• Title/Summary/Keyword: hypoglycemia.

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Effect of pertussis toxin pretreated centrally on blood glucose level induced by stress

  • Suh, Hong-Won;Sim, Yun-Beom;Park, Soo-Hyun;Sharma, Naveen;Im, Hyun-Ju;Hong, Jae-Seung
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.5
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    • pp.467-476
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    • 2016
  • In the present study, we examined the effect of pertussis toxin (PTX) administered centrally in a variety of stress-induced blood glucose level. Mice were exposed to stress after the pretreatment of PTX (0.05 or 0.1 mg) i.c.v. or i.t. once for 6 days. Blood glucose level was measured at 0, 30, 60 and 120 min after stress stimulation. The blood glucose level was increased in all stress groups. The blood glucose level reached at maximum level after 30 min of stress stimulation and returned to a normal level after 2 h of stress stimulation in restraint stress, physical, and emotional stress groups. The blood glucose level induced by cold-water swimming stress was gradually increased up to 1 h and returned to the normal level. The intracerebroventricular (i.c.v.) or intrathecal (i.t.) pretreatment with PTX, a $G_i$ inhibitor, alone produced a hypoglycemia and almost abolished the elevation of the blood level induced by stress stimulation. The central pretreatment with PTX caused a reduction of plasma insulin level, whereas plasma corticosterone level was further up-regulated in all stress models. Our results suggest that the hyperglycemia produced by physical stress, emotional stress, restraint stress, and the cold-water swimming stress appear to be mediated by activation of centrally located PTX-sensitive G proteins. The reduction of blood glucose level by PTX appears to due to the reduction of plasma insulin level. The reduction of blood glucose level by PTX was accompanied by the reduction of plasma insulin level. Plasma corticosterone level up-regulation by PTX in stress models may be due to a blood glucose homeostatic mechanism.

Identification of Novel Compound Heterozygous Mutations in the ACADS Gene of an Asymptomatic Korean Newborn with Short Chain Acyl-CoA Dehydrogenase Deficiency by Tandem Mass Spectrometry

  • Cheon, Chong-Kun;Choi, Hyung-Soon;Kim, Su-Yung;Yoo, Han-Wook;Kim, Gu-Hwan
    • Journal of Genetic Medicine
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    • v.9 no.1
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    • pp.42-46
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    • 2012
  • Short-chain acyl-CoA dehydrogenase deficiency (SCADD; OMIM # 201470) is an autosomal recessive inborn error of mitochondrial fatty acid ${\beta}$-oxidation, presenting with a variety of clinical signs and symptoms. Developmental delay, hypertonia or hypotonia, ketotic hypoglycemia, and epilepsy are most frequently reported. In general, patients diagnosed through newborn screening have shown normal growth and development in contrast to those diagnosed as a result of clinically initiated evaluations. Here, the case of an asymptomatic Korean newborn with SCADD identified by tandem mass spectrometry is reported. The patient showed an elevated concentration of butyrylcarnitine detected on newborn screening. Urinary excretion of ethylmalonic acid was elevated by urine organic acid analysis. To confirm the diagnosis of SCADD, a direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Genetic analysis of ACADS showed the following novel compound heterozygous missense mutations: c.277C>A (p.Leu93Ile) on exon3 and c.682G>A (p.Glu288Lys) on exon6. These results will provide further evidence of mutational heterogeneity for SCADD.

Efficacy and Safety of Azithromycin for the Treatment of COVID-19: A Systematic Review and Meta-analysis

  • Mangkuliguna, Ghea;Glenardi, Glenardi;Natalia, Natalia;Pramono, Laurentius A.
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.299-316
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    • 2021
  • Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

A study on research trends for gestational diabetes mellitus and breastfeeding: Focusing on text network analysis and topic modeling (임신성 당뇨와 모유수유에 대한 연구 동향 분석: 텍스트네트워크 분석과 토픽모델링 중심)

