Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of cerebral tuberculosis following miliary tuberculosis. A 54-year-old man was admitted to our hospital in October 1990 because of fever and general fatigue. Chest x-ray film on admission showed diffuse granular shadows in both lungs. Tubercle bacilli were seen in the sputum (Gaffky 5) by the Ziehl Neelsen's staining, and anti-tuberculous therapy was quickly started. But a few days after admission, the disturbance of consciousness, neck stiffness, and headache appeared. The examination of cerebrospinal fluid disclosed that leucocytes was increased in number, and that ADA was elevated to 14.6 IU/l. Tubercle bacilli were detected from cerebrospinal fluid by culture. Although CT scan of the brain was normal at first week of admission, brain CT at eighth week of admission showed several nodulus enhanced with contrast medium. The findings were confirmed by T2 weighted magnetic resonance images (MRI) as high intense areas. Although T1 weighted MRI showed isointensity of the gray matter, T1 weighted MRI enhanced by Gd-DTPA revealed abnormal enhancement. At twenty-ninth week of admission CT showed no abnormality even by contrast enhancement, but enhanced T1 weighted MRI revealed a small lesion with enhancement which was not shown by CT. MRI enhanced by Gd-DTPA was more useful for evaluating cerebral tuberculosis than brain CT.
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PMID:[A follow-up study by MRI and enhanced-MRI in a case of cerebral tuberculosis]. 154 5

A case of spinal cord sarcoidosis was reported with special reference to MRI findings. A 15-year-old man was admitted to our hospital because of gait disturbance for last six months. Neurological examination on admission showed spastic paraparesis and posterior column signs. MRI of the cervical spinal cord revealed diffuse swelling and low intensity signal in T1-weighted sequences, diffuse high intensity signal in T2-weighted, and multiple micro-nodular lesion in Gd-DTPA enhanced T1-weighted. At first multiple sclerosis was suspected, although the data of cerebrospinal fluid was not suggestive. Four weeks after admission general fatigue, fever, cough, and headache appeared and the neurological symptoms got worse. Chest film and CT revealed diffuse small nodular shadows in the lung field. Abdominal ultrasonography and CT showed hepatosplenomegaly. The general condition became worse in spite of antibiotic and antituberculotic drug therapy, but remitted spontaneously in four weeks. MRI findings also exacerbated and improved during the same period, being compatible with neurological manifestations. The diagnosis of sarcoidosis was made by transbronchial lung biopsy which revealed sarcoid granuloma. Multiple small nodules on Gd-DTPA enhanced T1-weighted MRI had not been reported in patient with spinal cord sarcoidosis.
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PMID:[A case of spinal cord sarcoidosis with interesting MRI findings]. 178 58

A rare case of simultaneous hypersecretion of thyroid stimulating hormone (TSH) and growth hormone (GH) in a pituitary adenoma is reported. A 59-year-old male complaining of general fatigue, dyspnea on exertion and finger tremor was admitted. Examination on admission, he revealed with hyperthyroidism and hypersecretion of TSH and thyroid hormones. Administration of TRH did not further increase serum TSH level, and administration of T3 also had no effect on TSH secretion. CT scan showed a pituitary macroadenoma 13mm in diameter. MRI demonstrated a homogenously hypointense mass with Gd-DTPA enhancement in the left side of the sella turcica. The entire chromophobic adenoma was removed by trans-sphenoidal surgery. Immunostaining of the specimen showed that the cytoplasm of the adenoma cells was positive for both TSH and GH. Double immunostaining using avidin-biotin-peroxidase complex (ABC) method and immunogold silver staining (IGSS) method, showed that the adenoma cells had been secreting both GH and TSH at the same time. After the adenomectomy, the hyperthyroidism disappeared, and all altered indicators of pituitary function returned to normal.
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PMID:[A case of pituitary adenoma with simultaneous secretion of TSH and GH detected by double immunostaining method]. 193 Dec 60

