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1.
《Endocrine practice》2005,11(4):272-280
ObjectiveTo describe 3 patients with calcium carbonate-induced hypercalcemia and gain insights into the cause and management of the milk-alkali syndrome.MethodsWe report the clinical and laboratory data in 3 patients who presented with severe hypercalcemia (corrected serum calcium ≥ 14 mg/dL) and review the pertinent literature on milk-alkali syndrome.ResultsThe 3 patients had acute renal insufficiency, relative metabolic alkalosis, and low parathyroid hormone (PTH), PTH-related peptide, and 1,25-dihydroxyvitamin D concentrations. No malignant lesion was found. Treatment included aggressive hydration and varied amounts of furosemide. The 2 patients with the higher serum calcium concentrations received pamidronate intravenously (60 and 30 mg, respectively), which caused severe hypocalcemia. Of the 3 patients, 2 were ingesting acceptable doses of elemental calcium (1 g and 2 g daily, respectively) in the form of calcium carbonate. In addition to our highlighted cases, we review the history, classification, pathophysiologic features, and treatment of milk-alkali syndrome and summarize the cases reported from early 1995 to November 2003.ConclusionMilk-alkali syndrome may be a common cause of unexplained hypercalcemia and can be precipitated by small amounts of orally ingested calcium carbonate in susceptible persons. Treatment with hydration, furosemide, and discontination of the calcium and vitamin D source is adequate. Pamidronate treatment is associated with considerable risk for hypocalcemia, even in cases of initially severe hypercalcemia. (Endocr Pract. 2005;11: 272-280)  相似文献   

2.
At one time, when antacids were the primary medical means of treating peptic ulcer disease, the milk-alkali syndrome was not an uncommon cause of hypercalcemia. The simultaneous occurrence of hypercalcemia, alkalosis, and renal failure, in conjunction with the appropriate history of ingestion fof antacids, was suggestive of the syndrome. With the advent of antisecretory therapy, however, the milk-alkali syndrome has become an uncommon diagnosis. I report a case of milk-alkali syndrome and review the history of this syndrome as reported in the medical literature. Contemporary reports have focused on understanding the pathophysiology of the syndrome. Recent series have identified a shifting demographic profile, as increasing numbers of elderly women consume calcium carbonate as an anti-osteoporosis measure.  相似文献   

3.
An attempt was made to formulate medicated chewing gum to prevent motion sickness using natural gum base for faster onset of action and easy administration, anywhere and anytime, without access to water. To avoid the discard issue of gum cud, natural gum base of Triticum aestivum (wheat grain) was explored because of its biodegradable and biocompatible nature and easy availability. Prolamin, extracted from wheat, showed good chewing capacity, elasticity, high water retention capacity, antifungal activity, and compatibility with the drug. Formulations were prepared based on a two-factor and three-level factorial design. Amount of calcium carbonate (texturizer) and gum base were selected as independent variables. Elasticity and drug release were considered as the dependent variables. All batches were evaluated for the content uniformity, elasticity study, texture study, in vitro drug release study, and chewiness study. Results revealed that medicated chewing gum containing 80 mg of calcium carbonate and 500 mg of gum base showed good elasticity and more than 90% drug release within 16 min. Thus, this study suggested that both good elasticity and chew ability and abundant availability of wheat grain can act as a potential gum base for medicated chewing gum.KEY WORDS: biodegradable gum, gum base, medicated chewing gum, plasticizer, wheat prolamin  相似文献   

4.
《Endocrine practice》2009,15(6):563-566
ObjectiveTo report a case of Horner syndrome as the initial sign of locally advanced anaplastic thyroid cancer.MethodsWe present a case report in conjunction with a retrospective review and evaluation of the English-language literature on Horner syndrome and thyroid pathologic conditions.ResultsHorner syndrome is a rare complication of thyroid disease most often occurring in the postoperative setting after resections. Preoperatively, Horner syndrome is usually caused by a benign intrathoracic goiter that compresses the sympathetic plexus as it exits the thoracic cavity to enter the neck. Malignant thyroid disease leading to Horner syndrome is less common than benign causes of the syndrome. Treatment of compressive lesions can lead to resolution of nerve compression.ConclusionHorner syndrome is a rare complication of thyroid pathologic conditions. When present preoperatively, the majority of cases are due to benign compression of the cervical plexus. Therefore, Horner syndrome in the setting of a goiter does not necessarily portend a malignant process as one might suspect. Nonetheless, it still remains important that those patients who present with Horner syndrome undergo appropriate assessment for detection of mass lesions, underlying vascular etiologic factors, or other potentially treatable disorders causing sympathetic chain dysfunction. (Endocr Pract. 2009;15:563-566)  相似文献   