  • Lee, Junglim;Kim, Youngji;Kwak, Eunju;Park, Seungmi
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.2
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    • pp.175-185
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    • 2021
  • Purpose: The aim of this study was to identify core keywords and topic groups in the 'Gestational diabetes mellitus (GDM) and Breastfeeding' field of research for better understanding research trends in the past 20 years. Methods: This was a text-mining and topic modeling study composed of four steps: 1) collecting abstracts, 2) extracting and cleaning semantic morphemes, 3) building a co-occurrence matrix, and 4) analyzing network features and clustering topic groups. Results: A total of 635 papers published between 2001 and 2020 were found in databases (Web of Science, CINAHL, RISS, DBPIA, RISS, KISS). Among them, 3,639 words extracted from 366 articles selected according to the conditions were analyzed by text network analysis and topic modeling. The most important keywords were 'exposure', 'fetus', 'hypoglycemia', 'prevention' and 'program'. Six topic groups were identified through topic modeling. The main topics of the study were 'cardiovascular disease' and 'obesity'. Through the topic modeling analysis, six themes were derived: 'cardiovascular disease', 'obesity', 'complication prevention strategy', 'support of breastfeeding', 'educational program' and 'management of GDM'. Conclusion: This study showed that over the past 20 years many studies have been conducted on complications such as cardiovascular diseases and obesity related to gestational diabetes and breastfeeding. In order to prevent complications of gestational diabetes and promote breastfeeding, various nursing interventions, including gestational diabetes management and educational programs for GDM pregnancies, should be developed in nursing fields.

Status Analysis of Adulterated Herbal Medicine (국내외 위변조 한약 현황 분석)

  • Lee, Soojin
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.5
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    • pp.215-221
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    • 2020
  • Adulterated herbal medicine is intentionally added with undeclared improper or inferior ingredients which should not be in herbal medicine. The contamination with potentially hazardous substances such as heavy metal, pesticides, fungus, and microorganism sometimes can be regarded as one of adulteration in a broad sense. The problem of adulteration is that adulterated herbal medicine shows poor quality and/or can cause adverse events. Therefore, it is important to control adulteration issues for quality assurance and qualitative improvement of herbal medicines. This study aims to summarize and make a reference how to control adulterated herbal medicine. In this process, this study is to investigate studies about adulterated herbal medicine via searching Korean and foreign electronic databases such as PubMed, NDSL and OASIS. Finally eighteen papers were included to this study and analyzed according to the type of study, the category and efficacy of adulterants, the type of analysis methodologies and possible adverse events of adulterants. Phosphodiesterase type 5 (PDE-5) inhibitors for male sexual enhancement and anorexic, laxative, diuretic agents for weight loss and treating obesity has been used frequently as adulterants. The range of adverse event caused by adulterated herbal medicine were very wide from mild symptoms such as diarrhea, constipation, dizziness and blurred vision to very severe symptoms such as heart failure, hypoglycemia and renal impairment. This study showed the recent trend on the research of adulterated herbal medicine and this will be the ground to develop more detailed systems to control adulterated herbal medicine.

Exploring the quality standard of Phellinus spp through β-glucan content and sensory evaluation (β-glucan 함량과 관능검사를 통한 상황버섯 품질기준 모색)

  • Shin, Yong-Wook
    • The Korea Journal of Herbology
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    • v.32 no.4
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    • pp.47-52
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    • 2017
  • Objective : Phellinus spp. mushroom is an object of interest because it has excellent anticancer effect. Owing to the similalarities in the morphology, Phellinus linteus and Phellinus baumii are often used as same Sang Hwang Mushroom in the Korean market.. The quality control for mushrooms is needed because there are many differences in the efficacy according to cultivation method and cultivation area. Therefore, a reliable authentication method of these herbal medicine is necessary to compare and measure the amount of beta-glucan which is known to have a hypoglycemic effect, from the mushrooms collected in various regions Methods : 7 samples of medicinal mushrooms supplying phellinus spp. were collected in Korea, China and Cambodia. We investigated the hardness, colors, extract ratio, ${\alpha}-amylase$ and ${\alpha}-glucosidase$ inhibitory activities, glucose transporter 4 (GLUT-4) expressions of water extracts from Phellinus spp and also MTT assay were examined for cell toxicity. Results : The results revealed that Phellinus spp.water Ext.inhibited ${\alpha}-glucosidase$ activity. glucose transporter 4 (GLUT-4), the key insulin signaling pathway transcription factor, was remarkably increased by the Phellinus baumii water extract Conclusions : These results suggest that The more yellowish the mushroom is, the lower the hardness, the more the content of ${\beta}-glucan$ is proportional. Because the more ${\beta}-glucan$, the greater the effect of hypoglycemia. compared to the hypoglycemic effect, Phellinus Baumii grown at hanging on selves for 7 month in the green house is the best.

