• Title/Summary/Keyword: hypoglycemia.

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Sulfonylurea therapy in a patient with insulin treated neonatal diabetes due to mutation in Kir6.2 (Kir6.2 유전자변이에 의해 발생한 신생아 당뇨병 1례)

  • Kim, Min Sun;Lee, Dae Yeol;Yoo, Han Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.6 no.1
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    • pp.52-57
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    • 2006
  • Permanent neonatal diabetes(PND) is a rare form of diabetes characterized by insulin-requiring hyperglycemia that is diagnosed within the first 3 months of life. In most cases, the causes are not known. Recently, mutations in the gene KCNJ11 encoding the Kir6.2 subunit of the ATP-sensitive K+ charmel have been described in patients with PND. We report a child with PND due to a lysine-to-arginine substitution at position 170(K170R) of gene encoding Kir6.2 Our patient was diagnosed at 7 weeks of age and had been treated with subcutaneous insulin for 6.5 years. Recently, our patient has been changed from subcutaneous insulin to oral glibenclamide therapy at a daily dose of 7.5 mg 3 times a day(0.9 mg/kg/day) at the age of 6.5 years. Before glibenclamide therapy, c-peptide level was 0.1 ng/ml(normal 1.0-3.5 ng/ml) and hemoglobin HbA1c level was 7.8%(normal <6%). After 6 days of treatment, her c-peptide and insulin levels were 2.3 ng/ml and $9.6{\mu}U/ml$(normal $5-25{\mu}U/ml$), respectively. After 1 month later, the insulin and c-peptide levels were in the nonnal range without any episodes of hyper- or hypoglycemia. This case demonstrated that oral sulfonylurea may be the treatment of choice in PND patients with KCNJ11 mutation even at a young age.

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Hypoglycemic and Hypocholesterolemic Effects of Botryosphaeran from Botryosphaeria rhodina MAMB-05 in Diabetes-Induced and Hyperlipidemia Conditions in Rats

  • Miranda-Nantes, Carolina C.B.O.;Fonseca, Eveline A.I.;Zaia, Cassia T.B.V.;Dekker, Robert F.H.;Khaper, Neelam;Castro, Inar A.;Barbosa, Aneli M.
    • Mycobiology
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    • v.39 no.3
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    • pp.187-193
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    • 2011
  • Botryosphaeran, a water-soluble exopolysaccharide of the ${\beta}-(1{\rightarrow}3;1{\rightarrow}6)$-D-glucan type that has been isolated from the culture medium of Botryosphaeria rhodina MAMB-05 grown in submerged fermentation using glucose as the sole carbon source, was previously demonstrated to be non-genotoxic in peripheral blood and bone marrow, and exhibited strong anticlastogenic activity. In the present study, the effects of botryosphaeran were investigated in streptozotocin-induced diabetic rats as well as in high-fat diet-fed hyperlipidemic Wistar rats. The plasma glucose level was reduced by 52% in the diabetic group of rats after administration of 12 mg botryosphaeran/kg body weight of the rats (b.w.)/day by gavage over 15 days. A reduction in the median ration intake was accompanied by an increase in the median body weight gain, as well as the efficiency of food conversion. These results demonstrate that botryosphaeran has protective effects by reducing the symptoms of cachexia in Diabetes mellitus. Botryosphaeran administered by gavage at a concentration of 12 mg botryosphaeran/kg b.w./day over 15 days also reduced the plasma levels of total cholesterol and low density lipoprotein-cholesterol by 18% and 27%, respectively, in hyperlipidemic rats. Based on these findings, we conclude that botryosphaeran possesses hypoglycemic and hypocholesterolemic properties in conditions of diabetes mellitus and hyperlipidemia, respectively, and may be used as an oral anti-diabetic agent.

