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)

A 32-year-old man visited Kanto Teishin Hospital complaining of general fatigue in May, 1992. He had been diagnosed as having paroxysmal nocturnal hemoglobinuria since 1980, because of brownish urine in the morning. He received blood transfusion in 1980. In 1983, he was treated with medication. There was no remarkable improvement, however, and he stopped coming to the hospital. When he was admitted to our hospital, hemolytic anemia and hemosiderinuria were noticed. Sucrose hemolysis test and acidified-serum lysis test (Ham test) were both positive. Positive rates of decay accelerating factor and CD59 were 38.8% (control 100%) and 45.4% (control 100%), respectively. His diagnosis was thus confirmed. Bone marrow was slightly hypocellular, and erythroid cells were relatively hyperplastic (M/E ratio 0.68). The oral administration of iron and oxymetholone was not effective for anemia. He was treated with daily subcutaneous administration of recombinant human erythropoietin (EPO, 3,000U/body/day). His hemoglobin level increased from 7.5g/dl to 12.0g/dl in 4 weeks, and general fatigue disappeared. Since he had concurrent chronic hepatitis C, alpha-interferon was also administered and his hemoglobin level is now controlled between 10 and 11g/dl. This case suggests that EPO can be useful for treating hemolytic anemia, even though erythroid cells in the bone marrow are hyperplastic.
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PMID:[Improvement of anemia by recombinant human erythropoietin in paroxysmal nocturnal hemoglobinuria]. 823 Jul 45

A 24-year-old oil well tester was rendered semiconscious by hydrogen sulfide (H2S). He received oxygen and was hospitalized but released in 30 minutes. The next day, nausea, vomiting, diarrhea, and incontinence of urine and stool led to rehospitalization. These problems and leg shaking, dizziness, sweating, trouble sleeping, and nightmares prevented his return to work. A physical examination, chest x-ray, and pulmonary function tests were normal 39 months after the episode but vibration sense was diminished. Two choice visual reaction times were delayed. Balance was highly abnormal (5 to 6 cm/sec) with eyes closed. Blink reflex latency was slow (R-1 17.5 msec versus normal 14.3 msec). Numbers written on finger tips were not recognized. Verbal and visual recall were impaired but overlearned memory was intact. Cognitive functions measured by Culture Fair, block design, and digit symbol were impaired. Perceptual motor was slow. Scores for confusion, tension-anxiety, depression, and fatigue were elevated and vigor was reduced. Forty-nine months after exposure his reaction time, sway speed, and color vision had not improved. His recall and his cognitive, constructional, and psychomotor speeds had improved but remained abnormal. These deficits are most likely due to H2S. Similar testing of other survivors is recommended.
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PMID:Case report: profound neurobehavioral deficits in an oil field worker overcome by hydrogen sulfide. 823 84

Cases of hypothyroidism and hyperthyroidism associated with amiodarone therapy are described, and the mechanisms, clinical appearance, and management of amiodarone-induced thyroid dysfunction are discussed. A 72-year-old man with a history of recurrent ventricular tachycardia unresponsive to conventional antiarrhythmic drugs was started on amiodarone therapy. Initially he responded well, but after three months he began to have fatigue, dry skin, and intolerance of cold. His serum thyroid-stimulating hormone (TSH) concentration had risen from 4.4 microU/mL before amiodarone therapy began to 20 microU/mL, consistent with hypothyroidism. He was started on sodium levothyroxine for thyroid hormone replacement; the dosage was adjusted in accordance with subsequent TSH measurements. His hospital course was complicated by congestive heart failure. The second patient was a 43-year-old man with a history of atrial fibrillation who developed hyperthyroidism when placed on amiodarone therapy. He had persistent sweating, intolerance of heat, restlessness, and tachycardia. Thyroid function tests confirmed the presence of hyperthyroidism. The patient was treated with propylthiouracil and propranolol, and amiodarone was discontinued. He remained unresponsive to the propylthiouracil, which was discontinued, and was scheduled for radioactive iodine treatment. The mechanism of amiodarone-induced thyroid dysfunction may involve the large iodine content of the drug. Amiodarone-induced hypothyroidism may range in severity from mild symptoms to severe myxedema; the skin, hair, and nails are particularly affected. Persons with clinical hyperthyroidism secondary to amiodarone treatment show the signs and symptoms of a hypermetabolic state resulting from thyroid hormone excess. Amiodarone-induced hypothyroidism is treated with levothyroxine and hyperthyroidism with antithyroid drugs. Amiodarone can cause thyroid dysfunction, which can have serious consequences.
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PMID:Amiodarone-induced thyroid dysfunction. 825 59