5.
《Endocrine practice》2013,19(1):e12-e16
ObjectiveRapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is a rare disorder that mimics both common obesity and genetic obesity syndromes along with several endocrine disorders during early childhood. We aim to present the clinical features, laboratory and imaging results, and treatment outcomes of a patient with ROHHAD syndrome.MethodsIn this case report, we describe a 26-month-old boy who was admitted to our emergency department with dyspnea and cyanosis and was suspected to have ROHHAD syndrome due to his rapid-onset obesity and alveolar hypoventilation.ResultsA thoracal and abdominal magnetic resonance imaging was performed to demonstrate a possible accompanying neural crest tumor and it provided a yet asymptomatic retroperitoneal ganglioneuroblastoma. Based on these findings, the patient was diagnosed as ROHHADNET syndrome.ConclusionBecause of the high prevalence of cardiorespiratory arrest and probability of accompanying tumors, early recognition of ROHHAD syndrome is important. To prevent presumptive mortality and morbidity, ROHHAD syndrome should be considered in all cases of rapid and early-onset obesity associated with hypothalamic-pituitary endocrine dysfunctions. (Endocr Pract. 2013;19:e13-e16)  相似文献   

6.
《Endocrine practice》2013,19(1):e17-e20
ObjectiveHypoparathyroidism, deafness, and renal dysplasia (HDR) syndrome is an autosomal dominant disorder caused by a GATA3 gene mutation. Here we report a novel mutation of GATA3 in a patient diagnosed with HDR syndrome at the age of 58 with extensive intracranial calcification.MethodsA 58-year-old Japanese man showed severe hypocalcemia and marked calcification in the basal ganglia, cerebellum, deep white matter, and gray-white junction on computed tomography (CT). The serum intact parathyroid hormone level was relatively low against low serum calcium concentration. The patient had been diagnosed with bilateral sensorineural deafness in childhood and had a family history of hearing disorders. Imaging studies revealed no renal anomalies. The patient was diagnosed with HDR syndrome, and genetic testing was performed.ResultsGenetic analysis of GATA3 showed a novel nonsense mutation at codon 198 (S198X) in exon 3. The S198X mutation leads to a loss of two zinc finger deoxyribonucleic acid (DNA) binding domains and is considered to be responsible for HDR syndrome.ConclusionWe identified a novel nonsense mutation of GATA3 in an adult patient with HDR syndrome who showed extensive intracranial calcification. (Endocr Pract. 2013;19:e17-e20)  相似文献   

7.
Abstract

Atomic molecular dynamics simulations have been performed on the monolayer systems of N-acyl amino acid-based surfactants. The role of intermolecular hydrogen bonds and ionic side chain length of dicarboxylate surfactants were investigated through radial and spatial distribution functions. It was found that the hydrogen bonding capability between surfactants was the major factor determining the surface area each surfactant could occupy. Tighter packing of surfactants would lead to a weaker interaction with water molecule, and the protonation of carboxylate groups resulted in stronger inter-surfactant interactions. The hydrogen bonds with water molecules were found to prevail between the carboxylate groups, and regular cage-like water distributions surrounding the surfactant headgroups were seen. The introduction of divalent ions leads to a significant increase of counterion binding, and their intramolecular and intermolecular bindings of calcium ions were also well characterised. The intramolecular chelation of calcium ions was found impossible between the carboxylate groups for N-acyl glutamate due to its flexible side chain.  相似文献   