A case of chronic lymphocytic leukemia (CLL) in a Maltese dog

  • Lee, Ji-Yun;Hong, Eun-Sil;Kang, Byeong-Teck;Jung, Dong-in;Park, Chul;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.45 no.2
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    • pp.251-254
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    • 2005
  • An 11-year-old, 3.3 kg, male Maltese dog was referred to Veterinary Teaching Hospital of Konkuk University because of diarrhea and severe anemia. Abnormal physical examination findings included left submandibular lymph node enlargement, pale mucous membrane, cataract, and bloody diarrhea. Results of hematologic examination revealed a marked lymphocytosis resulting in leukocytosis and the markedly increased numbers of small, well-differentiated lymphocytes in the peripheral blood. Serum biochemical abnormalities consisted of elevated AST and ALP, hyperphosphatemia, hypoglycemia, and hypoalbuminemia. Radiographic examination showed cardiomegaly and hepatosplenomegaly. Results of urinalysis included bilirubinuria and proteinuria. Based on results of examination described above, chronic lymphocytic leukemia was diagnosed. Chemotherapy was initiated with cyclophosphamide ($300mg/m^2$, IV once every 2 weeks), vincristine ($0.75mg/m^2$, IV once every 2 weeks, alternating weeks with the cyclophosphamide), and plus prednisolone ($50mg/m^2$, PO, SID for a week, then $20mg/m^2$, PO every other day). The response to chemotherapy was partially present. This study first demonstrates clinicopathological findings and chemotherapeutic response of chronic lymphocytic leukemia in Korea.

A Case of Sheehan's Syndrome Mimicking Psychotic Depression (정신병적 우울증 양상을 나타낸 Sheehan씨 증후군 1례)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Lee, Sung-Pil;Han, Jin-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.118-122
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    • 1997
  • We experienced a case of 51-year-old female patient who showed symptoms of persecutory delusion, auditory hallucination and hallucinatory behavior, severe insomnia, psychomotor retardation and social withdrawal, along with some clinical signs of the deficiency of various hormones those gradually progressed after massive postpartum vaginal bleeding 13 years ago. She was admitted to a psychiatric ward under the impression of psychotic depression. However careful history taking and evaluation of clinical feature gave rise to the possibility of underlying medical condition. Laboratory work-up revealed panhypopituitarism, hypoglycemia and hyponatremia. After replacement of thyroid hormone and cortisol for 1 week, her clinical symptoms including psychiatric symptoms were improved. Taken together, these findings were compatible with the diagnosis of Sheehan's syndrome. On reporting this case, we would like to emphasize again the importance of differential diagnosis of medical problems causing psychiatric symptoms those are easily neglected in the clinical approach toward psychiatric patients.

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Bioequivalence of Dybis Tablet (Metformin Hydrochloride 500 mg) (다이비스 정 (염산메트폴민 500 mg)의 생물학적 동등성)

  • 최준식;박영진;박상묵;범진필
    • YAKHAK HOEJI
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    • v.47 no.4
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    • pp.239-243
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    • 2003
  • Metformin is an oral antihyperglycemic agent used in the therapy of noninsulin-dependent diabetes mellitus and does not cause hypoglycemia at the therapeutic dose. The purpose of the present study was to evaluate the bioequivalence of two metformin hydrochloride tablets, Glucophage tablet (DaeWoong Pharmaceutical Co., reference drug) and Dybis tablet (Shinpoong Pharmaceutical Co., test drug), according to the guidelines of Korea Food and Drug Administration(KFDA). Twenty-four normal volunteers, 26.6$\pm$4.01 years in age and 60.6$\pm$9.80 kg in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After one tablet containing 500 mg of metformin hydrochloride was orally administered, blood was taken at predetermined time intervals and the concentrations of metformin hydrochloride in serum were determined using HPLC with UV detector. The pharmacokinetic parameters such as AUCt, Cmax and Tmax were calculated and ANOVA test was utilized for the statistical analysis of the parameters. The results showed that the differences in AUCt, Cmax and Tmax between two products were -1.05%, -6.76% and -4.51%, respectively, when calculated against the reference drug. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log0.8$\leq$$\delta$$\leq$log1.25 (e.g., log0.9082$\leq$$\delta$$\leq$log1.0906 and log0.8188$\leq$$\delta$$\leq$log1.0392 for $AUC_{t}$ and $C_{max}$, respectively). The 90% confidence intervals using untransformed data was within $\pm$20% (e.g., -17.66%$\leq$$\delta$$\leq$8.63% for $T_{max}$). All parameters met the criteria of KFDA for bioequivalence, indicating that Dybis tablets (Shinpoong Pharmaceutical Co.) is bioequivalent to Glucophage tablets (DaeWoong Pharmaceutical Co.).