A Rare Case of Canine Huge Renal Cell Carcinoma with Ovarian Metastasis

  • Koo, Jiyoung;Song, Woo-Jin;Jo, Heesoo;Ahn, Hyerin;Choi, Solji;Jeong, Hyohoon;Cheong, Jongtae;Park, Hyun-Jung;Yun, Youngmin
    • Journal of Veterinary Clinics
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    • v.39 no.4
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    • pp.168-172
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    • 2022
  • A 10-year-old female Pomeranian weighing 2.25 kg with a history of gradual weight loss and an intraabdominal mass confirmed with ultrasonography at a local hospital was referred to the Veterinary Medical Teaching Hospital, Jeju National University. Physical examination revealed abdominal distention. Blood analysis revealed hypoglycemia (57 mg/dL; reference range, 60-110 mg/dL). On abdominal ultrasonography, a heterogeneously hyperechoic mass measuring 7.51 × 10.6 cm was found at the level of the left kidney. Computed tomographic findings showed a unilateral left kidney mass with a 10-cm diameter and vessel contrast enhancement in the corticomedullary phase. Unilateral nephrectomy and ovariohysterectomy were performed because left ovary enlargement was observed during surgery. The renal mass was adjacent to the aorta and vena cava and attached to a portion of the small intestine, greater omentum, and left ovary. The mass was huge (12.5 × 10 × 7 cm) and was 16.5% of the body weight. Histopathological examination revealed renal cell carcinoma (RCC) and ovarian metastasis. After surgery, clinical signs improved remarkably, and serum glucose level returned to normal. As RCC is resistant to radiation and chemotherapy, the owner decided not to proceed with postoperative adjunctive therapies. To the best of our knowledge, this is the first case report of ovarian metastasis with huge RCC in a dog.

Successful Treatment of Scabies-Induced Life Threatening Anemia in a Wild Raccoon Dog (Nyctereutes procyonoides)

  • Myeongsu Kim;Phyo Wai Win;Yoon-Hee Kim;Jae-IK Han
    • Journal of Veterinary Clinics
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    • v.41 no.3
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    • pp.195-199
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    • 2024
  • A free-range wild raccoon dog (Nyctereutes procyonoides) was rescued with cachexia. Physical examination revealed generalized hyperkeratosis and alopecia typical of scabies as well as hypothermia (35.6℃). The patient was obtunded and severely dehydrated (10%). Hematological parameters included a low packed cell volume (PCV; 15%) and hemoglobin concentration, leukocytosis, and hypoglycemia. A blood smear revealed different subtypes of hypochromic leptocytes, indicating a regenerative response against severe anemia. This case was initially tentatively diagnosed as a severe anemia due to chronic external bleeding presumed to be caused by scabies-induced skin injuries. Darbepoetin alpha (DPO), iron dextran, and fluralaner were administered at the initial presentation, and supportive care including oxygen supplementation, warming, and nutritional support was provided. However, on day 5, the PCV dropped to 5.9% presumably caused by rapid rehydration due to drinking water ad libitum. DPO was boosted on days 5 and 6 along with daily iron dextran. On day 21, the PCV had recovered to 19.8%, and a blood smear evaluation showed a strong regenerative response. This case shows that even if severe anemia occurs in a raccoon dog, it can be managed with an appropriate response. In particular, since the rehydration rate due to food intake is faster than the hematopoietic response rate of raccoon dogs, the PCV may decrease rapidly in the early stage of treatment; therefore, diagnostic examination and additional medical management for hematopoiesis are necessary.

Familial Glycogen Storage Disease Type IXa Diagnosed by Targeted Exome Sequencing (엑솜 시퀀싱으로 진단된 가족성 당원병 IXa 형 증례)

  • Sohn, Young Bae;Jang, Ju Young;Lee, Dakeun;Jang, Ja-Hyun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.96-102
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    • 2017
  • Glycogen storage disease type IX (GSD IX) is caused by deficiency of phosphorylase kinase which plays a role in breakdown of glycogen. Mutations in PHKA2 are the most common cause of GSD IX (GSD IXa). Clinical manifestations of GSD IXa include hepatomegaly, elevation of liver enzyme, growth retardation, fasting hypoglycemia, and fasting ketosis. However, the symptoms overlap with those of other types of GSDs. Here, we report Korean familial cases with GSD IXa whose diagnosis was confirmed by targeted exome sequencing. A 4-year old male patient was presented with hepatomegaly and persistently elevated liver enzyme. Liver biopsy revealed swollen hepatocyte filled with glycogen storage, suggesting GSDs. Targeted exome sequencing was performed for the differential molecular diagnosis of various types of GSDs. A hemizygous mutation in PHKA2 were detected by targeted exome sequencing and confirmed by Sanger sequencing: c.3632C>T (p.Thr121Met), which was previously reported. The familial genetic analysis revealed that his mother was heterozygous carrier of c.3632C>T mutation and his 28-month old brother had hemizygous mutation. His brother also had hepatomegaly and elevated liver enzyme. The hypoglycemia was prevented by frequent meals with complex carbohydrate, as well as cornstarch supplements. Their growth and development is in normal range. We suggest that targeted exome sequencing could be a useful diagnostic tool for the genetically heterogeneous and clinically indistinguishable GSDs. A precise molecular diagnosis of GSD can provide appropriate therapy and genetic counseling for the family.