8.
Summary The effective diffusion coefficient of oxygen, IDe, was determined in different gel support materials (calcium alginate, -carrageenan, gellan gum, agar and agarose) which are generally used for immobilization of cells. The method used was based upon fitting Crank's model on the experimental data. The model describes the solute diffusion from a well-stirred solution into gel beads which are initially free of solute. The effect of the gel concentration on IDe of oxygen in the gel was investigated. The results showed a decreasing IDe for both agar and agarose at increasing gel concentration. In case of calcium alginate and gellan gum, a maximum in IDe at the intermediate gel concentration was observed. It is hypothesized that this phenomenon is due to a changing gelpore structure at increasing gel concentrations. The IDe of oxygen in calcium alginate, -carrageenan and gellan gum varied from 1.5*10–9 to 2.1*10–9 m2s–1 in the gel concentration range of 0.5 to 5% (w/v).  相似文献   

9.
Lesser bushbabies (Galago senegalensis moholi)were studied by radiotracking over a 2-year period (August 1975 to August 1977)at a thornveld study site in the Northern Transvaal, South Africa. It was confirmed that the diet consisted exclusively of plant exudates (gums) and arthropods;available fruits were never eaten. The gums were taken from the trunks and branches of Acaciatrees, particularly from Acacia karroo(the major source), from A. tortilis,and to a small extent from A. nilotica.Chemical analysis shows that gums consist predominantly of carbohydrates and water, with small quantities of fiber, protein, and minerals (notably calcium, magnesium, and potassium). Thus, the gums probably present first and foremost a source of carbohydrate in the diet of the lesser bushbaby, though it seems likely that special mechanisms must exist for digestion of the polymerized pentose and hexose sugars. The calcium content of the gums (approx. 1% by weight) is probably significant in offsetting the low calcium content of the arthropod prey, and their high calcium:phosphorus ratio may well counterbalance the low calcium:phosphorus ratio of the arthropods. The gums are apparently produced largely in response to insect activity. Larvae of beetles (families Cerambycidae,Buprestidae, and Elateridae) and of moths (family Coccidae) bore channels beneath the tree surface, and gum is liberated through apertures made during invasion of the host Acacia.Fly larvae (family Odiniidae) may also develop in the gumfilled cavities. Gum exuding onto the surface is collected by the bushbabies on regular nightly visits, and firm evidence was obtained, in the form of characteristic marks on trap baseboards and certain gum sites, that the toothscraper in the lower jaw is used to scoop away gum from tree surfaces. Foraging for, and feeding upon, gum increased during the winter months, which may be particularly harsh in certain years. In the especially cold winter covered by the study, insect availability was minimal and the lesser bushbabies fed mainly on gum, with some of them reducing their total activity period during the night. Gums are available throughout the year and detailed records indicated no clearcut seasonal pattern of gum production. They are therefore an important yearround food resource for the lesser bushbabies. Feeding on gums has been reported for a wide range of primate species in recent years (especially for various species of the families Cheirogaleidae, Lorisidae, and Callitrichidae), and these plant exudates must now be regarded as an important dietary category within the order Primates.  相似文献   

10.
BackgroundHigh salt consumption is an important risk factor of elevated blood pressure. In Bangladesh about 20 million people are at high risk of hypertension due to climate change induced saline intrusion in water. The objective of this study is to assess beliefs, perceptions, and practices associated with salt consumption in coastal Bangladesh.MethodsThe study was conducted in Chakaria, Bangladesh between April-June 2011. It was a cross sectional mixed method study. For the qualitative study 6 focus group discussions, 8 key informant interviews, 60 free listing exercises, 20 ranking exercises and 10 observations were conducted. 400 adults were randomly selected for quantitative survey. For analysis we used SPSS for quantitative data, and Anthropac and Nvivo for qualitative data.ResultsSalt was described as an essential component of food with strong cultural and religious roots. People described both health benefits and risks related to salt intake. The overall risk perception regarding excessive salt consumption was low and respondents believed that the cooking process can render the salt harmless. Respondents were aware that salt is added in many foods even if they do not taste salty but did not recognize that salt can occur naturally in both foods and water.ConclusionsIn the study community people had low awareness of the risks associated with excess salt consumption and salt reduction strategies were not high in their agenda. The easy access to and low cost of salt as well as unrecognised presence of salt in drinking water has created an environment conducive to excess salt consumption. It is important to design general messages related to salt reduction and test tailored strategies especially for those at high risk of hypertension.  相似文献   