Two Cases of Falciparum Malaria with Acute Respiratory Distress Syndrome (중증 열대열 말라리아에 동반된 급성호흡곤란증후군 2예)

  • Park, Joo-Hun;Shin, Eun-Sug;Woo, Jun-Hee;Kim, Yeun-Ok;Bae, In-Gyu;Jang, Jae-Jeong;Chi, Hyun-Sook;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.888-895
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    • 1998
  • Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum, accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features that make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria, hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.

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Rat Malonyl-CoA Decarboxylase; Cloning, Expression in E. coli and its Biochemical Characterization

  • Lee, Gha-Young;Bahk, Young-Yil;Kim, Yu-Sam
    • BMB Reports
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    • v.35 no.2
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    • pp.213-219
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    • 2002
  • Malonyl-CoA decarboxylase (E.C.4.1.1.9) catalyzes the conversion of malonyl-CoA to acetyl-CoA. Although the metabolic role of this enzyme has not been fully defined, it has been reported that its deficiency is associated with mild mental retardation, seizures, hypotonia, cadiomyopathy, developmental delay, vomiting, hypoglycemia, metabolic acidosis, and malonic aciduria. Here, we isolated a cDNA clone for malonyl CoA decarboxylase from a rat brain cDNA library, expressed it in E. coli, and characterized its biochemical properties. The full-length cDNA contained a single open-reading frame that encoded 491 amino acid residues with a calculated molecular weight of 54, 762 Da. Its deduced amino acid sequence revealed a 65.6% identity to that from the goose uropigial gland. The sequence of the first 38 amino acids represents a putative mitochondrial targeting sequence, and the last 3 amino acid sequences (SKL) represent peroxisomal targeting ones. The expression of malonyl CoA decarboxylase was observed over a wide range of tissues as a single transcript of 2.0 kb in size. The recombinant protein that was expressed in E. coli was used to characterize the biochemical properties, which showed a typical Michaelis-Menten substrate saturation pattern. The $K_m$ and $V_{max}$ were calculated to be $68\;{\mu}M$ and $42.6\;{\mu}mol/min/mg$, respectively.

Application and Effects of a Blood Glucose Control Protocol for Medical Intensive Care Unit Patients (내과 중환자실 환자의 혈당조절 프로토콜 적용 및 효과)

  • Kim, Eun Sung;Choi-Kwon, Smi;Kim, Young Sam
    • Journal of Korean Critical Care Nursing
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    • v.7 no.2
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    • pp.45-57
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    • 2014
  • Purpose: The purpose of this study was to examine the effect of a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The subjects were recruited from medical ICU adult patients whose blood glucose levels exceeded 200 mg/dL in two consecutive tests. The experimental group (n=62) received the modified Yale (MY) insulin protocol, whereas the control group (n=64) was treated with the conventional insulin therapy methods. Results: In the experimental group, the mean blood glucose levels (p<.001) and the time to reach the target range of glucose (p<.001) decreased significantly while the incidence rates of a target range of glucose of 100-140 mg/dL (p<.001) increased significantly as compared to the control group. However, no statistically significant differences were found in the incidence of hypoglycemia(p=.644), or the number of glucose tests (p=.236) between the groups. The length of stays in the ICU (p=.001), ventilator care days (p=.038), and the Sequential Organ Failure Assessment (SOFA) score (p=.029) in the experimental group were significantly lower than those of the control group. Conclusion: Application of the protocol was effective in improving the state of blood glucose control in medical ICU patients. Therefore, this protocol is expected to be used as a part of nursing intervention in critical care nursing.

