Houn;Chang, Dongwoo;Yang, Mhan-Pyo
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.363-365
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    • 2013
  • A 15-year-old, spayed female Maltese dog weighing 2.80 kg was referred with seizure of unknown origin. At presentation, serum biochemistry showed marked hypoglycemia (46 mg/dL; reference interval [RI], 65-118 mg/dL). There were, however, no abnormalities on electrolytes, complete blood counts, urinalysis, survey radiographs, and abdominal ultrasonography. In the adrenocorticotropic hormone (ACTH) stimulation test, pre-ACTH and post-ACTH cortisol concentrations were within normal reference ranges. Serum insulin level was normal and fructosamine level was slightly lower than reference ranges. The clinical signs, including seizure and collapse caused by hypoglycemia, were gradually resolved with oral administration of prednisolone (PDS) twice daily. Forty five weeks later, serum biochemistry revealed hypoglycemia with markedly increased insulin level. On abdominal ultrasonography, increased heterogenous echogenecity with hypoechoic lesion was found within pancreatic parenchyma. Based on these findings, the dog was presumptively diagnosed to insulinoma. Hypoglycemic seizure was resolved with higher dose of PDS (1 mg/kg, q12h). At 688 days after first presentation, the patient was still alive without recurrence of hypoglycemic seizure. This case describes long-term management with PDS monotherapy in a Maltese dog with insulinoma.

Hyperinsulinism in a dog with beta-cell neoplasia (insulinoma)

  • Yu, Do-Hyeon;Lee, Jong-Hyun;Song, Ru-Hui;Noh, Dong-Ho;Li, Ying-Hua;Lee, Mi-Jin;Cho, Ara;Kim, Bumseok;Park, Jinho
    • Korean Journal of Veterinary Research
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    • v.49 no.4
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    • pp.365-368
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    • 2009
  • A six-year-old female cocker spaniel presented with recurring episodes of pelvic limb weakness and intermittent seizures. Laboratory analysis revealed marked hypoglycemia and an elevated serum insulin concentration. A pancreatic beta-cell tumor at stage III ($T_1N_1M_1$) was diagnosed based on serial blood glucose and insulin measurements along with diagnostic imaging. The patient survived for 140 days after diagnosis with medical management, including frequent feeding and prednisolone therapy. On necropsy, necrosis and masses in the peripancreatic omentum and liver were found; pancreatic beta-cell neoplasia with metastasis to the liver was confirmed by histopathologic examination. This case reports hyper-insulinism in a dog presenting with hypoglycemic seizures.

Antihyperglycemic activity of Biophytum sensitivum (L.) DC in alloxan diabetic rats

  • Mishra, Moumita;Bandyopadhyay, Durba;Pramanik, Kartick Chandra;Chatterjee, Tapan Kumar
    • Advances in Traditional Medicine
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    • v.7 no.4
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    • pp.418-425
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    • 2007
  • The study was to evaluate the antihyperglycemic activity of Biophytum sensitivum (L.) DC in different extracts. Albino Wistar rats with alloxan hydrate induced diabetes were divided into 7 groups of 6 each. Both aqueous and methanolic extract of Biophytum sensitivum were prepared and given individually at different doses to different batches of rats (both normal and diabetic rats) after an overnight fast. Methanolic extract at the dose of 200 mg/kg body weight showed maximum blood glucose lowering effect in diabetic rats. The same dosages did not produce any hypoglycemic activity in normal rats. The antihyperglycemic activity of Biophytum sensitivum was compared with a standard drug Glibenclamide, an oral hypoglycemic agent. The above results suggest that maximum hypoglycemic effect was found only with a dose of up to 200 mg/kg b.w. of methanolic extract which is therefore the optimum dose for hypoglycemia and was used in all the experiments of the present study.

A Temporary Increase of Liver Function Indicators, AST, ALT (일시적으로 증가하는 간기능지표에 대한 연구)

  • Kim, Sook Za;Jeon, Young Mi;Song, Woong Ju
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.13 no.1
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    • pp.43-47
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    • 2013
  • Introduction: ALT/AST enzymes are present inside the cells. AST is found in cardiac and skeletal muscle and red blood cells but the ALT is checked mainly in the liver. In general, the rise of these two indicators shows liver damage. The usual measurements of these enzymes are used in liver function tests, but the levels of AST and ALT do not always reflect liver function. Method and Cases: 17 cases of liver dysfunction transiently were evaluated clinically, biochemically, and imaging study of sonogram in pediatric in-patients for 3 years. Result: Most common causes of transient liver dysfunction were infection, especially viral gastroenteritis, and bacterial infection interfering oral food intake. More often occurred in the children who have infant hyperbilirubinemia, positive history of mitochondrial dysfunction or hypoglycemia. Fasting study in one case of hypoglycemia patient showed reversible liver dysfunction during fasting over 20 hours fasting. Discussion: A significant increase in AST and ALT with normal bilirubin can be observed in clinically healthy people during blunt trauma, viral infection, severe pain, metabolic syndrome, fasting or accidental health screening.