11.
《Endocrine practice》2011,17(5):e123-e125
ObjectiveTo describe the first case of established chromosome 22q11 deletion syndrome with late onset presentation of hypocalcemia secondary to hypoparathyroidism.MethodsWe present the history, clinical and laboratory investigations, and management of a 17-yearold adolescent boy who presented with 3 separate seizures secondary to hypocalcemia. This patient had an established diagnosis of chromosome 22q11 deletion syndrome at the time of the seizure presentations, but had previously normal calcium levels.ResultsHypocalcemia was noted during each seizure, with corrected calcium levels ranging from 6.64 to 7.76 mg/dL (reference range, 8.52 to 10.52 mg/dL). The hypocalcemia was secondary to hypoparathyroidism, with parathyroid hormone levels < 2.75 pg/mL (reference range, 22.9 to 68.75 pg/mL). He was treated with calcitriol, 0.5 μg daily, and calcium carbonate, 2,400 mg daily, leading to normalization of serum calcium and resolution of seizures.ConclusionChromosome 22q11 deletion syndrome is a relatively common genetic disorder with a wide variety of phenotypic manifestations including cardiac abnormalities, abnormal facies, thymic dysfunction, cleft palate, and hypocalcemia. This case shows that medical practitioners should be aware that hypocalcemia can present after an established diagnosis, which has implications for the management of this disorder. (Endocr Pract. 2011;17: e123-e125)  相似文献   

12.
“Viscol”, a water soluble permanent mounting medium hardening through evaporation of water under the cover glass, has been analyzed. It proves to consist of a mixture of gum arabic, glycerol, phenol and water and is especially suitable for simple botanical preparations. The use of gum arabic for hardening permanent mounting media is reviewed. Instead of a glycerol-phenol-water mixture a lactophenol, potassium acetate or zinc chloride solution mixed with gum arabic may be used for a permanent mounting medium. However, gum arabic contains calcium, magnesium and potassium ions giving crystals with the solutions mentioned. In the case of lactophenol and potassium acetate, the calcium and magnesium ions must be removed beforehand, which is done by precipitation with sodium or potassium carbonate. In the case of zinc chloride the potassium ions must be removed, which is done by dialysis with zinc chloride. It is pointed out that the same principles may be used for a great variety of different mounting media.  相似文献   

13.
Hydroxyapatite cements have recently been employed as bone substitutes in craniofacial reconstruction. They are easily applied, nonresorbable, available in unlimited quantity, and eliminate donor-site morbidity. Norian CRS (craniofacial repair system) is a new carbonated calcium phosphate paste that is unique in that it more closely resembles bone than do traditional hydroxyapatite pastes. Norian is a low-order crystalline apatite soluble at a low pH, facilitating its resorption and replacement by host bone. The cement was first used for craniofacial surgery in North America at the Children's Hospital of Philadelphia. This report presents the authors' experience with this bone substitute in both pediatric and adult craniofacial reconstruction. Sixteen adult and pediatric patients underwent craniofacial reconstruction involving the use of carbonated calcium phosphate paste for correction of defects that required from 5 to 110 g of carbonated calcium phosphate paste (mean, 28.5 g). The patients were all followed for a minimum of 14 months. Minor complications included one case of infection and two cases involving cement microfragmentation. In the authors' experience, carbonated calcium phosphate paste has proved to be an excellent alloplastic material for osseous augmentation and reconstruction in the craniofacial skeleton. Few problems were encountered using this material; no significant morbidity was encountered. Although this material seems to be promising as a bone substitute, further follow-up will be necessary to evaluate its potential role in craniofacial surgery.  相似文献   