A 85-year-old woman consulted our hospital with general fatigue, palpitation and chest discomfort changing with different postures. Her electrocardiogram showed sinus tachycardia, atrial premature beats and left atrial overload. 53% cardiothoracic ratio, slightly protruding third arch of the cardiac silhouette and dilated pulmonary artery were seen on the chest X-ray. Two dimensional echocardiography revealed a mass in the left atrium although the quality of echocardiography was suboptimal due to her thoracic deformity. There was no uptake of T1-201 or Ga-67 by the mass. The four-chamber view of Tc-99m ECG-gated SPECT radionuclide angiocardiography showed a filling defect in the left atrium. The T1 weighted magnetic resonance imaging revealed a left atrial mass with relatively low signal intensity. After intravenous injection of Gadolinium-DTPA the signal intensity of the mass increased significantly and the contrast of the mass was improved. The size of the mass was 4 x 4 x 3 cm with a stalk connecting to the interatrial septum. These findings were compatible with left atrial myxoma. Gadolinium-DTPA magnetic resonance imaging is useful in diagnosing left atrial myxoma because it provides information on the size, anatomical location, relationship with other cardiovascular structures and even the characteristics of the mass.
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PMID:[Gadolinium-DTPA magnetic resonance imaging in the diagnosis of left atrial myxoma in the elderly]. 829 60

We present a case of a thirty-eight-year-old man who had exercise-induced acute renal failure (exercise-induced ARF). He experienced oliguria, general fatigue, and vague discomfort in the lower abdomen after he exercised. As he had suffered from hypouricemia before, he was diagnosed as having exercise-induced ARF associated with hypouricemia. Enhanced computed tomography (CT) images showed patchy wedge-shaped contrast enhancement on his bilateral kidneys, consistent with characteristic observations for exercise-induced ARF. Tc-99m diethylene triamine pentaacetic acid (DPTA) renography revealed decreases in both the renal blood flow (RBF) and glomerular filtration rate (GFR), and revealed parenchymal dysfunction of the bilateral kidneys. Renogram revealed a hypofunctional pattern on the bilateral kidneys. CT images and Tc-99m DTPA renography also had improved when the symptoms of exercised-induced ARF indicated improvement. It has been hypothesized that one cause of exercise-induced ARF may be renal vasocontraction. Although CT images are useful in evaluating exercise-induced ARF, Tc-99m DTPA renography can more easily and safely evaluate renal function. We also show that Tc-99m DTPA renography is useful in precisely evaluating the degree of improvement of exercise-induced ARF.
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PMID:Evaluation of exercise-induced acute renal failure in renal hypouricemia using Tc-99m DTPA renography. 1609 44

A-46-year-old woman admitted to our hospital because of numbness of bilateral lower limbs and urinary incontinence. The initial neurological examination showed sensory impairment below S1 level with urinary incontinence, indicating epicornus syndrome. Spinal MR imaging demonstrated unremarkable on conventional and enhanced images with Gd-DTPA. Cerebrospinal fluid examination revealed slightly elevated protein level without pleocytosis. Thereafter, subacute ascending myelopathy including flaccid paraparesis and urinary retention, developed. Because the patient had low grade fever, fatigue, weight loss and elevated serum soluble IL-2 receptor and LDH titers, we investigated her for lymphoma. Although lymphadenopathy or mass lesions were not found on whole-body CT scan, bone marrow biopsy showed the presence of inravascular large B-cell lymphoma (IVL). Thus the patient's progressive myelopathy was probably caused by IVL invasion. Ten days after the initiation of chemotherapy, her neurological symptoms transiently improved; however, her paraparesis and urinary incontinence gradually worsened thereafter, despite of treatment. IVL often presents with neurological manifestations, including myelopathy. There have been a few reports of IVL presenting with lower lumbar spinal cord and conus medullaris. It should be noted that IVL can cause unidentified progressive ascending myelopathy without positive MRI findings.
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PMID:[A case of intravascular malignant lymphomatosis presenting with epicornus syndrome and diagnosed by bone marrow biopsy]. 2029 32

