Internal medicine
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Comparative Study Clinical Trial
High molecular weight form of adiponectin in antiretroviral drug-induced dyslipidemia in HIV-infected Japanese individuals based on in vivo and in vitro analyses.
High molecular weight (HMW)-adiponectin has been found to be a better negative regulator of insulin resistance than total adiponectin. The aim of this study was to investigate the influence of HMW-adiponectin on antiretroviral therapy (ART)-induced dyslipidemia in Japanese human immunodeficiency virus (HIV)-infected individuals. We also examined the effect of some antiretroviral drugs (ARVs) on adipocytes in vitro. ⋯ Effects of the ARVs on adiponectin may vary depending on the administration of different drugs. These data suggest that the distinct metabolic effects of ARV could therefore be a consequence of their differential effects on the production of adiponectin.
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Several studies have reported a significant association of metabolic syndrome with urinary albumin excretion, high-sensitivity C-reactive protein, or chronic kidney disease; however, no study has investigated the association of metabolic syndrome with these 3 factors together in the same individual. Therefore, we conducted the present study to obtain more information on this association. ⋯ Metabolic syndrome is associated with vascular dysfunction and low-grade inflammation and the latter association is strong, whereas the association of metabolic syndrome with low glomerular filtration rate may be less apparent among those without diabetes, macroalbuminuria, and medications.
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Case Reports
Bilateral phrenic nerve paralysis manifested by orthopnea for 6 months in a patient with neuralgic amyotrophy.
Bilateral phrenic nerve paralysis (BPP) is a relatively rare disease manifested by slight dyspnea at rest and on exertion in the sitting and standing positions and by dyspnea in the supine position. A 67-year-old man, who was a painter, presented with severe pain in both shoulder regions that had evolved into orthopnea and forced him to sleep in a sitting position at night. ⋯ The most striking feature in this case was that the rapid onset of pain in both shoulder regions was followed by BPP. The BPP was considered to be secondary to neuralgic amyotrophy (NA).
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Case Reports
Acute myocardial infarction associated with pregnancy successfully treated with percutaneous coronary intervention.
We describe the case of a 43-year-old primiparous woman who had acute myocardial infarction. She underwent successful primary percutaneous coronary intervention. Elective cesarean section was performed uneventfully at 32 weeks gestation.
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Case Reports
Genetic analysis of two Japanese patients with non-classical 21-hydroxylase deficiency.
We report two Japanese women with androgen excess symptoms. Analyses of 21-hydroxylase gene demonstrated that a 24-year-old Japanese woman had a homozygous mutation of IVS2-13 A/C>G, while a 25-year-old Japanese woman had a compound heterozygous mutation of I172N and E245del1nt, a novel mutation which would result in completely nonfunctional enzyme due to a frame shift. As IVS2-13 A/C>G and I172N have been classified as mutations leading to severe impairment in enzyme activity, this study not only clarified a novel mutation causing 21-hydroxylase deficiency, but also demonstrated that genotype and phenotype do not correlate well in these cases.