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Effect of DW282 on the Induction of Methemoglobinemia, Hypoglycemia or WBC Count and Hematological Changes

  • Moon, Eun-Yi;Hwang, Hyun-Sook;Choi, Chung-Ha;Jung, Sang-Hun;Yoon, Sung-June
    • Archives of Pharmacal Research
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    • v.22 no.6
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    • pp.565-570
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    • 1999
  • DW2282,(S)-(+)-4-phenyl-1-[1-(4-aminobenzoyl)-indoline-5-sulfonyl]-4,5-dihydro-2-imidazolone hydrochloride, is a new anticancer agent which is thought to exhibit a characteristic mechanism of action in the inhibition of tumor growth. In this study, we estimated the toxicities of DW2282 in mice. When mice were orally dosed for five consecutive days at the dosages of 50, 100 and 150 mg/kg, DW2282 did not induced methemoglobinemia and hypoglycemia at any of these doses. However, increased ALT and AST values were observed in the 150 mg/kg dosing group, and white blood cells (WBC) were significantly decreased at all doses. However, the changes in WBC count, ALT and AST immediately reversed after the cessation of drug administration. In addition, we found that DW2282 did not cause an increase in hemolysis in human blood. Taken together, these data suggested that DW2282 may have a relatively low level of toxicity, and that there may be a quick recovery from any toxicity it dose produce.

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Malignant Mesothelioma with Hypoglycemia -A Case Report1- (저혈당을 동반한 악성 중피종 -1례 보고-)

  • Kwon, Jong-Bum;Park, Chan-Beom;Kim, Jin-Ho;Kim, Kyung-Hee;Park, Gyu-Ho;Won, Yong-Soon;Park, Kuhn;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.978-981
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    • 2000
  • 중피종은 늑막의 중피세포에서 발생되는 매우 드문 종양이며, 저혈당은 비섬세포(Non-islet cell) 종양에서 발생되는 매우 드문 증상으로 알려져 있다. 본 저자들은 좌측 흉강을 차지하며 저혈당을 동반한 환자에서 종양의 수술적 제거직후 증상이 사라졌으며, 조직학적으로는 국소섬유종의 소견을 보일 경우를 치험하여 보고하는 바이다.

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Acute Respiratory Distress during Impression Taking in a TMJ Dislocation Patient with Pneumonia (폐렴을 동반한 턱관절 탈구환자에서 인상채득 중 유발된 급성 호흡장애)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.119-126
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    • 2014
  • Difficulty in breathing can be very disconcerting to a patient who is conscious yet unable to breath normally. The common causes of acute respiratory distress include hyperventilation, vasodepressor syncope, asthma, heart failure, and hypoglycemia. In most of these situations, the patient does not exhibit respiratory distress unless an underlying medical disorder becomes acutely exacerbated. Examples of this include acute myocardial infarction, anaphylaxis, cerebrovascular accident, hyperglycemia, and hypoglycemia. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Therefore, the most dental patient should be cared gently as the stress reduction protocol. This is a case report of acute respiratory distress with vasodepressor syncope during alginate impression taking of mandibular teeth in a long-standing temporomandibular joint dislocated 93-years-old pneumonic patient.

Cognitive dysfunctions in individuals with diabetes mellitus

  • Kim, Hye-Geum
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.183-191
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    • 2019
  • Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

Long-chain Fatty Acid Oxidation Disorders and Therapeutic Approach (장쇄 지방산 산화 장애와 치료적 접근법)

  • Lee, Jung Hyun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.22 no.1
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    • pp.1-8
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    • 2022
  • Long-chain fatty acid oxidation disorders (LC-FAOD) are an autosomal recessive inherited rare disease group that result in an acute metabolic crisis and chronic energy deficiency owing to the deficiency in an enzyme that converts long-chain fatty acids into energy. LC-FAOD includes carnitine palmitoyltransferase type 1 (CPT1), carnitine-acylcarnitine translocase (CACT), carnitine palmitoyltransferase type 2 (CPT2), very long-chain acyl-CoA dehydrogenase (VLCAD), long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD), and trifunctional protein (TFP) deficiencies. Common symptoms of LC-FAOD are hypoketotic hypoglycemia, cardiomyopathy, and myopathy. Depending on symptom onset, the disease can be divided as neonatal period, late infancy and early childhood, adolescence, or adult onset, but symptoms can appear at any time. The neonatal screening test (NBS) can be used to identify the characteristic plasma acylcarnitine profiles for each disease and confirmed by deficient enzyme analysis or molecular testing. Before introduction of NBS, the mortality rate of LC-FAOD was very high. With NBS implementation as routine neonatal care, the mortality rate was dramatically decreased, but severe symptoms such as rhabdomyolysis recur frequently and affect the quality of life. Triheptanoin (Dojolvi®), the first drug for pediatric and adult patients with molecularly confirmed LC-FAOD, has recently been approved by the US Food and Drug Administration in 2020. In this review, the diagnosis of LC-FAOD and treatment including triheptanoin are summarized.