A 71-year-old man was admitted to our hospital with vertigo and general fatigue. Examination of his blood and bone marrow showed pure red cell aplasia. His chest X-ray film revealed an anterior mediastinal mass and a nodular shadow in the right lower lobe. Extended thymothymectomy and right lower lobectomy were done. The mediastinal mass appeared to be an invasive thymoma and the nodular shadow in the right lower lobe proved to be from an adenocarcinoma. The patient was treated with radiation and steroids. Thymoma, pure red cell aplasia, and lung cancer had not recurred and he was alive and well as of 2 years after surgery.
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PMID:[Invasive thymoma associated with pure red cell aplasia and lung cancer]. 862 84

A 48-year-old male was admitted with chief complaints of fatigue and palpitation. He had a past history of closed chest trauma without rib fracture due to an automobile accident 7 years ago. He had been complaining of a gradual increase of palpitation since 4 years after the accident. A two-dimensional and transesophageal Doppler echocardiography revealed severe tricuspid regurgitation due to ruptured chorda tendinea of the tricuspid anterior leaflet. Cardiac catheterization revealed an elevated right atrial v wave (16 mmHg). At open heart surgery, complete tear of a chorda tendinea of the anterior leaflet and elongation of chordae tendineae of the posterior leaflet were observed. The valve was replaced with a 31 mm Carpentier-Edwards bioprosthesis. His post operative course was uneventful. A brief review of the reported surgical cases of traumatic tricuspid regurgitation in Japan is also described in this paper.
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PMID:[Traumatic tricuspid regurgitation: a case report and a review of operated cases in Japan]. 869 85

The characteristics and functional origin of the changes in transient atrioventricular (AV) nodal responses with heart rate history were studied in isolated rabbit heart preparations. For this purpose, ramp stimulation sequences were applied to the atrium from different initial conditions. A ramp decrease and increase in the His-stimulus interval and a reverse sequence consisting of a ramp increase and decrease were performed starting from a control basic cycle length, after 5 min of fast rate, or with 5 min of fast rate inserted between the two ramps. The nodal conduction times (NCT) obtained during the ramp stimulations formed hysteresis loops, the direction, shape, and magnitude of which varied markedly with the nodal history. That is, the nodal response to a given ramp took a variety of forms, depending on the initial condition. The effects of the initial condition also depended on ramp direction and sequence. A paradoxical NCT-recovery relationship (decrease in NCT with shortening His-atrial interval) was consistently observed at the onset of any ramp decrease performed after 5 min of fast rate. These effects also varied with the rate used to change the nodal history. The insertion of a control cycle at every 20th beat during repeated ramp protocols allowed the determination of the contribution of the nodal property of fatigue to these effects. Fatigue was found to account for all observed hysteresis patterns. In conclusion, heart rate history can, by modulating beat-to-beat changes in fatigue, transform transient nodal responses and hysteresis observed during stimulation ramps. Interpretation of transient nodal responses thus requires exact knowledge of previous nodal history.
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PMID:Characteristics and mechanisms of the effects of heart rate history on transient AV nodal responses. 876 58