We investigated the relationship between the frequency of the common cold and the conditions of the body's immune system among members of a generally healthy population. Self-reporting questionnaires on the frequency of the common cold and on fatigue and stress conditions were administered to a total of 67 healthy individuals aged 22 to 50. The activities of natural killer (NK) cells, which were determined by Eu(3+)-DTPA release assay, and of NK cell members in the peripheral blood of the subjects were phenotypically (CD3 CD16(+) CD56(+)) analyzed with three-color flow cytometry. The results showed that the frequency of the common cold was significantly correlated with NK activity and NK subset (CD3(-)CD16(+) CD56(+)) frequency (r=-0.34 and-0.47 respectively, P<0.01). After adjusting for age, the mean NK subset (CD3(-)CD16(+)CD56) significandy differed (F=3.384, P<0.05) among the four frequency groups for the common cold, and the frequencies of the common cold were significandy different among the four stress/fatigue groups (F=8.016, P<0.001) for the males, as evaluated by ANCOVA. These results indicate that conditions of high stress and fatigue may increase the chance of catching the common cold due to a decrease in activities of NK cells.
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PMID:The relationship between the frequency of the common cold and the activities of natural killer cells. 2143 87

A 44-year-old woman presented with symptoms of fatigue and increasing abdominal discomfort. MRI with the hepatobiliary contrast Gd-EOB-DTPA (Primovist) was performed showing a 6 cm lesion in segment 2/3 of the liver typical for focal nodular hyperplasia (FNH). Because of severe complaints attributed to the lesion, the patient was scheduled for resection. At laparotomy multiple small white lesions were found throughout the liver with enlarged locoregional lymph nodes. Macroscopically, the findings could be consistent with widespread metastases and the surgeon felt compelled to determine the nature of these lesions before continuing resection. Final diagnosis revealed multiple bile duct hamartomas and an FNH lesion as was expected.
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PMID:Von Meyenburg complexes mimicking metastatic disease at laparotomy for focal nodular hyperplasia. 2381 26

A 50-year-old female visited the hospital for further evaluation of multiple pulmonary and hepatic nodules. First, she visited her primary physician for general fatigue due to anemia. She had recurrent epistaxis, and her mother had suffered from hereditary hemorrhagic telangiectasia (HHT). Telangiectasias were present in the stomach. This patient was diagnosed with HHT. Computed tomography (CT) revealed multiple pulmonary and hepatic nodules. The pulmonary nodules were due to bleeding from arteriovenous malformations of the lung. Abdominal CT and angiography showed a dilated and meandering hepatic artery, arteriovenous shunts and multiple hepatic nodules. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) showed enhancement in the early dynamic phase and in the liver-specific phase. A liver tumor biopsy of a hepatic nodule showed nodular regenerative hyperplasia (NRH). This report presents a case of HHT with multiple pulmonary and hepatic nodular lesions. Gd-EOB-DTPA-enhanced MRI was useful for making a diagnosis of NRH.
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PMID:Hereditary hemorrhagic telangiectasia with multiple hepatic and pulmonary nodular lesions. 2619 79

Although most of the harmful radionuclides are of anthropogenic origin and released from military or industrial processes, radioactive substances also occur naturally in the environment, e.g. uranium. Low standards of nuclear facilities can lead to contamination of employees with radionuclides due to inhalation of gases or dust, or contamination of skin or wounds. Various sources for radionuclide exposure may represent concerns for radioactive polonium or plutonium exposure, for instance terrorist actions on the infrastructure such as on drinking water basins. Early health effects after extensive radiation exposure may be vomiting, headaches, and fatigue, followed by bone marrow depression, fever, and diarrhea. The main purpose of radionuclide mobilization is to minimize the radiation dose. Since some of the important radionuclides such as polonium and plutonium have very long biological half-times after their deposition in bone, liver or kidneys, rapid initiation of chelation treatment is usually imperative after a contamination event. The antidote DMPS (dimercaptopropanesulfonate is considered the drug of choice for polonium decorporation. DTPA (diethylenetriamine pentaacetate) is a potent chelator especially approved for radionuclide mobilization, including polonium and other actinides. Other chelators and drugs are under investigation as potential chelators of transuranic elements.
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PMID:Clinical therapy of patients contaminated with Polonium or Plutonium. 3308 68


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