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Anti-diabetic Effect of Wen-Pi-Tang-Hab-Wu-Ling-San Extract in Streptozotocin-induced Diabetic Rats (Streptozotocin으로 유도한 당뇨병 쥐에서 $WHW^{(R)}$의 항당뇨 효과에 대한 연구)

  • Bae, Hyo-Sang;Nam, Jung-Ki;Jung, Jun-Ki;Oh, Seung-Yeol;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.23 no.3
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    • pp.85-91
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    • 2008
  • Objectives : This study aimed to evaluate the anti-diabetic effect of Wen-Pi-Tang-Hab-Wu-Ling-San (WHW) extract in streptozotocin(STZ)-induced type-1 diabetic rats. Methods : Experimental diabetes were induced by intraperitoneal injection of streptozotocin (60 mg/kg). Two groups of STZ-induced diabetic rats were given the following treatments for 2 weeks by oral Administrations : (1) WHW 10 mg/kg, (2) WHW 100 mg/kg. In addition, vehicle-treated diabetic and nondiabetic controls were used in the experiment. The effects of WHW extract on STZ-induced diabetes were observed by measuring the changes of body weights and the levels of fasting blood glucose, insulin, urea nitrogen (BUN) and creatinine level in sera of rats, respectively. Results : In comparison control group, WHW-treated groups (100 mg/kg) were significantly decreased fasting blood glucose levels and increased serum insulin levels in STZ-induced diabetic rats. Moreover, WHW-treated groups (100 mg/kg) were reduced s-creatinie levels in STZ-induced diabetic rats. In addition, the changes related to diabetic nephropathy with body weight were significantly lower in WHW extract-dosing groups than in the diabetic control. Conclusions : The study thus showed that WHW extract enhanced the anti-diabetic effect in STZ-induced diabetic rats by improving the hypoglycemia. It also increased pancreatic insulin content in these rats.

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Methanol Extract of Cassia mimosoides var. nomame and Its Ethyl Acetate Fraction Attenuate Brain Damage by Inhibition of Apoptosis in a Rat Model of Ischemia-Reperfusion

  • Kim, Ki-Hong;Lee, Jong-Won
    • Preventive Nutrition and Food Science
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    • v.15 no.4
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    • pp.255-261
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    • 2010
  • Ischemic stroke, a major cause of death and disability worldwide, is caused by occlusion of cerebral arteries that, coupled with or without reperfusion, results in prolonged ischemia (hypoxia and hypoglycemia) and, ultimately, brain damage. In this study, we examined whether methanol extract of the whole plant of Cassia mimosoides var. nomame Makino that grows naturally in Korea, as well as Japan and China, and some of its fractions obtained by partitioning with organic solvents could protect human hepatocellular carcinoma cells (HepG2) under hypoxic condition by inhibiting apoptosis. We also investigated if these extracts could attenuate brain damage in a rat model of 2 hr of ischemia, generated by middle cerebral artery occlusion, and 22 hr of reperfusion. The whole extract ($100{\mu}g$/mL) maintained the cell number at more than half of that initially plated, even after 24 hr of cell culture under hypoxic condition (3% $O_2$). In the absence of the whole extract, almost all of the cells were dead by this time point. This improvement of cell viability came from a delay of apoptosis, which was confirmed by observing the timing of the formation of a DNA ladder when assessed by gel electrophoresis. Of fractions soluble in hexane, ethyl acetate (EA), butanol and water, EA extracts were selected for the animal experiments, as they improved cell viability at the lowest concentration ($10{\mu}g$/mL). The whole extract (200 mg/kg) and EA extract (10 and 20 mg/kg) significantly reduced infarct size, a measure of brain damage, by 34.7, 33.8 and 45.2.0%, respectively, when assessed by 2,3,5-triphenyl tetrazolium chloride staining. The results suggest that intake of Cassia mimosoides var. nomame Makino might be beneficial for preventing ischemic stroke through inhibition of brain cell apoptosis.