The third human case of natural infection by Heterophyopsis continua in Korea was found in Chinju, Kyongsangnam-do. The case was a 53-year-old man. He used to eat raw brackish and fresh water fish. After praziquantel treatment and purgation, H. continua were collected from the diarrheal stool together with Metagonimus yokogawai, Heterophyes nocens and Echinostoma hortense. His clinical complaints were indigestion, epigastric discomfort, poor appetite and fatigue. The complaints were considered rather due to heavy M. yokogawai infection.
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PMID:One human case of natural infection by Heterophyopsis continua and three other species of intestinal trematodes. 882 Jul 45

Phosphofructokinase (PFK) is the key regulatory enzyme of glycolysis. Patients lacking the muscular isoform of PFK typically present with myopathy and compensated hemolysis (glycogenosis type VII or Tarui's disease). Since 1965 about 30 cases of muscular PFK deficiency have been reported. In most cases family history suggests a recessive inherited trait. We describe a family of Ashkenazi Jewish origin with two members in subsequent generations suffering from muscular PFK deficiency. The propositus, a 19-year-old male patient presented with weakness, myalgias and exercise intolerance since early infancy. His father also had early fatigue on exercise with myalgias; the mother and a 12-year-old brother were asymptomatic. Muscle biopsy of both the propositus and his father showed increased glycogen storage and absent histochemical stain for PFK. Biochemical studies of muscle revealed a markedly decreased PFK activity and DNA analysis of the muscle PFK gene revealed compound heterozygosity in both cases. This is the first description of proven muscle PFK deficiency (glycogenosis type VII) in two subsequent generations.
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PMID:Muscle phosphofructokinase deficiency in two generations. 888 Jun 99

A 20-year-old man underwent total cavopulmonary shunt for univentricular heart type A (A.L.L.) with hemiazygos connection six years ago. Four years later, his condition deteriorated with easy fatigue and cyanosis. Cardiac catheterization showed recanalization of ligated SVC. Chest CT showed tight adhesion between the chest wall and the ascending aorta. We approached the heart through left anterolateral thoracotomy in order to avoid injury of the aorta and the ventricle during redo median sternotomy. Total cavopulmonary connection with intraatrial conduit was performed under circulatory arrest and retrograde cardioplegia without aortic cross clamp. His postoperative course was satisfactory. Left thoracotomy was useful for total cavopulmonary connection following total cavopulmonary shunt associated with postoperative adhesion.
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PMID:[A case report of total cavopulmonary connection following total cavopulmonary shunt]. 899 47

It is estimated that 10-20% of patients with multiple sclerosis (MS) have a chronic progressive (CP) course characterized by an insidious of neurological deficits followed by steady progression of disability in the absence of symptomatic remission. No therapeutic modality has shown specific efficacy in the treatment of patients with CP MS and there are no data to indicate that any pharmacologic or other modality alters the clinical course of CP MS. Treatment with picotesla electromagnetic fields (EMFs) is a highly effective modality for the symptomatic management of MS including the chronic progressive form. In addition, this treatment also appears to alter the natural course of the disease in CP patients. A 36 year-old man experienced, at the age of 31, insidious weakness in the legs and several months later developed difficulties with balance with ataxia of gait. His gait abnormality progressed slowly over the following years and at the age of 35 he was severely disabled with spastic paraparesis and ataxia using a rolling walker for ambulation and a scooter for longer distances. In particular, his disability had progressed rapidly over the six months preceding the initiation of treatment with EMFs. He as classified have CP MS and his prognosis was considered extremely unfavorable due to the degree of cerebellar and pyramidal tract involvement and the rapid course of deterioration. In July 1995 the patient began experimental treatment with EMFs. While receiving three treatment sessions a week over 12 months he experienced improvement in cerebellar functions such as gait, balance and tremor as well as bowel and bladder functions, mood, sleep and cognitive function and resolution of diplopia, blurring of vision, dysarthria, paresthesias in the hands, and fatigue. Most remarkably, there was no further progression of the disease during the course of magnetic therapy. This case illustrated that treatment with EMFs, in addition to producing symptomatic improvement, also reverses the clinical course of CP MS.
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PMID:Treatment with electromagnetic field alters the clinical course of chronic progressive multiple sclerosis--a case report. 900 66


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