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A Study of Nurses' Knowledges on Gestational Diabetes Mellitus (일부 간호사의 임신성 당뇨병에 대한 지식정도)

  • Choi, Euy-Soon;Oh, Jeong-Ah;Park, Chai-Soon
    • Women's Health Nursing
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    • v.7 no.4
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    • pp.419-431
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    • 2001
  • The purpose of this study was to provide the correct knowledge on GDM(Gestational Diabetes Mellitus) to nurses for effective care of pregnant women with GDM by investigating the knowledge of nurses about GDM. The subjects of this study were 557 nurses who work at six general hospitals in Seoul and Gyung-Gi province of Korea. The data were collected from November, 2000 to December, 2000, using a 30-item knowledge questionnaire about GDM consisted of eight areas developed by Choi et al. (2000): characteristics and diagnosis, influence on pregnancy, goal and method of management, diet therapy, exercise therapy, insulin therapy, hypoglycemia and hyperglycemia and postpartum care of GDM. The data were analyzed by SAS program for t-test, ANOVA and Scheffe test. The results were as follows: 1. The mean score of knowledge on GDM was 23.18. 2. There were significant differences according to age(p= 0.002), education background (p= 0.045). working period(p= 0.000), working unit(p= 0000), working experience of obstetric and gynecologic (OS & GY) units(p= 0.000), experience of pregnancy (p=0.003) and experience of delivery (p=0.014) in GDM knowledge. 3. The level of each area on GDM knowledge was as follows; 1) Area of characteristics and diagnosis of GDM The mean score of this area was 0.79. Nurses' knowledges were significantly different by age(p=0.003), marital status (p=0.018), working period(p=0.002) working unit(p=0.007), working experience of OB & GY units(p=0.005), experience of pregnancy(p=0.034) and experience of delivery(p=0.033). 2) Area of influence on pregnancy The mean score of this area was 0.93. Nurses' knowledges were significantly different by age(p=0.006), working unit (p=0.000) and working experience of OB & GY units(p= 0.000). 3) Area of goal and method of management The mean score of this area was 0.70. Nurses' knowledges were significantly different by age(p=0.004), region(p=0.006), education background(p=0.013), marital status(p=0.007), working period(p=0.000), working unit(p=0.011), working experience of OB & GY units(p=0.002), experience of pregnancy(p=0.025) and experience of delivery(p=0.043). 4) Area of diet therapy. The mean score of this area was 0.74. Nurses' knowledges were significantly different by age(p=0.002), region(p=0.011), marital status (p=0.001). working period (p=0.007). working unit(p=0.002), working experience of OB & GY units(p=0.001), experience of pregnancy(p=0.001), experience of delivery(p=0.011) and diabetes patients in family members(p=0.032). 5) Area of exercise therapy. The mean score of this area was 0.83. There were not significant differences in all general characteristics. 6) Area of insulin therapy The mean score of this area was 0.61. Nurses' knowledges were significant differences by age (p=0.024), marital status (p=0.048), working period(p=0.027), working unit(p=0.002), working experience of OB & GY units(p=0.000), experience of pregnancy (p=0.047) and experience of delivery(p=0.040). 7) Area of hypoglycemia and hyperglycemia. The mean score of this area was 0.83. Nurses' knowledges were significantly different by marital status (p=0.027), working period(p=0.001). experience of pregnancy(p=0.020) and experience of delivery(p=0.010). 8) Area of postpartum care The mean score of this area was 0.69. Nurses' knowledges were significantly different by working unit(p=0.000), working experience of OB & GY units (p=0.000) and working experience of medical unit(p=0.047). The results of this study are suggested that nurses might be taught systemically and individually about GDM so that they can become more proficient in detecting and preventing GDM, and therefore they will feel confident to teach GDM to women.

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