14.
《Endocrine practice》2005,11(6):382-384
ObjectiveTo report a case of ganglioneuroma masquerading as an incidental adrenal mass in an adult patient with Turner’s syndrome.MethodsWe present the clinical, laboratory, radiologic, and pathologic findings in this patient.ResultsA 31-year-old woman with Turner’s syndrome who had previously been treated with growth hormone replacement had an incidentally discovered mass, apparently arising from the left adrenal gland. The mass was “silent” clinically and biochemically, but imaging characteristics were not reassuring for a benign cortical adenoma. Because of uncertainty regarding the nature of the mass, it was removed laparoscopically; during this procedure, it was noted to be intimately associated with, but anatomically distinct from, the left adrenal gland. The pathology report confirmed the presence of a benign ganglioneuroma.Conclusion: Although ganglioneuroma has previously been noted to be associated with Turner’s syndrome (especially in pediatric patients), to the best of our knowledge this is the first report of a ganglioneuroma manifesting as an incidental adrenal mass in an adult patient with Turner’s syndrome. (Endocr Pract. 2005;11:382-384)  相似文献   

15.
《Endocrine practice》2012,18(4):e85-e90
ObjectiveTo discuss the role of bilateral adrenalectomy in Cushing syndrome, as illustrated in a case of severe hypercortisolism that was unresponsive to combination agent medical therapy.MethodsWe report the clinical, laboratory, imaging, and pathologic findings in a patient with ectopic Cushing syndrome attributable to an adrenocorticotropic hormone (ACTH)-secreting neuroblastoma. In addition, we provide a literature review regarding olfactory neuroblastoma and discuss current and emerging therapeutic options for Cushing syndrome.ResultsA 59-year-old man presented with nasal congestion and neck swelling and was noted to have hypokalemia, hypertension, and hyperglycemia. A nasal biopsy demonstrated a poorly differentiated carcinoma with neuroendocrine features. He was subsequently diagnosed as having ACTH-dependent Cushing syndrome, but despite high-dose combination medical therapy, his condition rapidly deteriorated. Urgent bilateral adrenalectomy provided rapid control of the hypercortisolism, and the patient was later able to undergo an uncomplicated total macroscopic resection of his locally metastatic primary tumor.ConclusionThis report describes the challenges in the diagnosis and management of ACTH-dependent Cushing syndrome and highlights the important role that bilateral adrenalectomy can still have in patients with severe hypercortisolism causing life-threatening complications. (Endocr Pract. 2012;18:e85-e90)  相似文献   

16.
《Endocrine practice》2010,16(2):284-290
ObjectiveTo present a unique case of transient, asymptomatic chemotherapy-induced hypocalcemia not attributable to hypomagnesemia or tumor lysis syndrome and review causes of hypocalcemia related to cancer with and without use of chemotherapy.MethodsWe present a case detailing the clinical and laboratory findings of a patient who had severe hypocalcemia during chemotherapy and discuss causes of hypocalcemia with an extensive literature review of chemotherapeutic agents associated with this biochemical abnormality.ResultsIn a 90-year-old man, hypocalcemia developed during 2 courses of chemotherapy for Hodgkin lymphoma, with partial recovery between courses and normal serum calcium 10 months after completion of treatment. Magnesium, vitamin D, and parathyroid hormone levels were low normal. There was no evidence of tumor lysis syndrome. Of the various agents administered, vinca alkaloids seemed the most likely cause. Serial testing suggested that the underlying mechanism may have been acquired, reversible hypoparathyroidism. No other similar case was found in the published literature.ConclusionThe severe hypocalcemia in our patient could not be attributed to hypomagnesemia or tumor lysis syndrome, and it was clearly associated with the timing of his chemotherapeutic regimen. Possibilities include direct parathyroid hormone suppression or alteration of calcium sensing by the chemotherapeutic drugs. Serum calcium surveillance before and during chemotherapeutic management of cancer patients may reveal more instances and provide insight into the exact mechanism of this lesser known yet striking complication. (Endocr Pract. 2010;16:284-290)  相似文献   

17.
Abstract

Experiments were carried out from 2002 to 2003 to determine the most suitable form of fungal delivery for possible use by farmers in biological control of Striga hermonthica. Six mycoherbicides were developed, based on Fusarium oxysporum isolated from wilted S. hermonthica. In mycoherbicide formulation, rock phosphate powder, sorghum bran and gum arabic powder were used as carriers. Besides its role as a carrier, gum arabic powder was used as a sticker. There were three carriers with two formulations each, making six treatments altogether. Living propagule studies were based on colony, mycelium and conidium number of F. oxysporum. In greenhouse evaluation of mycoherbicides, each kg sorghum seed was coated with 10 g mycoherbicide before sowing. Carrier rock phosphate powder with gum arabic powder as a sticking agent was the most suitable form of its delivery for use by peasant farmers.  相似文献   

