Internal medicine
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Comparative Study
Simultaneous ultrasonic monitoring of gallbladder emptying and gastric emptying after liquid test meal.
Gastric emptying and gallbladder emptying were measured simultaneously using simplified ultrasound (US) techniques after a liquid test meal in seven volunteers on two separate days. Sequential changes in cross-sectional areas of the gastric body and antrum and in gallbladder volume were represented as a monoexponential process after the test meal. ⋯ Sequential measurement of cross-sectional areas at the gastric body using ultrasound is simple and reliable for the assessment of gastric emptying after a liquid meal. US technique is promising for the evaluation of the relationship of gallbladder emptying to gastric emptying as a routine practice.
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Case Reports Clinical Trial
Effect of social factors on metabolic improvement in type II diabetic patients.
Psychological and social factors can profoundly influence a patient's success in adhering to a prescribed self-care regimen. A total of 34 inpatients with type II diabetes who attended the diabetes education program at a single clinic were studied as a retrospective cohort, beginning between 6 and 12 months after discharge. At the start of the study, the patients were classified into two groups, those with good control and those with poor control of diabetes, based on the rate of change of the glycosylated hemoglobin (HbAlc) value relative to the value at admission. ⋯ Patients' family function was assessed by the adaptability, partnership, growth, affection, and resolve (APGAR) scoring system. Multiple regression analysis was used to determine the effect of demographic, medical, and social factors on metabolic improvement. The family APGAR score was higher in the good control group than in the group with poor control.
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To evaluate the renal structural changes in non-insulin-dependent diabetes mellitus (NIDDM), we studied the renal histological findings and urinary albumin excretion in 75 patients with NIDDM. They were divided into two groups according to excretion of urinary albumin: 40 cases of normoalbuminuria and 35 cases of microalbuminuria. Renal biopsy specimens were evaluated by light microscopy. ⋯ Creatinine clearance differed significantly between the groups with and without microalbuminuria. There was no difference between the groups with normoalbuminuria and microalbuminuria in the incidence of retinopathy and hypertension, or in the urinary excretion of beta 2MG and NAG. We conclude that microalbuminuria in NIDDM indicates the early morphological changes of glomerular lesions.
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A rare case of protothecosis in a 40-year-old Japanese woman with systemic lupus erythematosus, under long-term prednisolone treatment is presented. The patient developed extensive ulcerative skin lesions after injury. ⋯ The lesions improved following treatment with amphotericin B. The immunodeficient state of this patient seemed to contribute to the infection with Prototheca.
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A 50-year-old man with neuro-Behçet syndrome showed truncal imbalance, dementia, palatal myoclonus, snoring and rhythmic inspiration synchronized with palatal myoclonus. Magnetic resonance imaging showed hypertrophy of the bilateral inferior olivary nuclei with slight pontine atrophy. A polysomnographic recording disclosed sleep apnea during non-REM sleep: 6% central type, 46% mixed type, and 48% obstructive type. We speculate that lesions of the respiratory center or related structures in the brainstem resulted in sleep apnea and that laryngeal myoclonus also affected the apnea.