18.
《Endocrine practice》2011,17(3):e43-e47
ObjectiveTo report a case of corticotropin-independent macronodular adrenal hyperplasia (AIMAH) associated with an insulinoma.MethodsWe describe the clinical, radiographic, laboratory, and histopathologic findings of the study patient; review the current protocols for management of AIMAH; and discuss the disease etiology.ResultsA 64-year-old woman with multiple intradermal facial nevi experienced intermittent light-headedness, tremor, and confusion and was found to have a venous plasma glucose concentration of 52 mg/dL. Hypoglycemia and hyperinsulinemia after 18 hours of fasting suggested the presence of an insulinoma. Hepatic venous sampling for insulin after selective arterial calcium injection localized the insulinoma to the pancreatic head. The insulinoma was excised, and there was no recurrence over the 5 years the patient was in our care. During the workup for insulinoma, bilateral adrenal masses were incidentally discovered on computed tomography. Twenty-hour urinary free cortisol excretion was elevated and serum corticotropin was suppressed. Overt signs of Cushing syndrome were not present, and subsequent urinary cortisol measurements were within the reference range for several years. After 4 years, Cushing syndrome developed and bilateral adrenalectomy was performed. AIMAH was diagnosed on the basis of histopathologic findings.ConclusionsThis appears to be the first reported case of AIMAH associated with an insulinoma. In the absence of other stigmata of multiple endocrine neoplasm type 1 and in the presence of multiple nevi, it may represent a novel endocrine syndrome. (Endocr Pract. 2011;17:e43-e47)  相似文献   

19.
《Endocrine practice》2014,20(10):e180-e182
ObjectiveTo report a rare case of primary hyperparathyroidism presenting with hyper-parathyroid crisis due to parathyroid hyperplasia with ectopic glands.MethodsWe present the initial clinical manifestations, laboratory results, radiologic and surgical findings, and management in a patient who had hyper-parathyroid crisis. The pertinent literature and management options are also reviewed.ResultsA 60-year-old female presented with hyper-parathyroid crisis requiring preoperative stabilization with rehydration, diuresis, bisphosphonate therapy, and ultimately hemodialysis. Parathyroidectomy revealed asymmetric 4-gland hyperplasia, with a massive ectopic parathyroid gland in the tracheoesophageal groove extending into the mediastinum. Her postoperative course was complicated by hungry bone syndrome and hypocalcemia.ConclusionThis case illustrates the rare occurrence of hyper-parathyroid crises due to asymmetric parathyroid hyperplasia with a massive ectopic parathyroid gland. (Endocr Pract. 2014;20:e180-e182)  相似文献   

20.
【背景】土壤盐渍化已经成为日益严重的世界性问题,盐渍化不仅影响作物的产量,还会影响土壤的理化性质,抑制种子的萌发,阻碍植物正常生长,以及种子对水分和养分的吸收,进而影响作物的产量。【目的】玉米在盐渍土壤上生长受限,探究在中、高盐浓度下田菁种子内生菌与田菁胶混合浸种对玉米发芽的影响,为促进盐渍土玉米生长提供技术支持。【方法】利用LB液体培养基测定田菁种子内生菌贝莱斯芽孢杆菌ZH60的耐盐性;分别利用1%浓度田菁胶、OD600为0.8的ZH60菌悬液及两者混合液对玉米浸种3 h,自然风干后分别置于0、100和200 mmol/L NaCl的0.8%琼脂培养基上培养,测定玉米种子发芽势、发芽率、根长及芽长。将两叶一心期的玉米幼苗移至装有蛭石的花盆中培养,用荧光标记的内生菌ZH60灌根,分别于1、5、11、17、25 d取玉米根系研磨,利用平板菌落计数法测定内生菌在玉米根部的定殖量;利用激光共聚焦显微镜观察第28天ZH60在玉米根部的定殖情况。【结果】菌株ZH60耐11%的NaCl盐浓度,在中、高盐浓度下混合浸种的发芽势较对照组分别提高了28%、22%、30%;芽长提高了158%、163%、1...  相似文献   

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